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Management Alone (management + alone)
Selected AbstractsMarine reserve effects on fishery profits: a comment on White et al. (2008)ECOLOGY LETTERS, Issue 3 2009Deborah R. Hart Abstract A recent study (White et al. 2008) claimed that fishery profits will often be higher with management that employs no-take marine reserves than conventional fisheries management alone. However, this conclusion was based on the erroneous assumption that all landed fish have equal value regardless of size, and questionable assumptions regarding density-dependence. Examination of an age-structured version of the White et al. (2008) model demonstrates that their results are not robust to these assumptions. Models with more realistic assumptions generally do not indicate increased fishery yield or profits from marine reserves except for overfished stocks. [source] Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horseEQUINE VETERINARY JOURNAL, Issue 4 2004O. M. CROWE Summary Reasons for performing study: Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. Objective: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. Hypothesis: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compared to previously published results of controlled exercise alone. Methods: The use of RPWT in the management of chronic or recurrent proximal suspensory desmitis (PSD) was evaluated in 65 horses. Diagnosis was based on response to local analgesia, ultrasonography and radiography. Horses were classified according to severity of ultrasonographic lesions, whether fore- or hindlimbs were affected, and duration of lameness prior to diagnosis. Horses were treated 3 times at 2-week intervals and followed a controlled exercise programme; they were reassessed clinically and ultrasonographically 10,12 weeks after diagnosis, when further exercise recommendations were made dependent upon the animal's progress. Results: Forty-one percent of horses with hindlimb lameness and 53% with forelimb lameness were nonlame and returned to full work 6 months after diagnosis. The prognosis was significantly affected by the ultrasonographic grade at the time of diagnosis and by ultrasonographic evidence of resolution of the lesion in hindlimb cases. Conclusions: These findings, when compared to previously published results of treatment using controlled exercise alone, suggest that RPWT improves the prognosis for PSD in the hindlimb. Potential relevance: RPWT is a useful treatment modality for chronic or recurrent PSD when combined with controlled exercise. Further studies are required on the effect of RPWT employing histology and biomechanics in order to fully evaluate its use on equine tissues. [source] Environment and prednisone interactions in the treatment of recurrent airway obstruction (heaves)EQUINE VETERINARY JOURNAL, Issue 5 2000C. A. Jackson Summary Recurrent airway obstruction (RAO) or heaves is a manifestation of a hypersensitivity to dust, moulds, and spores in the environment of a susceptible horse. Although in the majority of RAO-affected horses, clinical remission can be achieved by keeping horses at pasture to reduce their allergen exposure, this often is not practicable. For this reason, we investigated if changing the environment of a single stall in a 4 stall stable was sufficient to improve lung function and reduce inflammation in RAO-affected horses. In addition, we determined if addition of oral prednisone provided additional benefit. Twelve RAO-susceptible horses were stabled, fed hay, and bedded on straw until they developed airway obstruction. At this point, bedding was changed to wood shavings and they were fed a pelleted diet for 2 weeks. Lung function was measured and bronchoalveolar lavage was performed before and 3, 7, and 14 days after environmental modification. In a crossover design, horses were treated for the 14 days with prednisone tablets (2.2 mg/kg bwt, q. 24 h). Horses then returned to pasture for 30 days. Airway obstruction was greatest before environmental modification. Significant improvement in lung function occurred within 3 days of the change in environment and continued to Day 7. Airway function was best after 30 days at pasture. The clinical response achieved by environmental modification was not significantly improved by addition of oral prednisone. The total number of cells, total neutrophils, and percent neutrophils was greatest before environmental modification. In the absence of prednisone, total and percent neutrophils did not decrease until Day 14 and total cell number until 30 days at pasture. In the presence of prednisone, total cells and total and percent neutrophils decreased by Day 3 and again at pasture. The fact that lung function can be improved within 3 days by environmental management alone emphasises the need for allergen reduction as the cornerstone of treatment of RAO. Although prednisone induced a more rapid reduction in airway inflammation, this was not associated with a more rapid improvement in airway function. [source] Diagnosis and Management of Renovascular Disease and Renovascular HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 5 2007Michael J. Bloch MD Renovascular disease is a common but complex disorder, the most common causes of which are fibromuscular dysplasia and atherosclerosis. Clinically, it can present as asymptomatic renal artery stenosis, renovascular hypertension, or ischemic nephropathy. Assessing the clinical index of suspicion remains essential in determining an appropriate diagnostic strategy. For diagnosis in patients with suspected fibromuscular disease, it may be reasonable to proceed directly to renal angiography; however, for most patients with suspected atherosclerotic disease, there are a number of noninvasive tests available that can aid in decision making. The choice of the most appropriate initial test should be based on patient characteristics, clinical presentation, and local expertise. Treatment options include medical, surgical, or percutaneous approaches. Generally, in patients with fibromuscular disease, percutaneous intervention provides durable improvement or cure of hypertension. In patients with atherosclerotic disease, the data are less consistent, and there does appear to be a group of patients who will respond well to medical management alone. As technology advances, the diagnostic and treatment paradigms will continue to evolve. [source] Pancreatitis in adult orthotopic liver allograft recipients: Risk factors and outcomeLIVER TRANSPLANTATION, Issue 3 2000Deborah J. Verran Acute pancreatitis (AP) has been described after orthotopic liver transplantation but is uncommon in stable patients after the initial perioperative phase. The aim of this study is to review our experience with AP occurring more than 2 months after primary allografting and determine possible contributing factors plus patient outcome. A review of patient files and the unit database was performed. AP was diagnosed in 9 of 298 patients (3%) on 12 occasions. The incidence of AP was greater in men (8 of 163 men) than women (1 of 135 women; P< .04). Underlying factors to each episode of AP were biliary manipulation (4 of 12 episodes; 33%), history of recent alcohol ingestion (3 of 12 episodes; 25%), and malignancy in the region of the pancreas (2 of 12 episodes; 16%). AP was associated with a diagnosis of either hepatic artery thrombosis combined with biliary tract complications (P< .005) or malignancy (P< .004). In 7 of 12 episodes of AP (58%), conservative management alone was successful. In 3 of 9 patients (33%), subsequent surgery was required. One patient died of pancreatic malignancy. In conclusion, AP is uncommon in stable liver transplant recipients. Male sex, complications of hepatic artery thrombosis, and malignancy in the region of the pancreas are associated with AP in this study. [source] An Analysis of the Components of Pain, Function, and Health-Related Quality of Life in Patients with Failed Back Surgery Syndrome Treated with Spinal Cord Stimulation or Conventional Medical ManagementNEUROMODULATION, Issue 3 2010FRCA, Sam Eldabe MB Objectives:, Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. Materials and Methods:, The international multicenter PROCESS trial collected detailed HRQoL (EuroQol-5D; Short-Form 36) and function (Oswestry Disability Index) information on 100 FBSS patients. Results:, At baseline, patients reported moderate-to-severe leg and back pain adversely affecting all dimensions of function and HRQoL. Compared with conventional medical management alone, patients also receiving spinal cord stimulation (SCS) reported superior pain relief, function, and HRQoL at six months on overall and most sub-component scores. The majority of these improvements with SCS were sustained at 24 months. Nonetheless, 36,40% of patients experienced ongoing marked disability (standing, lifting) and HRQoL problems (pain/discomfort). Conclusions:, Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes. [source] Pneumatosis intestinalis in an infant undergoing bone marrow transplantation for Wiskott,Aldrich syndromePEDIATRIC TRANSPLANTATION, Issue 5 2001Duygu Uçkan Abstract: A 7-month-old patient with Wiskott,Aldrich syndrome (WAS) developed pneumatosis intestinalis (PI) in the immediate post-transplant period after receiving paternal human leucocyte antigen (HLA) phenotypically matched bone marrow (BM). PI has been described in patients with congenital or acquired immunodeficiency states and after bone marrow transplantation (BMT). To our knowledge, the condition has not been described in WAS. The underlying bowel mucosa damage as a result of the history of massive rectal bleeding, the effects of the conditioning regimen, immunosuppression, neutropenia, and infection, may all have contributed to the development of PI. Although the condition resolved by conservative management alone, the patient developed Klebsiella pneumonia sepsis, interstitial pneumonitis, failed to engraft, and died on day +66 following a second infusion of stem cells mobilized from his father's peripheral blood. [source] Social determinants of songbird vocal activity and implications for the persistence of small populationsANIMAL CONSERVATION, Issue 5 2008P. Laiolo Abstract Conspecific attraction is an important aspect of animal behaviour and several avian studies have shown that vocalizations may be used as an inadvertent cue to locate areas of suitable habitat. By studying the metapopulation system of a territorial passerine, the Dupont's lark Chersophilus duponti, we analysed the demographic correlates of population vocal activity, and the relationships between the occurrence of immigration and the availability of social information (e.g. vocal activity, population size, density and productivity) in 22 local populations. We found that the proportion of active singing days in spring and territorial call advertisement after breeding were positively related to the number of males within local populations. In turn, the intensity of vocal activity was associated with the likelihood of receiving immigrants, better explaining immigration than other kinds of social or public information. Because of depressed signalling, small local populations could experience reduced rescuing from others, thus compromising population persistence. In such cases, habitat management alone may not be enough to overcome this behavioural constraint. Because we found that the occurrence of inter-patch movements also depended on the size of nearby local populations, understanding regional processes may be as important as controlling social and environmental factors for the maintenance of small populations. [source] Emphysematous cystitis: a review of 135 casesBJU INTERNATIONAL, Issue 1 2007Anil A. Thomas OBJECTIVE To review recently published data on emphysematous cystitis (EC), a potentially life-threatening condition characterized by air within the bladder wall, and that most typically affects middle-aged diabetic women. METHODS All articles published in English between 1956 and 2006 were identified using a Medline search for keywords ,emphysematous cystitis', and ,cystitis emphysematosa.' Epidemiological, clinical, diagnostic, pathological and therapeutic data were evaluated, including risk factors such as the presence of diabetes mellitus or other comorbid emphysematous infections of the urinary tract. RESULTS In all, 102 published papers, including 135 cases of EC, were reviewed; the median patient age was 66 years, 64% were women and 67% had diabetes mellitus. Most cases were diagnosed using plain films of the abdomen (84%), although more recently, computed tomography was the primary imaging method. Escherichia coli was the most commonly isolated organism. Most patients were treated with medical management alone (90%), while 10% of infections were treated with a combination of medicine and surgery. The overall death rate was 7%. CONCLUSIONS EC is the most common and typically the least severe gas-forming infection of the urinary tract. Prompt diagnosis and treatment is warranted to prevent the potential morbidity and mortality of this infectious condition. 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