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Normal Functioning (normal + functioning)
Selected AbstractsPALLIATIVE CARE, PUBLIC HEALTH AND JUSTICE: SETTING PRIORITIES IN RESOURCE POOR COUNTRIESDEVELOPING WORLD BIOETHICS, Issue 3 2009CRAIG BLINDERMAN ABSTRACT Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries. [source] Neuropsychological and neurophysiological findings in individuals suspected to be at risk for schizophrenia: preliminary results from the Basel early detection of psychosis study , Früherkennung von Psychosen (FEPSY)ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2003U. Gschwandtner Objective: Our study aims to establish a scientific basis for the very early detection of patients at risk for schizophrenia during the nonspecific prodromal phase of the disorder and to predict its outbreak. Method: A multidomain approach is used. After screening, approved psychopathological, neurophysiological, neuropsychological and neuroradiological investigations are used to assess a sample of individuals suspected to be at risk for schizophrenia. Results: Neuropsychological and fine motor functioning tests as well as eye movement measurements showed statistically significant differences (P<0.01) between individuals suspected to be at risk for schizophrenia and healthy controls. Conclusion: Individuals suspected to be at risk for schizophrenia show specific impairments in various investigations including neuropsychological and fine motor functioning tests as well as eye movement measurements. A set of methods sensitive to even subtle changes in normal functioning may prove useful in predicting the subsequent outbreak of schizophrenia. [source] Regulation of NMDA receptor trafficking and function by striatal-enriched tyrosine phosphatase (STEP)EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2006Steven P. Braithwaite Abstract Regulation of N -methyl- d -aspartate (NMDA) receptors is critical for the normal functioning of the central nervous system. There must be precise mechanisms to allow for changes in receptor function required for learning and normal synaptic transmission, but within tight constraints to prevent pathology. Tyrosine phosphorylation is a major means by which NMDA receptors are regulated through the equilibrium between activity of Src family kinases and tyrosine phosphatases. Identification of NMDA receptor phosphatases has been difficult, the best candidate being striatal-enriched tyrosine phosphatase (STEP). Here we demonstrate that STEP is a critical regulator of NMDA receptors and reveal that the action of this tyrosine phosphatase controls the constitutive trafficking of NMDA receptors and leads to changes in NMDA receptor activity at the neuronal surface. We show that STEP binds directly to NMDA receptors in the absence of other synaptic proteins. The activity of STEP selectively affects the expression of NMDA receptors at the neuronal plasma membrane. The result of STEP's action upon the NMDA receptor affects the functional properties of the receptor and its downstream signaling. These effects are evident when STEP levels are chronically reduced, indicating that there is no redundancy amongst phosphatases to compensate for altered STEP function in the CNS. STEP may have evolved specifically to fill a pivotal role as the NMDA receptor phosphatase, having a distinct and restricted localization and compartmentalization, and unique activity towards the NMDA receptor and its signaling pathway. [source] Eletriptan in Migraine Patients Reporting Unsatisfactory Response to RizatriptanHEADACHE, Issue 7 2006Jerome Goldstein MD Objective.,The objective of this open-label study was to evaluate the efficacy of switching patients who had a previous unsatisfactory response to rizatriptan to eletriptan 40 mg. Background.,The characteristics of individual migraine patients can vary tremendously and can have a significant impact on treatment outcomes. In addition, clinical experience has demonstrated that the triptans are not identical or interchangeable and that patients who respond poorly or who are dissatisfied with one agent can derive benefit by being switched to another agent within the triptan class. Methods.,Patients were eligible if they met International Headache Society criteria for migraine, with a frequency of 1 to 6 migraine attacks per month, and had documented "unsatisfactory treatment response" to rizatriptan within the past year (54% on the melt formulation; 46% on tablets). Reasons for dissatisfaction with rizatriptan (>1 could be cited) included inadequate (84%) or slow onset (50%) of pain relief, high recurrence rate (69%), and lack of improvement in associated symptoms (60%). One hundred twenty-three patients were eligible for treatment. Patients were instructed to take eletriptan 40 mg as soon as they were certain that their headache was a migraine, regardless of level of pain severity (8% treated headaches that were mild). Results.,Headache response at 2 hours (first-attack data) was 64%. Absence of nausea (from baseline to 2 hours) increased from 50% to 78%, absence of photophobia from 30% to 72%, and absence of phonophobia from 39% to 77%. Functional response at 2 hours was 63%, with 41% of patients reporting normal functioning. Treatment with eletriptan 40 mg was associated with a 27% to 40% reduction in migraine attack-related functional impairment, as measured by the PQ-7. Recurrence rates were 36.6%. Overall, 72% of patients rated eletriptan as a "good-to-excellent" treatment, and 78% reported overall satisfaction with the degree of headache relief. Conclusion.,The results of this study suggest that eletriptan is an efficacious treatment option for patients who are dissatisfied with their response to rizatriptan. [source] Assessment of endothelial function as a marker of cardiovascular risk in patients with rheumatoid arthritisINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2010Faisel KHAN Abstract The endothelium is a major regulator of cardiovascular function and maintains an atheroprotective role through several mechanisms, including vasodilatation, inhibition of platelet aggregation, having anticoagulant and profibrinolytic effects, and having an anti-inflammatory effect. Early changes in the normal functioning of the endothelium are key initiating factors in the development and progression of atherosclerosis. These changes are present well before the presentation of clinical symptoms. Thus, researchers have focused much attention on developing methods for reliable non-invasive testing of endothelial function to allow early detection and monitoring and progression of subclinical atherosclerosis. To date, there is a wide range of methods in use to assess endothelial function, each with its own advantages and limitations. Ideally, the tests should be non-invasive to allow repeated measurements and be applicable in normal healthy subjects and also in children. Given the wide range of regulatory functions of the endothelium, it is not surprising that there is no single measure of endothelial function that provides all the necessary information regarding vascular integrity in different vascular beds. Therefore, a combination of tests examining different components of the vascular system is more appropriate. Since patients with rheumatoid arthritis have increased mortality due to cardiovascular disease, assessment of endothelial function could prove to be useful tools in the identification and monitoring of cardiovascular risk. The purpose of this review is to give a brief overview of some of the commonly used techniques for assessment of endothelial function, and in particular on those that have been used in studies of patients with rheumatoid arthritis. [source] Skeletal muscle tissue engineeringJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 4 2004A. D. Bach Abstract The reconstruction of skeletal muscle tissue either lost by traumatic injury or tumor ablation or functional damage due to myopathies is hampered by the lack of availability of functional substitution of this native tissue. Until now, only few alternatives exist to provide functional restoration of damaged muscle tissues. Loss of muscle mass and their function can surgically managed in part using a variety of muscle transplantation or transposition techniques. These techniques represent a limited degree of success in attempts to restore the normal functioning, however they are not perfect solutions. A new alternative approach to addresssing difficult tissue reconstruction is to engineer new tissues. Although those tissue engineering techniques attempting regeneration of human tissues and organs have recently entered into clinical practice, the engineering of skletal muscle tissue ist still a scientific challenge. This article reviews some of the recent findings resulting from tissue engineering science related to the attempt of creation and regeneration of functional skeletal muscle tissue. [source] Skin hydration: a review on its molecular mechanismsJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2007Sylvie Verdier-Sévrain MD Summary Water is absolutely essential for the normal functioning of the skin and especially its outer layer, the stratum corneum (SC). Loss of water from the skin must be carefully regulated, a function dependent on the complex nature of the SC. The retention of water in the SC is dependent on two major components: (1) the presence of natural hygroscopic agents within the corneocytes (collectively referred to as natural moisturizing factor) and (2) the SC intercellular lipids orderly arranged to form a barrier to transepidermal water loss (TEWL). The water content of the SC is necessary for proper SC maturation and skin desquamation. Increased TEWL impairs enzymatic functions required for normal desquamation resulting in the visible appearance of dry, flaky skin. There have been recent discoveries regarding the complex mechanisms of skin hydration. In particular, it has been discovered that glycerol, a well-known cosmetic ingredient, exists in the SC as a natural endogenous humectant. Hyaluronan, which has been regarded mainly as dermal component, is found in the epidermis and is important for maintaining normal SC structure and epidermal barrier function. More importantly, the discovery of the existence of the water-transporting protein aquaporin-3 in the viable epidermis and the presence of tight junction structures at the junction between the stratum granulosum and SC have brought new insights into the mechanisms of skin water distribution and barrier function. [source] Inflammation: A new candidate in modulating adult neurogenesisJOURNAL OF NEUROSCIENCE RESEARCH, Issue 6 2008Sulagna Das Abstract Any pathological perturbation to the brain provokes a cascade of molecular and cellular events, which manifests in the form of microglial activation and release of various proinflammatory molecules. This eventually culminates in a profound neuroinflammatory reaction that characterizes the brain's response to stress, injury, or infection. The inflammatory cascade is an attempt by the system to eliminate the challenge imposed on the brain, clear the system of the dead and damaged neurons, and rescue the normal functioning of this vital organ. However, during the process of microglial activation, the proinflammatory mediators released exert certain detrimental effects, and neural stem cells and progenitor cells are likely to be affected. Here we review how the proliferation, maturation, and migration of the neural stem cells are modulated under such an inflammatory condition. The fate of the noncommitted neural stem cells and its differentiation potency are often under strict regulation, and these proinflammatory mediators seem to disrupt this critical balance and finely tune the neurogenesis pattern in the two niches of neurogenesis, the subventricular zone and the subgranular zone of the hippocampus. Moreover, the migration ability of these stem cells, which is important for localization to the proper site, is also affected in a major way by the chemokines released following inflammation. © 2007 Wiley-Liss, Inc. [source] Cancer as a consequence of the rising level of oxygen in the Late PrecambrianLETHAIA, Issue 3 2007JOHN M. SAUL The origin of multicelled animal life required collagen-family molecules whose own formation depended on the availability of molecular oxygen. Cancers, by contrast, are characterized by their low use of oxygen. In discussing the relationship between the origin of multicelled life and the origin of cancer, it is useful to think in terms of tissues rather than individual cells or complete animals. When animal tissues are disturbed, their constituent cells may be partially released from the constraints of multicellularity. This permits or obliges cells to reactivate anaerobic metabolic ways used by their single-celled ancestors in the oxygen-deficient Precambrian seas. Inhibition or loss of cell respiration under such circumstances may cause reversion to glycolytic fermentation, a less efficient metabolic style that generates waste products that are retained, thereby producing excess cell-growth. Distortion of tissue architecture may ensue with impairment of cell-to-cell adhesion, thereby liberating individual cells. Cells freed from tissue constraints undergo Darwinian variation which leads to loss of differentiation and produces cell types that are incompatible with the normal functioning of tissues. These steps, which may manifest themselves as carcinogenesis, are not reversible by restoration of oxygen and in effect constitute a demergence from the metazoan state. The existence of cancer among diverse phyla and especially among domesticated animals, suggests that the risk of cancer may be an initial condition of complex multicellular life and that it remains preferentially associated with newly modified designs. If so, there would be therapeutic strategies that have not yet been adequately considered. ,Cambrian explosion, cancer, cell differentiation, collagen, glycolysis, hard parts, metazoan origins. [source] Relaxation and guided imagery as an intervention for children with asthma: A replicationPSYCHOLOGY IN THE SCHOOLS, Issue 7 2005Robin L. Dobson Asthma is a pervasive inflammatory disorder of the bronchial airways that causes the normal functioning of the airways to become overreactive. This disorder affects approximately 8 million children in schools per year and accounts for a significant amount of absences. Researchers have speculated that pharmacological interventions are alone insufficient or overaggressive in treating asthma, and numerous studies have demonstrated a connection between emotions and asthma. It has therefore been suggested that psychological interventions may be appropriate for this population. One such intervention, relaxation and guided imagery (RGI), that incorporates mental representations as well as the senses in a process of relaxing all the parts of the body has been shown to be effective with children with asthma. The current study served as a replication and extension of this previous research. The purpose of the investigation was to examine the effectiveness of RGI with an elementary school sample as well as determine the overall improvement in happiness, anxiety, and quality of life of the participants. Results demonstrated that RGI significantly improved the lung functioning of 3 out of 4 participants in the study. Furthermore, overall happiness improved for 1 participant in the study, state anxiety decreased for 2 of the 4 participants, and trait anxiety decreased for all 4 participants. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 707,720, 2005. [source] Impaired conflict resolution and alerting in children with ADHD: evidence from the Attention Network Task (ANT)THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 12 2008Katherine A. Johnson Background:, An important theory of attention suggests that there are three separate networks that execute discrete cognitive functions. The ,alerting' network acquires and maintains an alert state, the ,orienting' network selects information from sensory input and the ,conflict' network resolves conflict that arises between potential responses. This theory holds promise for dissociating discrete patterns of cognitive impairment in disorders where attentional deficits may often be subtle, such as in attention deficit hyperactivity disorder (ADHD). Methods:, The Attentional Network Test (ANT), a behavioural assay of the functional integrity of attention networks, was used to examine the performance of 73 children with ADHD and 73 controls. Results:, Performance on the ANT clearly differentiated the children with and without ADHD in terms of mean and standard deviation (SD) of reaction time (RT), the number of incorrect responses made and the number of omission errors made. The ADHD group demonstrated deficits in the conflict network in terms of slower RT and a higher number of incorrect responses. The ADHD group showed deficits in the alerting network in terms of the number of omission errors made. There was no demonstration of a deficit in the orienting network in ADHD on this task. Conclusions:, The children with ADHD demonstrated deficits in the alerting and conflict attention networks but normal functioning of the orienting network. [source] Physical and psychological long-term and late effects of cancer,CANCER, Issue S11 2008Kevin D. Stein PhD Abstract The number of long-term cancer survivors (,5 years after diagnosis) in the U.S. continues to rise, with more than 10 million Americans now living with a history of cancer. Along with such growth has come increasing attention to the continued health problems and needs of this population. Many cancer survivors return to normal functioning after the completion of treatment and are able to live relatively symptom-free lives. However, cancer and its treatment can also result in a wide range of physical and psychological problems that do not recede with time. Some of these problems emerge during or after cancer treatment and persist in a chronic, long-term manner. Other problems may not appear until months or even years later. Regardless of when they present, long-term and late effects of cancer can have a negative effect on cancer survivors' quality of life. This article describes the physical and psychological long-term and late effects among adult survivors of pediatric and adult cancers. The focus is on the prevalence and correlates of long-term and late effects as well as the associated deficits in physical and emotional functioning. In addition, the emergence of public health initiatives and large-scale research activities that address the issues of long-term cancer survivorship are discussed. Although additional research is needed to fully understand and document the long-term and late effects of cancer, important lessons can be learned from existing knowledge. Increased awareness of these issues is a key component in the development of follow-up care plans that may allow for adequate surveillance, prevention, and the management of long-term and late effects of cancer. Cancer 2008. © 2008 American Cancer Society. [source] Incision design in implant dentistry based on vascularization of the mucosaCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005Johannes Kleinheinz Abstract Objectives: The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the vessels as well as of their supply area are crucial to the decision of the incision. The aim of this study was to visualize the course of the arteries using different techniques, to perform macroscopic- and microscopic analyses, and to develop recommendations for incisions in implant dentistry. Material and methods: The vascular systems of seven edentulous human cadavers were flushed out and filled with either red-colored rubber bond or Indian ink and formalin mixture. After fixation a macroscopic preparation was performed to reveal the course, distribution and supply area of the major vessels. In the area of the edentulous alveolar ridge specimens of the mucosa were taken and analyzed microscopically. Results: The analyses revealed the major features of mucosal vascularization. The main course of the supplying arteries is from posterior to anterior, main vessels run parallel to the alveolar ridge in the vestibulum and the crestal area of the edentulous alveolar ridge is covered by a avascular zone with no anastomoses crossing the alveolar ridge. Conclusion: The results suggest midline incisions on the alveolar ridge, marginal incisions in dentated areas, releasing incisions only at the anterior border of the entire incision line, and avoidance of incisions crossing the alveolar ridge. Résumé Fournir une quantité adéquate de sang aux capillaires pour un fonctionnement normal de l'organe est le but premier du système vasculaire. Préserver la viabilité du segment de tissu mou dépend de l'incision du tissu mou qui doit être effectuée de manière précise pour prévenir la détérioration de la circulation. Une connaissance de géographie des vaisseaux ainsi que de leurs aires de réserve sont essentiels pour la décision de l'incision. Le but de cette étude a été de visualiser les artères en utilisant différentes techniques afin d'effectuer des analyses tant macro- que microscopiques et pour developper des recommandations pour les incisions lors de la pose d'implants dentaires. Les systèmes vasculaires de sept cadavres humains édentés ont été vidés et remplis avec soit de l'encre de Chine ou une solution rouge et du formol. Après fixation une préparation macroscopique a été effectuée pour mettre en évidence le cours, la distribution et l'aire de réserve des principaux vaisseaux. Dans la zone du rebord alvéoaire édenté des spécimens des muqueuses ont été prélevés et analysés microscopiquement. Les analyses ont mis en évidence les principaux caractères de la vascularisation de la muqueuse. Le cours principal des artères converge de l'arrière vers l'avant, les vaisseaux principaux courent parallèlement au rebord alvéolaire dans le vestibule et l'aire crestale des rebords alvéolaires édentés et sont couverts par une zone non-vascularisée sans anastomose traversant le rebord alvéolaire. Ces résultats suggèrent donc des incisions au milieu de la ligne du rebord alvéolaire, des incisions marginales dans les zones dentées, des incisions d'accès seulement dans la frontière antérieure de la ligne d'incision générale et l'abstention d'incision traversant la crête alvéolaire. Zusammenfassung Ziele: Das erste Ziel des Gefässsystems ist es, eine adäquate Menge Blut zu den Kapillaren zu führen, um eine normale Funktion des Organs zu gewährleisten. Der Erhalt der Lebensfähigkeit des Weichteilsegments hängt von der Weichgewebsinzision ab, welche sauber gestaltet sein sollte, um die Zirkulation nicht zu beeinträchtigen. Die Kenntnis des Verlaufs und der Versorgungsgebiete der Gefässe ist für die Wahl der Inzision entscheidend. Das Ziel dieser Studie war, den Verlauf der Arterien mittels verschiedener Techniken sichtbar zu machen, um makroskopische und mikroskopische Analysen durchführen zu können und um Empfehlungen für Inzisionen in der oralen Implantatchirurgie zu entwickeln. Material und Methoden: Das Gefässsystem von 7 zahnlosen menschlichen Kadavern wurde ausgespült und entweder mit rot gefärbter Gummiflüssigkeit oder mit indischer Tinte und einer Formalinmixtur aufgefüllt. Nach der Fixierung wurde eine makroskopische Präparation durchgeführt, um den Verlauf, die Verteilung und die Versorgungsgebiete der grossen Gefässe aufzuzeigen. Im Bereich des zahnlosen Alveolarkammes wurden Proben der Mukosa entnommen und mikroskopisch analysiert. Resultate: Die Analysen zeigten die generellen Eigenschaften der Vaskularisation von Schleimhäuten. Die Hauptrichtung der versorgenden Gefässe verläuft von posterior nach anterior, die Hauptgefässe liegen parallel zum Alveolarkamm im Vestibulum und die Kammregion des zahnlosen Alveolarkammes wird durch eine avaskuläre Zone ohne den Alveolarkamm überkreuzende Anastomosen bedeckt. Schlussfolgerung: Aufgrund der Resultate werden Inzisionen im Bereich der Kammmitte des zahnlosen Alveolarkammes und marginale Inzisionen im bezahnten Bereich vorgeschlagen. Entlastungsschnitte sollten nur an der anterioren Grenze der gesamten Inzisionslinie gelegt werden. Inzisionen, welche den Alveolarkamm überkreuzen, sollten vermieden werden. Resumen Objetivos: El suministro de una cantidad adecuada de sangre a los capilares tisulares para el funcionamiento normal de un órgano es el propósito primario del sistema vascular. La preservación de la viabilidad del segmento de tejido blando depende en la incisión del tejido blando que debe estar debidamente diseñada en orden a prevenir mermas en la circulación. Un conocimiento del curso de los vasos al igual que del área de suministro es crucial para la decisión de la incisión. La intención de este estudio fue visualizar el curso de las arterias usando diferentes técnicas, para realizar análisis macro- y microscópicos, y desarrollar recomendaciones para incisiones en odontología de implantes. Material y métodos: Se vaciaron los sistemas vasculares de 7 cadáveres humanos edéntulos y rellenados con pegamento de goma de color rojo o con una mezcla de tinta india y formalina. Tras la fijación se llevó a cabo una preparación macroscópica para revelar el curso, distribución y área de suministro de los vasos principales. En el área de la cresta alveolar edéntula se tomaron especímenes y se analizaron microscópicamente. Resultados: Los análisis revelaron las principales características de la vascularización mucosa. El curso principal de las arterias de suministro as desde posterior a anterior, los vasos principales corren paralelos a la cresta alveolar en el vestíbulo y el área crestal de la cresta alveolar esta cubierta por una zona avascular sin anastomosis que crucen la cresta alveolar. Conclusión: Los resultados sugieren incisiones en la cresta alveolar, incisiones marginales en áreas dentadas, incisiones liberadoras solo en el borde anterior de la línea completa de incisión, y evitar las incisiones que crucen la cresta alveolar. [source] | ||||||||||||||||