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Ongoing Study (ongoing + study)
Selected AbstractsFatigue in children with long-term conditions: an evolutionary concept analysisJOURNAL OF ADVANCED NURSING, Issue 8 2009Margaret McCabe Abstract Title.,Fatigue in children with long-term conditions: an evolutionary concept analysis. Aim., This paper is a report of a concept analysis of fatigue in children with long-term conditions. Background., There is little research focused on the experience of fatigue in children. Previous work has focused primarily on children living with cancer. It is necessary to clarify and refine the concept, and add to the knowledge base that supports ongoing theoretical work in order to improve the clinical care of children with long-term conditions who experience fatigue. Method., English language literature published from 1989 to 2007 was searched using the CINAHL, Medline and PsychINFO data bases. Sixty-two papers and two book chapters were used in this concept analysis. Rodgers' method of evolutionary concept analysis was used. This inductive method helps us to view the concept in a sociocultural and temporal context. Findings., The number of publications focusing on fatigue in children is increasing. The analysis yielded two surrogate terms, five attributes, three antecedents and seven consequences. Based on this analysis, fatigue in children with long-term conditions appears to be a subjective experience of tiredness or exhaustion that is multidimensional and includes physical, mental, and emotional aspects. Conclusions., Evidence suggesting children with long-term conditions experience fatigue is increasing, but conceptual gaps remain. This analysis has yielded a view of fatigue in children that illustrates healthcare professionals' limited yet growing awareness of the symptom. Ongoing study as a means to refine our understanding of the concept could potentially lead to important contributions to clinical care of children with long-term conditions. [source] Trials update in walesCYTOPATHOLOGY, Issue 2007A. Fiander Three ongoing studies will be presented and discussed. Prevalence of Human Papillomavirus Infection in a South Wales Screening population Methods: A total of 10 000 consecutive, anonymous liquid based cytology screening samples were collected over a five month period in 2004. Age, cytology result and social deprivation score was provided for each specimen. The methodology was chosen to ensure inclusion of all women attending routine cervical screening, avoiding potential constraints associated with obtaining individual informed consent. The liquid based cytology samples were processed and reported by the receiving cytology laboratory and the residual specimens sent to the HPV Research Laboratory, Wales College of Medicine, where they were processed and stored at -80°C until analysis. High risk and low risk HPV Typing was undertaken using PCR , EIA (Jacobs et al 1997). Full high risk typing was performed on HPV positive specimens. Results: The study population had a mean age of 38 years with 92% negative, 5% borderline and 3% dyskaryotic cytology. The average social deprivation score was 17.4 (based upon the Welsh Index of multiple deprivation). The following results will be presented: HPV prevalence by age. HPV prevalence by cytology result. Type specific HPV prevalence in single and multiple infection. Conclusion: This study represents the largest type specific HPV Prevalence Study in the UK to date. As such it will form a useful base line against which to access performance of marketed HPV tests and evaluating the impact following implementation of HPV vaccination. [Funded by Welsh Office for Research and Development] CRISP , 1 Study (Cervical Randomized Intervention Study Protocol -1) Background: Indole-3-carbinol (I3C) and Diindolylmethane (DIM) are found in cruciferous vegetables and have been identified as compounds that could potentially prevent or halt carcinogenesis. I3C spontaneously forms DIM in vivo during acid digestion. I3C has been shown to prevent the development of cervical cancer in HPV 16 transgenic mice and both I3C and DIM have been shown to promote cell death in cervical cancer cell models. DIM is the major active bi-product of I3C and preliminary data indicate that DIM is active in cervical dysplasia and may be better tolerated than I3C. Aim: To investigate chemoprevention of high grade cervical neoplasia using Diindolylmethane (DIM) supplementation in women with low grade cytological abnormalities on cervical cytology. Objectives: To observe any reduction in the prevalence of histological proven high-grade cervical intraepithelial neoplasia (CIN) after 6 months of supplementation. ,,To observe any reduction in the prevalence of cytological abnormalities. ,,To observe any changes in the clinical appearance of the cervix. To assess acceptability and monitor any side effects of DIM supplementation. ,,To assess whether any benefit is seen in relation to Human Papillomavirus (HPV) status including HPV Type, Viral load and integration. Methods: This is a double blind randomized placebo-controlled trial involving 600,700 women with low grade cytological abnormalities on a cervical smear. Randomization is in the ratio of 2 : 1 in favour of active medication. Women with first mildly dyskaryotic smear or second borderline smear are eligible. They are asked to take two capsules daily for 6 months. At the end of 6 months they undergo repeat cervical cytology, HPV testing and colposcopy. Results: A progress report will be given for this ongoing study. [Funded: - Cancer Research UK] Type Specific HPV Infection in Welsh Cervical Cancers Background: Whilst there have been numerous studies of HPV infection associated with cervical cancer and on prevalence of Human Papillomavirus in diverse populations there have been no studies of these variables in the same population. Against a background of prophylactic HPV vaccination it is important to assess potential protection against cervical cancer within a given population. The most comprehensive analysis of HPV type specific cervical cancer is a meta-analysis published by the IARC in 2003. This however included only three UK based studies, totalling 118 cases, 75 of which were only investigated by HPV type PCR for four high risk types. None of this data was presented with associated population based prevalence data. Therefore, the research objectives for this study in combination with the first study above, are as follows: To determine the frequency of specific HPV types in cervical cancers in Wales. To compare the distribution of specific HPV types amongst cervical cancers with their prevalence in the general population. This will allow accurate delineation of the relationship between prevalence of specific HPV types in the general population and their association with clinically relevant disease. This information is a pre-requisite to assess the potential impact of prophylactic vaccination against HPV infection in Wales. Methods: Welsh Cervical Cancer specimens from 2000,2005 will be identified from pathology departments within Wales. The pathology of each tumour will be reviewed by a single Gynaecological Pathologist. The age of the patient and pathological features of the tumour will be noted. DNA will be extracted from the paraffin sections and HPV typed by PCR-EIA. Results: A progress report will be given for this ongoing study. [Funded by Welsh Office for Research and Development] [source] Weathering rates of buried machine-polished rock disks, Kärkevagge, Swedish LaplandEARTH SURFACE PROCESSES AND LANDFORMS, Issue 8 2002Colin E. Thorn Abstract Some 48 dolomite, 37 granite, and 19 limestone machine-polished disks were buried at soil horizon boundaries in 16 soil pits to maximum depths of 0·5,0·6 m within Kärkevagge, a presently periglacial, glaciated trough in Arctic Sweden. The objective of the ongoing study is to determine near-surface ,potential' weathering rates beneath birch forest, Dryas heath, heath, meadow, solifluction meadow, and willow vegetation cover types. Selected disks were excavated after 1 year, and all disks were excavated after 4 or 5 years. The limestone disks weathered fastest, followed closely by the dolomite disks, but the granite disks weathered at much slower rates. Mean annual percentage mass loss over 4 or 5 years was 0·473 ± 0·145% (two standard errors) for dolomite disks, 0·032 ± 0·005% (two standard errors) for granite disks, and 1·104 ± 0·446% (two standard errors) for limestone disks. For dolomite disks the Dryas heath and heath environments weathered the most slowly, a trend that was generally followed by the granite disks. Poor drainage (i.e. increasing wetness) and decreasing pH were found to promote dolomite weathering rates in a statistically significant manner. Surficial and subsurface weathering rates at individual sites were generally found to be correlated for dolomite, but not granite. Copyright © 2002 John Wiley & Sons, Ltd. [source] Individual, partner and relationship factors associated with non-medical use of prescription drugsADDICTION, Issue 8 2010Gregory G. Homish ABSTRACT Aims The objective of the current report was to examine individual, partner and relationship factors (e.g. relationship satisfaction) associated with the non-medical use of prescription drugs (NMUPD) in a community sample of married adults. Design The current report used two waves of data from an ongoing study of couples who were recruited at the time they applied for their marriage license and are now in the 10th year of follow-up. Logistic regression models examined the relation between individual, partner and relationship factors and NMUPD. Participants This report is based on 273 couples. Measurements Participants completed questionnaires that assessed prescription drug use, alcohol use, other substance use, depression, marital satisfaction and socio-demographic factors. Findings Among wives, there was evidence that a partner's prescription drug use and relationship factors were associated with increased risk for NMUPD. There was some evidence suggesting that it was the increased access or availability, and not the partner's use per se, that was related to the NMUPD. These results persisted after controlling for other illicit drug use, heavy drinking, depressive symptomatology and socio-demographic factors. Among men, neither partner use nor relationship factors were associated with NMUPD after considering the impact of individual-level risk factors. Conclusion Prevention and intervention efforts directed at reducing the risk for NMUPD should consider the influence of partner and relationship factors in addition to individual-level risk factors. [source] Pain Scores Improve Analgesic Administration Patterns for Trauma Patients in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 3 2004Paul A. Silka MD Abstract Objective: To determine the efficacy of pain scores in improving pain management practices for trauma patients in the emergency department (ED). Methods: A prospective, observational study of analgesic administration to trauma patients was conducted over a nine-week period following educational intervention and introduction of verbal pain scores (VPSs). All ED nursing and physician staff in an urban Level I trauma center were trained to use the 0,10 VPS. Patients younger than 12 years old, having a Glasgow Coma Scale score (GCS) <8, or requiring intubation were excluded from analysis. Demographics, mechanism of injury, vital signs, pain scores, and analgesic data were extracted from a computerized ED database and patients' records. The staff was blinded to the ongoing study. Results: There were 150 patients studied (183 consecutive trauma patients seen; 33 patients excluded per criteria). Pain scores were documented for 73% of the patients. Overall, 53% (95% confidence interval [CI] = 45% to 61%) of the patients received analgesics in the ED. Of the patients who had pain scores documented, 60% (95% CI = 51% to 69%) received analgesics, whereas 33% (95% CI = 18% to 47%) of the patients without pain scores received analgesics. No patient with a VPS < 4 received analgesics, whereas 72% of patients with a VPS > 4 and 82% with a VPS > 7 received analgesics. Mean time to analgesic administration was 68 minutes (95% CI = 49 to 87). Conclusions: Pain assessment using VPS increased the likelihood of analgesic administration to trauma patients with higher pain scores in the ED. [source] Capillary electrophoresis-mass spectrometry characterisation of secondary metabolites from the antihyperglycaemic plant Genista teneraELECTROPHORESIS, Issue 11 2006Emma L. Edwards Abstract Genista tenera is endemic to the Portuguese island of Madeira, where an infusion of the aerial parts of the plant is used in folk medicine as an antidiabetic agent. Consequently the medicinal properties of the secondary metabolites of this plant have been the subject of an ongoing study. A recently reported LC-MS method using a 100,min separation allowed identification of five flavonoid components in an extract of the aerial parts of this plant. In order to obtain additional information on the range and complexity of the plant's secondary metabolite components a CE-MS method has been developed and applied for the analysis of an extract of G.,tenera. Twenty-six different components are distinguished in an analysis time of only 10,min. Results demonstrate that CE-MS/MS rapidly generates data complementary to those obtainable by LC-MS/MS and is particularly suited to the analysis of plant metabolites where concentration is not limiting. [source] Alternate oils in fish feedsEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 3 2007Jana Pickova Abstract Nearly half of the fish consumed as food worldwide are raised on fish farms rather than caught in the wild, as shown by FAO statistics. The increasing aquaculture of predatory carnivorous fish demands new sources of feed constituents, particularly oils at the moment. Common terrestrial plant oils contain only traces of the long-chain polyunsaturated fatty acids. In connection with fish feed, especially the lack of n -3 "marine fatty acids" is obvious. Recommendations on the required amounts of the fatty acids DHA (22:6n -3) and EPA (20:5n -3) exist from 1994. When plant oil-based diets are fed during the growing phase and replaced by a fish oil-based diet during a period prior to slaughter, most of the beneficial lipid composition of fish in terms of human dietary recommendations is restored. Little attention has been focused on the fish welfare in connection to substitution of dietary oil sources, and studies are still scarce. New fish diets will rely heavily on the use of alternate ingredients such as plant oils also for carnivorous cold-temperate water fish species. In the future, an addition of synthetic or GMO-produced "marine" fatty acids is a possible scenario. The aim of this review is to highlight some plant oils used in fish feeds, with special emphasis on compounds other than fatty acids. We also include some results from an ongoing study, where the effect of dietary soy oil on gonad maturation in Atlantic cod (Gadus morhua) is indicated. [source] Dietary zinc, copper and selenium, and risk of lung cancerINTERNATIONAL JOURNAL OF CANCER, Issue 5 2007Somdat Mahabir Abstract Zinc, copper and selenium are important cofactors for several enzymes that play a role in maintaining DNA integrity. However, limited epidemiologic research on these dietary trace metals and lung cancer risk is available. In an ongoing study of 1,676 incident lung cancer cases and 1,676 matched healthy controls, we studied the associations between dietary zinc, copper and selenium and lung cancer risk. Using multiple logistic regression analysis, the odds ratios (OR) and 95% confidence intervals (CI) of lung cancer for all subjects by increasing quartiles of dietary zinc intake were 1.0, 0.80 (0.65,0.99), 0.64 (0.51,0.81), 0.57 (0.42,0.75), respectively (p trend = 0.0004); similar results were found for men. For dietary copper, the ORs and 95% CI for all subjects were 1.0, 0.59 (0.49,0.73), 0.51 (0.41,0.64), 0.34 (0.26,0.45), respectively (p trend < 0.0001); similar reductions in risk and trend were observed by gender. Dietary selenium intake was not associated with risk, except for a significant inverse trend (p = 0.04) in men. Protective trends (p < 0.05) against lung cancer with increased dietary zinc intake were also found for all ages, BMI > 25, current smokers, pack-years ,30, light drinkers and participants without emphysema. Increased dietary copper intake was associated with protective trends (p < 0.05) across all ages, BMI, smoking and vitamin/mineral supplement categories, pack-years ,30 and 30.1,51.75 and participants without emphysema. Our results suggest that dietary zinc and copper intakes are associated with reduced risk of lung cancer. Given the known limitations of case,control studies, these findings must be interpreted with caution and warrant further investigation. © 2006 Wiley-Liss, Inc. [source] Hormone Use and Cognitive Performance in Women of Advanced AgeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004J. Galen buckwalter PhD Objectives: To explore the association between hormone replacement therapy (HRT) and cognitive performance in a group of elderly women (,75) using a battery of well-standardized neuropsychological instruments. Design: Equivalent samples from existing cohort. Setting: Healthcare provider organization. Participants: All women enrolled were participants in an ongoing study of the association between HRT and the prevalence and incidence of dementia. Prescription records were used to establish HRT status. Fifty-eight users and 47 nonusers of HRT participated in this substudy. Measurements: Given previous reports that HRT has a positive effect on verbal memory, the California Verbal Learning Test and the Logical Memory Test were used as primary outcomes. A range of validated tests that assess other cognitive domains was also included. Results: There were no significant differences between users and nonusers of HRT on any cognitive measures. Conclusion: Given equivalent groups of users and nonusers of HRT no support was found for the hypothesis that use of HRT improves cognitive performance in older women. [source] Comparison of Adaptive Behavior in Children With Heavy Prenatal Alcohol Exposure or Attention-Deficit/Hyperactivity DisorderALCOHOLISM, Issue 11 2009Nicole Crocker Background:, Adaptive behavior, the ability to respond successfully to everyday demands, may be especially sensitive to the effects of heavy prenatal alcohol exposure. Similar adaptive dysfunction is common in other developmental disorders including attention-deficit/hyperactivity disorder (ADHD). ADHD is frequently present in alcohol-exposed children and this overlap in clinical presentation makes identification of alcohol-exposed children difficult. Direct comparison of children with prenatal alcohol exposure and ADHD may yield distinct patterns of cognitive and behavioral performance and add to growing knowledge of the neuropsychological and behavioral profile of prenatal alcohol exposure. Therefore, the aim of the current study was to compare adaptive behavior in children with histories of heavy prenatal alcohol exposure (ALC), nonexposed children with ADHD (ADHD), and typically developing controls (CON). Methods:, Sixty-five children (ALC = 22, ADHD = 23, CON = 20) were selected from a larger ongoing study of the behavioral teratogenicity of alcohol. Alcohol-exposed and control participants were selected to match the ADHD subjects on age, sex, socioeconomic status, and race/ethnicity. Caregivers were administered the Vineland Adaptive Behavior Scales, a semi-structured interview, and were asked to rate their child's behavior on 3 domains of adaptive function. Data were analyzed using regression techniques. Results:, Relative to controls, children in both the ALC and ADHD groups showed adaptive behavior deficits on all 3 domains and children in the ALC group were significantly more impaired than the ADHD group on the daily living skills domain. Within the ALC group, socialization standard scores were lower at older ages. This negative relationship between age and standard scores in the ALC group was also observed on the communication domain, a finding not previously reported. Conclusions:, This study suggests that both children with prenatal alcohol exposure and children with ADHD show impairments in adaptive function relative to controls, but that the pattern of impairment differs between these clinical groups. Adaptive ability in children with prenatal alcohol exposure is characterized by an arrest in development, as evidenced by a lack of improvement with age in socialization and communication scores. In contrast, children with ADHD exhibit a developmental delay in adaptive ability as their scores continued to improve with age, albeit not to the level of control children. Continued research focused on elucidating the patterns of deficits that exist in alcohol-exposed children ultimately will lead to improved differential diagnosis and effective interventions. [source] Acamprosate: Recent Findings and Future Research DirectionsALCOHOLISM, Issue 7 2008Karl Mann This article explores the mechanisms of action and the potential responder profile of acamprosate, a compound efficacious in relapse prevention of alcoholism. New evidence at the molecular and cellular level suggests that acamprosate attenuates hyper-glutamatergic states that occur during early abstinence and involves iono (NMDA)- and metabotrotropic (mGluR5) glutamate receptors along with augmented intracellular calcium release and electrophysiological changes. Thus mutant mice with enhanced glutamate levels exhibit higher alcohol consumption than wild type mice and respond better to acamprosate, demonstrating that acamprosate acts mainly on a hyper-glutamatergic system. This mode of action further suggests that acamprosate exhibits neuroprotective properties. In rats, cue-induced reinstatement behavior is significantly reduced by acamprosate treatment whereas cue-induced craving responses in alcohol-dependent patients seem not to be affected by this treatment. An ongoing study ("Project Predict") defines specific responder profiles for an individualized use of acamprosate and naltrexone. Neurophysiological as well as psychometric data are used to define 2 groups of patients: "reward cravers" and "relief cravers". While naltrexone should work better in the first group, acamprosate is hypothesized to be efficacious in the latter where withdrawal associated and/or cue induced hyper-glutamatergic states are thought to trigger relapse. Further research should target the definition of subgroups applying endophenotypic approaches, e.g. by detecting a hyperglutamatergic syndrome using MR spectroscopy. [source] Anaphylaxis to Ophthalmic Medication in a CatJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000Signe J. Plunkett D.V.M. Summary There is an increasing incidence of anaphylactic reactions in cats due to the administration of ophthalmic bacitracin, neomycin, polymyxin medications. Most of the reported cases have been fatal. This is the report of a cat that survived the initial episode only to develop renal failure and cardiomyopathy. This lead to euthanasia seven days later. Dr. Kathryn Meyer of the U.S. Pharmacopeia and Dr. Signe Plunkett of the Emergency Animal Clinic in Phoenix are conducting an ongoing study, and they are interested in the reports of any additional cases. [source] Unravelling causal components of the Ordovician Radiation: the Builth Inlier (central Wales) as a case studyLETHAIA, Issue 2 2008JOSEPH P. BOTTING Hypotheses about the causes of biodiversification during the Ordovician have been focused in three main areas: tectonic activity and nutrient supply, palaeogeography, and ecological escalation. There is as yet no consensus on mechanisms, and it is unclear whether it is better to study the patterns at local or regional scales. By applying ecological knowledge to the available palaeontological information, it can be shown that neither tectonic nor palaeogeographic effects could account for the permanence of the diversity rise, in the absence of elements of ecological escalation. However, it may be possible to identify trigger mechanisms resulting in enhanced speciation or reduced extinction. Areas of local diversity increase should be distinguished from speciation centres. An ongoing study of the Middle Ordovician Builth-Llandrindod Inlier of central Wales, conducted over 10 years, has identified elements of all three of the above categories of causal mechanisms affecting local diversity. This implies that the patterns of causal relationship and diversification are complex even at very local scales, and at this stage we should not anticipate a clear correlation of global diversity with any single factor. More data are needed from small-scale but intensive studies before we can generalize about the causal mechanisms of the Ordovician Radiation. [source] Quantification of global DNA methylation with infrared fluorescence in liver and muscle tissues of differentially fed boarsLUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 4 2009Martin H. Braunschweig Abstract Methylation of cytosine residues at CpG sites is involved in various biological processes to control gene regulation and gene expression. Global DNA methylation is changed in different tumors and in cloned animals. Global DNA methylation can be accurately quantified by dot blot analysis with infrared (IR) fluorophores. Methylated lambda DNA was used as model DNA to develop and validate an immunochemical assay with IR fluorescence detection. Two different IR fluorophores were used, one to detect 5-methylcytosine and another to account for DNA loading. A sensitive infrared detection method was established which is suitable for accurate and reproducible quantification of global DNA methylation across a wide dynamic range. This method was subsequently employed to quantify global DNA methylation in liver and in muscle tissues of boars which have received either a control diet or a methyl supplemented diet in an ongoing study. A significant difference in global DNA methylation is indicated in muscle but not in liver tissue between the two groups of boars. Copyright © 2009 John Wiley & Sons, Ltd. [source] Coffee, caffeine-related genes, and Parkinson's disease: A case,control study,MOVEMENT DISORDERS, Issue 14 2008Maurizio F. Facheris MD Abstract An inverse association between coffee and Parkinson's disease (PD) has been reported. However, it remains uncertain why some but not all coffee drinkers are less susceptible to PD. We considered the possibility of a pharmacogenetic effect. In our study, we included 1,208 subjects (446 case-unaffected sibling pairs and 158 case-unrelated control pairs) recruited from an ongoing study of the molecular epidemiology of PD in the Upper Midwest (USA). We collected information on lifetime coffee drinking and we studied two genes: ADORA2A, which encodes the major receptor activity of caffeine in the brain (variants rs5751876 and rs3032740), and CYP1A2, which encodes the major rate-limiting step of caffeine metabolism (variants rs35694136 and rs762551). We did not observe significant associations of coffee drinking or of the genetic variants with PD susceptibility, either independently or jointly, in the sample overall and in most strata. Our study neither supports the hypothesis that coffee protects against PD nor provides evidence for a pharmacogenetic effect. © 2008 Movement Disorder Society [source] The Effects Of Tizanidine HCL (Zanaflex®) In Patients With FibromyalgiaPAIN MEDICINE, Issue 2 2000Article first published online: 25 DEC 200 David McLain, MD, Brookwood Medical Center, Birmingham, AL This open-label, single-center, dose-finding study of Zanaflex (tizanidine hydrochloride) in 43 patients diagnosed with fibromyalgia showed some effectiveness in reducing pain and other symptoms of this syndrome. Fibromyalgia is a common syndrome characterized by chronic musculoskeletal pain in all 4 quadrants and pain in 18 identified tender points. Effects on fatigue, pain, sleep, and tender points were assessed before and during treatment. Starting doses of 2 mg/day were increased to 4 mg/day after 5 days and increased further as tolerated. Most patients stayed at 4 mg/day or 8 mg/day, and the highest dosage achieved was 12 mg/day. After the initial visit, 6 patients discontinued Zanaflex because of side effects (headaches in 3, hallucinations in 1, hypotension in 1, asthenia in 1), and 11 did not return for a follow-up visit. Results are presented for the remaining 26 patients (25 females; average age 50 years (range, 36,64 years); 25 Caucasian, 1 African-American; 9 on disability or applying for it; all stable on one or more of the following concomitant medications: narcotic analgesics 15%, antidepressants 65%, NSAIDs 46%). On average, at the first follow-up visit (average time 7.8 weeks), patients showed reduction in tender points and improvement on global assessment (GA) scores, Fibromyalgia Impact Questionnaire (FIQ) results, and visual assessment (VAS) scores for fatigue, pain, and sleep. The results for patients still working or retired were better than those for patients on disability or applying for it. Of the 26 patients in this ongoing study, 14 have had second follow-up visits (average time 13.3 weeks). Of these, 2 discontinued the drug at the second follow-up visit. Six of these patients responded especially well to long-term treatment (average age 51 years; range 46,60 years; 5 females; 1 on disability or applying for it) and showed the following averaged results: global assessment improved by 47%, FIQ by 35%, VAS-fatigue by 48%, VAS-pain by 40%, VAS-sleep by 37%, and tender points by 18%. Zanaflex appears to be effective in improving overall functioning, reducing pain and fatigue, improving sleep, and reducing the number of painful tender points in some patients with fibromyalgia, especially in those who are not on disability or applying for it. [source] An open-label, phase 2 trial of denosumab in the treatment of relapsed or plateau-phase multiple myeloma,,AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2009Ravi Vij RANKL is a key mediator of osteoclast differentiation, activation, and survival. Preclinical data suggest that aberrant production and activation of osteoclasts may influence proliferation of multiple myeloma (MM) cells in the bone marrow. Reports have also shown that inhibiting RANKL may have a direct effect on RANK-expressing myeloma cells and a therapeutic role in treating the disease. In mouse myeloma models, inhibition of RANKL led to reduced serum paraprotein levels and tumor burden. Based on this hypothesis, this proof-of-concept, single-arm study investigated whether RANKL inhibition with denosumab could reduce serum M-protein levels in relapsed or plateau-phase myeloma subjects. All subjects received denosumab monthly, with loading doses on days 8 and 15 of month one, until disease progression or subject discontinuation. Results of this ongoing study demonstrated that no subjects in either cohort met the protocol-defined objective response criteria of complete response (CR) or partial response (PR), but that denosumab effectively inhibited the RANKL pathway regardless of previous exposure to bisphosphonates, as evidenced by suppressed levels of the bone turnover marker, serum C-terminal telopeptide of type 1 collagen (sCTx). Eleven (21%) subjects who relapsed within 3 months before study entry maintained stable disease for up to 16.5 months. Nineteen (46%) subjects with plateau-phase myeloma maintained stable disease for up to 18.3 months. The adverse event (AE) profile for denosumab and its dosing schedule in these populations was consistent with that for advanced cancer patients receiving systemic therapy. Additional controlled clinical studies of denosumab in subjects with both relapsed and plateau-phase MM are warranted. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source] Control of Aspergillus growth and aflatoxin production using natural maize phytochemicals under different conditions of water activityPEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 8 2006Andrea V Nesci Abstract The effects of the natural phytochemicals trans -cinnamic acid (CA) and ferulic acid (FA) alone at concentrations of 1,25 mM and in 16 combinations (M: mixtures) on growth and aflatoxin B1 production by Aspergillus flavus Link and A. parasiticus Speare were evaluated. Studies on growth rate and aflatoxin B1 production were carried out in vitro in relation to a water activity aw of 0.999, 0.971, 0.955 and 0.937. Overall, CA at concentrations of 10 and 20 mM and FA,CA mixtures M3 (20 + 5 mM respectively), M8 (25 + 5 mM), M9 (1 + 10 mM), M10 (10 + 10 mM), M11 (20 + 10 mM), M12 (25 + 10 mM), M13 (1 + 20 mM), M14 (10 + 20 mM), M15 (20 + 20 mM) and M16 (25 + 20 mM) were the treatments most effective at inhibiting growth of the four species assayed. All strains were much more sensitive to all natural phytochemicals tested on growth rate at aw = 0.937. CA and the FA,CA mixtures M1 (1 + 1 mM respectively), M4 (25 + 1 mM), M5 (1 + 5 mM), M6 (10 + 1 mM), M7 (20 + 1 mM), M8 (25 + 5 mM), M9 (1 + 10 mM), M10 (10 + 10 mM), M11 (20 + 10 mM), M12 (25 + 10 mM), M13 (1 + 20 mM), M14 (10 + 20 mM), M15 (20 + 20 mM) and M16 (25 + 20 mM) completely inhibited aflatoxin B1 production by all strains at aw = 0.999, 0.971, 0.955 and 0.937. Decreased aflatoxin B1 levels in comparison with the control were observed with FA at 1, 10, 20 and 25 mM with the strains RCM89, RCM108 and RCM38 at aw = 0.971, 0.955 and 0.999 respectively. The data show that CA and FA can be considered as effective fungitoxicants for A. flavus and A. parasiticus in in vitro assay. The information obtained is part of an ongoing study to determine their application at the storage level. Copyright © 2006 Society of Chemical Industry [source] Optimizing DNA yield from buccal swabs in the elderly: Attempts to promote buccal cell growth in cultureAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2003David J. Vandenbergh Participation in genetic studies is often limited by a volunteer's reluctance to donate blood samples. We wished to determine if alternate, less painful, methods to venipuncture could be used to collect cells to provide DNA for genotyping, and whether the cells could be grown in culture for extraction of DNA. Volunteers in the study were comprised of two groups. Nine individuals from a university campus were recruited to provide samples for initial experiments. A second group of 710 twins and singletons from North Carolina and of African-American descent were a part of an ongoing study of age-related traits and participated in collection of buccal swabs via the mail. A protocol was generated that maximizes the recovery of DNA from buccal swabs, which are easier to handle than saline rinses. The DNA recovered is stable over several years, allowing genotype tests at a future date. Attempts to encourage growth of buccal epithelial cells recovered from swabs in tissue culture proved unsuccessful. Buccal swabs work well for the collection of DNA, especially from nonclinic-based volunteers, and can be sent via the mail to the laboratory for DNA extraction. Thus, an inexpensive and efficient method exists for genetic studies of population-based samples. Am. J. Hum. Biol. 15:637,642, 2003. © 2003 Wiley-Liss, Inc. [source] Building an integrated model of information behavior through information journalsPROCEEDINGS OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE & TECHNOLOGY (ELECTRONIC), Issue 1 2008Bhuva Narayan Information behavior models generally focus on one of many aspects of information behavior, either information finding, conceptualized as information seeking, information foraging or information sense-making, information organizing and information using. This ongoing study is developing an integrated model of information behavior. The research design involves a 2-week-long daily information journal self-maintained by the participants, combined with two interviews, one before, and one after the journal-keeping period. The data from the study will be analyzed using grounded theory to identify when the participants engage in the various behaviors that have already been observed, identified, and defined in previous models, in order to generate useful sequential data and an integrated model. [source] No place called home: the causes and social consequences of the UK housing ,bubble'THE BRITISH JOURNAL OF SOCIOLOGY, Issue 2 2010John Bone Abstract This paper examines the key causes and social consequences of the much debated UK ,housing bubble' and its aftermath from a multidimensional sociological approach, as opposed to the economic perspective of many popular discussions. This is a phenomenon that has affected numerous economies in the first decade of the new millennium. The discussion is based on a comprehensive study that includes exhaustive analysis of secondary data, content and debate in the mass media and academia, primary data gathered from the monitoring of weblogs and forums debating housing issues, and case histories of individuals experiencing housing difficulties during this period. This paper is intended to provide a broad overview of the key findings and preliminary analysis of this ongoing study, and is informed by a perspective which considers secure and affordable housing to be an essential foundation of stable and cohesive societies, with its absence contributing to a range of social ills that negatively impact on both individual and collective well being. Overall, it is argued that we must return to viewing decent, affordable housing as an essential social resource, that provides the bedrock of stable individual, family and community life, while recognizing that its increasing treatment as a purely economic asset is a key contributor to our so-called ,broken society'. [source] Mycophenolate Blood Level Monitoring: Recent ProgressAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009T. Van Gelder The concentration,effect relationship for mycophenolic acid (MPA), and the high variability in MPA concentrations in patients on standard dose mycophenolate mofetil (MMF) therapy, for some centers has provided enough evidence to implement therapeutic drug monitoring (TDM) for MMF in daily practice. Two randomized trials Adaption de Posologie du MMF en Greffe Renale (APOMYGRE) and fixed-dose versus concentration controlled (FDCC) investigated the added benefit of TDM for MMF in renal transplant recipients. The APOMYGRE study showed a significant reduction in the incidence of acute rejection in concentration-controlled patients, while the FDCC study had a negative outcome, despite a similar study design. Although it was expected that these prospective trials would give the final answer to the question of whether or not TDM for MMF would be of benefit, it seems that the studies have not had much impact on patient management. Several trials have shown the importance of early adequate exposure to MPA in the first week after transplantation. As it will be hard to improve MPA exposure with TDM, this early, ongoing study now investigates the use of an increased starting dose. The increased starting dose will avoid underexposure to MPA in higher proportions of patients shortly after transplantation but may result in more toxicity in patients with MPA exposures exceeding the upper threshold of the therapeutic window. [source] Integrated geophysical and topographical investigation in the territory of Ancient Tarquinia (Viterbo, central Italy)ARCHAEOLOGICAL PROSPECTION, Issue 3 2007S. Piro Abstract This paper presents the results of an ongoing study of the territory of Ancient Tarquinia (Viterbo, central Italy). The work is part of the University of Milano's ,Tarquinia Project', which studies the monumental area of this territory with particular emphasis on the ,Ara della Regina' temple site. To enhance the knowledge of this territory, a scientific collaboration between the University of Milano (Department of Science of Antiquity) and the Institute of Technologies Applied to Cultural Heritage (ITABC-C.N.R.) was initiated in 2000 and is still in progress. The primary objective of the study was to determine the location and degree of conservation of unknown buried structures below the sites studied, using the integration of topographical surveys, three-dimensional laser scanner surveys of the temple and ground-based remote sensing surveys. The remote sensing surveys were carried out using the ground-penetrating radar (GPR). The analysis of the GPR time-slice maps indicates that some structural formations and walls of the buildings are still present below the surface. The results presented and discussed in this paper demonstrate the potential of both the topographical survey combined with the three-dimensional laser scanner survey of the monument and the remote sensing technique for understanding of the presence and the extent of buried buildings with respect to the temple area. Copyright © 2007 John Wiley & Sons, Ltd. [source] Focus group composition: a comparison between natural and constructed groupsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2001Julie Leask Objective: To provide insight into the effects of focus group composition. Method: In an early phase of an ongoing study of parental reception to messages about childhood immunisation, we conducted four focus groups; two with participants who had never met before (constructed groups) and two with participants who were part of a preestablished first-time mothers' group (natural groups). Results: Marked differences were noted in the group dynamics, depth of interaction and diversity between groups. Discussions with constructed groups were animated, enthusiastic, expressed more divergent views and articulated greater complexities of the topic. Discussions with natural groups were generally flatter and less enthusiastic, displaying a higher level of apparent conformity to conventional wisdom. The need to protect other participants from potentially disturbing information about vaccination was expressed across groups but acted to censor natural groups, where participants knew more of each others' sensitivities. Implications: Insight into the factors contributing to such differences may enhance understanding of the contexts in which constructed groups are more appropriate. The processes of social censorship may be of primary interest to the researcher. However, where it is paramount to elicit a range of opinions about a potentially controversial topic, we suggest that natural groups in the delicate stage of norming be avoided. The peculiarities of each individual research circumstance are best explored in pilot studies. [source] Prevalence and side preference for tooth grinding in twinsAUSTRALIAN DENTAL JOURNAL, Issue 3 2006KV Dooland Abstract Background: Estimates of the prevalence of tooth grinding in children range considerably, reflecting different methods of recording. The main aims of this study were to determine the prevalence of tooth grinding in monozygotic (MZ) and dizygotic (DZ) twin pairs by assessing wear faceting on the primary canines, and to compare the faceting on the right and left to determine whether children have a side preference for grinding. Methods: The sample consisted of 116 MZ twin pairs and 124 dizygous DZ twin pairs, all participants in an ongoing study of dento-facial development at the dental schools in Adelaide and Melbourne. Evidence of wear faceting on primary maxillary and mandibular canine tips was recorded from dental casts, and the side with the larger wear facet recorded. Types of occlusal relationship, handedness, zygosity and gender were also recorded, and associations between variables analysed statistically. Results: Canine tip wear facets were found in 100 per cent of the sample, and grinding was lateralized in 59 per cent of children. MZ twin pairs showed a higher discordance for grinding side preference than DZ twin pairs (33.8 per cent compared with 16.8 per cent), providing evidence of a mirror-imaging effect for grinding side preference. There was no strong evidence that individuals had the same preference for grinding side and handedness, although right-handers (RH) showed a preference for a grinding side more often than non-righthanders (NRH) (63.6 per cent compared with 51.2 per cent), consistent with previous findings that RHs display more cerebral lateralization than NRHs. Conclusions: Tooth grinding appears to be a universal phenomenon in children and is commonly expressed more on one side than the other. The significantly higher discordance for grinding side preference in MZ twin pairs compared with DZ twin pairs may reflect a mirror-imaging effect in the former. However, at present we have no evidence to suggest that handedness and preferred tooth grinding side are associated. [source] Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunctionBIPOLAR DISORDERS, Issue 2 2008Carmen Simonsen Objectives:, Studies on neurocognitive functioning in bipolar disorder, reporting deficits in memory, attention, and executive functioning, have primarily focused on bipolar I disorder. The aim of this study was to examine whether patients with bipolar I and bipolar II disorder have different neurocognitive profiles. Methods:, Forty-two patients with bipolar I disorder, 31 patients with bipolar II and 124 healthy controls, from a large ongoing study on psychotic disorders, were included. Neurocognitive function was measured with a comprehensive neuropsychological test battery. Results:, The bipolar I group performed significantly poorer than the healthy control group and the bipolar II group on all measures of memory. Compared with the control group, the bipolar I group also had significantly reduced performance on most measures of attention and executive functioning, while the bipolar II group only had a significantly reduced performance on a subset of these measures. On average, 24% of the bipolar I group had clinically significant cognitive impairment (,1.5 SD below the control group mean) across measures, compared with 13% of the bipolar II group. Conclusions:, Patients with bipolar I and bipolar II disorder in this study have different neurocognitive profiles. Bipolar I patients have more widespread cognitive dysfunction both in pattern and magnitude, and a higher proportion has clinically significant cognitive impairments compared with patients with bipolar II. This may suggest neurobiological differences between the two bipolar subgroups. [source] Genital sensation after feminizing genitoplasty for congenital adrenal hyperplasia: a pilot studyBJU INTERNATIONAL, Issue 1 2004N.S. Crouch OBJECTIVE To assess sensation in the clitoris and vagina in women with congenital adrenal hyperplasia (CAH) who have previously had genital surgery, and to evaluate sexual function in this group as the latter, and particularly the experience of orgasm, appear to be closely related to sensitivity. PATIENTS AND METHODS Six women were recruited from a multidisciplinary clinic specialising in intersex conditions, and representing an initial cohort from a larger ongoing study. The patients were asked to complete a postal questionnaire with a specialized sexual function assessment. Thermal, vibratory and light-touch sensory thresholds were assessed in the clitoris and vagina using a genito-sensory analyser and Von Frey filaments. RESULTS All six women had highly abnormal results for sensation in the clitoris. Only three of them had an introitus capable of admitting the vaginal probe, and the vaginal sensory data of all three were within the validated ranges. A self-administered sexual function assessment was completed by the five women who were sexually active. The scores indicated sexual difficulties, particularly in the areas of infrequency of intercourse and anorgasmia. CONCLUSIONS The sensory data for all six women were outside the normal range for the clitoris. The results for the upper vagina, which had not had surgery, were within normal ranges. These findings suggest that genital surgery may disrupt sensory input. Sexual function also appears to be impaired and this may relate to the compromised sensitivity and restricted introitus. The possibility that women with CAH have deficient clitoral sensation ab initio cannot be excluded. These striking findings must be evaluated further in the light of the controversy about the issue of genital surgery in children with CAH. [source] Antiplatelet Therapy in Cerebrovascular Disease: Implications of MATCH and CHARISMA Results for CardiologistsCLINICAL CARDIOLOGY, Issue 12 2007Dan James Fintel M.D. Abstract Cardiovascular disease is prevalent among patients with stroke; thus, cardiologists frequently treat patients at high risk for stroke. Results from recent clinical trials of antiplatelet medications, given alone or in combination, may be of special interest to cardiologists. The MATCH study demonstrated no significant difference between clopidogrel alone and clopidogrel plus aspirin in reducing risk of vascular events after stroke or transient ischemic attack. A 1.3% increased risk of major bleeding was associated with clopidogrel plus aspirin. In CHARISMA, clopidogrel plus aspirin did not reach statistical significance vs. placebo plus aspirin in reducing incidence of myocardial infarction (MI), stroke, or death from cardiovascular causes in patients with stable atherothrombotic disease; clopidogrel was associated with an increase in moderate bleeding. These results suggest that clopidogrel plus aspirin may be inappropriate as first-line therapy for secondary stroke prevention. In patients with established cardiovascular disease at risk for MI or other vascular events, physicians must weigh the benefits and risks before choosing this therapy. Selection of an antiplatelet agent must be based on patient history, including previous MI and stroke, susceptibility to bleeding, and other high-risk factors (e.g. advanced age and diabetes). Aspirin plus extended-release dipyridamole may be more effective than clopidogrel for preventing stroke in high-risk patients. This article strives to put MATCH and CHARISMA results into context by providing an overview of antiplatelet therapy, including relevant clinical trial results, a review of current practice guidelines, and a summary of an ongoing study that will improve clinical decision making. Copyright © 2007 Wiley Periodicals, Inc. [source] Emotional issues after kidney transplantation: a prospective psychotherapeutic studyCLINICAL TRANSPLANTATION, Issue 6 2002Lyndsay S Baines Abstract:,Background:, Negative emotional states are the single most influential factor in determining quality of life after a successful kidney transplant. We designed a prospective study using psychotherapeutic principles to understand and intervene in emotional issues in adult recipients of first cadaver kidney transplants. Methods:, Forty-nine recipients of first cadaver kidney transplants were subjected to 12 sessions (at weekly intervals) of psychotherapy within 3 months of receiving their transplant. The Beck Depression Inventory (BDI) was utilized as a measure of change in emotional state, pretherapy, at 3, 6, 9 and 12 months. A higher score on BDI was suggestive of psychological dysfunction. In the first instance, data was analysed within a quantitative framework, by virtue of the BDI. In the second instance, data was considered in terms of recurring themes described by patients during psychotherapy and was analysed qualitatively. In the third instance, both qualitative and quantitative data was considered in terms of individual patient's ability to achieve some feeling of having implemented some social, relational and vocational equilibrium into their everyday life. Recipients of live kidneys, paediatric transplants and patients who received more than one transplant were excluded, as emotional issues are different in this cohort of patients. All patients have completed 1 yr of follow up. None of the patients were on antidepressant medication before or after therapy. Results:, This is an ongoing study in which we are comparing individual vs. group therapy vs. controls (who receive no therapy). The total number of patients recruited will be 120 and the final report will be available in 2003,04. The results reported in this paper form the 49 patients in the individual arm of the study. All the patients in our study happened to be white people. There was significant improvement in the BDI scores following therapy. The mean score was 26.3 ± 7.9 before and 20.5 ± 8.8 after therapy (p = 0.001); the lowering of the scores remained sustained at 12 months. Multivariate analysis of age, gender, employment status, duration of dialysis (if in dialysis for more than 3 yrs) and psychotherapy given before transplantation did not affect the results of our study. For the qualitative aspect of the study, we grouped the emotional problems as expressed by the patients into three recurring themes (i) fear of rejection, (ii) feelings of paradoxical loss post-transplant despite having received a successful transplant and (iii) the psychological integration of the newly acquired kidney. Conclusions:, Psychotherapeutic intervention was an effective means of addressing emotional problems in recipients of kidney transplants. The recurring themes as identified above provided a baseline for psychotherapeutic exploration and resolution of these issues. Successful resolution of these issues was associated with lower BDI scores and the redefinition of normality in daily living post-transplant. [source] Exception from Informed Consent Enrollment in Emergency Medical Research: Attitudes and AwarenessACADEMIC EMERGENCY MEDICINE, Issue 2 2007Wayne Triner DO Objectives To explore attitudes surrounding exception from informed consent enrollment into research studies. In addition, the authors sought to determine the level of awareness of such an ongoing study among potential subjects, as defined by their presence in an emergency department (ED). Methods A convenience sample of urban academic ED patients and visitors was surveyed during a visit regarding their attitudes and awareness of an emergency exception from informed consent, blood-substitute trial ongoing in the community. Results There was a 13% refusal rate, and 32% of those approached had characteristics that met exclusion criteria. There were 497 surveys analyzed. There was a predominance of women, Caucasians, and persons with at least some college education. Only 39 (8%) of respondents reported awareness of the ongoing blood substitute trial, and only 19 (4%) were able to list a risk or benefit of participation. Education, income, and age were not associated with reported awareness. Male gender, younger age, awareness of the existing exception from informed consent study, and being married were associated with greater acceptability for such enrollment practices. Conclusions The overall awareness of an ongoing exception from informed consent trial after community consultation and notification was low. A population with potential for enrollment in such a study did not demonstrate a high degree of acceptance of such practices. There were differences among certain demographic groups in the degree of acceptance. These differences may guide institutional review boards and investigators in community-consultation strategies for future waiver of or exception from informed consent studies. [source] | ||||||||||||||||||||||