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Rapid Deterioration (rapid + deterioration)
Selected AbstractsLooking beyond food aid to livelihoods, protection and partnerships: strategies for WFP in the Darfur statesDISASTERS, Issue 2007Helen Young The humanitarian crisis in Darfur remains extremely serious. The optimism that followed the signing of the Abuja Peace Accord was followed by a rapid deterioration in security on the ground in part associated with increasing factionalism in various rebel movements. This paper briefly reviews the evolution of the crisis, its impact on lives and livelihoods and the response by the World Food Programme (WFP) to June 2006. The major challenges and issues facing the food aid programme in the previous 18 months included: dealing with insecurity while maintaining or even extending programme outreach; the need to link protection with assistance more explicitly; and determining the wider impact of food aid programming on the processes and institutions linked with the conflict. The paper discusses the main strategic issues facing WFP in the future such as: integrating security and protection with needs assessments and operational decisions, broadening response strategies beyond food aid and bringing livelihoods to the fore, the need to review cost-efficiency, promoting partnerships and strengthening national and regional capacities. [source] Earlier stress exposure and subsequent major depression in aging womenINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2010Stephanie Kasen Abstract Objective Despite evidence that stress exposure earlier in the life course may have long-term consequences for psychopathology, most models of vulnerability for late life depression are limited to current stressors or to retrospective reports of stress history. This study estimates the influences of earlier stressors assessed longitudinally on subsequent major depressive disorder (MDD) in women at average age 60 (range 50,75). Method MDD, negative life events (NLE), and marital stress were assessed multiple times in a community-based sample of 565 women followed for three decades. Adverse events experienced in childhood also were assessed prior to outcome. Results Greater childhood adversity, earlier high levels of NLE and marital stress, and a more rapid increase in marital stress over time elevated the odds of MDD at average age 60 independent of all stressors and other salient risk factors. Childhood adversity was mediated in part by intervening risks. Prior depression, earlier poor health status, a more rapid deterioration in health with age, and current disability owing to physical problems also were related independently to later MDD. Conclusions These findings support the enduring effects of earlier stress burden on MDD in women into old age and, in light of the increasing proportion of older women in the population, have important clinical implications for identification and treatment of those at risk for depression. Findings also underscore the need to develop resources to counteract or buffer similar stress exposure in younger generations of women. Copyright © 2009 John Wiley & Sons, Ltd. [source] Conservative management of an extensive renal graft subcapsular hematoma arising during living donor nephrectomy.JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2010Role of Doppler sonographic posttransplant follow-up Abstract We report a case of subcapsular hematoma (SH) of a kidney graft arising during minimal-incision living-donor nephrectomy. SH covered at least two-thirds of the cortical surface. Capsulotomy was not done because it was deemed too risky. In the immediate postoperative period, a rapid deterioration of graft function was observed associated with Doppler sonographic evidence of graft compression. However, in the following days, spontaneous resolution of SH and progressive improvement of Doppler findings was observed, which preceded full recovery of graft function. Conservative management seemed a valid approach of this complication in this case where Doppler sonography proved essential for the follow-up. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Sampling flower scent for chromatographic analysisJOURNAL OF SEPARATION SCIENCE, JSS, Issue 11 2008Elena E. Stashenko Abstract The analysis of flower volatiles requires special methods for their isolation with enrichment. Living flowers show a continuous change in their volatile profile that depends on intrinsic (genetic) and external (light, temperature, hydric stress) factors. Excised flowers suffer rapid deterioration and loss of volatiles. While industrial isolation methods for flower volatiles are well established, those at the laboratory-scale experience progressive development, in the search for higher sensitivity, reproducibility, and simplicity. This review covers the flower scent sampling methods most commonly employed during the last decade, and includes comments on their strengths and limitations. The strengths of headspace solid-phase microextraction (HS-SPME) for in vivo monitoring are emphasized with the examples of monitoring the circadian variation of Brugmansia suaveolens flower scent and of volatile aldehyde detection in flower scent using on-fiber derivatization. [source] The first Japanese patient with variant Creutzfeldt-Jakob disease (vCJD)NEUROPATHOLOGY, Issue 6 2009Akiyo Shinde Eleven years after a brief visit to some European countries, a 48-year-old Japanese man developed writing difficulty, irritability and general fatigue. Then he complained of dysesthetic pains in his legs, for which benzodiazepines were prescribed. However, at the time pulvinar sign was retrospectively confirmed on brain MRI. Eighteen months after the onset, his gait became ataxic with rapid deterioration of mental status over the following several months. Thirty-one months after the onset, he became akinetic and mute with periodic synchronous discharges on EEG, and died at the age of 51. The total clinical course was approximately 43 months. Pathological examination revealed the characteristic alterations of spongiform encephalopathy, severe in the thalamus, moderate but widely spread in the cerebral cortices, and moderate in the cerebellum. Abundant amyloid plaques were easily identified in the cerebral cortex and the cerebellum on HE staining. Immunohistochemistry for abnormal prion protein (PrPsc) confirmed amyloid plaques in several forms, such as florid, uni- and multi-centric plaques as well as perineuronal and periaxonal deposits in the basal ganglia and synaptic patterns in the thalami. A Western blotting study identified type 2B protease-resistant PrP. This is the first Japanese patient who was definitely diagnosed as variant Creutzfeldt-Jakob disease (vCJD). The pathological findings were similar to those of previous reports of vCJD in the UK. However, the changes were much more severe both in degree and distribution, probably due to a longer duration of the illness than those in the UK. [source] The feasibility and validity of forced spirometry in ataxia telangiectasia,,PEDIATRIC PULMONOLOGY, Issue 10 2010Daphna Vilozni PhD Abstract Objectives To explore the feasibility and validity of forced spirometry in patients with ataxia telangiectasia (A-T). Study design Twenty-eight patients (aged 3.7,19.3 years) performed spirometry on 47 occasions. Parameters studied were technical quality and relation to: predicted values, pulmonary illness. Results Start of test criteria for correct expiratory effort was significantly prolonged (183,±,115,ms; P,<,0.001). The rise-time to peak flow in children free of respiratory symptoms (Group-FRS; n,=,8) increased by 16.2,±,12.5,ms/year above recommended and in children having recurrent infections (n,=,8) 30.4,±,16.1,ms/year, P,<,0.01. Expiration-time was significantly shorter than requested (1.21,±,0.47,sec) and was ended abruptly in 57% of the patients. FEV1 could not be established by 8/20 patients. The intra-subject reproducibility met criteria (4.4,±,2.7%, 5.2,±,2.8%, 2.9,±,3.2%, 6.3,±,5.3%, for FVC, FEV0.5, PEF, FEF25,75, respectively). Group-FRS showed yearly deterioration in FVC of 2.2%, while patients with hyper-reactive airways (Group-HRA; n,=,12) had a deterioration rate of 3.6%/year. FEV0.5 deterioration rate was similar in both groups (2.2 and 2.0, respectively), but baseline values in Group-HRA were significantly lower than those of Group-FRS (P,=,0.029) in similar young ages, indicating airway obstruction at early ages in Group-HRA. FEV0.5 values deterioration also correlated with body mass index (P,<,0.017). Conclusion Forced spirometry in A-T patients is reproducible and has a distinct pattern, although curves do not meet other recommendations for acceptable criteria. The study insinuates that a rapid deterioration in lung function occurs in A-T patients with recurrent respiratory infection, suggesting that early intervention may prevent further deterioration or improve their lung function. Further studies are needed to confirm our results. Pediatr Pulmonol. 2010; 45:1030,1036. © 2010 Wiley-Liss, Inc. [source] Identification and quantitation of phenolic compounds in faecal matrix by capillary gas chromatography and nano-electrospray mass spectrometryRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 20 2006Ulrike Knust Very few relevant methods have been described for the detection and quantitation of phenolic compounds in faecal matrix. Extraction with conventional organic solvents such as chloroform/methanol (2:1, Folch reagent), methanol and ethanol (72%) showed high extraction efficiency for lipids and also gave good recovery of the major phenolic compounds present in the matrix. However, in comparison with a newly developed phosphate buffer method, the yield of minor phenolics was negligible when detected by these conventional methods. Conventional methods also lead to contamination of the ion source of the mass spectrometer and rapid deterioration of column performance mostly due to the high concentration of lipids. However, if the faecal matrix is initially extracted with phosphate buffer, and the extract acidified and re-extracted with diethyl ether, the range and yield of phenolic compounds are enhanced and the problem of lipid contamination is substantially alleviated. Following pilot studies and optimisation of the procedure, individual phenolic compounds (n,=,29) were identified by nano-electrospray ionisation mass spectrometry (nano-ESI-MS), nano-ESI-tandem mass spectrometry (MS/MS) and gas chromatography/mass spectrometry (GC/EI-MS) and quantitated (n,=,27) by GC/MS in subsets (n,=,5) of faecal samples, collected during the European Agency for Cancer Prevention calcium/fibre intervention study from four European countries (Italy, Germany, Spain and Denmark). A range of phenolic compounds (mainly acids) was detected, dominated by phenylacetic, benzoic, phenylpropionic and m -hydroxyphenylpropionic acids, representing on average 9.91 (93%), 8.25 (92%), 9.45 (95%) and 11.05 (98%) mM in the Italian, German, Spanish and Danish samples, respectively. The new method should enable large epidemiologic, case-control and intervention studies on the relevance of phenolic antioxidants in the aetiology of colorectal cancer to be conducted in the future. Copyright © 2006 John Wiley & Sons, Ltd. [source] Palliative care in aged care facilities for residents with a non-cancer disease: results of a survey of aged care facilities in South AustraliaAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2005Carol Grbich Objectives:,This study reports the results of a cross-sectional study of residential aged care facilities in South Australia which sought to quantify the extent of specialist palliative care involvement in residential aged care facilities as well as identifying the current need for palliative care. Method:,A questionnaire was completed by 51 Directors of Care from 51 of 90 facilities targeted, representing a response rate of 57% and representing 20% of the total number of South Australian licensed beds. Facilities responding were representative of residential aged care facilities in South Australia for location, type of funding and level of care. Results:,Thirty facilities (59%) used specialist palliative care services during 2001 with the average number of residents consulted being four. There were 627 deaths recorded in the 2785 licensed beds, a death rate of 23%. The majority of these deaths were from non-cancer diseases (83%) and up to two-thirds of all deaths occurred away from low care facilities, usually in an acute care setting. Main reasons for transfer away from the facility were; an acute care episode requiring other expertise, rapid deterioration of the resident, care needs beyond the facility, or the general practitioner or family requested a transfer. Care Directors estimated that 7% of their current residents would be considered palliative and the majority of these had non-cancer diseases (78%). Conclusion:,These findings indicate that palliative care is an important aspect of care in residential aged care facilities for clients with a non-cancer diagnosis. [source] Etanercept combined with methotrexate for high-need psoriasisBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008R.J.B. Driessen Summary Background, For some high-need psoriatic patients, the efficacy of etanercept monotherapy is insufficient. In these cases it might be indicated to combine etanercept with other conventional treatments. Objectives, To provide daily practice safety and efficacy data for etanercept and methotrexate combination therapy. Methods, Data were extracted from an existing database, which contains prospective safety and efficacy data of all patients who were treated with etanercept in clinical practice. A case was defined as a patient using etanercept and methotrexate simultaneously for an indefinite period during follow-up. For all cases, baseline data, Psoriasis Area and Severity Index (PASI) scores, adverse events and laboratory values were investigated. Furthermore, the influence of introduction and discontinuation of methotrexate on these parameters was analysed. Results, Fourteen patients with simultaneous use of etanercept and methotrexate were selected. In six patients, methotrexate was introduced after etanercept to avoid further psoriasis deterioration, which resulted in an improvement of psoriasis in four of these patients. Eight patients were on methotrexate therapy before start of etanercept. Discontinuation of methotrexate in six of these patients resulted in a decrease in PASI improvement in five patients. Etanercept combined with methotrexate was well tolerated, and only mild adverse events were reported. No clinically significant changes in laboratory parameters occurred. Conclusions, Results show that combining etanercept with methotrexate is reasonable when efficacy of etanercept monotherapy is insufficient, or when rapid deterioration of psoriasis after abrupt discontinuation of methotrexate is expected. Laboratory values and adverse events were not different from what would have been expected when using methotrexate alone. [source] Shifting Paradigms in Corporate Environmentalism: From Poachers to GamekeepersBUSINESS AND SOCIETY REVIEW, Issue 3 2010SUKHBIR SANDHU ABSTRACT This article provides an insight into the changing role of businesses in dealing with the natural environment issues. From being regarded as poachers of the natural environment, many businesses have now started to position themselves as gamekeepers of the natural environment. This article traces the events and factors that have contributed toward this shift. The article starts with an introduction to the current state of the natural environment. It then discusses the role that businesses have traditionally played in contributing toward the rapid deterioration of the natural environment. The article then traces the events that have gradually resulted in businesses accepting that they have a responsibility to address environmental issues. This is followed by an overview of the business responses, to the risks and opportunities, posed by changes in the natural environment. The article then provides a brief overview of the various phase models that attempt to categorize business responses to environmental issue. The conclusion focuses on the challenges that lie ahead. [source] Peritubular capillary C4d deposition and renal outcome in post-transplant IgA nephropathyCLINICAL TRANSPLANTATION, Issue 2 2007Jung Choi Abstract:, Backgrounds:, Immunological staining of the transplanted kidney for C4d in peritubular capillaries (C4dPTC) has emerged as a useful method to detect antibody-mediated rejection in situ. In this retrospective study, we evaluated the prevalence of C4dPTC deposition in allograft renal biopsies diagnosed of IgA nephropathy (IgAN) and analysed its clinical significance. Method:, Sixty-six biopsy specimens of post-transplant IgAN, which were obtained to evaluate azotemia and/or heavy proteinuria, were examined by immunohistochemical staining of the paraffin sections with polyclonal antibody for C4d. Results:, C4d was stained positively in peritubular capillaries in 16 (24%) of the 66 cases. The C4dPTC -negative (n=50) and C4dPTC -positive groups (n=16) were not different in recipient gender, age, donor age, type of donor (living vs. cadaveric), interval from transplantation to graft biopsy (41.6± 21.8 vs. 48.3±26.1 months) and post-biopsy follow-up period (60.3±23.3 vs. 56.9±25.4 months). During the follow-up period, 12 of 50 (24%) although the incidence of graft failure was not different by the C4d deposition in peritubular capillaries, intervals from renal biopsy to graft failure tended to be shorter in C4dPTC -positive cases than C4dPTC -negative cases. In Kaplan,Meier analysis, the renal allograft function of the C4dPTC -positive group deteriorated more rapidly than that of the C4dPTC -negative group (p<0.05). Histologically, the C4dPTC -positive group had findings suggestive of acute cellular rejection more commonly than the C4dPTC -negative group (p<0.01). Conclusions:, Evidence of humoral rejection, as demonstrated by C4dPTC deposition, was concurrently present in significant portions of post-transplant IgAN biopsy specimens and was associated with more rapid deterioration of renal function. These results suggest that C4dPTC positivity needs to be determined at the time of biopsy even in cases of post-transplant glomerulonephritis and immunosuppression may need to be modified accordingly. [source] | |||||||||||||