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Selected AbstractsEquilibrium and growth shapes of crystals: how do they differ and why should we care?CRYSTAL RESEARCH AND TECHNOLOGY, Issue 4-5 2005Robert F. SekerkaArticle first published online: 15 MAR 200 Abstract Since the death of Prof. Dr. Jan Czochralski nearly 50 years ago, crystals grown by the Czochralski method have increased remarkably in size and perfection, resulting today in the industrial production of silicon crystals about 30 cm in diameter and two meters in length. The Czochralski method is of great technological and economic importance for semiconductors and optical crystals. Over this same time period, there have been equally dramatic improvements in our theoretical understanding of crystal growth morphology. Today we can compute complex crystal growth shapes from robust models that reproduce most of the features and phenomena observed experimentally. We should care about this because it is likely to result in the development of powerful and economical design tools to enable future progress. Crystal growth morphology results from an interplay of crystallographic anisotropy and growth kinetics by means of interfacial processes and long-range transport. The equilibrium shape of a crystal results from minimizing its anisotropic surface free energy under the constraint of constant volume; it is given by the classical Wulff construction but can also be represented by an analytical formula based on the ,-vector formalism of Hoffman and Cahn. We now have analytic criteria for missing orientations (sharp corners or edges) on the equilibrium shape, both in two (classical) and three (new) dimensions. Crystals that grow under the control of interfacial kinetic processes tend asymptotically toward a "kinetic Wulff shape", the analogue of the Wulff shape, except it is based on the anisotropic interfacial kinetic coefficient. If it were not for long range transport, crystals would presumably nucleate with their equilibrium shape and then evolve toward their "kinetic Wulff shape". Allowing for long range transport leads to morphological instabilities on the scale of the geometric mean of a transport length (typically a diffusivity divided by the growth speed) and a capillary length (of the order of atomic dimensions). Resulting crystal growth shapes can be cellular or dendritic, but can also exhibit corners and facets related to the underlying crystallographic anisotropy. Within the last decade, powerful phase field models, based on a diffuse interface, have been used to treat simultaneously all of the above phenomena. Computed morphologies can exhibit cells, dendrites and facets, and the geometry of isotherms and isoconcentrates can also be determined. Results of such computations are illustrated in both two and three dimensions. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Hemidesmosome protein dynamics in live epithelial cellsCYTOSKELETON, Issue 2 2003Daisuke Tsuruta Abstract Hemidesmosomes mediate stable anchorage of epithelial cells to laminin-5 in the basement membrane zone and have been likened to spot-welds. Indeed, it has been assumed that hemidesmosomes are not dynamic, at least when compared to other matrix adhesion sites including focal contacts. We tested this notion by monitoring the fate of green fluorescent protein (GFP)-tagged human integrin ,4 subunit (GFP-h,4) and GFP-tagged 180-kD human bullous pemphigoid (BP) autoantigen (GFP-BP180) in live cultures of 804G cells that assemble numerous mature hemidesmosomes. In subconfluent 804G cells, both GFP-h,4 and GFP-BP180 protein clusters are not stable but assemble into and disassemble out of cat paw,like arrays at a relatively rapid rate. In confluent populations of 804G cells, although some cat paw,like clusters of both GFP-h,4 and GFP-BP180 are stable over periods of >60 min, other GFP-h,4 and GFP-BP180 protein arrays form and/or disappear during the same time period. Moreover, individual labeled particles show considerable motility in the plane of the membrane. Fluorescence recovery after photobleaching analyses provide a further indication of the dynamics of hemidesmosome proteins. In particular, bleached GFP-h,4 protein clusters in confluent cells recover signal within about 30 min, indicating that there is a relatively rapid turnover of hemidesmosome components in protein arrays clustered along the substratum attached surface of a cell. The rate of recovery is dependent on an intact microfilament system. In sharp contrast, bleached GFP-BP180 protein clusters in confluent cells fail to recover signal even when observed for longer than 60 min. To evaluate hemidesmosome protein dynamics in motile cells, we monitored GFP-h,4 and GFP-BP180 in 804G cells populating scrape wound sites in vitro. In these migratory cells, which lack mature hemidesmosomes, integrin ,4 subunit and BP180 protein clusters progressively assemble and disassemble into linear and cat-paw arrays. In summary, hemidesmosome protein clusters, like their counterparts in focal contacts, are dynamic. We discuss these results in relation to hemidesmosome functions. Cell Motil. Cytoskeleton 54:122,134, 2003. © 2003 Wiley-Liss, Inc. [source] Surgery for temporal lobe epilepsy associated with mesial temporal sclerosis in the older patient: A long-term follow-upEPILEPSIA, Issue 6 2010Michael Murphy Summary Purpose:, To assess the outcomes from temporal lobectomy for hippocampal sclerosis in patients 50 years or older. Controversy exists as to the suitability of older patients for epilepsy surgery, with most of the previous studies demonstrating a correlation between increasing age and poor outcome. However, the inclusion of temporal lobe epilepsy of multiple etiologies has confounded many previous studies of this age group. Methods:, Twenty-one patients aged 50 years or older (mean 54.9 years) at the time of surgery were included in the study group. All patients had a pathologic diagnosis of hippocampal sclerosis. A retrospective analysis was performed comparing seizure outcomes following a standardized anterior temporal lobectomy with those from 103 patients younger than 50 (mean age 34.7 years) operated upon over the same time period. The mean follow-up period for the study was 9.57 years. Results:, Twenty of the 21 patients in the older group (95.2%) had a satisfactory seizure outcome (Engel classes I and II) compared with 90.3% of the younger patients. There was no statistically significant difference in the outcomes between the two groups (p = 0.719). Across both groups of patients combined, there was no significant difference between the mean age in the patients with a satisfactory seizure outcome compared to those with an unsatisfactory outcome (38.3 vs. 34.7 years, p = 0.213). Discussion:, Patients 50 years or older with intractable seizures from hippocampal sclerosis have seizure outcomes following temporal lobectomy that are comparable to young patients over the long term. Older patients should not be denied treatment on the basis of age. [source] Blood morphine levels in naltrexone-exposed compared to non-naltrexone-exposed fatal heroin overdosesADDICTION BIOLOGY, Issue 3 2003DIANE ARNOLD-REED The aim of this study was to investigate the association between prior exposure to naltrexone and increased risk of fatal heroin overdose using a review of toxicology reports for heroin-related fatalities between July 1997 to August 1999 for two groups: those treated with oral naltrexone and those who were not treated. Additional information for the oral naltrexone group was obtained from clinic files. Naltrexone-treated deaths were identified from the patient database at the Australian Medical Procedures Research Foundation (AMPRF), Perth, Western Australia (WA) through the Western Australian Department of Health, Data Linkage Project. Non-treated cases were identified from the database at the Forensic Science Laboratory, State Chemistry Centre (WA). We identified and investigated blood morphine concentrations following 21 fatal heroin overdoses with prior exposure to naltrexone and in 71 non-naltrexone-exposed cases over the same time period. The proportion of deaths where heroin use was a major contributing factor was little different in the non-naltrexone compared to the naltrexone-exposed group. Furthermore, in ,acute opiate toxicity' deaths, blood morphine levels were lower in non-naltrexone-exposed compared with naltrexone-exposed cases. Although there was a higher number of deaths designated as rapid (i.e. occurring within 20 minutes) in the naltrexone-exposed (89%) compared with the non-exposed group (72%) this was not statistically significant. Other drug use in relation to heroin-related fatalities is discussed. Findings do not support the hypothesis that prior exposure to naltrexone increases sensitivity to heroin toxicity. [source] The strength of anticipatory spatial biasing predicts target discrimination at attended locations: a high-density EEG studyEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2009Simon P. Kelly Abstract Cueing relevant spatial locations in advance of a visual target results in modulated processing of that target as a consequence of anticipatory attentional deployment, the neural signatures of which remain to be fully elucidated. A set of electrophysiological processes has been established as candidate markers of the invocation and maintenance of attentional bias in humans. These include spatially-selective event-related potential (ERP) components over the lateral parietal (around 200,300 ms post-cue), frontal (300,500 ms) and ventral visual (> 500 ms) cortex, as well as oscillatory amplitude changes in the alpha band (8,14 Hz). Here, we interrogated the roles played by these anticipatory processes in attentional orienting by testing for links with subsequent behavioral performance. We found that both target discriminability (d') and reaction times were significantly predicted on a trial-by-trial basis by lateralization of alpha-band amplitude in the 500 ms preceding the target, with improved speed and accuracy resulting from a greater relative decrease in alpha over the contralateral visual cortex. Reaction time was also predicted by a late posterior contralateral positivity in the broad-band ERP in the same time period, but this did not influence d'. In a further analysis we sought to identify the control signals involved in generating the anticipatory bias, by testing earlier broad-band ERP amplitude for covariation with alpha lateralization. We found that stronger alpha biasing was associated with a greater bilateral frontal positivity at ,390 ms but not with differential amplitude across hemispheres in any time period. Thus, during the establishment of an anticipatory spatial bias, while the expected target location is strongly encoded in lateralized activity in parietal and frontal areas, a distinct non-spatial control process seems to regulate the strength of the bias. [source] Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activityEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2007Michelle A. Ommerborn The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects. [source] Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: A national survey from DAHANCAHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2003Cai Grau MD, DMSc Objective. In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. Patients. A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987,June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. Results. Median time between radiotherapy and laryngectomy was 10 months (range, 1,348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987,1992 vs 1993,1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. Conclusions. The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine. © 2003 Wiley Periodicals, Inc. Head Neck 25: 711,716, 2003 [source] Floral resources impact longevity and oviposition rate of a parasitoid in the fieldJOURNAL OF ANIMAL ECOLOGY, Issue 3 2008Jana C. Lee Summary 1The use of floral resource subsidies to improve herbivore suppression by parasitoids requires certain trophic interactions and physiological changes to occur. While the longevity and fecundity of parasitoids are positively affected by nectar subsidies in laboratory studies, the impacts of floral subsidies on the fecundity and longevity of freely foraging parasitoids have not been studied. 2We studied the longevity and per capita fecundity of naturally occurring Diadegma insulare foraging in cabbage plots with and without borders of flowering buckwheat, Fagopyrum esculentum, as well as relationships between longevity, fecundity, sugar feeding and parasitism rates on larvae of the diamondback moth, Plutella xylostella. 3Relative longevity was estimated by counting broken setae on the fringe of the forewing. Floral borders increased the longevity of males and females in adjacent cabbage plots. 4The egg maturation rate of D. insulare was estimated by comparing egg loads of females collected early in the day with egg loads of females held without hosts in field cages throughout the day. Females in buckwheat cages matured 2·7 eggs per hour while females in control cages resorbed 0·27 eggs over the same time period. 5The fecundity of females collected in the afternoon was estimated by comparing their actual egg load to the estimated egg load in the absence of oviposition for females in a given plot. Females foraging in buckwheat plots had marginally fewer eggs remaining in their ovaries, and laid marginally more eggs than females in control plots. Females from both treatments carried 30,60 eggs by the afternoon and therefore were time-limited rather than egg-limited. 6Plots where a greater proportion of females had fed on sugar had longer-lived females. This suggests that feeding enhanced longevity of D. insulare. However, plots with longer-lived and more fecund females did not exhibit higher parasitism rates, although the power of these tests were low. [source] Comparative analysis of cost factors in sturgeon fingerling production in Iranian hatcheries (2000,2004)JOURNAL OF APPLIED ICHTHYOLOGY, Issue 5 2009H. Salehi Summary Production cost analysis in aquaculture is an essential exercise to assist farm managers. Economic assessment of a farm operation also provides the basis to formulate governmental aquaculture and enhancement policies in many regions. The present study employed questionnaires and interviewed managers while also using governmental statistics to gain insight into production cost variables in Iranian sturgeon hatcheries. Within a decade, production of sturgeon fingerlings for release and stock enhancement increased in Iran to more than 21 million fingerlings by 2004. Costs and contributions of various production factors were determined using data obtained from a questionnaire involving all hatcheries between 2000 and 2004. A team of experts completed the questionnaire data sets while conducting interviews at all sturgeon centres and other related departments. From 2000 to 2004 the contribution of A. persicus was 79% of the total number of sturgeon fingerlings produced followed by A. nudiventris with 7.5% and Huso huso with 6.6%. Among the various expenditures between 2000 and 2004, the costs for permanent and part-time employees contributed the greatest share of total costs, averaging 44%, with a noticeable declining trend from 51% in 2000 to 36% in 2004. Obtaining and incubating fertilized eggs averaged 22% of total costs, increasing during the same time period from 6 to 35%, respectively. On average, the 2000,2004 production cost for a single sturgeon fingerling was estimated at Rials 1667 (US$ 0.20), increasing from Rials 992 (US$ 0.12) to Rials 2623 (US$ 0.29) over these 4 years. Permanent staff at a hatchery was determined as being the principal cost, followed by costs for obtaining fertilized eggs (including broodstock handling). Over the 5-year study period the results indicated that costs for part-time labour declined yearly and, conversely, the costs of obtaining broodstocks as well as fertilizing and incubating eggs increased. Considering the background of hatchery production and stock enhancement of sturgeon species and the results of fishing data, it is possible to arrive at a first estimate of the potential contribution of Persian sturgeon farming to the total catch in Iranian waters; it is assumed that these increases were most likely through stock enhancement. [source] Investigation of the genetic diversity among isolates of Salmonella enterica serovar Dublin from animals and humans from England, Wales and IrelandJOURNAL OF APPLIED MICROBIOLOGY, Issue 5 2002E. Liebana Aims: To assess the degree of genetic diversity among animal Salmonella Dublin UK isolates, and to compare it with the genetic diversity found among human isolates from the same time period. Methods and Results: One hundred isolates (50 human and 50 animal) were typed using plasmid profiling, XbaI-pulsed field gel electrophoresis (PFGE) and PstI- SphI ribotyping. Antimicrobial resistance data to 16 antibiotics was presented, and the presence of class-I integrons was investigated by real-time PCR. Seven different plasmid profiles, 19 ribotypes and 21 PFGE types were detected. A combination of the three methods allowed clear differentiation of 43 clones or strains. Eighteen isolates were resistant to at least one antimicrobial; five of them were multi-resistant and of these, only three presented class I integrons. Conclusions: Ribotyping data suggest the existence of at least three very different clonal lines; the same distribution in well-defined groups was not evident from the PFGE data. The existence of a variety of clones in both animals and humans has been demonstrated. A few prevalent clones seem to be widely disseminated among different animal species and show a diverse geographical and temporal distribution. The same clones were found in animals and humans, which may infer that both farm and pet animals may act as potential vehicles of infection for humans. Some other clones seem to be less widely distributed. Clustering analysis of genomic fingerprints of Salmonella Dublin and Salm. Enteritidis isolates confirms the existence of a close phylogenetic relationship between both serotypes. Significance and Impact of the Study: This paper describes the utility of a multiple genetic typing approach for Salm. Dublin. It gives useful information on clonal diversity among human and animal isolates. [source] Increased CaV,1a expression with aging contributes to skeletal muscle weaknessAGING CELL, Issue 5 2009Jackson R. Taylor Summary Ca2+ release from the sarcoplasmic reticulum (SR) into the cytosol is a crucial part of excitation,contraction (E-C) coupling. Excitation,contraction uncoupling, a deficit in Ca2+ release from the SR, is thought to be responsible for at least some of the loss in specific force observed in aging skeletal muscle. Excitation,contraction uncoupling may be caused by alterations in expression of the voltage-dependent calcium channel ,1s (CaV1.1) and ,1a (CaV,1a) subunits, both of which are necessary for E-C coupling to occur. While previous studies have found CaV1.1 expression declines in old rodents, CaV,1a expression has not been previously examined in aging models. Western blot analysis shows a substantial increase of CaV,1a expression over the full lifespan of Friend Virus B (FVB) mice. To examine the specific effects of CaV,1a overexpression, a CaV,1a -YFP plasmid was electroporated in vivo into young animals. The resulting increase in expression of CaV,1a corresponded to decline of CaV1.1 over the same time period. YFP fluorescence, used as a measure of CaV,1a -YFP expression in individual fibers, also showed an inverse relationship with charge movement, measured using the whole-cell patch-clamp technique. Specific force was significantly reduced in young CaV,1a -YFP electroporated muscle fibers compared with sham-electroporated, age-matched controls. siRNA interference of CaV,1a in young muscles reduced charge movement, while charge movement in old was restored to young control levels. These studies imply CaV,1a serves as both a positive and negative regulator CaV1.1 expression, and that endogenous overexpression of CaV,1a during old age may play a role in the loss of specific force. [source] Structural adjustment and soil degradation in Tanzania A CGE model approach with endogenous soil productivityAGRICULTURAL ECONOMICS, Issue 3 2001Henrik Wiig CGE model; Soil degradation; Economic growth; Structural adjustment Abstract In this paper, a model of the nitrogen cycle in the soil is incorporated in a Computable General Equilibrium (CGE) model of the Tanzanian economy, thus establishing a two-way link between the environment and the economy. For a given level of natural soil productivity, profit-maximising farmers choose input levels , and hence production volumes , which in turn influence soil productivity in the following years through the recycling of nitrogen from the residues of roots and stover and the degree of erosion. The model is used to simulate the effects of typical structural adjustment policies like a reduction in agro-chemicals' subsidies, reduced implicit export tax rate etc. After 10 years, the result of a joint implementation is a 9% higher Gross Domestic Product (GDP) level compared to the baseline scenario. The effect of soil degradation is found to represent a reduction in the GDP level of more than 5% for the same time period. [source] Prenatal Stretching Exercise and Autonomic Responses: Preliminary Data and a Model for Reducing PreeclampsiaJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2010SeonAe Yeo RNC Abstract Purpose: Preeclampsia is a leading cause of perinatal mortality and morbidity, and it increases maternal risk for future cardiovascular disease. The purpose of the study was to explore the relationships among stretching exercise, autonomic cardiac response, and the development of preeclampsia. Design: Secondary data analysis. Methods: Heart rate and pulse pressure were longitudinally examined in this secondary data analysis among women who engaged in stretching exercise daily from 18 weeks of gestation to the end of pregnancy compared with women who did walking exercise daily during the same time period. A total of 124 women were randomized to either stretching (n=60) or walking (n=64) in the parent study. Findings: Heart rates in the stretching group were consistently lower than those in the walking group. Conclusions: Based on the results of this secondary data analyses, a physiologic framework for possible beneficial effects of stretching exercise by enhancing autonomic responses on reducing risks for preeclampsia is proposed and discussed. Clinical Relevance: If the protective effect is established, stretching exercise can be translated into nursing intervention for prenatal care. [source] Representations of nature of science in high school chemistry textbooks over the past four decadesJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 7 2008Fouad Abd-El-Khalick Abstract This study assessed the representations of nature of science (NOS) in high school chemistry textbooks and the extent to which these representations have changed during the past four decades. Analyses focused on the empirical, tentative, inferential, creative, theory-driven, and social NOS, in addition to the myth of "The Scientific Method," the nature of scientific theories and laws, and the social and cultural embeddedness of science. A total of 14 textbooks, including five "series" spanning one to four decades, were analyzed. The textbooks commanded significant market shares in the United States and were widely used in some of the most populace states. Relevant textbook sections were scored on each of the target NOS aspects on a scale ranging from ,3 to +3, which reflected the accuracy, completeness, and manner (explicit versus implicit) in which these aspects were addressed. The textbooks fared poorly in their representations of NOS. Additionally, with a few exceptions, textbook scores either did not change or decreased over the past four decades. These trends are incommensurate with the discourse in national and international science education reform documents, which has witnessed an increasing emphasis on the centrality of NOS to scientific literacy and pre-college science education during the same time period. Assessment and evaluation strategies, and policies need to be targeted if substantial and desired changes in the ways NOS is addressed in science textbooks are to be effected. © 2008 Wiley Periodicals, Inc. J Res Sci Teach 45: 835,855, 2008 [source] Prospective study of zonisamide therapy for refractory idiopathic epilepsy in dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2007T. Von Klopmann Objectives: Investigation of the efficacy of zonisamide as an add-on therapy in dogs with refractory epilepsy. Methods: Thirteen dogs fulfilled the inclusion criteria of poor seizure control despite adequate serum levels of phenobarbital, potassium bromide or both. One further dog was treated with zonisamide as monotherapy because of severe blood dyscrasia due to phenobarbital treatment. Various seizure parameters were evaluated retrospectively for a four month period without zonisamide and prospectively for the same time period under zonisamide add-on therapy. The study time period was extended by up to 17 months to evaluate long-term outcome. Results: Data of 11 dogs could be evaluated: nine of them were responders. The median reduction of seizure frequency of all dogs on zonisamide add-on therapy was 70 per cent (range 14 to 100 per cent). Only transient central nervous system side effects were reported. No further increase of liver enzymes occurred. In three of the responder dogs, seizure control subsided after individual time periods (between 69 days and seven months). Clinical Significance: In dogs with refractory epilepsy, zonisamide may have a beneficial effect on seizure control. In three responder dogs, seizure activity relapsed possibly because of an induction of tolerance. Limiting factors are the high costs. [source] Exocrine pancreatic insufficiency as an end stage of pancreatitis in four dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 7 2003P. J. Watson Chronic pancreatitis is a common cause of exocrine pancreatic insufficiency (EPI) in humans and cats but is rarely recognised in dogs in which pancreatic acinar atrophy (PAA) is reportedly more common. This paper describes four dogs which developed EPI secondary to pancreatitis. Two of the dogs also had diabetes mellitus which developed before EPI. One diabetic dog had concurrent hyperadrenocorticism and was euthanased five months after presentation; the other diabetic dog died 48 months after diagnosis. The remaining dogs were alive 78 and 57 months after diagnosis. The number of affected dogs was comparable to the number of cases of presumed PAA seen over the same time period in the same institution. Chronic pancreatitis may be a more common cause of EPI in dogs than previously assumed and may be under-recognised because of difficulties in diagnosis. The relative importance of chronic pancreatitis as a cause of canine diabetes mellitus remains to be ascertained. [source] Pediatric Travel Consultation in an Integrated ClinicJOURNAL OF TRAVEL MEDICINE, Issue 1 2001John C. Christenson Background: In May 1997, a pediatric travel service was created within a larger integrated University-County Health Department international travel clinic. The purpose of the service was to further enhance the travel advice and care provided to children and their parents or guardians. The current study was designed to describe the care of children in this setting and to compare the care of children seen in the Pediatric Travel Service with that of children seen by other providers. Methods: All pediatric patients (defined as individuals , 18 years of age) receiving care in the travel clinic were considered candidates for inclusion in the analysis. Patients seen by the Pediatric Travel Service were compared to those seen by other staff members in the travel clinic (referred to as Regular Clinic). The following information was noted: basic demographic data, medical history including allergies, prior immunization records, intended place and duration of travel, and immunizations and medications prescribed at the time of visit. Travel advice covering water and food precautions, preventive measures against insect bites, injury prevention, malaria prevention, prevention of parasitic infections, and environmental-related problems was provided to all patients in both groups when necessary. Results: Between May 1997 and December 1999, 287 pediatric age individuals were given pretravel care by the Pediatric Travel Service (median age, 6 years; range, 1 month-18 years). During the same time period, 722 pediatric age travelers (median age, 14 years; range, 8 months-18 years) were evaluated in the Regular Clinic by other staff members. Travel destinations most commonly traveled by both groups in descending order were: Africa, Central America and Mexico, South America, and Southeast Asia. When compared to travelers seen in the Regular Clinic, individuals in the Pediatric Travel Service group were more likely to travel for humanitarian work, and for parental work relocation. Persons in the Regular Clinic were more likely to travel to Mexico and Central America. They were also more likely to travel on vacation and for missionary work or study. Hepatitis B and tetanus-diphtheria booster vaccinations were given more frequently to travelers seen in the Regular Clinic. Also, ciprofloxacin and antimotility agents were more commonly prescribed in this group. No differences were noted in the duration of travel or in the time interval between clinic visit and departure. Conclusions: While general travel advice was considered to be similar in both clinic groups, some differences were observed in the frequency of administration of certain vaccines and prescriptions of medications. These differences were likely due to a difference in age in the two study groups. The high volume and success of the clinic suggest that integrated pediatric and adult travel services in a coordinated setting can be effective. [source] Fulminant liver failure from acute autochthonous hepatitis E in France: description of seven patients with acute hepatitis E and encephalopathyJOURNAL OF VIRAL HEPATITIS, Issue 5 2007J. M. Péron Summary., Fulminant hepatitis E has not been well characterized in industrialized countries. The aim of this study was to prospectively describe patients with acute hepatitis E presenting as fulminant hepatic failure, i.e. with encephalopathy and prothrombin index <50%. Between February 1997 and April 2005, seven patients with encephalopathy were diagnosed with acute hepatitis E using viral RNA detection. These patients were compared with 33 patients diagnosed with a mild form (absence of encephalopathy) of acute hepatitis E during the same time period. Patients were 65 ± 11 years old. Five were active drinkers and six had chronic liver disease. All hepatitis E virus sequences evaluated (5/7) were of genotype 3. All patients but two died (71%). Four patients had no travel history. When compared with patients with a mild form of acute hepatitis E, active alcohol abuse and chronic liver disease were more frequent in patients with the severe form. Duration of hospitalization was longer. Aspartate transferase and bilirubin levels were significantly higher. Prothrombin index and accelerin levels were lower and death was more frequent. Acute nontravel-associated hepatitis E can appear as fulminant hepatitis with encephalopathy and coagulation disorders. Prognosis is severe and this may be due to the age at which it occurs and frequent underlying chronic liver disease. [source] Emergency hospital admissions in idiopathic Parkinson's diseaseMOVEMENT DISORDERS, Issue 9 2005Henry Woodford BSc Abstract Little is known about the hospital inpatient care of patients with idiopathic Parkinson's disease (PD). Here, we describe the features of the emergency hospital admissions of a geographically defined population of PD patients over a 4-year period. Patients with PD were identified from a database for a Parkinson's disease service in a district general hospital with a drainage population of approximately 180,000. All admissions of this patient subgroup to local hospitals were found from the computer administration system. Two clinicians experienced in both general medicine and PD then reviewed the notes to identify reasons for admission. Admission sources and discharge destinations were recorded. Data regarding non-PD patients was compared to PD patients on the same elderly care ward over the same time period. The total number of patients exposed to analysis was 367. There was a total exposure of 775.8 years and a mean duration of 2.11 years per patient. There were 246 emergency admissions to the hospital with a total duration of stay of 4,257 days (mean, 17.3 days). These days were accounted for by 129 patients (mean age, 78 years; 48% male). PD was first diagnosed during 12 (4.9%) of the admissions. The most common reasons for admission were as follows: falls (n = 44, 14%), pneumonia (n = 37, 11%), urinary tract infection (n = 28, 9%), reduced mobility (n = 27, 8%), psychiatric (n = 26, 8%), angina (n = 21, 6%), heart failure (n = 20, 6%), fracture (n = 14, 4%), orthostatic hypotension (n = 13, 4%), surgical (n = 13, 4%), upper gastrointestinal bleed (n = 10, 3%), stroke/transient ischemic attack (n = 8, 2%), and myocardial infarction (n = 7, 2%). The mean length of stay for the PD patients on the care of elderly ward specializing in PD care was 21.3 days compared to 17.8 days for non-PD patients. After hospital admission, there was a reduction in those who returned to their own home from 179 to 163 and there was an increase in those requiring nursing home care from 37 to 52. Infections, cardiovascular diseases, falls, reduced mobility, and psychiatric complications accounted for the majority of admissions. By better understanding the way people with PD use hospital services, we may improve quality of care and perhaps prevent some inpatient stays and care-home placements. © 2005 Movement Disorder Society [source] Presentation and management of major complications of midurethral slings: Are complications under-reported?,NEUROUROLOGY AND URODYNAMICS, Issue 1 2007Donna Y. Deng Abstract Aims Midurethral slings have become the mainstay of stress urinary incontinence (SUI) treatment due to their efficacy and low complication rates. The purpose of this study was to report the presentation and treatment of major complications from these minimally invasive treatments presented to a tertiary referral practice and to highlight a discrepancy in major complications between literature and the food and drug administration (FDA) device failure database. Methods From 2001 through 2005, we reviewed all cases of midurethral sling complications that presented to our institution. A literature review of all complications due to midurethral slings during the same time period was performed as was the FDA manufacturer and user facility device experience (MAUDE) database queried for self-reported complications. Results A total of 26 patients referred to UCLA with voiding dysfunction after sling placement was found to have mesh in the urethra or bladder. Treatments required a combination of urethrolysis with mesh removal, urethral reconstruction with graft, and bladder excision. These were compared to major complications reported in the world literature of <1%. The MAUDE database contained 161 major complications out of a total of 928 complications reported for suburethral slings. There was significantly more major complications reported in MAUDE than in published literature. Conclusions Although rare, major complications of midurethral slings are more common than appear in literature. Devastating complications involving urethral and bladder perforations can present with mild urinary symptoms and thus are likely under-diagnosed and under-reported. Most of these cases need to be managed with additional reconstructive surgery. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] Interactions between habitat quality and connectivity affect immigration but not abundance or population growth of the butterfly, Parnassius smintheusOIKOS, Issue 10 2009Stephen F. Matter Habitat geometry has been a primary focus in studies of spatially structured systems. Recent studies have indicated that a more comprehensive approach including habitat quality may be needed, however most previous studies have neglected potential interactions between quality and geometry. We investigated the effects of habitat quality for the butterfly Parnassius smintheus among a series of 17 sub-populations. Specifically, we examined how habitat connectivity and local nectar flower density affect dispersal, and local population abundance and growth. We first determined which flower species were potentially important by examining nectar flower electivity and then quantified nectar flower density in meadows over a five year period (2003,2007). These data along with meadow connectivity were compared to local population statistics derived from mark,recapture over the same time period. The number of immigrants to a meadow increased as meadow connectivity increased, but showed no direct relationship with nectar flower density; however, there was a significant interaction between meadow connectivity and nectar flower density such that meadows with high connectivity and a high density of nectar flowers received the greatest number of immigrants. The number of emigrants from a meadow increased with increasing habitat quality and connectivity, but showed no interactive effect. The abundance of butterflies increased with meadow connectivity, but showed no relationship with habitat quality or any interactive effect. Separate experiments showed that access to nectar flowers significantly increased female reproductive output, but not lifespan. Despite the effects on immigration and reproductive output, local population growth rates also showed no relationship to nectar flower density. Our results indicate that habitat quality can be important for immigration in spatially structured populations; however, effects of habitat quality may not necessarily translate into higher abundance or population growth. Additionally, habitat quality should not be considered independently from habitat isolation, particularly if it directly affects dispersal. Preserving or augmenting habitat quality will do little to bolster immigration or colonization without adequate connectivity. [source] Idiotype-pulsed antigen presenting cells following autologous transplantation for multiple myeloma may be associated with prolonged survival,AMERICAN JOURNAL OF HEMATOLOGY, Issue 12 2009Martha Q. Lacy Vaccines are attractive as consolidation therapy after autologous stem cell transplantation (ASCT) for multiple myeloma (MM). We report the results of a phase II trial of the immunotherapeutic, APC8020 (MylovengeÔ), given after ASCT for MM. We compared the results with that of other patients with MM who underwent ASCT at Mayo Clinic during the same time period. Twenty-seven patients were enrolled on the trial between July, 1998 and June, 2001, and the outcomes were compared to that of 124 consecutive patients transplanted during the same period, but not enrolled on the trial. The median (range) follow-up for patients still alive from the vaccine trial is 6.5 (2.9,8 years), and 7.1 (6,8 years) in the control group. The median age was 57.4 range (36.1,71.3) in the DB group and 56.4 (range, 30,69) in the trial group. Known prognostic factors including PCLI, B2M, and CRP were comparable between the groups. The median overall survival for the trial patients was 5.3 years (95% CI: 4.0 years,N/A) compared to 3.4 years (95% CI: 2.7,4.6 years) for the DB group (P = 0.02). The median time to progression and progression-free survival for the trial group was similar to the DB group. Although not a controlled trial, the vaccines given after ASCT appear to be associated with improved overall survival compared to historical controls. This approach warrants further investigation to confirm this and define the role of vaccine therapy in myeloma. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source] Increasing deaths from opioid analgesics in the United States,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2006Leonard J. Paulozzi MD Abstract Purpose Since 1990, numerous jurisdictions in the United States (US) have reported increases in drug poisoning mortality. During the same time period, the use of opioid analgesics has increased markedly as part of more aggressive pain management. This study documented a dramatic increase in poisoning mortality rates and compared it to sales of opioid analgesics nationwide. Methods Trend analysis of drug poisoning deaths using underlying cause of death and multiple cause of death mortality data from the Centers for Disease Control and Prevention and opioid analgesic sales data from the US Drug Enforcement Administration. Results Unintentional drug poisoning mortality rates increased on average 5.3% per year from 1979 to 1990 and 18.1% per year from 1990 to 2002. The rapid increase during the 1990s reflects the rising number of deaths attributed to narcotics and unspecified drugs. Between 1999 and 2002, the number of opioid analgesic poisonings on death certificates increased 91.2%, while heroin and cocaine poisonings increased 12.4% and 22.8%, respectively. By 2002, opioid analgesic poisoning was listed in 5528 deaths,more than either heroin or cocaine. The increase in deaths generally matched the increase in sales for each type of opioid. The increase in deaths involving methadone tracked the increase in methadone used as an analgesic rather than methadone used in narcotics treatment programs. Conclusions A national epidemic of drug poisoning deaths began in the 1990s. Prescriptions for opioid analgesics also increased in this time frame and may have inadvertently contributed to the increases in drug poisoning deaths. Copyright © 2006 John Wiley & Sons, Ltd. [source] Public Management Reform: Competing Drivers of ChangePUBLIC ADMINISTRATION REVIEW, Issue 5 2002Lois Recascino Wise Public management reforms often are portrayed as part of a global wave of change, and all organizational change is interpreted within a single reform paradigm that is rooted in economics and market,based principles. Reforms outside this paradigm go unnoticed. This article examines the assertion that different drivers of change competing with the dominant focus of management discourse remain present and influence the direction of reform. It presents three alternative drivers of change rooted in normative values and provides evidence of their relevance from three national cases. Normative influences are reflected in a stream of activities occurring within the same time period in different civil service systems. The direction of public management practice cannot be seen as fully determined by any one approach to government reform or as traveling in only one direction. Understanding the balance among competing drivers of change is a key to interpreting both contemporary and future administrative reform. [source] Hypothalamic input is required for development of normal numbers of thyrotrophs and gonadotrophs, but not other anterior pituitary cells in late gestation sheepTHE JOURNAL OF PHYSIOLOGY, Issue 4 2008Eva Szarek To evaluate the hypothalamic contribution to the development of anterior pituitary (AP) cells we surgically disconnected the hypothalamus from the pituitary (hypothalamo-pituitary disconnection, HPD) in fetal sheep and collected pituitaries 31 days later. Pituitaries (n= 6 per group) were obtained from fetal sheep (term = 147 ± 3 days) at 110 days (unoperated group) of gestation and at 141 days from animals that had undergone HPD or sham surgery at 110 days. Cells were identified by labelling pituitary sections with antisera against the six AP hormones. Additionally, we investigated the colocalization of glycoprotein hormones. The proportions of somatotrophs and corticotrophs were unchanged by age or HPD. Lactotrophs increased 80% over time, but the proportion was unaffected by HPD. Thyrotrophs, which were unaffected by age, increased 70% following HPD. Gonadotrophs increased with gestational age (LH+ cells 55%; FSH+ cells 19-fold), but this was severely attenuated by HPD. We investigated the possible existence of a reciprocal effect of HPD on multipotential glycoprotein-expressing cells. Co-expression of LH and TSH was extremely rare (< 1%) and unchanged over the last month of gestation or HPD. The increase of gonadotrophs expressing FSH only or LH and FSH was attenuated by HPD. Therefore, the proportions of somatotrophs, lactotrophs and corticotrophs are regulated independently of hypothalamic input in the late gestation fetal pituitary. In marked contrast, the determination of the thyrotroph and gonadotroph lineages over the same time period is subject to complex mechanisms involving hypothalamic factors, which inhibit differentiation and/or proliferation of thyrotrophs, but stimulate gonadotrophs down the FSH lineage. Development of a distinct population of gonadotrophs, expressing only LH, appears to be subject to alternative mechanisms. [source] Implementation of a Clinical Pathway in Management of the Postoperative Vestibular Schwannoma Patient,THE LARYNGOSCOPE, Issue 11 2001Katrina R. Stidham MD Abstract Objective The purpose of the study was to evaluate the effectiveness of a new clinical pathway in management of patients with postoperative vestibular schwannoma. The impact on duration of hospitalization and quality of care was evaluated. Study Design The study was a retrospective review of 59 consecutive patients undergoing surgical intervention for vestibular schwannoma between January 1995 and July 1999. Methods A new clinical pathway for management of postoperative vestibular schwannoma patients was implemented at The California Ear Institute at Stanford (Palo Alto, CA) in January 1995. All patients undergoing surgical intervention subsequent to initiation of the pathway were included in the study. Data including surgical approach, patient age, sex, and tumor size were included. Duration of hospitalization and postoperative complications were recorded. During the same time period, data for patients undergoing radiation therapy for vestibular schwannomas were evaluated for length of hospital stay and in-hospital complications. Data were compared with norms recorded in the literature for duration of hospitalization and complications following surgical intervention. Results Fifty-nine patients underwent 35 middle fossa approaches and 24 translabyrinthine approaches to their tumors. The average patient age was 53 years; there were 34 female and 25 male patients. The average length of hospital stay was 3.83 days (SD = 1.4 days) with a range from 2 to 10 days. Postoperative complications were observed in 19% of patients, including eight (13%) cerebrospinal fluid (CSF) leaks, two requiring lumbar drains (3.4%); one hematoma (1.6%), one postoperative fever (1.6%), and one dural tear with associated hyponatremia (1.6%). These results compared favorably with previously recorded average hospital stays of 5.95 to 9.5 days 1,5,7 and CSF leak complication rates of 7% to 15%. 9,10 Conclusions Implementation of a clinical pathway for management of the patient with postoperative vestibular schwannoma improves efficiency of patient care, allowing decreased duration of hospitalization. This goal is achieved without increasing complication rates and, in our experience, actually improving the quality of clinical care. The cost-effectiveness of clinical pathways may become increasingly important in a managed care,driven environment. [source] Organ Donation and Utilization in the United States: 1998,2007AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2009J. E. Tuttle-Newhall Organ transplantation remains the only life-saving therapy for many patients with organ failure. Despite the work of the Organ Donation and Transplant Collaboratives, and the marked increases in deceased donors early in the effort, deceased donors only rose by 67 from 2006 and the number of living donors declined during the same time period. There continues to be increases in the use of organs from donors after cardiac death (DCD) and expanded criteria donors (ECD). This year has seen a major change in the way organs are offered with increased patient safety measures in those organ offers made by OPOs using DonorNet©. Unfortunately, the goals of 75% conversion rates, 3.75 organs transplanted per donor, 10% of all donors from DCD sources and 20% growth of transplant center volume have yet to be reached across all donation service areas (DSAs) and transplant centers; however, there are DSAs that have not only met, but exceeded, these goals. Changes in organ preservation techniques took place this year, partly due to expanding organ acceptance criteria and increasing numbers of ECDs and DCDs. Finally, the national transplant environment has changed in response to increased regulatory oversight and new requirements for donation and transplant provider organizations. [source] Human Islets Derived From Donors After Cardiac Death Are Fully BiofunctionalAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2007M. Zhao Islets from brain-dead donors (BDDs) are being used in the treatment of Type 1 diabetes. However, both donor numbers and islet survival are limited. We explored the clinical potential for islets from non-heart-beating donors (NHBDs), who have lower circulating cytokines, by comparing islets from 10 NHBDs against 12 identically-isolated islets from BDDs over the same time period. The quantity and quality of islets from NHBDs was good. NHBD yielded ,12.6% more islets than those of BDDs (505 000 ± 84 230 vs. 400 970 ± 172 430 islet equivalent number [IEQ]/pancreas, p = 0.01) with comparable viability. ATP and GTP contents were lower (6.026 ± 3.076 vs. 18.105 ± 7.8 nM/mg protein, p = 0.01 and 1.52 ± 0.87 vs. 3.378 ± 0.83 nM/mg protein, p = 0.04) and correlated negatively to warm ischemia time (R2= 0.8022 and R2= 0.7996, respectively). Islets from NHBDs took longer to control hyperglycemia in diabetic mice, but were equally able to sustain euglycemia. With a warm ischemia time (WIT) of ,25 min, islets from NHBDs are at least as competent as islets from BDDs and should be suitable for clinical use. [source] Effect of an episode of critical illness on subsequent hospitalisation: a linked data studyANAESTHESIA, Issue 2 2010T. A. Williams Summary Healthcare utilisation can affect quality of life and is important in assessing the cost-effectiveness of medical interventions. A clinical database was linked to two Australian state administrative databases to assess the difference in incidence of healthcare utilisation of 19 921 patients who survived their first episode of critical illness. The number of hospital admissions and days of hospitalisation per patient-year was respectively 150% and 220% greater after than before an episode of critical illness (assessed over the same time period). This was the case regardless of age or type of surgery (i.e. cardiac vs non-cardiac). After adjusting for the ageing effect of the cohort as a whole, there was still an unexplained two to four-fold increase in hospital admissions per patient-year after an episode of critical illness. We conclude that an episode of critical illness is a robust predictor of subsequent healthcare utilisation. [source] Assessing the long-term impact of Ranavirus infection in wild common frog populationsANIMAL CONSERVATION, Issue 5 2010A. G. F. Teacher Abstract Amphibians are declining worldwide, and one cause of this is infectious disease emergence. Mass mortalities caused by a virus or a group of viruses belonging to the genus Ranavirus have occurred in wild common frogs Rana temporaria in England since the 1980s, and ranaviral disease is widespread in amphibians in North America and Canada, where it can also cause mass die-offs. Although there have been numerous reports of Ranavirus -associated mass mortality events, no study has yet evaluated the long-term impacts of this disease. This study follows up archived records of English common frog mortalities likely caused by Ranavirus. There is a preliminary indication that common frog populations can respond differently to the emergence of disease: emergence may be transient, catastrophic, or persistent with recurrent mortality events. We subsequently focused on populations that had recurring mortality events (n=18), and we report median declines of 81% in the number of adult frogs in these populations from 1996 to 2008. Comparable uninfected populations (n=16) showed no change in population size over the same time period. Regressions show that larger frog populations may be more likely to experience larger declines than smaller populations, and linear models show that percentage population size change is significantly correlated with disease status, but that habitat age (a possible proxy for environmental quality) has no significant effect on population size change. Our results provide the first evidence of long-term localized population declines of an amphibian species which appear to be best explained by the presence of Ranavirus infection. [source] | ||||||||||||||||||||||||||||||||||||||||