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Baseline Rate (baseline + rate)
Selected AbstractsPrimary prevention of neural tube defects with folate in Western Australia: the value of the Western Australian Birth Defects RegistryCONGENITAL ANOMALIES, Issue 2 2006Carol Bower ABSTRACT This paper reviews the role of the Western Australian Birth Defects Registry in the primary prevention of neural tube defects. The Registry provides complete and up-to-date information on all neural tube defects (NTD), including terminations of pregnancy. These data have been used to determine a baseline rate of NTD and to monitor trends in NTD over time, when health promotion of folic acid supplement use and voluntary fortification of food with folate were introduced. The register has also been used to investigate NTD in special populations (Indigenous infants in Australia) and as a sampling frame for case control studies. The data derived from these studies have been used to assist in assessing whether mandatory food fortification in Australia is indicated to prevent NTD. [source] Abnormalities in cardiac and respiratory function observed during seizures in childhoodDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2005Mary E O'Regan MRCP MRCPCH The aim of this study was to observe any changes in cardiac and respiratory function that occur during seizures. Thirty-seven children (20 males, 17 females; median age 7y 6mo, range 1y 6mo to 15y 6mo) were studied. We recorded electroencephalograms, respiratory rate, heart rate, electrocardiograms, blood pressure, oxygen saturation, heart rate variability (time domain analysis), and cardiac vagal tone. A respiratory pause was defined as an interruption in respiration lasting more than 3s but less than 15s. Apnoea was defined as absence of respiration for more than 15s. Tachypnoea was defined as a 10% increase in respiratory rate from the pre-ictal baseline. Bradypnoea was defined as a 10% decrease in respiratory rate from the pre-ictal baseline. Significant hypoxia was defined as a saturation of less than 85%. A significant change in heart rate was taken as a 10% increase or decrease below the baseline rate. Data were obtained from 101 seizures: 40 focal seizures, 21 generalized seizures, and 40 absences. Focal seizures were frequently associated with significant respiratory abnormalities, tachypnoea in 56%, apnoea in 30%, frequent respiratory pauses in 70%, and significant hypoxaemia in 40%. The changes seen in respiratory rate were statistically significant. Changes in cardiac parameters, an increase or decrease in heart rate, were observed in only 26% of focal seizures and 48% of generalized seizures. We conclude that seizure activity can disrupt normal physiological regulation and control of respiratory and cardiac activity. [source] Continuous local intrahippocampal delivery of adenosine reduces seizure frequency in rats with spontaneous seizuresEPILEPSIA, Issue 9 2010Annelies Van Dycke Summary Purpose:, Despite different treatment options for patients with refractory epilepsy such as epilepsy surgery and neurostimulation, many patients still have seizures and/or drug-related cerebral and systemic side effects. Local intracerebral delivery of antiepileptic compounds may represent a novel strategy with specific advantages such as the option of higher local doses and reduced side effects. In this study we evaluate the antiepileptic effect of local delivery of adenosine in the kainic acid rat model, a validated model for temporal lobe epilepsy. Methods:, Fifteen rats, in which intraperitoneal kainic acid injection had induced spontaneous seizures, were implanted with a combination of depth electrodes and a cannula in both hippocampi. Cannulas were connected to osmotic minipumps to allow continuous hippocampal delivery. Rats were freely moving and permanently monitored by video-EEG (electroencephalography). Seizures were scored during 2 weeks of local hippocampal delivery of saline (baseline), followed by 2 weeks of local adenosine (6 mg/ml) (n = 10) or saline (n = 5) delivery (0.23 ,l/h) (treatment). In 7 of 10 adenosine-treated rats, saline was also delivered during a washout period. Results:, During the treatment period a mean daily seizure frequency reduction of 33% compared to the baseline rate was found in adenosine-treated rats (p < 0.01). Four rats had a seizure frequency reduction of at least 50%. Both nonconvulsive and convulsive seizures significantly decreased during the treatment period. In the saline-control group, mean daily seizure frequency increased with 35% during the treatment period. Conclusions:, This study demonstrates the antiseizure effect of continuous adenosine delivery in the hippocampi in rats with spontaneous seizures. [source] The Long-Term Effects of Reconciliation in Japanese Macaques Macaca fuscataETHOLOGY, Issue 11 2001Nicola F. Koyama With one exception, all previous studies of reconciliation in non-human primates (friendly reunion between former opponents) have focused on demonstrating the immediate, short-term effects despite the widely held view that reconciliation has a long-term function of repairing social relationships following aggression. To investigate this long-term function I compared mean interaction rates between opponents during the 10 d following reconciled and non-reconciled conflicts to baseline levels of interaction. Aggression rates during the 10 d after non-reconciled conflicts were significantly higher than the baseline rate, whereas after reconciled conflicts aggression was minimal. Similarly, grooming, proximity and approach rates during the 10 d after non-reconciled conflicts were significantly lower than the baseline rate whereas grooming, proximity and approach rates in the 10 d after reconciled conflicts were restored to baseline levels. These results indicate that there are consequences to not reconciling with a former opponent and highlight the fact that these may be costly in terms of increased risk of long-term aggression and reduced affiliation. The data support predictions from the Relationship-Repair Hypothesis suggesting that reconciliation functions as a mechanism for the repair of social relationships damaged by aggression. [source] Functional dentate gyrus neurogenesis in a rapid kindling seizure modelEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2006Paul D. Smith Abstract Neurogenesis in the adult mammalian hippocampus resulting in long-term persistence of new neurons with features of capacity for functional activation is recognized. Many stimuli are capable of increasing the rate of neurogenesis, including seizure activity. Whether these insults result in an increased number of new functionally active neurons over and above the baseline rate of neurogenesis is not known. The rapid electrical amygdala kindling (REAK) model of seizures isolates the effects of seizures alone in the absence of neuronal death and the resulting seizures induce expression of c-Fos in the vast majority of dentate gyrus (DG) granule cells. C57BL/6 mice were exposed to REAK then injected with bromodeoxyuridine (BrDU) to label dividing cells, then re-exposed to REAK after a delay period to allow detection of functional activation in new neurons by measurement c-Fos expression in response to seizures. Adult subgranular zone cells migrated into the DG granule cell layer (GCL), assumed a neuronal phenotype and demonstrated seizure-dependent responsiveness. Larger absolute numbers of new neurons demonstrating seizure-dependent activation were found in the GCL of previously kindled mice. Seizures are capable of increasing the number of new neurons with the capacity for functional activation laid down in the postseizure period and incorporated into seizure-activated circuitry. [source] Hospitalization risk following initiation of highly active antiretroviral therapyHIV MEDICINE, Issue 5 2010SA Berry Objectives While highly active antiretroviral therapy (HAART) decreases long-term morbidity and mortality, its short-term effect on hospitalization rates is unknown. The primary objective of this study was to determine hospitalization rates over time in the year after HAART initiation for virological responders and nonresponders. Methods Hospitalizations among 1327 HAART-naïve subjects in an urban HIV clinic in 1997,2007 were examined before and after HAART initiation. Hospitalization rates were stratified by virological responders (,1 log10 decrease in HIV-1 RNA within 6 months after HAART initiation) and nonresponders. Causes were determined through International Classification of Diseases, 9th Revision (ICD-9) codes and chart review. Multivariate negative binomial regression was used to assess factors associated with hospitalization. Results During the first 45 days after HAART initiation, the hospitalization rate of responders was similar to their pre-HAART baseline rate [75.1 vs. 78.8/100 person-years (PY)] and to the hospitalization rate of nonresponders during the first 45 days (79.4/100 PY). The hospitalization rate of responders fell significantly between 45 and 90 days after HAART initiation and reached a plateau at approximately 45/100 PY from 91 to 365 days after HAART initiation. Significant decreases were seen in hospitalizations for opportunistic and nonopportunistic infections. Conclusions The first substantial clinical benefit from HAART may be realized by 90 days after HAART initiation; providers should keep close vigilance at least until this time. [source] Incidence of inhibitors in a cohort of 838 males with hemophilia A previously treated with factor VIII concentratesJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 12 2006C. L. KEMPTON Summary.,Background:,Development of an inhibitory antibody to factor VIII is currently the most serious complication of hemophilia A treatment. The rate of inhibitor development in those that have been previously treated with factor concentrates is poorly defined. Understanding the baseline rate of inhibitor development in the population of previously treated patients (PTPs) is important when evaluating the effect of exposure to new factor replacement products on inhibitor formation. Objectives:,To determine the rate of inhibitor development in PTPs with hemophilia A. Methods:,A cohort of males with hemophilia A who had data collected on four or more occasions prior to 30 March 2003, as part of the Center for Disease Control and Prevention's Universal Data Collection Project, were eligible for inclusion in the cohort. Patients were included in the cohort if they had at least two Bethesda assay measurements and did not have an inhibitor prior to or at the start of the study period. The overall incidence rate was estimated as the number of verified incident inhibitor cases divided by the total follow-up time in years multiplied by 1000 (cases per 1000 person-years). Results:,A total of 838 patients were included in the study. The overall incidence rate was calculated to be 2.14 cases per 1000 person years. All incident cases had more than 50 exposure days prior to inhibitor development. Conclusions:,Given the low rate of inhibitor development in PTPs with hemophilia A, small, non-randomized studies are inadequate to determine the rate of inhibitor development after exposure to novel products. Ongoing, standardized, postmarketing surveillance is needed to determine if novel factor products pose an increased risk of inhibitor development. [source] ORIGINAL RESEARCH,ERECTILE DYSFUNCTION: Baseline Prevalence of Erectile Dysfunction in a Prostate Cancer Screening PopulationTHE JOURNAL OF SEXUAL MEDICINE, Issue 2 2008Jochen Walz MD ABSTRACT Introduction., Erectile dysfunction (ED) is common in older men and can be worsened by prostate cancer (PCa) treatment. True ED rates before PCa treatment are mandatory, in order to assess the rate of ED attributable to PCa treatment. Data derived from population-based studies or from patients surveyed after PCa diagnosis, as well as just prior to treatment may not represent a valid benchmark, as health profiles of the general population might be different to those undergoing PCa screening or as anxiety may worsen existent ED. Aim., To circumvent these limitations, we assessed the baseline rate of ED in PCa diagnosis-free men participating in a PCa awareness event. Methods., ED was classified according to the International Index of Erectile Function (IIEF) score as absent (IIEF: 25,30), mild (22,24), mild to moderate (17,21), moderate (11,16), or severe (,10). Analyses were adjusted according to age and socioeconomic status. Main Outcome Measures., Of 1,273 asymptomatic men who participated in the event, 1,134 (89.1%) completed the IIEF score. Results., Mean age was 57.6 years (range 40,89 years). Of all participating men, 50.0% (N = 566) were potent, 8.8% (N = 100) reported mild, 10.4% (N = 118) mild to moderate, 9.4% (N = 107) moderate, and 21.4% (N = 243) severe ED. Men with ED were significantly older (P < 0.001), had no stable partner (P < 0.001), lower education (P < 0.001), and lower annual income (P < 0.001) than men without ED. Conclusions., One in two men who participated in this PCa awareness event is affected by ED, independent of PCa diagnosis or treatment. Such high prevalence of baseline ED in a PCa screening cohort suggests that in patients treated for PCa, ED may represent a common disorder already present prior to treatment. Moreover, socioeconomic variables were seen to have an important influence on erectile function in this patient cohort. Walz J, Perrotte P, Suardi N, Hutterer G, Jeldres C, Bénard F, Valiquette L, Graefen M, Montorsi F, and Karakiewicz PI. Baseline prevalence of erectile dysfunction in a prostate cancer screening population. J Sex Med 2008;5:428,435. [source] Multifaceted functional behavior assessment for students with externalizing behavior disordersPSYCHOLOGY IN THE SCHOOLS, Issue 2 2002Daniel E. Olympia Recent federal mandates have increased interest in the use of functional behavior assessment as a necessary part of initial and ongoing work with students with externalizing behavior disorders. A multifaceted approach to functional behavior assessment provides a comprehensive assessment of both behavioral excesses and deficits commonly found in externalizing behavior disorders and also provides for the linkage of assessment information to educational interventions that can be implemented and monitored in educational settings for students with behavior disorders. The authors, using a variety of empirically derived methods, describe specific components of a multifaceted approach to functional behavior assessment in the context of the widely accepted behavioral excess/deficit model for students with externalizing behavior disorders. Empirically derived and validated methodologies (i.e., indirect data collection and analysis, direct observation and recording of behavior, and use of probes to establish baseline rates and measure impacts of intervention) are described. Technology-assisted data collection and analysis using computer-assisted functional behavior assessment interviews and direct observation of behavior using personal digital assistant (PDA) based software are also presented as a means to improve efficiency and reduce time needed to conduct adequate functional behavior assessments. Specific strategies to address academic skill and performance deficits as well as social skills deficiencies in the context of a multifaceted functional behavior assessment are also presented for students with externalizing behavior disorders. © 2002 Wiley Periodicals, Inc. [source] | |||||||||||||