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Treatment Requirement (treatment + requirement)
Selected AbstractsThe Next Generation Road Weather Information System: A New Paradigm for Road and Rail Severe Weather Prediction in the UKGEOGRAPHY COMPASS (ELECTRONIC), Issue 4 2008John Thornes The use of road weather information systems for the winter maintenance of roads is now widespread around the world. However, road weather forecasts are normally only made available for a limited number of road sensor sites in a region. For example, in Birmingham, UK, there is one forecast site for 26 salting routes. XRWIS is the next generation road weather information system that forecasts for every 20 m along each salting route (typically 50 km long) using a geographical information system, sky-view factor analysis and mesoscale weather forecasts. Treatment requirements for each salting route are then visualised in simple ,traffic-light' style colours. In a recent winter-long trial in Devon, UK, up to 78 salting runs on six salting routes could have been prevented saving up to £80,000 in labour and materials. Other potential applications of XRWIS include the prediction of low rail adhesion in winter, due to ice, frost and snow, and track buckling in summer. [source] Variability in clinical phenotype of severe haemophilia: the role of the first joint bleedHAEMOPHILIA, Issue 5 2005K. van Dijk Summary., To quantify variation in clinical phenotype of severe haemophilia we performed a single centre cohort study among 171 severe haemophilia patients. Age at first joint bleed, treatment requirement (i.e. annual clotting factor use), annual bleeding frequency and arthropathy were documented. Because treatment strategies intensified during follow-up, patients were stratified in two age groups: patients born 1968,1985 (n = 91), or 1985,2002 (n = 80). A total of 2166 patient-years of follow-up were available (median 12.0 years per patient). Age at first joint bleed ranged from 0.2 to 5.8 years. Patients who had their first joint bleed later needed less treatment and developed less arthropathy. In patients born 1968,1985 during both on-demand and prophylactic treatment, the 75th percentile of annual joint bleed frequency was consistently four times as high as the 25th percentile. In both age groups variation in annual clotting factor use between 25th and 75th percentiles was 1.4,1.5 times for prophylaxis and 3.8 times for on-demand treatment. To conclude, the onset of joint bleeding is inversely related with treatment requirement and arthropathy and may serve as an indicator of clinical phenotype. Thus, providing a starting point for aetiological research and individualization of treatment. [source] Confirmation of severe GH deficiency after final height in patients diagnosed as GH deficient during childhoodCLINICAL ENDOCRINOLOGY, Issue 4 2002Andrea F. Attanasio Summary objective Human GH treatment of patients with childhood-onset (CO) growth hormone deficiency (GHD) ceases when they reach final height; this provides an opportunity to retest GH status in all patients before determining whether GH therapy will be required in adult life. At present, the diagnostic approach to these patients is not fully standardized. This study aimed to characterize a large group of previously GH-treated CO GHD patients and establish their GH status. patients and methods The multinational study included 167 patients diagnosed as GH deficient and treated with hGH to final height during childhood. Mean age was 19·2 years and mean height standard deviation score (SDS) was ,1·08. Peak serum GH concentrations were determined in standard GH stimulation tests. IGF-I and IGFBP-3 concentrations were determined at a central laboratory and converted to SDS values by reference to a normal population. results Using only a peak GH value of less than 3 µg/l (1 mg = 3 U) in stimulation tests as the cut-off, 133 (79·6%) patients would be classed as GH deficient. Using only an IGF-I value less than ,2 SDS as the cut-off, 134 (80·2%) patients would be classed as GH deficient. However, by using both criteria there were 120 (71·9%) patients who were definitely severely GH deficient (group 1) and 20 (12·0%) who were not GH deficient (group 2), leaving 14 (8·4%) classed as GH deficient from IGF-I SDS only (group 3) and 13 (7·8%) classed as GH deficient from stimulation test only (group 4). There was no difference between the groups in height SDS or body mass index (BMI), but the GH-deficient patients tended to have been diagnosed at a younger age (group 1, 8·2 ± 3·9; group 2, 10·0 ± 4·0; P = 0·052). For patients classed as GH deficient compared with those not GH deficient, the percentage of males was lower (group 1, 64·2%; group 2, 90·0%; P = 0·022) and the percentage with multiple pituitary hormone deficiencies was higher (group 1, 81·7%; group 2, 20·0%; P < 0·001), with the other two groups being intermediate in each case. Only the group classed as GH deficient by both criteria had a mean IGFBP-3 less than ,2 SDS and both IGF-I SDS and IGFBP-3 SDS increased steadily across the four groups. conclusions A high percentage (71·9%) of these childhood-onset GH-deficient patients were still GH deficient in adult life and are likely to require further hGH treatment. While 12·0% could be classed as definitely no longer GH deficient, there are some patients who are intermediate (16·2%) and may be classed as GH deficient by one criterion but not the other. When GH stimulation test results and IGF-I concentration are discordant, the IGFBP-3 level does not establish diagnosis and the hGH treatment requirement of such patients remains a dilemma. [source] Oral health status in epileptic childrenPEDIATRICS INTERNATIONAL, Issue 2 2010Taskin Gurbuz Abstract Background:, The aim of the present study was to evaluate the oral hygiene status and dental treatment requirements in children with epilepsy. Methods:, The treatment group consisted of 211 children with epilepsy (120 boys and 91 girls, 4,15 years old, mean age 7.85 ± 2.98 years). The control group consisted of healthy children, matched by age and gender. Clinical features of the patients were obtained from hospital records. Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and to record the periodontal health of each child. Statistical analysis was performed using ,2 test, Fisher exact test and anova. Results:, The number of decayed and missing teeth, the degree of abrasion and periodontal indexes were significantly worse in patients with epilepsy, compared to the control group (P < 0.001). Gingival enlargement was documented in 42% of patients on valproate monotherapy compared to only in 16% of patients on phenobarbital. Dental caries and halitosis were the most common oral disorders. Generalized tonic,clonic seizures often cause minor oral injuries and traumatized anterior teeth. Conclusions:, Epileptic children are at an increased risk of developing caries and gingivitis compared with healthy subjects. [source] | ||||||||||