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Selected AbstractsCaffeinated Cocktails: Energy Drink Consumption, High-risk Drinking, and Alcohol-related Consequences among College StudentsACADEMIC EMERGENCY MEDICINE, Issue 5 2008Mary Claire O'Brien MD Abstract Objectives:, The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences. Methods:, In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina. Results:, A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days/week vs. 0.73 days/week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a student's reported typical alcohol consumption (interaction p = 0.027). Conclusions:, Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk. [source] Long slow night hemodialysis and quality of lifeHEMODIALYSIS INTERNATIONAL, Issue 1 2005P. Hakkarainen Background:,Long slow hemodialysis (LS-HD) improves many biochemical parameters compared with conventional HD. However, its influences on quality of life are less well known. Aims:,The objective of this study was to examine the quality of life of patients on LS-HD performed overnight compared to the patients on standard hemodialysis. This extends the previous study, conducted in 2001, which examined the LS-HD patients, quality of life. Patients and methods:,We sent questionnaires to 12 LS-HD (overnight, treatment time 8 h × 3/wk) patients and 15 day HD (4.5 h × 3/wk) patients, all being treated using the limited care method. Data was collected using two different structured questionnaires. One was constructed for a previous study (2001) and the other one was a standardized set of questionnaires (RAND-36). Research material was collected from patient documents, such as the essential biochemical parameters, blood pressure, weight gain, and weekly EPO doses were recorded. Ten of the LS-HD patients (83%) and 13/15 (87%) of day HD patients returned the questionnaires. Three day hemodialysis patients returned empty questionnaires, which were disqualified. Results:,Based on the medical facts, the results showed that the patients of LS-HD felt better than the patients in another group. Patients on the LS-HD had higher Kt/V (2.623 vs. 1.577) and Hb (118 vs. 111) and lower Pi (1.36 vs. 1.63) and EPO dose (epoietin-beta 2667 ky/week vs. 5833 ky/week; darbepoetin 16 ky/week vs. 37 ky/week). However, their predialysis BP as well as the weight gain between treatments and salt and fluid balances caused problems furthermore. The experiences of the therapy of the LS-HD patients were more positive than of the control group: they felt their medical condition was better than of the patients on day HD. However we didn't observe significant differences in the replies showing physical or psychosocial conditions between the two groups. Conclusions:,The study suggests that when patients can themselves make the choice between treatment modalities, it improves the quality of life of the patients. Control of anemia is improved in LS-HD overnight patients with lower doses of EPO. The LS-HD gives the patients more freedom of diet. However, more attention must be paid to salt and fluid restriction. The LS-HD makes it possible for many patients to work normally. [source] Carers and the digital divide: factors affecting Internet use among carers in the UKHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2005Clare Blackburn BA (Hons) DipHE RHV RGN Abstract This paper presents data from a cross-sectional survey of 3014 adult carers, examining use of the Internet and factors associated with it. Carers recruited from the databases of three local authorities and other carer organisations within their geographical boundaries and that of Carers UK, a national carers organisation, were sent a postal questionnaire (response rate: 40%). A comparison of our data with national data on carers suggests some under-representation of men and younger adult carers and some over-representation of those who had been caring for long periods and those with substantial caring responsibilities. Two measures of Internet use were used and are presented in this analysis: previous use (ever used vs never previously used) and frequency (less than once a week vs once a week or more). Bivariate analyses identified patterns of Internet use and socio-demographic and socio-economic factors and caring circumstances associated with them. Factors significantly associated with each measure of Internet use were entered into direct logistic regression analyses to identify factors significantly associated with each measure. Half (50%) of all carers had previously used the Internet. Of this group, 61% had used it once a week or more frequently. Factors significantly associated with having previously used the Internet were carer's age, employment status, housing tenure and number of hours per week they spent caring. Frequency of Internet use was significantly associated with carer's age, sex, employment status and number of hours spent caring. Our study suggests that a significant number of carers may not currently be Internet users and that age, gender, socio-economic status and caring responsibilities shape Internet use in particular ways. Given the targets set by government for the development of online services, it is important to address the digital divide among carers and to continue to develop other services and information systems to meet the needs of those who do not access the Internet. [source] A controlled evaluation of monthly maintenance interpersonal psychotherapy in late-life depression with varying levels of cognitive functionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2008Kristen Carreira Abstract Objective To evaluate the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function. Methods/Design Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., 2006). We used Cox regression analysis to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression. Results We observed a significant interaction between cognitive status and treatment: lower cognitive performance was associated with longer time to recurrence in IPT than in CM (58 weeks vs 17 weeks) (HR,=,1.41 [95% CI,=,1.04, 1.91], p,=,0.03). Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence (38 vs 32 weeks, respectively). Conclusion Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning. Copyright © 2008 John Wiley & Sons, Ltd. [source] The G20210A prothrombin-gene mutation and the plasminogen activator inhibitor (PAI-1) 5G/5G genotype are associated with early onset of severe preeclampsiaJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 4 2005A. GERHARDT Summary., Hereditary risk determinants of venous thrombosis have been reported to be associated with severe preeclampsia. So far there are no data to support whether these risk determinants are related to the time of onset of severe preeclampsia. We used a case,control design, studying 97 women with severe preeclampsia in previous pregnancies and 277 normal women, to assess hereditary risk factors of venous thrombosis as risk determinants for severe preeclampsia. A case-only design comprising solely the 97 women with a history of preeclampsia was used to evaluate these risk factors as risk determinants for early onset of severe preeclampsia. Using the case,control design, there was no significant risk association of the hereditary risk factors with severe preeclampsia [factor V Leiden, odds ratio (OR) 0.9, 95% confidence interval (CI) 0.4, 2.2; prothrombin mutation, OR 1.9, 95% CI 0.5, 7.0; methylentetrahydrofolate reductase 677TT genotype, OR 0.8, 95% CI 0.4, 1.8; plasminogen activator inhibitor (PAI-1) 4G/4G genotype, OR 1.2, 95% CI 0.7, 2.1; PAI-1 5G/5G genotype, OR 1.0, 95% CI 0.5, 1.8]. However, the onset of severe preeclampsia was significantly earlier in women with the G20210A prothrombin gene mutation (24.5 weeks vs. 30.1 weeks, P = 0.046) and in women with the PAI-1 5G/5G genotype (25.7 weeks vs. 30.8 weeks, P = 0.024). Hereditary risk factors for venous thrombosis do not predispose for severe preeclampsia. However, women who are carriers of the G20210A prothrombin gene mutation and the PAI-1 5G/5G genotype are at risk for early onset of severe preeclampsia. It appears that these risk factors do not induce the pathomechanism but accelerate the course of preeclampsia. [source] Pre- and postnatal diagnosis and outcome of fetuses and neonates with esophageal atresia and tracheoesophageal fistulaPRENATAL DIAGNOSIS, Issue 3 2010E. M. de Jong Abstract Objectives Clinical symptoms and ultrasound signs during pregnancy could suggest the presence of esophageal atresia (EA). However, most often EA is diagnosed postnatally. The aim of our study is to evaluate the course and outcome for prenatally and postnatally diagnosed EA. In addition, we studied the outcome of isolated versus nonisolated EA. Methods In a retrospective data analysis, ultrasound characteristics, maternal and neonatal variables as well as clinical outcome were compared for fetuses/neonates with prenatal (n = 30) or postnatal (n = 49) diagnosis of EA. Clinical outcome in terms of morbidity and mortality of isolated EA was compared with that of EA complicated by chromosomal or structural anomalies. Results Prenatally diagnosed children were born 2 weeks earlier than postnatally diagnosed children (36.4 weeks vs 38.2 weeks; P = 0.02). The former had higher mortality rates (30 vs 12%; P = 0.05) and more associated anomalies (80 vs 59%; P = 0.04). In both subsets, there was a high morbidity rate in the survivors (not significant). Nonisolated EA was associated with greater occurrence of polyhydramnios (53 vs 27%; P = 0.04) and higher mortality rate (28 vs 0%; P = 0.002). Conclusions Mortality was significantly higher in prenatally diagnosed infants and in infants with additional congenital anomalies. Isolated EA is associated with good outcome. Copyright © 2010 John Wiley & Sons, Ltd. [source] EGFR mutation testing in NSCLC: Patterns of care and outcomes in Western AustraliaASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2009Suzanne WEBB Abstract Aims: This study evaluated the EGFR mutation status, administration of gefitinib or erlotinib and outcomes of patients assessed for EGFR mutations since the commencement of testing in Western Australia. Methods: A retrospective study identified patients with NSCLC who undergone EGFR mutation testing in the Department of Anatomical Pathology, Royal Perth Hospital, Western Australia from March 2005 until May 2007. Patient characteristics, cancer history, treatment, outcomes and survival were collected from the medical records and pathology reports. Results: Tumor samples from 64 patients were sequenced for mutations in exons 18,21 EGFR and, of these, 53 patients with NSCLC were included in the analysis. The mean age at diagnosis was 61 years (range 19,80) and most of the tumor samples tested were from female patients (76%). Overall 36% of patients tested were mutation-positive with 95% of mutations occurring in exons 19 or 21. A total of 63% of mutation-positive and 18% of mutation-negative patients were treated with gefitinib or erlotinib. Of these, 83% of patients whose tumors had an EGFR mutation had a favorable response following treatment, compared to 17% of mutation-negative patients. The duration of treatment was longer in mutation-positive patients (mean 30 weeks vs 9 weeks). Conclusion: EGFR mutation testing is not routinely performed in NSCLC in Western Australia. Referral for testing is at the discretion of the treating physician, accounting for the high proportion of women and adenocarcinoma histology. Selection of mutation-positive tumors for treatment with gefitinib or erlotinib is associated with good responses to treatment. This study supports the use of gefitinib or erlotinib in routine clinical practice in patients with NSCLC carrying an EGFR mutation. [source] HER-2/neu overexpression in patients with radically resected nonsmall cell lung carcinomaCANCER, Issue 10 2002Impact on long-term survival Abstract BACKGROUND Using immunohistochemistry, the authors prospectively investigated the expression of HER-2/neu protein in radically resected specimens of nonsmall cell lung carcinoma (NSCLC) and evaluated its impact on long-term prognosis. METHODS Between January 1991 and February 1992, surgical specimens from 130 consecutive patients who underwent radical resection for NSCLC (60 squamous cell carcinoma, 48 adenocarcinoma cases, and 22 large cell carcinomas) and that were staged (according to the TNM staging system) pathologically as Stage I (41 cases [ 32%]), Stage II (37 cases [28%]), and Stage IIIA (52 cases [40%]) were investigated for the expression of HER-2/neu using an avidin-biotin complex immunohistochemical technique. A semiquantitative four-stage grading system was used (0%, 1,5%, 6,20%, and > 20% positive cells) and an average number of 1500 cells/section was considered. Data were correlated with clinical and pathologic variables. RESULTS Normal bronchial tissue was found to be completely negative for HER-2/ neu expression whereas 21 of the 130 tumor specimens (16%) were positive (range 1,> 20%). HER-2/neu positivity did not appear to differ significantly among pathologic stages and histotypes. Using a predetermined cutoff value of 5% positive cells, 15 tumor specimens (12%) were found to be above this value. The median survival time (85 weeks vs. 179 weeks) and overall survival rate were significantly lower in patients with > 5% HER-2/neu -positive tumors (hazard ratio for the group with > 5% positive cells: 2.94, 95% confidence interval, 1.62,5.34; P < 0.0004). On multivariate analysis, HER-2/ neu and extent of tumor emerged as independent factors for disease-related mortality. CONCLUSIONS In NSCLC, the negative impact of HER-2/neu overexpression on survival was maintained in the long-term follow-up of radically resected patients. HER-2/neu overexpression may be a valuable prognostic factor as well as a potential target for biologic therapies. Cancer 2002;94:2669,74. © 2002 American Cancer Society. DOI 10.1002/cncr.10531 [source] Late and ultra late onset Streptococcus B meningitis: clinical and bacteriological data over 6 years in FranceACTA PAEDIATRICA, Issue 1 2010J Guilbert Abstract Background:, Group B Streptococcus (GBS) is one of the leading causes of sepsis and meningitis in newborn. The objective of this study was to describe the characteristics of GBS meningitis in children aged between 7 and 89 days (late onset disease , LOD group) and to compare them with children aged more than 3 months (ultra late onset disease , ULOD group). Methods: Clinical and biological data were gathered by ACTIV/GPIP (a nationwide active surveillance network). The study population included 242 children hospitalized between 2001 and 2006 for GBS meningitis (220 in the LOD group and 22 in the ULOD group). Results:, Univariate analysis revealed that gestational age (GA) was significantly lower in the ULOD group as compared with the LOD group (respectively 35.6 weeks vs. 37.9 weeks, p = 0.002). Prevalence of early preterm birth (before the 32nd week GA) was significantly higher in the ULOD group than in the LOD group (32% vs. 7%, p = 0.002). No significant difference was found between the two groups for biological characteristics of lumbar puncture, GBS serotypes, complications and survival rate. Conclusion: These data suggest that LOD and ULOD would be the same clinical and bacteriological entity, except for prematurity, which seems significantly associated with ULOD. [source] | ||||||||||