School of Medicine Publications - UQ eSpace

A comparison of the Yale-Brown obsessive compulsive scale for "Heavy drinking" with a single item craving measure: Construct validity and clinical utility

Connor, JP og Feeney, GFX og Young, RM — 2007-08-15T00:00:00Z

The measurement of alcohol craving began with single-item scales. Multifactorial scales developed with the intention to capture more fully the phenomenon of craving. This study examines the construct validity of a multifactorial scale, the Yale-Brown Obsessive Compulsive Scale for heavy drinking (Y-BOCS-hd). The study compares its clinical utility with a single item visual-analogue craving scale. The study includes 212 alcohol dependent subjects (127 males, 75 females) undertaking an outpatient treatment program between 1999-2001. Subjects completed the Y-BOCS-hd and a single item visual-analogue scale, in addition to alcohol consumption and dependence severity measures. The Y-BOCS-hd had strong construct validity. Both the visual-analogue alcohol craving scale and Y-BOCS-hd were weakly associated with pretreatment dependence severity. There was a significant association between pretreatment alcohol consumption and the visual-analogue craving scale. Neither craving measure was able to predict total program abstinence or days abstinent. The relationship between obsessive-compulsive behavior in alcohol dependence and craving remains unclear.

A comparison of three therapy methods for children with different types of developmental phonological disorder

Dodd, B og Bradford, A — 2007-08-13T00:00:00Z

Treatment case studies of three children whose speech was characterized by non-developmental errors are described. Three therapy methods were trialed with each child: phonological contrast; core vocabulary and PROMPT. The accuracy and intelligibility of the children's connected speech improved throughout: the course of the programme. Intervention that focused on teaching a rule about the contrastive use of phonemes was most successful for a child who consistently made non-developmental errors. Children making inconsistent errors received most benefit from the core vocabulary approach that markedly enhanced consistency of production. However, once consistency was established, one child benefited from phonological contrast therapy. While the results of the study should be interpreted with caution due to the small sample size and the cumulative effects of intervention, the findings suggest that different parts of a child's phonological and phonetic system may respond to various types of treatment approaches that target different aspects of speech production. The implication drawn is that just as no single treatment approach is appropriate for all children with disordered phonology, management of some children may involve selecting and sequencing a range of different approaches.

A comparison of total thyroidectomy and lobectomy in the treatment of dominant thyroid nodules

2011-03-14T00:00:00Z

Patients with a clinically concerning dominant thyroid nodule have been managed by lobectomy or total thyroidectomy at our institution. We determined the complications associated with both approaches and the ability of thyroid lobectomy to avoid the need for thyroid hormone replacement therapy. Records of all patients with a dominant thyroid nodule managed with surgery from August 1993 through December 2000 were reviewed for demographics, history of head and neck radiation, indication for surgery, preoperative fine-needle aspirate results, final pathologic evaluation, perioperative complications, determinations of need for subsequent thyroid surgery after lobectomy, and need for thyroid hormone replacement therapy after surgery. Patients with a preoperative diagnosis of malignancy or bilateral or diffuse disease were excluded because these conditions would uniformly be managed by bilateral thyroidectomy. The complications for the lobectomy group (n = 131) compared with the total thyroidectomy group (n = 84) were: recurrent laryngeal nerve paresis (4.6% vs 2.4%), recurrent laryngeal nerve injury (0.8% vs 0), and transient hypoparathyroidism (1.5% vs 9.5%; P = 0.007). No permanent hypoparathyroidism was identified in either group. Postoperative thyroid hormone replacement was required in 64 of 131 lobectomy patients (48.8%). Complications associated with either surgery were low. Total thyroidectomy was not associated with clinically significant additive morbidity. Patients treated by lobectomy should be aware of a nearly 50 per cent chance of requiring thyroid hormone replacement. Total thyroidectomy avoids future thyroid surgery; lobectomy patients remain at risk. When complications can be minimized total thyroidectomy should be considered an option in the management for patients with dominant thyroid nodules that require surgery.

A comparison of treatment outcome between adenocarcinoma and squamous cell carcinoma of the eosophagus

2009-03-10T00:00:00Z

Purpose Combined modality therapy has been used to treat oesophageal cancer. We compared the treatment outcome between adenocarcinoma and squamous cell carcinoma (SCC) in terms of survival and recurrence. Methodology A prospective database of patients with oesophageal cancer was collected from 1988 to 2001. 294 patients with adenocarcinoma and 191 patients with SCC were treated with curative intention. The options included surgical resection alone, neoadjuvant chemoradiotherapy (CRT) (cisplatin 80 mg/m2, 5 fluorouracil 800 mg/m2 and 35 Gy) followed by surgical resection, and definitive CRT (2 courses of cisplatin 80 mg/m2 and 5 fluorouracil 800 mg/m2 and 60 Gy). Kaplan-Meier estimates of survival and the log rank test were used to compare results. Results The survival rate of patients with adenocarcinoma or SCC treated by resection was not significantly different (P = 0.352). Patients with SCC receiving neoadjuvant CRT have a better 2-year survival rate (69.2%) than patients with adenocarcinoma (35.6%)(P = 0.009). Patients with SCC who were treated by definitive CRT also have a better 2-year survival rate (42.4%) than those with adenocarcinoma (26.2%) (P = 0.024). Patients with adenocarcinoma treated with neoadjuvant or definitive CRT have a higher recurrence rate than those with SCC. Distant metastases was the major failure in both histologic groups. Conclusion The results of surgical resection of SCC and adenocarcinoma of the oesophagus were comparable. However, when CRT was included in the treatment either as preoperative or definitive therapy, the outcome was significantly different. Future trials that involve CRT should consider the different histologic types separately.

A comparison of two measures of hospital foodservice satisfaction

2009-03-16T00:00:00Z

There are few published papers on patient satisfaction with food or nutrition services in either acute or chronic health care settings. The aim of this study was to evaluate two questionnaires for measuring patient satisfaction with hospital foodservice, the “Parkside Inpatient Questionnaire” and the “Wesley Hospital Foodservice Patient Satisfaction Questionnaire”. Data were collected from 540 patients at a Queensland Public Hospital.Results indicated the Wesley Hospital Foodservice Patient Satisfaction Questionnaire obtained more positive patient feedback and was more reliable at measuring patient satisfaction (?=0.89) than the Parkside Inpatient Questionnaire (?=0.75), thus it is a more effective foodservice quality management tool.

A comparison of two screening methods to determine the validity of 24-h food and drink records in children and adolescents

2011-08-10T00:00:00Z

A compartmental model of hepatic disposition kinetics: 1. Model development and application to linear kinetics

Anissimov, YG og Roberts, MS — 2007-08-14T00:00:00Z

The conventional convection-dispersion model is widely used to interrelate hepatic availability (F) and clearance (Cl) with the morphology and physiology of the liver and to predict effects such as changes in liver blood flow on F and Cl. The extension of this model to include nonlinear kinetics and zonal heterogeneity of the liver is not straightforward and requires numerical solution of partial differential equation, which is not available in standard nonlinear regression analysis software. In this paper, we describe an alternative compartmental model representation of hepatic disposition (including elimination). The model allows the use of standard software for data analysis and accurately describes the outflow concentration-time profile for a vascular marker after bolus injection into the liver. In an evaluation of a number of different compartmental models, the most accurate model required eight vascular compartments, two of them with back mixing. In addition, the model includes two adjacent secondary vascular compartments to describe the tail section of the concentration-time profile for a reference marker. The model has the added flexibility of being easy to modify to model various enzyme distributions and nonlinear elimination. Model predictions of F, MTT, CV2, and concentration-time profile as well as parameter estimates for experimental data of an eliminated solute (palmitate) are comparable to those for the extended convection-dispersion model.

A comprehensive analysis of granzyme/perforin expression and cytotoxic function of influenza-specific CD8(+) T cells

2012-03-04T00:00:00Z

A comprehensive analysis of MNG1, TCO1, fPTC, PTEN, TSHR, and TRKA in familial nonmedullary thyroid cancer: confirmation of linkage to TCO1

2012-10-08T00:00:00Z

About 5% of nonmedullary thyroid cancer is familial. These familial nonmedullary thyroid cancer cases are characterized by an earlier age of onset, more aggressive phenotype, and in some families a high propensity to benign thyroid disease. Little is known about the genes conferring predisposition to nonmedullary thyroid cancer. Three loci have been identified through genetic linkage: MNG1 on 14q32, TCO1 on 19p13.2, and fPTC on 1p21. In addition to these putative genes, a number of loci represent candidate familial nonmedullary thyroid cancer predisposition genes by virtue of their involvement in sporadic disease (TRKA), their role in benign disease (TSHR), and because they underlie syndromes with a risk of nonmedullary thyroid cancer (PTEN). To evaluate the roles of MNG1, TCO1, fPTC, PTEN, TSHR, and TRKA in familial nonmedullary thyroid cancer, we have carried out a comprehensive mutation and linkage analysis of these genes in 22 families. One family was linked to chromosome 19q13.2, confirming that TCO1 underlies a subset of familial nonmedullary thyroid cancer. None of the families was linked to MNG1 or fPTC, and there was no evidence to support the roles of PTEN, TSHR, or TRKA. Familial nonmedullary thyroid cancer is an emerging clinical phenotype that is genetically heterogeneous, and none of the currently identified genes accounts for the majority of families.

A computationally efficient implementation of quadratic time-frequency distributions

2008-02-27T00:00:00Z

A computer-aided detection of EEG seizures in infants: A singular-spectrum approach and performance comparison

Celka, P og Colditz, P — 2007-10-17T00:00:00Z

This paper presents a scalp electroencephalogram (EEG) seizure detection scheme based on singular spectrum analysis (SSA) and Rissanen minimum description length (MDL) model-order selection (SSA-MDL). Preprocessing of the signals allows for the drastic reduction of the number of false alarms. Statistical performance comparison with seizure detection schemes of Gotman et al. and Liu et al. is performed on both synthetic data and real EEG seizures. Monte Carlo simulations based on synthetic infant EEG seizure data reveals some detection drawbacks on a large variety of seizure waveforms. Detection using both Monte Carlo and four real infant scalp EEG signals shows the superiority of the SSA-MDL method with an average good detection rate of > 93 % and false detection rate < 4 %.

A computerised prescribing decision support system to improve patient adherence with prescribing: A randomised controlled trial

2007-08-15T00:00:00Z

A conceptual framework for linking and guiding domestic cross-cultural and international practice in speech-language pathology

Pickering, Marisue og McAllister, Lindy — 2009-12-03T00:00:00Z

This article argues that domestic cross-cultural and international work are linked, even though the two arenas of practice usually are discussed separately in the speech-language pathology literature. Examples are presented of cross-cultural service delivery around the world, thus illustrating similarities between international work and domestic cultural diversity. the second half of the article explores links-such as immigration-between domestic cross-cultural and international speech-language pathology, considers concepts operative within intercultural encounters, and discusses the use of adult learning principles as a tool to assist practitioners in cross-cultural speech-language pathology, whether undertaken domestically or internationally. A conceptual framework is thus provided that can guide cross-cultural service delivery and professional preparation irrespective of context.

A Conceptual framework to guide the Development of Self-directed, lifelong learning in problem Based Medical Curricula

2008-06-10T00:00:00Z

Context: The information explosion and continual changes in the means of accessing information have reinforced the importance of preparing graduates to direct their own learning throughout their careers. Increasingly, medical schools are turning to problem-based curricula to develop in graduates the capacity to 'self-direct' further learning. Problem: Experience shows that, to achieve this goal, there needs to be consistency in interpretation of the goal and faculty-wide agreement about the way the problem-based curriculum fosters self-direction. Suggested solution: This paper describes the conceptual framework developed by the Graduate School of Medicine, The University of Queensland, to guide the achievement of self-directed, lifelong learning in a graduate entry, problem-based curriculum. Implications: It may be useful for others who are experiencing difficulties with implementing problem-based curricula, and for those who are contemplating changing to problem-based models.

A concise overview of micronutrient deficiencies in Africa and future directions

2007-08-15T00:00:00Z

A confirmatory factor analysis of the Toronto Alexithymia Scale (TAS-20) in an alcohol-dependent sample

2010-09-12T00:00:00Z

Confirmatory factor analyses were conducted to evaluate the factorial validity of the Toronto Alexithymia Scale in an alcohol-dependent sample. Several factor models were examined, but all models were rejected given their poor fit. A revision of the TAS-20 in alcohol-dependent populations may be needed. © 2009 Elsevier Ireland Ltd. All rights reserved.

A consensus document on bowel preparation before colonoscopy: Prepared by a Task Force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal

2011-03-14T00:00:00Z

Colonoscopy is the most commonly used technique for inspection of the colonic mucosa. The safety and effectiveness of colonoscopy in identifying important colonic pathology is directly impacted by the quality of the bowel preparation performed in anticipation of the procedure. Physicians favor preparations associated with the best patient compliance to achieve the best results. Patients favor preparations that are low in volume, palatable, have easy to complete regimens, and are reimbursed by health insurance or are inexpensive. Both patients and physicians favor preparations that are safe to administer in light of existing comorbid conditions and those that will not interact with previously prescribed medications. Aqueous NaP solutions, NaP tablets, and PEG solutions, especially low-volume solutions, are all accepted and well tolerated by the majority of patients undergoing bowel preparation for colonoscopy. Physicians are advised to select a preparation for each patient based on the safety profile of the agent, NaP or PEG, in light of the overall health of the patient, their comorbid conditions, and currently prescribed medications. In certain circumstances, such as bowel preparation in children and some elderly patients, patients with renal insufficiency, and those with hypertension who are receiving ACE inhibitors or ARBs, it may be advisable to adhere to PEG-based solutions because of the risks of occult physiologic disturbances that may potentially contraindicate the use of NaP-based regimens. A variety of other preparations, none of which seem as popular because of inferior efficacy and/or patient acceptance, remain available for use in other circumstances in which bowel preparation is necessary. Many adjuncts to bowel preparation have been proposed but remain largely inefficacious and therefore cannot be recommended for routine use.

A controlled exercise training trial in patients with diastolic dysfunction

2007-08-23T00:00:00Z

A controlled exercise training trial in patients with diastolic dysfunction

2007-08-23T00:00:00Z

A controlled exercise training trial in patients with diastolic dysfunction

2007-08-23T00:00:00Z

A controlled exercise training trial in patients with diastolic dysfunction

2007-08-19T00:00:00Z

A controlled study of the effects of mental relaxation on autonomic excitatory responses in healthy subjects

2011-03-14T00:00:00Z

A controlled trial comparing the efficacy of rice-based and hypotonic glucose oral rehydration solutions in infants and young children with gastroenteritis

Wall, CR og Swanson, CE og Cleghorn, GJ — 2007-08-13T00:00:00Z

A prospective randomized trial was conducted to compare the efficacy of a rice-based oral rehydration solution (ORS) with glucose ORS in infants and children under 5 years of age with acute diarrhoea and mild to moderate dehydration (<10%). One hundred children presenting to a large metropolitan teaching hospital were eligible for entry to the study and were randomized to receive rice ORS or glucose ORS. Outcome measures were stool output (SO), duration of illness (DD) and recovery time to introduction of other fluids (RTF) and diet (RTD). Significant differences were found for all outcome measures in favour of the rice ORS group. Mean SO was lower (160 vs 213 mt; P<0.02), mean DD was reduced (17.3 vs 24.3 h; P = 0.03) and median RTF was decreased (12.7 vs 18.1 h; P< 0.001) in the rice ORS group compared with the glucose ORS group. The median rime to introduction of diet and mean length of hospital stay showed similar significant reductions. Our study has shown rice ORS to be an acceptable alternative to glucose ORS in young children and have shown that it is significantly more effective in reducing the course of diarrhoeal illness and the time taken to return to normal drinking and eating habits.

A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis

2009-12-22T00:00:00Z

A controlled trial of training in supervision

2007-08-13T00:00:00Z

A Copper-Salicylate Gel for Pain Relief in Osteoarthritis: a Randomised Controlled Trial

2004-12-20T00:00:00Z

Objective: To assess the efficacy and safety of a copper-salicylate gel in osteoarthritis of the hip and knee. Design: Randomised, double-blind, placebo-controlled study. Setting: Rheumatology Clinic of St Vincent's Hospital, Sydney, New South Wales (a tertiary referral hospital), June 1993 to October 1994. Patients: 116 patients with pain associated with osteoarthritis of the hip and/or knee (diagnosed by criteria of the European League against Rheumatism), drawn from patients attending the Clinic or self-referred after newspaper advertisements. Intervention: Copper-salicylate or placebo gel (1.5 g) applied twice daily to the forearm for four weeks. Outcome measures: Self-assessment of pain before the trial and after two and four weeks of treatment; patient and investigator assessments of efficacy; additional analgesia required; adverse reactions; and withdrawal rates. Results: Pain scores at rest and on movement decreased in both the copper-salicylate and placebo groups by 13%-20%. There was no significant difference between the two groups for decrease in pain score, patient and investigator efficacy ratings, number of patients requiring paracetamol for extra analgesia (active, 77%; placebo, 71%) and average dose of paracetamol (active, 555 mg/day; placebo, 600 mg/day). Significantly more patients in the copper-salicylate group reported adverse reactions (83% versus 52% of the placebo group), most commonly skin reactions, and withdrew from the trial because of these reactions (17% versus 1.7% of the placebo group). Conclusion: Copper-salicylate gel applied to the forearm was no better than placebo gel as pain relief for patients with osteoarthritis of the hip or knee, but produced significantly more skin rashes.

A coproantigen diagnostic test for Strongyloides infection

Sykes, Alex M. og McCarthy, James S. — 2011-03-13T00:00:00Z

A core breast biopsy diagnosis of invasive carcinoma allows for definitive surgical treatment planning

2011-03-14T00:00:00Z

BACKGROUND: We reviewed our image-guided core needle breast biopsy (IGCNBB) experience with patients diagnosed with invasive carcinoma (IC) to determine the accuracy of a core biopsy diagnosis of invasion and our ability to perform a single definitive cancer operation. METHODS: All IGCNBBs between July 1993 and July 1997 were reviewed to identify patients diagnosed with IC. Data included initial surgical treatment, surgical pathology, and subsequent surgical treatment. RESULTS: Of the 1,676 biopsies, invasive carcinoma was diagnosed in 208 with follow-up in 204 cases. Invasive carcinoma diagnosis was confirmed in 202 of 204 cases (99%). One hundred ninety-two patients had surgical treatment. Of these 192 patients, 173 (90%) could have achieved definitive surgical treatment with a single operation. CONCLUSIONS: An IGCNBB diagnosis of IC is accurate and allows for definitive breast cancer therapy. The potential impact on patient management is that a single operation can usually accomplish what traditionally has required at least two surgical procedures.

A core vocabulary approach for management of inconsistent speech disorder

2007-08-15T00:00:00Z

Developmental speech disorder is accounted for by theories derived from psychology, psycholinguistics, linguistics and medicine, with researchers developing assessment protocols that reflect their theoretical perspective. How theory and data analyses lead to different therapy approaches, however, is sometimes unclear. Here, we present a case management plan for a 7 year old boy with unintelligible speech. Assessment data were analysed to address seven case management questions regarding need for intervention, service delivery, differential diagnosis, intervention goals, generalization of therapeutic gains, discharge criteria and evaluation of efficacy. Jarrod was diagnosed as having inconsistent speech disorder that required intervention. He pronounced 88% of words differently when asked to name each word in the 25 word inconsistency test of the Diagnostic Evaluation of Articulation and Phonology three times, each trial separated by another activity. Other standardized assessments supported the diagnosis of inconsistent speech disorder that, according to previous research, is associated with a deficit in phonological assembly. Core vocabulary intervention was chosen as the most appropriate therapy technique. Its nature and a possible protocol for implementation is described.

A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program

2008-03-05T00:00:00Z

A cost-effectiveness analysis of genetic testing in the evaluation of families with hypertrophic cardiomyopathy

2012-05-31T00:00:00Z

A cost-effectiveness analysis of the intrapartum fetal pulse oximetry multicentre randomised controlled trial (the FOREMOST trial)

2007-08-15T00:00:00Z

A cost-effectiveness model of genetic testing for the evaluation of families with hypertrophic cardiomyopathy

2012-05-21T22:33:47Z

Acquired central diabetes insipidus in children: A 12 year Brisbane experience

2007-08-14T00:00:00Z

Objective: To study the clinical, endocrine and radiological features and progress of children presenting with acquired diabetes insipidus (CDI). Methodology: Chart review of children presenting because of CDI to Brisbane paediatric endocrine clinics between 1987 and 1999. Results: Thirty-nine children (female/male ratio 21/18) aged 0.1-15.4 years (mean age 6.7 years) were identified. Aetiologies were head trauma or familial in eight cases (20.5%) each, central nervous system (CNS) tumours in five cases (12.8%), CNS malformations in four cases (10.2%), histiocytosis in three cases (7%) and hypoxia and infection in two cases (5.1%) each. Seven cases (17.9%) remain undiagnosed. Of the 32 (82%) cases with isolated anti-diuretic hormone deficiency at presentation, 24 cases (61.5%) experienced no further endocrine deficit. Additional endocrine deficits occurred mainly in the tumour or undiagnosed groups. On follow-up brain magnetic resonance imaging (MRI) scans in the seven undiagnosed cases, six patients bad mild or no change and one patient had marked improvement of MRI findings. These changes occurred 10-48 months (mean 18 months) after presentation. Conclusions: Children without an aetiological diagnosis for the uncommon condition of acquired CDI require careful follow-up. More intensive investigation at presentation (e.g. estimation of cerebrospinal fluid human chorionic gonadotrophin) promises to lessen the number of such cases. Pituitary stalk biopsies should be reserved for those patients with progressive MRI changes. If these changes do not occur early, our experience suggests that follow-up MRI scans may need to be performed only yearly.

Acquired cholesteatoma: Classification and outcomes

Black, Bruce og Gutteridge, Ian — 2011-09-29T00:00:00Z

Acquired hypernatraemia is an independent predictor of mortality in critically ill patients

2010-04-20T00:00:00Z

This study reports the incidence and associated mortality of acquired hypernatraemia (Na > 150 mmol.l−1) in a general medical/surgical intensive care unit. Patients admitted over a 5-year period with normal sodium values were eligible for inclusion; exclusions were made for burn/neurosurgical diagnoses and for hypertonic saline therapy. From 3475 admissions (3317 patients), 266 (7.7%) episodes of hypernatraemia were observed. Hospital mortality was 33.5% in the hypernatraemic group and 7.7% in the normonatraemic group (p < 0.001). Acquired hypernatraemia was an independent risk factor for in-hospital mortality (OR 1.97, 95% CI 1.37–2.82, p < 0.001). Intermediate sodium levels (145–150 mmol.l−1) were associated with increased mortality (OR 1.42, 95% CI 1.02–1.98). Uncorrected sodium at discharge (p = 0.001) and peak sodium (p = 0.001) were better predictors of mortality than time to onset (p = 0.71) and duration of hypernatraemia (p = 1.0). Hypernatraemia avoidance is justified, but determinants of hypernatraemia and benefits of targeted treatment strategies require further elucidation.

Acquired immunity and reinfection to Schistosoma japonicum IV. Levels of specific antibody isotype and reinfection nine months after treatment.

2007-08-14T00:00:00Z

Acquired immunity to malaria

2010-03-12T00:00:00Z

Naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from severe disease and death. There is no clear concept about how this protection works. There is no general agreement about the rate of onset of acquired immunity or what constitutes the key determinants of protection; much less is there a consensus regarding the mechanism(s) of protection. This review summarizes what is understood about naturally acquired and experimentally induced immunity against malaria with the help of evolving insights provided by biotechnology and places these insights in the context of historical, clinical, and epidemiological observations. We advocate that naturally acquired immunity should be appreciated as being virtually 100% effective against severe disease and death among heavily exposed adults. Even the immunity that occurs in exposed infants may exceed 90% effectiveness. The induction of an adult-like immune status among high-risk infants in sub-Saharan Africa would greatly diminish disease and death caused by P. falciparum. The mechanism of naturally acquired immunity that occurs among adults living in areas of hyper- to holoendemicity should be understood with a view toward duplicating such protection in infants and young children in areas of endemicity.

Acquiring multiple parameters from multiple tests: The real principle of multimodality imaging

Marwick, Thomas H. og Narula, Jagat — 2011-09-05T00:00:00Z

2012 ACR Commission on Human Resources Workforce Survey

2012-11-05T14:44:23Z

A critical appraisal of treatment for T3N0 colon cancer

2011-03-14T00:00:00Z

A critical evaluation of the potential benefits of public access defibrillation

2011-03-02T00:00:00Z

A critical role for the parabrachial nucleus in generating central nervous system responses elicited by a systemic immune challenge

2007-08-15T00:00:00Z

Using Fos immunolabelling as a marker of neuronal activation, we investigated the role of the parabrachial nucleus in generating central neuronal responses to the systemic administration of the proinflarnmatory cytokine interleukin-1beta (1 mug/kg, i.a.). Relative to intact animals, parabrachial nucleus lesions significantly reduced the number of Fos-positive cells observed in the central amygdala (CeA), the bed nucleus of the stria terminalis (BNST), and the ventrolateral medulla (VLM) after systemic interleukin-1beta. In a subsequent experiment in which animals received parabrachial-directed deposits of a retrograde tracer, it was found that many neurons located in the nucleus tractus solitarius (NTS) and the VLM neurons were both retrogradely labelled and Fos-positive after interleukin-1beta administration. These results suggest that the parabrachial nucleus plays a critical role in interleukin-1beta-induced Fos expression in CeA, BNST and VLM neurons and that neurons of the NTS and VLM may serve to trigger or at least influence changes in parabrachial nucleus activity that follows systemic interleukin-1beta administration. (C) 2004 Elsevier B.V. All rights reserved.

A critique of the overfill hypothesis of sodium and water retention in the nephrotic syndrome

Schrier, R. W. og Fassett, R. G. — 2011-03-09T00:00:00Z

A critique of the overfill hypothesis of sodium and water retention in the nephrotic syndrome. Recent reviews have claimed that the majority of patients with the nephrotic syndrome have plasma volume expansion (that is, they are overfilled). Here we attempt to re-establish balance to the debate on body fluid volume status in nephrotic patients by: (a) discussing the conflicting literature on plasma volume measurements in the nephrotic syndrome; (b) providing alternate explanations for data purporting to support an overfill hypothesis in the nephrotic syndrome; (c) emphasizing secondary neurohumoral responses that support underfilling at least as frequently as overfilling; and (d) emphasizing the clinical importance of fluid assessment in the individual patient with the nephrotic syndrome particularly in relation to diuretic use.

A cross-over trial comparing intravenous (IV) and oral iron supplementation in erythropoietin (EPO) - treated peritoneal dialysis (PD) patients

2007-08-23T00:00:00Z

A cross-sectional analysis of patterns of obesity in a cohort of working nurses and midwives in Australia, New Zealand, and the United Kingdom

2012-02-28T08:11:11Z

A cross-sectional study of the association between Heberden's nodes, radiographic osteoarthritis of the hands, grip strength, disability and pain

Jones, G og Cooley, HM og Bellamy, N — 2007-08-14T00:00:00Z

Objective: To describe the associations between hand osteoarthritis (OA), pain and disability in males and females and to further validate the Australian/Canadian CA hand index (AUSCAN LK3.0). Design: Cross-sectional study of 522 subjects from 101 Tasmanian families (males N=174, females N=348). Hand OA was assessed by two observers using the Altman atlas for joint space narrowing and osteophytes at distal interphalangeal and first carpometacarpal joints as well as a score for Heberden's nodes based on hand photography. Hand pain and function were assessed by the AUSCAN LK3.0 and grip strength by dynamometry in both hands on two occasions. Results: The prevalence of hand CA was high in this sample at 44-71% (depending on site). Pain and dysfunction increased with age while grip strength decreased (all P <0.001). All three measures were markedly worse in women, even after taking the severity of arthritis into account. Hand CA explained 5.7-10% of the variation in function, grip strength and pain scores, even after adjustment for age and sex. Further adjustment suggested that the osteoarthritic associations with function and grip strength were largely mediated by pain. Severity of disease was more strongly associated with these scores than presence or absence. Lastly, the AUSCAN LK3.0 showed a comparable association to grip strength with structural damage providing further evidence of index validity. Conclusions: Hand CA at these two sites makes substantial contributions to hand function, strength and pain. The associations with function and strength measures appear mediated by pain. Gender differences in all three measures persist after adjustment for variation in age and CA severity indicating that factors apart from radiographic disease are responsible. (C) 2001 OsteoArthritis Research Society International.

A cross-sectional study to investigate current social adjustment of offspring of patients with schizophrenia

2008-02-18T00:00:00Z

Objective To investigate the impact of parental disorder in the life of adult offspring by evaluating education, current employment and marital status of a sample of offspring of patients with schizophrenia and comparing findings with population rates. Methods A sample of 489 patients with DSM-IV diagnoses of schizophrenia was identified in the public outpatient mental health services of the city of Cuiaba, Brazil. Of these patients, 294 had children, and a total of 828 offspring were identified. Data for 431 offspring aged 18 years or older were collected using a structured questionnaire answered by the patient-parent and a family member. Results The percentage of age-grade discrepancy for offspring aged 18 and 19 years was 59.2% (95% CI 45.4-73.0), not significantly different from the discrepancy rate for the same age group in the general population, which was 71.1%. Offspring of patients with schizophrenia had a significantly poorer employment situation than the general population (66.7% and 75.6%; 95% CI 62.1-71.3). Fewer male offspring were married than males in the general population (54.7% and 66.0%; 95% CI 48.2-61.2). Conclusion Adult offspring of patients with schizophrenia had social adjustment problems that were markedly reflected in employment and marital status.

A cross-sectional survey of influenza A infection, and management practices in small rural backyard poultry flocks in two regions of New Zealand

2010-07-25T00:00:00Z

A cross-study transcriptional analysis of Parkinson's disease

2011-03-09T00:00:00Z

The study of Parkinson's disease (PD), like other complex neurodegenerative disorders, is limited by access to brain tissue from patients with a confirmed diagnosis. Alternatively the study of peripheral tissues may offer some insight into the molecular basis of disease susceptibility and progression, but this approach still relies on brain tissue to benchmark relevant molecular changes against. Several studies have reported whole-genome expression profiling in post-mortem brain but reported concordance between these analyses is lacking. Here we apply a standardised pathway analysis to seven independent case-control studies, and demonstrate increased concordance between data sets. Moreover data convergence increased when the analysis was limited to the five substantia nigra (SN) data sets; this highlighted the down regulation of dopamine receptor signaling and insulin-like growth factor 1 (IGF1) signaling pathways. We also show that case-control comparisons of affected post mortem brain tissue are more likely to reflect terminal cytoarchitectural differences rather than primary pathogenic mechanisms. The implementation of a correction factor for dopaminergic neuronal loss predictably resulted in the loss of significance of the dopamine signaling pathway while axon guidance pathways increased in significance. Interestingly the IGF1 signaling pathway was also over-represented when data from non-SN areas, unaffected or only terminally affected in PD, were considered. Our findings suggest that there is greater concordance in PD whole-genome expression profiling when standardised pathway membership rather than ranked gene list is used for comparison.