bluuebunny/crossref_metadata_2025 huggingface dataset:
Health and Aged Care Enabled by Information Technology
Authors: SOAR JEFFREY , SEO YOUNGJOON
Published: November 2007

Abstract:  One of the challenges facing health and welfare policymakers as well as researchers in most developed countries is the increasing demand for aging services and aged care. Low birth rates and rapid increases in the percentages of elderly people make aging and aged care one of the top‐priority issues among the national agenda of many countries. The responses of governments have included initiatives to extend productive working lives and promote self‐funded retirement; to promote healthy, active aging; and to encourage more care to be delivered in home and community settings. Technology will be a major enabler of these strategies. People requiring health services are increasingly being offered more care in their own homes and community settings as an alternative to hospital admission and to delay or avoid moving into institutional care. Research is providing intelligent technology to enable care in the home as well as to monitor safety, security, and quality. Innovation will provide greater independence and better access to care in their own homes for the elderly, sufferers of chronic illness, and persons with disability and reduce the incidence of hospital admissions and the length of stay when admissions do occur. Technologies will support families and professional caregivers and are expected to reduce costs. This paper reports on developments in technology to support care for the aged in home and community settings.
Cytomegalovirus Infection
Authors: KOCH SVEN , LARBI ANIS , ÖZCELIK DENNIS , SOLANA RAFAEL , GOUTTEFANGEAS CÉCILE , ATTIG SEBASTIAN , WIKBY ANDERS , STRINDHALL JAN , FRANCESCHI CLAUDIO , PAWELEC GRAHAM
Published: November 2007

Abstract:  The human immune system evolved to defend the organism against pathogens, but is clearly less well able to do so in the elderly, resulting in greater morbidity and mortality due to infectious disease in old people, and higher healthcare costs. Many age‐associated immune alterations have been reported over the years, of which probably the changes in T cell immunity, often manifested dramatically as large clonal expansions of cells of limited antigen specificity together with a marked shrinkage of the T cell antigen receptor repertoire, are the most notable. It has recently emerged that the common herpesvirus, cytomegalovirus (CMV), which establishes persistent, life‐long infection, usually asymptomatically, may well be the driving force behind clonal expansions and altered phenotypes and functions of CD8 cells seen in most old people. In those few who are not CMV‐infected, another even more common herpesvirus, the Epstein‐Barr virus, appears to have the same effect. These virus‐driven changes are less marked in “successfully aged” centenarians, but most marked in people whom longitudinal studies have shown to be at higher risk of death, that is, those possessing an “immune risk profile” (IRP) characterized by an inverted CD4:8 ratio (caused by the accumulation primarily of CD8+ CD28− cells). These findings support the hypothesis that persistent herpesviruses, especially CMV, act as chronic antigenic stressors and play a major causative role in immunosenescence and associated mortality.
Senescence Viewed through the Lens of Comparative Biology
Authors: CARNES BRUCE A.
Published: November 2007

Abstract:  Although mortality and longevity are inherently biological phenomena, their study has historically been the purview of demography and the actuarial sciences. An infusion of biological thinking into these disciplines transforms demography into biodemography and provides expectations and coherency to observations on age‐determined mortality that would not be explainable otherwise. Comparative biology teaches us that reproduction is life's solution to the inevitability of death in the hostile environments of Earth.
That solution, however, places a higher priority on investing physiological resources into reproduction that could otherwise have been used to maintain the soma (body) longer. As such, aging is an inescapable but inadvertent byproduct of imperfect maintenance and its attendant surveillance and repair. Biology also reveals that while bodies are not designed to fail, neither are they designed for extended operation. In other words, bodies are subject to biological warranty periods for normal operation. For sexually reproducing species, that warranty period includes the time from conception to sexual maturity, the production and nurturing of offspring, and a period of grand‐parenting in some species. Humans are the only species capable of exploiting the loophole in the biological contract of life (bodies that are not designed to fail). Human ingenuity (science, medicine, public health) has produced interventions that manufacture
survival time by delaying death, and in so doing, has created a phenomenon never before seen in the history of life—population aging (and all the societal and health consequences that go with it).
From Beans to Berries and Beyond
Authors: LILA MARY ANN
Published: November 2007

Abstract:  It is now well known to consumers around the world that certain fruits and vegetables can help prevent or treat chronic human diseases. But, what many people don't fully appreciate is that it is not a single component in these plant‐derived foods, but rather complex mixtures of interacting natural chemicals, that produce such powerful health‐protective effects. These natural components accumulate simultaneously together in a plant, and provide a multifaceted defensive strategy for both the plant, and the human consumer. In order to investigate the strength of natural chemical cooperation in highly‐pigmented, flavonoid‐rich functional foods, our lab has relied on analysis of both whole fruits, and continuous, reliable plant cell culture production systems which accumulate anthocyanins and proanthocyanidins in high concentrations. Successive rounds of relatively gentle, rapid, and large‐volume fractionations are linked to bioassay of complex to simple mixtures and semi‐purified compounds. By means of this strategy, additive interactions or synergies between related compounds in health maintenance can be sorted out. Interestingly, phytochemical interactions between the same classes of compounds intensify the efficacy of flavonoid‐rich fruits against multiple, not necessarily discrete, human disease conditions including CVD, cancer, metabolic syndrome, and others.
Nutritional Interventions in Aging and Age‐Associated Diseases
Authors: ROTH GEORGE S. , INGRAM DONALD K. , JOSEPH JAMES A.
Published: November 2007

Abstract:  Dietary interventions have proven to be the most robust and consistent means of ameliorating the diseases and dysfunctions of aging. A large literature includes both quantitative (caloric restriction [CR]) and qualitative (micronutrients, antioxidants, etc.) alterations of nutrient and caloric intake and the resulting positive outcomes for age‐related disease protection, maintenance of vitality, and quantitative and qualitative life‐span extension. In recognition of the importance of this research area, two sessions concerning nutritional interventions in aging and age‐associated diseases were organized for this symposium, one dealing with diet and the other with dietary supplements. This brief report covers both, providing selected examples of the most recent research into both these types of interventions and their mechanisms of action.
Computed Tomography Scans Do Not Improve the Predictive Power of 1996 National Cancer Institute–Sponsored Working Group Chronic Lymphocytic Leukemia Response Criteria
Authors: Blum Kristie A. , Young Donn , Broering Sarah , Lucas Margaret S. , Fischer Beth , Lin Thomas S. , Grever Michael R. , Byrd John C.
Published: November 2007

Purpose

National Cancer Institute–sponsored Working Group (NCI-WG) response criteria for chronic lymphocytic leukemia (CLL) rely on physical examination, blood, and bone marrow evaluations. The widespread use of computed tomography (CT) scans has prompted many to advocate for the incorporation of this test into CLL response criteria.

Patients and Methods

In a retrospective review of 82 CLL patients treated at the Ohio State University (Columbus, OH), we compared CT assessed response using non-Hodgkin's lymphoma (NHL) response definitions with NCI-WG response.

Results

Responses by NCI-WG criteria included five complete responses (CRs), 32 partial responses (PRs), 21 patients with stable disease (SD), 17 patients with progressive disease (PD), and seven patients not assessable (NA). Responses by NHL-CT criteria included three CRs, 12 unconfirmed CRs (CRus), 16 PRs, 26 with SD, four with PD, and 21 NA. Using NCI-WG criteria, progression-free survival (PFS) was 27.3 months for CR and 11.4 months for PR. With NHL-CT criteria, PFS was 18.4 months for CR, 11.7 months for CRu, and 14.5 months for PR. In multivariate analysis, both NCI-WG and NHL-CT response correlated with PFS (P = .009 and .001, respectively).

Conclusion

Current NCI-WG CLL response criteria are a significant predictor of PFS in previously treated CLL patients, with no additional benefit from the inclusion of CT scans. Although retrospective, these results highlight the importance of prospective validation of CT scans before routine inclusion in CLL response criteria.
The Kalapalo Affinal Civility Register
Authors: Basso Ellen B.
Published: November 2007

Data from narratives, conversations, and didactic speech are employed to describe a multimodal, combinatorial civility register used by speakers of Kalapalo, a central Brazilian Southern Carib language. Practiced among family members, these intimate ritual communications involve complementary grammatical, lexical, discursive, and interactive features, including self‐abnegation and avoidance practices. Examples of conventional usage, and the consequences of register misuse and the collapse of civility are included. Affinal civility enables both specific domestic unions, and more extensive social networks or chains of partnerships within the multilingual Alto Xingu macropolity. The question of the relationship of affinal civility to multilingual macro‐polities more generally is addressed with respect to evidence from Australia.
Youth Language, Gaul Sociability, and the New Indonesian Middle Class
Authors: Smith‐Hefner Nancy J.
Published: November 2007

This article examines the linguistic form and social functions of bahasa gaul, the informal Indonesian "language of sociability," as it is used among Indonesian university students and in various publications aimed at middle‐class Indonesian youth. Bahasa gaul registers youth modernity in both its positive and more contested aspects. It expresses not only young people's aspirations for social and economic mobility, but also an increasingly cosmopolitan, national youth culture. Perhaps most significantly, bahasa gaul articulates the desire of Indonesian youth for new types of social belonging through the formulation of relationships that are more egalitarian and interactionally fluid as well as more personally expressive and psychologically individualized.
Kinterm Usage and Hierarchy in Thai Children's Peer Groups
Authors: Howard Kathryn
Published: November 2007

This article examines Northern Thai children's language socialization into the elder sibling/younger sibling relationship, including the communicative practices for inhabiting it, through routinized person‐referring practices in their peer groups. Notwithstanding a strong cultural emphasis on hierarchy in this community, children's unmarked practices for self and other reference reflect and create an egalitarian and intimate social space. When children invoke the hierarchical elder/junior relationship through their use of person reference—especially kinterms—it is done as a means of seeking compliance within these play groups. It is argued children's practices of kinterm usage socialize them into the affective and social dimensions of their relationships with siblings and friends.
Book Reviews
Authors: Jackson, Jr. John L.
Published: November 2007

The Tailenders, Adele Horne, writer, director, and producer. 2005. New Day Films. 72 minutes.
Book Reviews
Authors: Corvey William
Published: November 2007

Learning Identity: The Joint Emergence of Social Identification and Academic Learning. Stanton Wortham. Cambridge: Cambridge University Press, 2006. 305 pp.
Book Reviews
Authors: Hill Jane H.
Published: November 2007

Language and Social Relations. Asif Agha. Cambridge: Cambridge University Press, 2007. xv. 427 pp.
Book Reviews
Authors: Hufford Mary
Published: November 2007

Speech Play and Verbal Art. Joel Sherzer. Austin: University of Texas Press, 2002. ix. 186 pp.
Book Reviews
Authors: Mansouri Aous
Published: November 2007

Speaking in Queer Tongues: Globalization and Gay Language. William L. Leap and Tom Boellstroff, eds. Urbana and Chicago: University of Illinois Press, 2004. 288 pp.
Book Reviews
Authors: Sturzsreetharan Cindi L.
Published: November 2007

Vicarious Language: Gender and Linguistic Modernity in Japan. Miyako Inoue. Berkeley: University of California Press, 2006. xvii. 323 pp.
Book Reviews
Authors: Trawick Margaret
Published: November 2007

Masking Terror: How Women Contain Violence in Southern Sri Lanka. Alex Argenti‐Pillen. Philadelphia: University of Pennsylvania Press, 2003. 272 pp.
Major Congenital Anomalies Place Extremely Low Birth Weight Infants at Higher Risk for Poor Growth and Developmental Outcomes
Authors: Walden Rachel V. , Taylor Sarah C. , Hansen Nellie I. , Poole W. Kenneth , Stoll Barbara J. , Abuelo Dianne , Vohr Betty R. ,   for the National Institute of Child Health and Human Development Neonatal Research Network
Published: November 2007

BACKGROUND. Studies of growth and neurodevelopmental impairment in extremely low birth weight infants often exclude infants with major congenital anomalies; thus, there are few outcome data available on these infants.

OBJECTIVES. The purpose of this work was to compare growth and neurodevelopmental outcomes of extremely low birth weight infants with major anomalies to extremely low birth weight infants without these findings. It was hypothesized that infants with severe anomalies would have worse growth, neurodevelopmental, and survival outcomes.

METHODS. A retrospective cohort analysis was performed on 5920 extremely low birth weight infants surviving beyond 12 hours of life at 19 neonatal network centers between 1998 and 2001. Infants with significant anomalies were more likely to die before 18 to 22 months' corrected age. A total of 3705 children underwent neurodevelopmental and anthropometric evaluation at 18 to 22 months' corrected age. Statistical significance for unadjusted comparisons was determined by Wilcoxon tests for continuous variables and χ2 or Fisher's exact tests for categorical variables. Regression models were used to compare the outcomes after adjusting for potential confounders.

RESULTS. Children with major congenital anomalies were more likely to have Bayley Mental Development Index scores of ≤70, Psychomotor Development Index scores of ≤70, neurodevelopmental impairment, moderate-to-severe cerebral palsy, length in the ≤10th percentile, head circumference in the ≤10th percentile, more rehospitalizations, and higher rates of early intervention use at 18 to 22 months' corrected age.

CONCLUSIONS. At 18 to 22 months' corrected age, extremely low birth weight infants born with major anomalies have nearly twice the risk for neurodevelopmental impairment, increased risk of poor growth, and >3 times greater risk of rehospitalization when compared with extremely low birth weight infants without major anomalies. This information may be valuable for counseling parents regarding the outcomes of these infants and for the facilitation of appropriate support and intervention services.
Endoscopos stent vagy sebészi bypass? A pancreastumor esetében alkalmazható palliatív módszerek összehasonlítása klinikai vizsgálatok bizonyítékai alapjánr
Authors: Olgyai Gábor , Oláh Attila
Published: November 2007

Absztrakt

A szerzők a rendelkezésre álló legfrissebb evidence based adatok alapján tekintik át az irresecabilis pancreastumorok kapcsán alkalmazható palliatív módszerek két alternatívájának, a hagyományos sebészi bypassműtéteknek és az endoscopos stentimplantatióknak az eredményeit. A meta-analízisek elemzése alapján biliaris plasztikstentek alkalmazása csak rövid, 6 hónapot meg nem haladó várható túlélés esetén javasolható. Ennél hosszabb életkilátás esetén az öntáguló fémstent a költséghatékonyabb. Ez utóbbi módszer a hagyományos sebészi bypassműtéttel minden szempontból egyenrangú. Feltétlenül a sebészi módszernek van azonban prioritása minden esetben, ahol az irresecabilitas a korrekt staginget követően is kétséges, vagy ahol egyidejűleg gyomorürülési zavar is fennáll.

A duodenalis stentek alkalmazása nem javasolható rutinszerűen. A magas késői szövődmények aránya (stentmigratio, perforatio, obstructio) miatt csak szelektált esetekben, előrehaladott stádiumban, vagy fokozott műtéti kockázat mellett érdemes megkísérelni a módszert.
A laparoscopia szerepe a májdaganatok resecabilitasának megítélésébenr
Authors: Dede Kristóf , Mersich Tamás , Nagy Péter , Baranyai Zsolt , Zaránd Attila , ifj. Besznyák István , Faludi Sándor , Jakab Ferenc
Published: November 2007

Absztrakt

A májdaganatok terápiás lehetőségei közül a sebészi resectio átlagosan 40%-os, 5 éves túlélést, míg a májtranszplantáció (OLTX) ennél is jobb eredményeket biztosíthat. A betegek jelentős része azonban a daganatok száma, elhelyezkedése, disseminatio miatt alkalmatlan a beavatkozásra, és ez sokszor csak a sebészi feltárás során igazolódik. A klinikai, képalkotó és egyéb speciális preoperatív vizsgálatok mellett esetenként fontos szerep juthat a laparoscopiának mind a staging pontosításában, mind a resecabilitas megítélésében.

Retrosprektív módon elemeztük a malignus májelváltozás miatt műtétre került, laparoscopizált betegeink adatait. A 2000. január 1. és 2006. március 31. közötti időszakban az osztályunkon sebészileg májtumor miatt kezelt 310 beteg közül 39 betegnél végeztünk staging laparoscopiát. 22 (56%) esetben primer hepatocellularis carcinoma (HCC), 17 (44%) esetben májmetastasis miatt történt a beavatkozás.

A primer és a szekunder májdaganatokat vizsgálva a laparoscopizált betegek 70%-nál igazoltunk irresecabilitast. A resecabilisnak ítélt betegek esetében azonban csupán 50%-os volt a staging pontossága. Az irresecabilitas okaként legjobban a carcinosis tényét, valamint a daganat multiplex megjelenését lehetett igazolni laparoscopiával, a daganat centrális kiterjedését, a nagyerek invázióját nem jelezte kellő pontossággal.

A malignus májdaganatok preoperatív staging vizsgálatainak egyik eleme lehet a staging laparoscopia, és segíthet megelőzni egy felesleges laparotomiát, azonban minden májresectióra váró betegnél rutinszerűen nem ajánlott, válogatott betegcsoportban javasolható.
Bilateralis carotis interna aneurysmar
Authors: Szabó Gábor Viktor , Szeberin Zoltán , Bíró Gábor , Laczkó Ágnes , Dzsinich Csaba , Acsády György
Published: November 2007

Absztrakt

A szerzők ismertetik kétoldali carotis aneurysma miatt kezelt öt betegük esetét, áttekintik a vonatkozó irodalmi adatokat és ajánlásokat. A betegek kivizsgálásakor duplex scan, angiographia és CT készült. Az aneurysmák átmérője 9–40 mm volt. Sok tényező mérlegelése, egyedi döntések alapján két betegen kétoldali, további kettőn egyoldali rekonstrukciós műtéteket végeztek end-to-end anastomosissal, egy esetben a konzervatív kezelést választották. Egy betegen multiplex aneurysmatosis miatt több ülésben végeztek műtéteket. Posztoperatív szövődményként egy esetben reverzibilis stroke alakult ki. Az operált és a nem operált betegeket éveken át (3–14 év), folyamatosan, félévenként duplex scan vizsgálattal ellenőrzik. A carotis aneurysma magas kockázatú szövődményeinek megelőzésére (kompresszió, ruptura, embolisatio) a 15 mm-es legnagyobb átmérő felett, növekedés, thromboticusfelrakódás vagy neurológiai tünetek esetén műtéti megoldást javasolnak.
Collum chirurgicum törését rögzítő, elvándorolt Kirschner-tűződrótok sikeres szívsebészeti eltávolításar
Authors: Hüttl Tivadar , Kassai Imre , Hartyánszky István , Daróczi László , Friedrich Orsolya , Széphelyi Katalin , Szabolcs Zoltán
Published: November 2007

Absztrakt

Felkartörések ellátásánál használt tűződrótok dislocatióját és elvándorlását találták az első kontrollvizsgálaton mindössze 13 nappal a traumatológiai ellátást követően. Észleléskor az egyik tűződrót a lateralis mellkasfal izomzatában helyezkedett el, míg a másik, hegyével a szívcsúcs izomzatába fúródva, a szívkontrakciókkal szinkron mozgott. Eltávolításukra szívsebészeti műtőben, bal oldali anterolateralis thoracotomiából került sor.
Necrotizing otitis externa in a 5-month-old infant
Authors: Fücsek Mihály , Kelemen Ágnes , Jakabos Péter
Published: November 2007

A szerzőkPseudomonas aeruginosaokozta akut jobb oldali mastoiditis, sepsis következtében kialakult kétoldali otitis externa necrotica (maligna) gyógyult esetét ismertetik öt hónapos csecsemőn. Azonnal elvégzett mastoidectomia, célzott antibakteriális és intenzív helyi kezelések ellenére mindkét oldali hallójáratbőr külső kétharmada körkörösen nekrotizált, kilökődött, illetve ismételt necrectomia során távolították el. A gyulladásos tünetek megszűnése után sikeres kétoldali hallójárat-plasztikát végeztek. A betegség kezdetekor kialakult jobb oldali perifériás facialis paresis változatlan maradt. Két hónapos kezelés után maradványtünetekkel gyógyult. A kivizsgálás során sem immunhiány, sem cukorbetegség nem igazolódott.
Successful renal transplantation following lung transplantation: a survey of the first Hungarian case
Authors: Csánky Eszter , Asztalos László , Vaskó Attila , Szűcs Ildikó , Dévényi Katalin , Szilasi Mária , Balla József
Published: November 2007

A tüdőtranszplantáció széles körben elfogadott kezelési lehetőség végstádiumú tüdőbetegek számára, akiknek a funkcionális státusza maximális kezelés mellett romlik. A szerzők egy fiatal betegük esetét ismertetik, aki végstádiumú idiopathiás tüdőfibrosis miatt Bécsben tüdőtranszplantáción esett át. Az elhúzódó, szövődményes posztoperatív szakban akut veseelégtelenség alakult ki, emiatt a beteg hemodialízisre szorult. Pulmonológiai szempontból teljes rehabilitációja valósult meg, és a rendszeres művesekezelés az opportunista fertőzések kialakulásának a kockázatát jelentős mértékben megnövelte, a beteg életminőségét is jelentősen rontotta, ezért négy évvel a tüdőtranszplantáció után vesetranszplantációra került sor Debrecenben. Ez az első magyar tüdőtranszplantált beteg, aki Magyarországon veseátültetésen is átesett. Több mint két évvel a vesetranszplantáció után a beteg kompenzáltan, rehabilitáltan él, légzésfunkciós értékei tovább javultak, és vesefunkciós paraméterei is kielégítőek. Az elmúlt évek során szignifikánsan megnövekedett a különböző szervtranszplantáción áteső betegek száma világszerte és hazánkban is. Ezeknél a betegeknél elsősorban az immunszuppresszív szerek, calcineurininhibitorok hatására számtalan szövődménnyel kell számolni. Kiemelendő a szekunder veseelégtelenség, amely mind akut, mind krónikus formában jelentkezhet, és akár vesetranszplantáció indikációját is képezheti. A veseátültetés kiváló kezelési lehetőség olyan végstádiumú vesebetegek számára, akik korábban más szervtranszplantáción estek át. A veseátültetés javítja az életminőséget, és a várható túlélést is növeli.
The prevalence of hyperbilirubinaemia and the diagnostics of Gilbert-syndrome in our work fitness examinations
Authors: Soós Pál
Published: November 2007

A Gilbert-szindróma világszerte elterjedt enyhe fokú anyagcsere-anomália. Az általános populációban minden huszadik ember érintett. A Magyar Honvédség munkaköri alkalmasságot vizsgáló intézetében a 2006. év első három hónapjában 1307 személyt vizsgáltunk meg a célirányosan működtetett szakorvosi munkahelyeken. A laboratóriumi eredmények értékelésekor feltűnő volt a szérum-összbilirubin szintjének gyakori emelkedése, amelyet összesen 117 esetben észleltünk. A folyamatosan eddig elvégzett kontrollvizsgálataink megerősítették, hogy ezekből 57 alkalommal az indirekt, konjugálatlan bilirubin szaporodott fel. Májbetegség vagy fokozott haemolysissel járó kórkép gyanúja célzott vizsgálatokkal sem merült fel. Így a kóros lelet, egyéb más diagnosztikus jel hiányában, a Gilbert-szindróma megállapításához vezetett. A Gilbert-szindróma megítélése a fizikai terhelhetőség kérdésében sem egységes. Ezért intézetünk fizikai alkalmasságot vizsgáló osztályán 57 Gilbert-szindrómás „betegünk” egzakt módon mért és dokumentált terhelési adatait összehasonlítottuk 57 egészséges, azonos nemű és korú személyével. A teljesítményben különbséget nem találtunk. Ezek és az erre vonatkozó eddigi tapasztalatok alapján a munkaköri korlátozás kérdése revízióra szorul. Adataink egy reprezentatív csoportra vonatkoznak. Reményeink szerint a diagnosztikai megfontolásokban és az anyagcsere-anomália jelentőségének általános megítélésében mégis segíthetnek.
The autosomal dominant cerebellar ataxias are hereditary neurodegenerative diseases
Authors: Sáfrány Enikő , Balikó László , Guseo András , Faragó Bernadett , Melegh Béla
Published: November 2007

Az autoszomális domináns cerebellaris ataxiák örökletes neurodegeneratív betegségek. Az ataxiák még néhány évtizeddel ezelőtt is a legkevésbé megértett idegi rendellenességek közé tartoztak, de molekuláris hátterük tisztázása mára lehetőséget teremtett a pontos diagnózis megállapítására, és segítséget nyújtott számos olyan különös jelenség értelmezésében is, mint például a családon belül változatosan megjelenő fenotípus. A spinocerebellaris ataxiák patogenezisének megismerése esélyt kínálhat sikeres terápiák kifejlesztésére, a jelenlegi, pusztán tüneti kezelések helyett. A gyors egymásutánban felfedezett gének és génlocusok, valamint a kialakított ataxiaaltípusok azonban zavart is okozhatnak a betegség pontos meghatározásában. Célunk rövid betekintést nyújtani e neurodegeneratív kórképek genetikai hátterébe, és a fontosabb ataxiaaltípusok jellemzésével megkönnyíteni az egyértelmű diagnózis felállítását.
Malignant tumors following renal transplantation
Authors: Végső Gyula , Járay Jenő
Published: November 2007

A vese és egyéb szervek átültetését követően, többek között a korszerű immunszuppresszív kezelés eredményeként a betegek túlélési ideje egyre növekszik. Ugyanakkor a tartós immunszuppresszió hátrányos következménye, hogy a túlélési idővel arányosan növekszik a rosszindulatú daganatok kialakulásának a valószínűsége is. A fokozott daganatos kockázatért elsősorban az elnyomott immunrendszer tumor- és vírusellenes funkciójának károsodása felelős. A poszttranszplantációs daganatok gyakorisága átlagosan 2–4-szerese a nem transzplantált lakosságénak, és összetétele is eltér a populációra jellemző tumorokétól. Elsősorban azok a daganatok gyakoriak, melyek kialakulásában fontos szerepet tulajdonítunk az onkogén vírusoknak (bőrrák, lymphoma, Kaposi-szarkóma, szájüregi rák, anogenitalis régió tumorai stb.). A szervátültetés utáni daganatok kezelhetősége és prognózisa rosszabb, mint a lakosság hasonló daganataié. A poszttranszplantációs tumorok növekvő gyakoriságuk miatt a transzplantált betegek hosszú távú sorsának egyre fontosabb meghatározó tényezőjévé kezdenek válni. A daganatos kockázat csökkentését segítheti a karcinogén hatások kerülése, a rákmegelőző állapotok és a tumorok korai felismerése és kezelése, az alacsony dózisú immunszuppresszív kezelés, valamint az onkológiai szempontból kedvezőbb hatású, a sejtproliferáció gátlásával ható immunszuppresszív vegyületek alkalmazása.
Diagnosis and control of polypharmacy in the elderly
Authors: Medeiros-Souza Patrícia , Santos-Neto Leopoldo Luiz dos , Kusano Liana Tieko Evangelista , Pereira Maurício Gomes
Published: November 2007

The article had the purpose of commenting on studies on polypharmacy in the elderly, focusing on diagnosis and control. Polypharmacy is defined as the use of a number of medications at the same time and the use of additional drugs to correct drug adverse effects. The fact that the elderly take more medications for the treatment of several diseases makes them more susceptible to the occurrence of adverse reactions. Prophylactic actions such as balanced prescriptions are vital to reduce the incidence of these reactions and prevent longer hospital stay, increased costs and aggravation of the elderly health condition.
Integrating environmental issues in estuary flood plans
Authors: Matthewson T.
Published: November 2007

The Humber Estuary is designated at national and international levels on account of its importance for the conservation, among other things, of estuarine habitats and the wildlife these support. The estuary and its floodplain also contain major industry and ports, and important historic buildings, settlements, landscapes and archaeological sites. Since the mid-1990s the Environment Agency has been developing a strategy for managing the Humber Estuary's flood defences for the next 100 years, culminating in the publication in August 2005 of works proposed for the first five years of this period. Environmental considerations have been integrated into the decision making throughout this development process, from high-level strategy planning through to detailed selection of options at specific locations. This has been achieved by a series of ‘tiered’ environmental appraisals, with the type and level of analysis reflecting the stage of flood risk management. The flood risk management planning has been especially effective at integrating wildlife conservation within its development; indeed the impact on important natural habitats has been a major driver for the selection of the preferred approach. In future projects of this scale, a similar focus may be required on other aspects of the environment to ensure all aspects of sustainability are addressed.
Hydrodynamic analysis of a skirt breakwater
Authors: Koutandos E. V.
Published: November 2007

In the present study, wave interaction with a fixed double partially immersed (skirt) breakwater was investigated numerically and experimentally. The large-scale laboratory experiments concerning the interaction of regular and irregular waves with the breakwater were conducted in the Canal d'Investigació i Experimentació Marítima flume of maritime engineering laboratory at Universitat Politècnica de Catalunya in Barcelona. The experimental results were compared with numerical results obtained with the use of the Cobras model for the regular waves case. The effects of relative width (structure length/wave length) and the relative distance (distance between two barriers/wave length) on the hydrodynamic characteristics (wave transmission, reflection, dissipation, velocity, turbulence kinetic energy) were investigated. The experimental water surface elevation compared satisfactorily with the computed results. Detailed computed velocities and turbulence kinetic energy in the vicinity of the two structures indicate the effects of the breakwater on the flow pattern and the turbulence structure.
Modelling water renewal in a coastal embayment
Authors: Stamou A. I. , Memos C. D. , Kapetanaki M. E.
Published: November 2007

A hydrodynamic model was applied to calculate the flow field and the renewal time in Salman Bay, a semi-enclosed coastal water body of particular environmental significance in the region of Jeddah, Saudi Arabia. Initially the model was calibrated with field data. It was then applied to assess the effect of a series of engineering modifications of Salman Bay, involving enlarging of the cross-section of a link channel to the Red Sea, dredging of the bay, and reclamation of islands inside the bay, on the flow characteristics and the renewal of waters. Calculations showed that the channel upgrading would significantly improve the renewal of the bay waters. For tidal calculations the renewal time was reduced from 48·6 days to 12·7 days, whereas for a wind-driven regime it was reduced from extremely large values to 13–34 days.
Retrofit SuDS—cost estimates and decision-support tools
Authors: Stovin V. R. , Swan A. D.
Published: November 2007

Many urban water quality and flooding problems may potentially be addressed by disconnecting stormwater from the formal drainage system and installing source control sustainable drainage systems (SuDS) instead. This approach is referred to as SuDS retrofit. This paper focuses on the construction costs associated with a range of SuDS devices likely to be implemented in a retrofit context. Three distinct types of costs have been prepared. The costs of construction per device are provided as unit costs. This approach does not, however, enable devices to be compared in terms of an area served. For this reason, schemes have been designed and costed according to representative contributory areas, such as a residential roof or a small car park. These contributory area-based cost comparisons are embodied within a decision-making framework for retrofit SuDS. A case study highlights how secondary costs need to be combined with device unit costs accurately to cost the construction of a whole scheme. The evaluation indicates that infiltration basins represent the cheapest form of SuDS to construct, followed by soakaways, ponds, infiltration trenches and porous pavements. This ranking does not, however, take account of land purchase or sterilisation costs, potential conflicts with requirements for high-density developments or other life-cycle costs—these could alter this preference ranking significantly.
Fuzzy logic model to predict hydraulic jump aeration efficiency
Authors: Kucukali S. , Cokgor S.
Published: November 2007

A fuzzy logic model was constructed to predict hydraulic jump aeration efficiency. Fuzzy subsets and rules were created based on experimental observations and measurements carried out in a 0·5 m wide flume with upstream Froude and Reynolds numbers of 2·3–6·4 and 1·4–5·4 × 104, respectively. A strong correlation was found between the aeration efficiency and Froude number. Upstream Froude and Reynolds numbers were selected as input parameters for the model. In this study, rather than mathematical equations, linguistic expressions were used to relate the upstream Froude and Reynolds numbers with aeration efficiency in an IF–THEN format. The proposed fuzzy model made good predictions and captured the system dynamic behaviour. Experimental observations confirmed the fact that hydraulic jump can be used as an aerator and mixing device in water treatment plants. Estimation of the aeration efficiency of a hydraulic jump could be made by any designer with the help of the fuzzy logic procedure described in this paper.
3-D computation of flood processes in sharp river bends
Authors: Tritthart M. , Gutknecht D.
Published: November 2007

Three different three-dimensional computational fluid dynamics codes—SSIIM, Fluent and RSim-3D—were used to predict water surface and flow field during the 100-year flood of August 2002 in a sharp bend of the Danube River near the Austrian municipality of Grein. All models solved the Reynolds-averaged Navier–Stokes equations using a finite-volume approach. For the SSIIM and Fluent models, a structured grid of hexahedral cells was employed, while the basis for the RSim-3D model was an unstructured grid of arbitrary polyhedrons. The non-hydrostatic pressure field was computed using the Simple method and the standard k−ε model provided turbulence closure. The position of the water surface was derived from the pressure field. Computed water surface elevations were compared with each other and verified using field data observed during the flood event. It was found that the maximum super-elevation of bank water levels was predicted within an error margin of 10–20% of the observed value. Flow velocity magnitudes were found to vary among the different models, which is primarily credited to different pressure distribution schemes. Strong secondary motions with velocity magnitudes of up to 1 m/s were predicted by the computer codes, contributing to the extreme super-elevations observed.
Hydrotherapy Versus Conventional Land-Based Exercise for the Management of Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial
Authors: Silva Luciana E , Valim Valeria , Pessanha Ana Paula C , Oliveira Leda M , Myamoto Samira , Jones Anamaria , Natour Jamil
Published: November 2007

Background and Purpose

This study was designed to evaluate the effectiveness of hydrotherapy in subjects with osteoarthritis (OA) of the knee compared with subjects with OA of the knee who performed land-based exercises.

Subjects and Methods

Sixty-four subjects with OA of the knee were randomly assigned to 1 of 2 groups that performed exercises for 18 weeks: a water-based exercise group and a land-based exercise group. The outcome measures included a visual analog scale (VAS) for pain in the previous week, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain during gait assessed by a VAS at rest and immediately following a 50-foot (15.24-m) walk test (50FWT), walking time measured at fast and comfortable paces during the 50FWT, and the Lequesne Index. Measurements were recorded by a blinded investigator at baseline and at 9 and 18 weeks after initiating the intervention.

Results

The 2 groups were homogenous regarding all parameters at baseline. Reductions in pain and improvements in WOMAC and Lequesne index scores were similar between groups. Pain before and after the 50FWT decreased significantly over time in both groups. However, the water-based exercise group experienced a significantly greater decrease in pain than the land-based exercise group before and after the 50FWT at the week-18 follow-up.

Discussion and Conclusion

Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee.
Physical Therapy Interventions for Patients With Osteoarthritis of the Knee: An Overview of Systematic Reviews
Authors: Jamtvedt Gro , Dahm Kristin Thuve , Christie Anne , Moe Rikke H , Haavardsholm Espen , Holm Inger , Hagen Kåre B
Published: November 2007

Patients with osteoarthritis of the knee are commonly treated by physical therapists. Practice should be informed by updated evidence from systematic reviews. The purpose of this article is to summarize the evidence from systematic reviews on the effectiveness of physical therapy for patients with knee osteoarthritis. Systematic reviews published between 2000 and 2007 were identified by a comprehensive literature search. We graded the quality of evidence across reviews for each comparison and outcome. Twenty-three systematic reviews on physical therapy interventions for patients with knee osteoarthritis were included. There is high-quality evidence that exercise and weight reduction reduce pain and improve physical function in patients with osteoarthritis of the knee. There is moderate-quality evidence that acupuncture, transcutaneous electrical nerve stimulation, and low-level laser therapy reduce pain and that psychoeducational interventions improve psychological outcomes. For other interventions and outcomes, the quality of evidence is low or there is no evidence from systematic reviews.
Effect of stack pins on the stiffness of interlocking nails in an unstable osteotomy model
Authors: Basinger R. R. , Suber J.
Published: November 2007

Interlocking nails have been shown to be an effective means to stabilise long bone fractures. When used in non-load sharing fracture repairs with minimal medullary canal filling, the authors noted instabilityofthe main fracture fragments. The addition of multiple intramedullary pins in stack pin fashion eliminated the instability. ILN and ILN/SP constructswere loaded in four-point bending using an unstable osteotomy model. The gap between the ILN and ILN/SP groups was compared. Significant changes were seen with the ILN/SP constructs in the cranial to caudal plane.
In vivo comparison of two hinged transarticular external skeletal fixators for multiple ligamentous injuries of the canine stifle
Authors: Hosgood G. , Ramirez S. , Lopez M. , Lauer S.
Published: November 2007

Controlled mobilization after the surgical repair of multiple disrupted ligaments is considered to be essential for return to normal function. This study compared the outcome after post-surgical mobilization without any protection to mobilization with two transarticular external skeletal fixator hinge prototypes after surgical repair of experimental injuries to multiple stifle ligaments in 15 hounds. The repair was left unprotected (NP: n = 5), protected with a self-centering hinge (SH: n = 5) andwith a conventional hinge (CH: n = 5) for four weeks after surgical repair. Outcome measurements included: orthopaedic examination, goniometric and thigh circumference (TC) measurements, total tibial translation (TT), radiographs, and kinetic gait analysis up to 120 days post-operatively. Asignificant effect of treatment controlling for time for medial collateral stability, TC, TT, osteophyte scores, peakvertical force (PVF) and vertical impulse (VI) was not found. There was a significant difference between time points for subjective lameness scores, TC, PVF, VI, TT and osteophyte scores within treatment. Stifle extension was significantly decreased in CH dogs compared to NP dogs on day 28. Stifle flexion was significantly decreased in CH and SH dogs on day 28 compared toNP dogs. Stifle flexion was normal in all dogs by day 42. Both hinges compromised stifle flexion initially after hinge removal, but range of motion normalized within two weeks. Hinges were not indicated for adjunct treatment after repair of multiple experimentally induced ligamentous stifle injuries.
Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs
Authors: Pozzi A. , Litsky A. S. , Field J. , Apelt D. , Meadows C. , Johnson K. A.
Published: November 2007

Objective: To evaluate the effect of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on pressure distribution in the cranial cruciate ligament (CCL) deficient canine stifle, and with tibial plateau levelling osteotomy (TPLO). Animals: Twelve adult dogs. Methods: In experiment one, six pairs of cadaveric canine stifles with an intact CCL were axially loaded with a servo-hydraulic material testing machine and pressure distributions were mapped and quantified using pressure sensitive films. Axial loading of each joint was then repeated following MMR, and again after MCH. In experiment two, six pairs of cadaveric canine stifles with or without TPLO were tested before and after CCL transection, and each MMR and MCH procedure using the same methods of experiment 1. Results: In experiment one, MMR and MCH had significant effects on the pressure distribution resulting in a 2.5-fold increase in the percentage of surface area with pressure higher than 10 MPa. In experiment two, CCL transection resulted in a significant change in pressure distribution only in the stifle without TPLO (P<0.05). Both MMR and MCH resulted in a 1.7-fold increase in the percentage of area with peak pressure in the stifle with TPLO (P<0.05). Conclusions: Meniscal surgery results in a change in pressure distribution and magnitude within the medial compartment of the stifle. Clinical relevance: Compromised function of the meniscus by either MMR or MCH result in stress concentration which may predispose to osteoarthritis.
Comparison of radiofrequency treatment and mechanical debridement of fibrillated cartilage in an equine model
Authors: Edwards R. B. , Cole B. J. , Muir P. , Markel M. D. , Lu Y.
Published: November 2007

Objective: To compare a radiofrequency energy (RFE) prototype probe to mechanical debridement (MD) and a commercially available RFE system used for chondroplasty in the treatment of an experimentally created partial thickness cartilage lesion in horses. The study design was experimental, randomized complete block, n=8, using fifteen mature ponies. Methods: Grade 2 to 3 cartilage lesions were prepared in both patellae. After 10 months duration, the injuries were used to study the effects of MD, a commercially available bipolar RFE device (CoVac 50; ArthroCare Corporation) and a prototype monopolar RFE device (Smith & Nephew Endoscopy). Six months after treatment the patellae were examined for chondrocyte viability and cartilage structure. Results: Mean depth of cell death was significantly different among groups (controls, MD <prototype<CoVac 50) (P<0.05). Total histologic scores did not demonstrate any significant differences among the controls, MD and prototype RFE groups, which were all better than the CoVac 50 scores (P<0.05). There was a trend for the prototype RFE probe treated regions to have better surface structural characteristics than MD (P=0.11). Cartilage thickness was greater for the prototype RFE group than all other groups, and was the thinnest for the CoVac 50 group (P<0.05). Conclusion: When thermal chondroplasty is performed with a power-controlled prototype RFE probe, there is a better surface smoothing effect compared to MD, which causes less chondrocyte death and has the potential to maintain thicker cartilage compared to the commercially available RFE system.
Prevalence of hip dysplasia according to official radiographic screening, among 31 breeds of dogs in France
Authors: Remy D. , Viguier E. , Carozzo C. , Collard F. , Cachon T. , Maitre P. , Fau D. , Genevois J.-P.
Published: November 2007

In order to determine the prevalence of hip dysplasia (HD) from radiographs that were submitted for authorative grading, and its changes over the time in 31 breeds of dogs in France, a 14-year retrospective study was conducted. Significant differences were observed between breeds, with HD prevalence ranging from 59.7% (Cane Corso) to 3.9% (Siberian Husky). When comparing the 1993–1999 with the 2000–2006 period in 15 breeds, a significant decrease in HD prevalence was detected in Berger Picard, Bernese Mountain dog, Briard, Gordon Setter, White Swiss Sheepdog and Rottweiler. Modifications observed in the other breeds were not statistically significant.
Fracture configurations of the equine radius and tibia after a simulated kick
Authors: Oswald S. , Jäggin S. , Piskoty G. , Michel S. , Auer J. A. , Fürst A. E.
Published: November 2007

The objective of this postmortem study was to determine the fracture configurations of the equine radius and tibia after a simulated kick. Fracture configurations of 35 radii and 36 tibiae from 19 adult horses were evaluated after a simulated kick in an experimental exvivo study. The bones were dissected, the proximal and distal ends were embedded in resin, fixed horizontally and preloaded in compression, and a steel impactor, designed to simulate a shod equine hoof, was dropped from a height of three to six metres onto the diaphysis. The experiments were filmed with a high-speed camera (30,000 pictures/second). The bones were then photographed and radiographed using a C-arm based 3D imaging device. A software programme (Osirix) was used to reconstruct the fissured and fractured bones three-dimensionally on a computer screen for assessment of the fracture configuration and fissure lines. Incomplete fractures occurred in 26 bones and complete fractures in 42. The complete fractures included 22 butterfly and 20 simple fractures; the latter included 17 oblique, two transverse and one longitudinal fracture. Additional longitudinal fissures occurred in 98% of the fractures. The butterfly fragment was always located on the side opposite the impact. There was a significant correlation between the type of bone and the fracture configuration: butterfly and oblique fractures occurred more frequently in the tibia, and incomplete fractures occurred more frequently in the radius. The data collected can be used to optimize evaluation of fractures and fissures caused by a kick and thereby improve surgical stabilization.