bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximal Tolerated Insulin Therapy in Gestational Diabetes
Authors: Roversi G D , Gargiulo M , Nicolini U , Ferrazzi E , Pedretti E , Gruft L , Tronconi G
Published: December 2014

Beginning in 1963 we have administered fast-acting insulin in three daily injections up to the maximal tolerated dose (M.T.D.), which can be defined as the highest quantity that can be given without bringing about hypoglycemic disturbances. This therapeutic criteria was applied both to gestational (280 pregnant women) and clinical (199 pregnant women) diabetes. M.T.D. was established on first admission to hospital and afterward controlled weekly in the outpatient clinic and during short periods of hospitalization (average of 53 days per patient). The average increase of the M.T.D. was 38 IU from 15 wk until delivery. As regards maternal blood sugar, at the M.T.D. average values at fasting and over the 24-h period were very close to the corresponding values of the control group (normal pregnancy). Total perinatal mortality (P.M.) was 2.9%; in the gestational diabetes group it was 2%. The incidence of congenital malformations (C.M.) (2.4%) increased with the severity of diabetes. No congenital defects were observed in 96 infants of patients treated before the 15th wk. Labor started spontaneously in 90.4% of the cases. The incidence of cesarean section was 21% in patients in White's Classes Al and A2 (as recently redefined by Freinkel and Metzger8) and 28% in other classes and that of forceps and vacuum extraction was 1% and 6%, respectively. The incidence of small-for-dates and overweight newborns from mothers with gestational and clinical diabetes without vascular complications is consistent with normal figures (macrosomia 3.4%). Small-for-dates newborns from pregnant diabetic women with vascular complications had a significant incidence. Respiratory distress syndrome (RDS) was 0.6% and hypoglycemia was 13.4%. No case of death was due to these two causes. Clinical results are discussed.
Diabete, in the Internai Medicine Literature
Authors: Shuman Charles R
Published: December 2014

The format of Mini-Reviews is the presentation of abstracts of selected articles, with commentary on the topics raised by these articles. Previous Mini-Reviews in DIABETES CARE examined the literature on Psychosocial Issues in Diabetes, Diabetes in the Pediatrie Literature, and Diabetes Mellitus in the Internal Medicine Literature.
Classification of Diabetes
Authors: Jarrett R J , Keen H
Published: December 2014

We would agree with Drs. O'Sullivan and Fajans1 that neither the National Diabetes Data Group nor any other proposals should be accepted uncritically; indeed we have ourselves already entered into the polemic on the subject and we welcome it.2 The proposals will no doubt require modification if and when relevant new data appear. However, the Group's report was the result of a critical review of the unsatisfactory situation concerning, at a certain level, the diagnostic criteria and, at another, the concept of diabetes itself. It took its direction from the availability of new data. Contrary to O'Sullivan and Fajans' statement, the blood glucose levels adopted were based largely on three prospective studies in the United Kingdom, and not on the Pima Indian data, which was regarded as confirming, in a different and special population group studied by different methods, the findings in the United Kingdom.
Selecting Criteria for the Diagnosis of “Diabetes Mellitus”
Authors: O'Sullivan John B , Fajans Stefan S
Published: December 2014

We would agree with Drs. O'Sullivan and Fajans1 that neither the National Diabetes Data Group nor any other proposals should be accepted uncritically; indeed we have ourselves already entered into the polemic on the subject and we welcome it.2 The proposals will no doubt require modification if and when relevant new data appear. However, the Group's report was the result of a critical review of the unsatisfactory situation concerning, at a certain level, the diagnostic criteria and, at another, the concept of diabetes itself. It took its direction from the availability of new data. Contrary to O'Sullivan and Fajans' statement, the blood glucose levels adopted were based largely on three prospective studies in the United Kingdom, and not on the Pima Indian data, which was regarded as confirming, in a different and special population group studied by different methods, the findings in the United Kingdom.
Comparison of Various Methods for Rapid Glucose Estimation
Authors: Clements Rex S , Keane Nancy A , Kirk Katharine A , Boshell Buris R
Published: December 2014

We studied the accuracy of three techniques for the rapid estimation of the blood glucose concentration with reagent strips in samples of blood from inpatients with diabetes mellitus. We observed that the visual inspection of Dextrostix gave results that were too inaccurate for this technique to be of practical clinical benefit. In contrast, when performed by registered nurses, both the Dextrostix-Eyetone method and the visual inspection of Chemstrips yielded results that were closely correlated with the measured serum glucose concentrations. With both of the latter techniques, less than 11% of the determinations varied from the actual serum glucose concentration by more than 20%. We conclude that both these techniques are sufficiently accurate to be of potential use in the home monitoring of blood glucose concentrations.
Comparison of Blood Glucose Testing Using Reagent Strips With and Without a Meter (Chemstrips bG and Dextrostix/Dextrometer)
Authors: Kubilis Paul , Rosenbloom Arlan L , Lezotte Dennis , Silverstein Janet H , Cimino Pat , Rosenbloom Eric D , Harvey Chris
Published: December 2014

Eighteen counselors at a children's diabetes camp examined 360 blood specimens using the Dextrostix/Dextrometer (DX/DM) and Chemstrip bG (CS) systems. Sixty-five percent of the DX/DM and 60% of the CS observations were within 20% of plasma glucose results determined with the glucose analyzer (P = 0.19). CS errors were underestimates below 150 mg/dl and overestimates above that level. DX/DM reading errors were almost exclusively underestimates.
Physician-Patient Communication in Chronic Illness
Authors: Solowiejczyk Joseph N , Baker Lester
Published: December 2014

The traditional model of doctor-patient communication allows little room for the incorporation of the expertise in self-care acquired by a patient with a chronic illness. When this knowledge is ignored or challenged, potentially damaging situations may arise. Two illustrative case reports are presented. It is suggested that the relationship between referring physician and consultant may provide a more relevant model for communication in chronic illness,
Inhibition of Pancreatic Glucagon Responses to Arginine by Human Insulin (recombinant DNA) and Purified Porcine Insulin in Normal and Diabetic Subjects
Authors: Raptis Sotos , Hadjidakis Dimitrios , Enzmann Franz , Raptis Athanassios , Diamantopoulos Emmanuel , Rosenthal Julian
Published: December 2014

This study investigates and compares human insulin (recombinant DNA) and purified porcine insulin (PPI) in healthy volunteers and in type II diabetic patients, in terms of whether both these insulins were capable of influencing in a different manner pancreatic glucagon, C-peptide, and free fatty acids (FFA) concentrations. The findings reveal that the β-cell of human pancreas apparently recognizes human insulin more readily than PPI, as assessed by the inhibition of C-peptide, and a similar conclusion follows for the α-cell; this conclusion is underscored by the inhibited glucagon values. The delayed increments of glucagon under human insulin following arginine stimulation may be the result of a more rapid insulin absorption from subcutaneous tissue and a greater biologic action of this insulin in comparison with the PPI. Finally, human insulin has additional properties as demonstrated by its stronger antilipolytic effects.
Insulin Treatment Reverses the Insulin Resistance of Type II Diabetes Mellitus
Authors: Scarlett J A , Gray R S , Griffin J , Olefsky J M , Kolterman O G
Published: December 2014

Type II diabetic subjects are both insulin-deficient and insulin-resistant. Recent studies suggest that the insulin resistance is due to a combined receptor and postreceptor defect with the postreceptor defect being the predominant lesion. In the present study, we examined the effects of exogenous insulin therapy upon these defects in insulin action in six untreated type II diabetic subjects. Glycemic control and adipocyte insulin binding were measured and in vivo insulin dose-response curves for overall glucose disposal and suppression of hepatic glucose output were constructed before treatment. Following these initial studies, the diabetic subjects were treated with twice-daily injections of regular and NPH purified pork insulin for 14 days and the pretreatment studies repeated. Glycemic control was significantly improved by this treatment regimen. The mean fasting serum glucose level (±SE) fell from 287 ± 20 to 125 ± 13 mg/dl, the mean glycosylated hemoglobin level (± SE) decreased from 14.2 ± 1.1% to 8.3 ± 0.5%, and the mean 24-h urinary glucose excretion (±SE) declined from 65.6 ± 40.3 to 0.6 ± 0. 1 g/24 h. Adipocyte insulin binding did not change significantly during the treatment period. In contrast, the 14-day period of insulin treatment produced a 72% increase (P < 0.005) in the maximal rate of insulin-stimulated glucose disposal, 321 ± 32 mg/M2/min compared with 187 ± 32 mg/M2/min before treatment, indicating that the postreceptor defect in insulin action was significantly ameliorated by insulin treatment. The dose-response curve for insulin-mediated suppression of hepatic glucose output was rightshifted, consistent with the decrease in insulin binding, with no decrease in the maximal effect before treatment and not significantly changed following insulin treatment. In conclusion, the postreceptor defect in insulin-stimulated glucose disposal is largely ameliorated by exogenous insulin treatment, suggesting that this defect in insulin action is an acquired abnormality which is secondary to some aspect of the insulin-deficient state.
Perspectives on the Role of Viruses in Insulin-dependent Diabetes
Authors: Yoon Ji-Won , Ray Usha R
Published: December 2014

Insulin-dependent diabetes mellitus (IDDM) results from the destruction of pancreatic beta cells. Viruses have been suggested as one of the possible causes. The evidence for viruses comes largely from experiments in animals, but several studies in humans also point to viruses as a trigger of this disease in some cases. Encephalomyocarditis (EMC) virus, Mengovirus (2T), and Coxsackie B4 virus infect and destroy pancreatic beta cells when inoculated into mice. This results in hypoinsulinemia and hyperglycemia. The development of EMC virus–induced diabetes is dependent on the genetic background of the host and genetic makeup of the virus. Animals with diabetes for several months show some long-term complications, including glomerulosclerosis, ocular changes, and decreased bone formation and mineralization in addition to acute metabolic changes. EMC virus–induced diabetes can be prevented by a live-attenuated vaccine. The capacity of Coxsackie B4 virus to induce diabetes is also influenced by the genetic background of the host. However, Mengovirus-induced diabetes is not dependent on the genetic background of the host. In contrast to the EMC, Mengo, and Coxsackie B4 viruses, reovirus type 1 seems to be somehow associated with an autoimmune response producing a diabetes-like syndrome in suckling mice. This virus produces an autoimmune polyendocrinopathy that results in very mild and transient glucose intolerance. Several common human viruses including mumps, Coxsackie B3 and B4 viruses, and reovirus type 3 can infect human beta cells in culture and destroy them. A variant of Coxsackie B4 virus has been isolated from the pancreas of a child who died of acute-onset IDDM. Serologic studies revealed a rise in the titer of neutralizing antibody to the virus. This virus produced diabetes when inoculated into certain inbred strains of mice. Support for the idea that viruses can trigger some cases of diabetes in man has been strengthened lately by additional case reports and epidemiologic studies. However, it is evident that diabetes is not a common consequence of virus infection. In conclusion, based on the experiments in mice and studies in humans, it appears that at least an occasional case of IDDM may be triggered by a viral infection.
Surveillance of Acute Complications of New Therapies
Authors: Teutsch Steven M , Herman William H
Published: December 2014

In its essence, surveillance is the continuous gathering, analysis, and dissemination of data to those who need to know for the purposes of disease control. To understand the complications of new therapies, data concerning the type and number of complications (numerator) and the population at risk for complications (denominator) must be gathered. Information about the expected rates of complications among comparison populations must be known to place the observed rates into perspective. Such data may be developed through active or passive reporting systems, clinic-based surveillance, follow-up of sentinel events, and registries. An investigation of mortality among users of continuous subcutaneous insulin infusion (CSII) pumps is used as an example.
Precipitants of Hospitalization in Insulin-dependent Diabetes Mellitus (IDDM): A Statewide Perspective
Authors: Fishbein Howard A
Published: December 2014

A statewide insulin-dependent diabetes mellitus (IDDM) registry is used to identify and epidemiologically characterize patients admitted to Rhode Island's hospitals. Physician interviews and record reviews are obtained to ascertain reasons for hospitalization. Poor diabetes control (noncompliance with diet/ medication) and infection accounted for 44–54% of hospital admissions among 691 known diabetic patients; these patients were readmitted more often (65%) compared with new-onset patients (46%) during a 3-yr follow-up of hospitalization patterns. An outpatient diabetic education program was successful in reducing the number of persons hospitalized (P = 0.04) and the number of hospitalizations for participants (P = 0.01) when comparisons of hospital admissions before and after the program were made. Potential cost savings for persons with IDDM over the 4 yr of the study are estimated at $674,400.00.
Rhabdoid Tumor Predisposition Syndrome
Authors: Sredni Simone T. , Tomita Tadanori
Published: December 2014

Rhabdoid tumors (RT), or malignant rhabdoid tumors, are among the most aggressive and lethal forms of human cancer. They can arise in any location in the body but are most commonly observed in the brain, where they are called atypical teratoid/rhabdoid tumors (AT/RT), and in the kidneys, where they are called rhabdoid tumors of the kidney. The vast majority of rhabdoid tumors present with a loss of function in the SMARCB1 gene, also known as INI1, BAF47, and hSNF5, a core member of the SWI/SNF chromatin-remodeling complex. Recently, mutations in a 2nd locus of the SWI/SNF complex, the SMARCA4 gene, also known as BRG1, were found in rhabdoid tumors with retention of SMARCB1 expression. Familial cases may occur in a condition known as rhabdoid tumor predisposition syndrome (RTPS). In RTPS, germline inactivation of 1 allele of a gene occurs. When the mutation occurs in the SMARCB1 gene, the syndrome is called RTPS1, and when the mutation occurs in the SMARCA4 gene it is called RTPS2. Children presenting with RTPS tend to develop tumors at a younger age, but the impact that germline mutation has on survival remains unclear. Adults who carry the mutation tend to develop multiple schwannomas. The diagnosis of RTPS should be considered in patients with RT, especially if they have multiple primary tumors, and/or in individuals with a family history of RT. Because germline mutations result in an increased risk of carriers developing RT, genetic counseling for families with this condition is recommended.
Modeling of A Two Stages Electrostatic Air Precipitation Process using Response Surface Modeling
Authors: Berrached Djelloul , Tilmatine Amar , Miloua Farid , Bengrit Malika
Published: December 2014

Any industrial process needs to work with the optimal operating conditions and thus the evaluation of their robustness is a critical issue. A modeling of a laboratory-scale wire-to-plane two stages electrostatic precipitator for guiding the identification of the set point, is presented this in paper. The procedure consists of formulating recommendations regarding the choice of optimal values for electrostatic precipitation. A two-stages laboratory precipitator was used to carry out the experiments, with samples of wood particles of average granulometric size 10 µm. The parameters considered in the present study are the negative applied high voltage of the ionization stage, the positive voltage of the collection stage and the air speed. First, three “one-factor-at-a-time” experiments were performed followed by a factorial composite design experiments, based on a two-step strategy: 1) identify the domain of variation of the variables; 2) set point identification and optimization of the process.
Evolution Time of Composed Stochastic Systems with Final Sequence of States and Independent Transitions
Authors: Lazari Alexandru
Published: December 2014

In this paper the composed stochastic systems with final sequence states and independent transitions are studied. The ordered and unordered sequential compositions and excludable and nonexcludable parallel compositions are analyzed. For these stochastic systems the problem of determining the main probabilistic characteristics of evolution time is considered. The elaborated algorithms are based on the properties of the homogeneous linear recurrences.
Some Algebraic Properties of Generalized Rings
Authors: Fatehi F. , Molaei M.R.
Published: December 2014

In this paper we show that the identity function e of a generalized ring R is a generalized ring homomorphism if e(x + y) = e(x) + e(y), for all x, y e R. Moreover, we show that if R is a generalized ring with an identity, then e is a generalized ring homomorphism. Properties of identities and identity mappings of generalized rings are considered. A method for constructing a new generalized ring with an identity via a given quotient generalized ring with an identity, is presented. Second isomorphism theorem and third isomorphism theorem for M-rings are proved.
Delimitation of Areas of Environmental Conflicts on the Background of Geological Conditions, Exemplified by Stary Sącz Commune
Authors: Gałaś Slávka
Published: December 2014

Delimitation and characterization of areas of conflict are essential to assess suitability of land for different activities carried out in the field of rational land use. In the paper, delimitation of the conflict areas and conflicts categorization in terms of possibility of their overcoming, the scale of the range and the period of their occurrence exemplified by urban - rural commune Stary Sącz have been presented. The software ArcGIS 10.1, the method of maps superimposing and analysis of interactions between different geoenvironmental factors have been applied to obtain the goal of the investigation. Specific geological structure together with morphological and climatic conditions in Stary Sącz commune create ideal conditions for occurrence of con-flict areas on the background of the geological conditions. Accurate and early recognition of these conflicts - existing and potential ones, is a prerequisite for the environmental risk prevention and elimination of its effects through the proper preparation of planning documents and development plans and programs.
Aerophytic Cyanobacteria as a Factor in the Biodegradation of Technical Materials on External Building Walls
Authors: Piontek Marlena , Lechów Hanna
Published: December 2014

A study conducted at the Institute of Environmental Engineering, University of Zielona Góra showed the presence of 4 species of aerophytic cyanobacteria in the biological material sampled from the external building wall with visible biocorrosion: Gloeocapsa montana Kützing, Phormidium calcareum Kützing, Aphanothece saxicola Nägeli, Gloeothece caldariorum (P. Richter) Hollerbach. High levels of moisture were detected in the places of biofilm occurrence.
Social Tourism Support in the Czech Republic
Authors: Kouřilová Jana , Kratochvílová Lucie
Published: December 2014

Social tourism is a form of tourism that takes into account the participation of physically or socially handicapped individuals, and at the same time the social tourism activities are in accordance with the environmental sustain-ability of the territory. in the czech republic the social tourism has been supported at the national level since 2010 by the National tourism support Programme. this paper is aimed at the evaluation of social tourism support in the czech republic in the period of 2010-2012. The evaluation is performed by regions and target groups (families with children, young people under 26 years, seniors and the disabled). the other aim is to identify which model of social tourism was implemented in the czech republic during the period of 2010-2012.
Analysis of cross-ply laminated plates using
isogeometric analysis and unified formulation
Authors: Natarajan S. , Ferreira A.J.M. , Nguyen-Xuan Hung
Published: December 2014

In this paper, we study the static bending and
free vibration of cross-ply laminated composite plates using
sinusoidal deformation theory. The plate kinematics
is based on the recently proposed Carrera Unified Formulation
(CUF), and the field variables are discretized
with the non-uniform rational B-splines within the framework
of isogeometric analysis (IGA). The proposed approach
allows the construction of higher-order smooth
functions with less computational effort.Moreover, within
the framework of IGA, the geometry is represented exactly
by the Non-Uniform Rational B-Splines (NURBS) and the
isoparametric concept is used to define the field variables.
On the other hand, the CUF allows for a systematic study
of two dimensional plate formulations. The combination
of the IGA with the CUF allows for a very accurate prediction
of the field variables. The static bending and free vibration
of thin and moderately thick laminated plates are
studied. The present approach also suffers fromshear locking
when lower order functions are employed and shear
locking is suppressed by introducing a modification factor.
The effectiveness of the formulation is demonstrated
through numerical examples.
The Police System Reform in Georgia (Informal Power its Forms, Types and Spheres of Influence)
Authors: Charkviani Tamar
Published: December 2014

It is a widely accepted notion that the major change brought by the 2003 November revolution in Georgia was the reform of the public services. Two major tasks were to be achieved for the state institutions: to monopolize the use of legitimate power on the state territory and to start providing services to the citizens. Police reform was at the heart of both these objectives. The major obstacle identified on the way of this reform was corruption. Indeed it was widely known that posts in police forces were to be purchased; policemen were involved in organized crime, extortion, and other illegal pursuits. But the corruption itself was the effect of the broader system in which patrimonial system of not distinguishing between the public office and private sphere was hybridized with the legal-rational rule, having its origin in the Soviet Union. The main subject of our research is to analyze the model of informal power network in Georgian police, to describe its configurations and identify its social actors.

For the theoretical approach in our study we will use different theories describing informal institutes and the reasons of their existence. One of the main theoretical sources for our analysis will be the theoretical concept of Helmke and Levitsky. Helmke and Levitsky are describing four types of informal institutions which we plan to apply to Georgian police system and identify which of them is more relevant for Georgian reality. Also we will refer to such theories as: Mark Granoveter's strength of week ties and social “embeddedness” of economic action; Mars and Altman's Cultural Basis of Soviet Georgia; Ledeneva's theory of “Blat”, which is one of most popular analytical theory about informal relations in post-Soviet countries.

The main methods we have used are in-depth and narrative interviews. The interviews have been conducted with policemen currently working in different police departments, policemen no more working in this structure, expert and NGO representatives.
From life to death: microRNAs in the fine tuning of the heart
Authors: Nath Sayantan , Rizvi S I , Kumar Munish
Published: December 2014

The heart is one of the most important vital organs, and any malfunctioning of the heart and its blood vessels may contribute to cardiovascular disorders. Diseases of the cardiovascular system represent the most common cause of human morbidity and mortality around the globe. Thus, there is always a need for innovative new therapies and diagnostics for cardiovascular disorders. In the past decades, a plethora of tiny, endogenous, singlestranded RNA sequences called microRNAs (miRNAs) has been studied meticulously in cardiovascular development and pathophysiology, providing a new dimension to the heart’s biology. miRNAs posttranscriptional inhibit the gene expression of specific mRNA targets through Watson– Crick base pairing between the miRNA “seed region” and the 3′ untranslated regions (UTRs) of target mRNAs. Better recognized as “master switches”, miRNAs are emerging as vital regulators of mammalian cardiovascular development and disease and thus are helpful in understanding therapeutic targets and diagnostics for a variety of cardiovascular disorders. In this review, a detailed discussion of the roles of various microRNAs in cardiovascular development and pathophysiology with potential therapeutics is considered.
Interpersonal Communication in Medical Profession on the Example of Physiotherapists
Authors: Matyja Anna , Stój Karina
Published: December 2014

Introduction. The article introduces the reader into the problem area, based on interpersonal relationships between physiotherapists and patients.

Aim. The aim of the study is to learn the factors determining the quality of physiotherapeutic services. The research was carried out in relation to verbal and non-verbal aspects of contact between physiotherapists and patients.

Material and method. The method used in the study was a quantitative survey based on a questionnaire.

Results. Ninety-six percent of respondents state that they have no problems with making interpersonal contact with patients. Fifty-three percent of them show interest in patients during the dialogue and the remaining group only initiates the contact and limits it to personal creativity. The research shows that the gender of the respondents does not significantly affect the ways of showing interest in patients. However, the length of service differentiates their approach to patients as well as the age of the patients themselves.

Discussion. Communication in a profession of physiotherapist refers to the personal preferences and interpersonal skills of the respondents, which can be determined by a specific style of their work. In addition, significantly it is determined by the level of education of future physical therapists, which was mentioned not only by the people in this study, but also in the studies cited in the literature included in the discussion.

Conclusions.The quality of physiotherapy services is determined not only by instrumental preparation of a physiotherapist but also by expression that results from the interpersonal contact. Physiotherapists are aware of building relationships during the first contact. Therefore, they try to make a positive impression. In such way, the quality of treatment can be increased.
Methods for Molecular Surveillance of Influenza Used in Macedonia
Authors: Bosevska Golubinka , Janceska Elizabeta , Kuzmanovska Gordana , Mikik Vladimir , Panovski Nikola
Published: December 2014

The aim: To present and compare different Nucleic Acid Testing assays used for laboratory diagnosis of influenza virus infection in our country.

Materials and methods: Respiratory samples used were nose and throat swabs. The RNA extraction was performed with a QIAamp viral RNA kit. During the season 2009–2010 the first 25 samples were tested with: conventional gel-based RT-PCR and CDC rtRT-PCR using published specific matrix and HA gene primers and probes for influenza virus typing and subtyping.

Results: Of 25 samples tested with conventional RT-PCR 7(28%) were positive for influenza A, but negative for A/H1seasonal and A/H3. Retested with rtRT-PCR 9(36%) were positive for influenza A, 8(32%) were positive for A/H1pdm and 1(4%) was A/H3. Two samples positive with rtRT-PCR for influenza A were negative with RT-PCR. The sensitivity of the RT-PCR in comparison with rtRT-PCR is 100% and the specificity is 88.89%. Positive predictive value for RT-PCR is 77.78%, and negative predictive value is 100%. RT-PCR is a four-step and rtRT-PCR a one-step procedure. The turn-around time of RT-PCR is 6 hours and for rtRT-PCR it is 2 hours.

Discussion and conclusion: For surveillance purposes nose and throat swabs are the more easy and practical to collect. It was proved that RT-PCR is too laborious, multi-step and time-consuming. The sensitivity of both assays is equal. The specificity of rtRT-PCR is higher. NAT assays for detection of influenza viruses have become an integral component of the surveillance programme in our country. They provide a fast, accurate and sensitive detection of influenza.
Symptomatic Epileptogenic Lesions
Authors: Chepreganova-Changovska Tatjana , Petrovska-Cvetkovska Dragana , Srceva-Jovanovski Marija , Filipce Venko
Published: December 2014

Background and objectives: The main aim of this study is to prove the association of seizure types with the MRI findings of the brain (etiological factor). Also, to prove which type of lesion is mostly represented in which age-group, and with which type of seizure.

Methods: A total of 100 patients with symptomatic epilepsy, aged from 16 to 80 years, were hospitalized at the Neurology Clinic or in its Outpatient Unit, in the period from 2009 to 2012. They were neurologically examined and the seizure type registered. All patients underwent MRI of the brain.

Results: (56%) men and 44 (44%) women were examined. The represented type of epileptic seizures were 41.0% with SPC + CPC, followed by 15.0% GTCC, and 14.0% CPC with secondary generalization, 12,0% CPC, 10,0% SPC and 8.0% with absences. The epileptic lesions of 25.0% were hippocampal sclerosis, 20.0% post-traumatic injuries, 19.0%, post-vascular and brain tumours, and the lowest percentage of 17.0% with post-infectious lesions.

Conclusions: Post-traumatic lesions occur more frequently in the elderly population with the accent on the male, while hippocampal sclerosis occurs in the adolescent and younger population with higher frequency in the female.
Depression in Ophthalmological Patients
Authors: Pop-Jordanova Nada , Ristova Jovanka , Loleska Sofija
Published: December 2014

Introduction: Vision is the most important sensorial part of the human information system. Visual loss leads to reduced ability to perform routine activities of daily living and can be a risk for stable mental health.

Aim: The aim of this cross-sectional study is to assess the incidence of depression in patients treated in an ophthalmological outpatient clinic. To our knowledge this is the first study of its kind in our country.

Subjects and method: The number of evaluated patients was a hundred; mean age 41.6 ± 15.9 years, with different educational levels and common ophthalmological disorders. For the assessment of the level of depression the Beck Depression Inventory was used. Patients were divided into two groups: serious ophthalmological diagnoses where we expected psychological problems (N = 65) and the simplest ones (N = 35) as a control.

Results: Obtained results show that the levels of depression correlate with the diagnoses. Patients in the first group (serious ophthalmological diagnoses) showed moderate depression in 12% and severe in 13% of patients. It was shown that the most depressed were the patients suffering from age-related macular degeneration and proliferative diabetic retinopathy, as well as glaucoma and cataract. The second group showed BDI scores of normal values. The level of depression is positively correlated with age and the level of education (p < 0.05).

Conclusion: Depression is an important mental problem in ophthalmological practice. It is usually unrecognized and untreated. Depression could be the risk factor for treatment and prognosis of eyes diseases. Some measures for mitigation of psychological problems are proposed.
Continuous Versus Patient-Controlled Epidural Analgesia for Labour Analgesia and Their Effects on Maternal Motor Function and Ambulation
Authors: Lovach-Chepujnoska Margarita , Nojkov Jordan , Joshevska-Jovanovska Slagjana , Domazetov Robert
Published: December 2014

Background and objectives: The advantages of patient-controlled epidural analgesia (PCEA) for delivery compared with continuous epidural analgesia (CEA) have been a point of interest in research obstetric anaesthesia for more than two decades.

The aim of this single blind randomized controlled study was to evaluate the incidence of motor block and ability to perform partial knee flexion in women who received CEA or PCEA.

Method: Fifty-one healthy nulliparous women were included in this study. After an initial dose and established sensory block at Th 10, parturients were randomized into two groups: group CEA (10 ml/h), and group PCEA (bolus − 5 ml, lockout interval − 15 minutes, basal rate − 0 ml) with bupiva-caine 0.08% and fentanyl 2 μg/ml. The motor function of the lower limbs was evaluated by modified Bromage scale at regular hourly intervals until full cervical dilatation. The quality of analgesia was assessed using a visual analogue pain scale (VAPS) and maternal satisfaction. Mode of delivery, the total number of additional rescue boluses, foetal and neonatal outcomes were recorded.

Results: Motor block was significantly lower in the third (33.3% vs. 4.35%; p = 0.008), fourth (57.9% vs. 6.3%; p = 0.003) and fifth hour (75.0% vs. 18.2%; p = 0.001) in the PCEA group. Ambu-lation occurred in 18% in the CEA and 46% in the PCEA group (p = 0.036). VAPS was with borderline significance in the second (p = 0.076) and significantly lower in the fourth hour (p = 0.034).

Conclusion: Compared with CEA, PCEA provided less motor block and better first-stage analgesia, which leads to the conclusion that patient-controlled analgesia techniques are the preferred model in obstetric anesthesia.
Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture
Authors: Temelkovska-Stevanovska Marina , Durnev Vesna , Jovanovski-Srceva Marija , Mojsova-Mijovska Maja , Trpeski Sime
Published: December 2014

Introduction: Systemic postoperative analgesia is inefficient in most patients with hip fracture, which is the reason for pain, especially during leg movement. Peripheral and plexus nerve blocks are an efficient option for postoperative pain relief.

The aim of this study was to compare the effect and duration of continuous FNB versus a single FIC block as a postoperative analgesia in patients with hip fracture.

Methods: Sixty patients with hip fracture were included and were randomly assigned to two groups of 30 patients: FNB group – patients with continuous femoral nerve block; and FIC group –patients with a single fascia iliaca compartment block. In all patients, pain intensity was measured at rest and in passive leg movement by using VDS (0–4) at several intervals: 1, 2, 12, 24, 36 and 48 hours after intervention. The amount of supplemental analgesia was measured, together with the time when the patient needed it for the first time, as well as the side effects.

Results: The values of VDS were significantly lower in patients with FNB block versus patients with FIC block in rest and movement at the 24-hour intervals (46.67% vs 0% felt moderate pain), after 36 hours (43.33% vs 0% felt moderate pain) and 48 hours after intervention (46.67% vs 3.33% felt moderate to severe pain) for p < 0.05. Patients with FNB block received a significantly lower amount of supplemental analgesia, 23.3% of the FNB group vs 50% of the FIC group (p < 0.05). Registered side effects were were nausea, dizziness and sedation, and they were statistically significantly more frequent in the FIC group (p < 0.05).

Conclusion: Pain relief in the postoperative period was superior in the FNB group versus the FIC group at rest and in movement in patients with hip fracture.
Effect of Lipid Parameters on Foetal Growth In Gestational Diabetes Mellitus Pregnancies
Authors: Simeonova-Krstevska Slagjana , Krstevska Brankica , Velkoska-Nakova Valentina , Lega Marija Hadji , Samardjiski Igor , Serafimoski Vladimir , Livrinova Vesna , Todorovska Irena , Sima Aneta
Published: December 2014

Introduction: Women with gestational diabetes mellitus (GDM) often deliver newborns large for their gestational age (LGA). The aim of the study was to evaluate the effect of lipid parameters in the second half of pregnancy on foetal growth in GDM pregnancies.

Material and methods: In two hundred consecutive women with GDM the age, body mass index before pregnancy, body mass index before delivery, gestational week of GDM diagnosis, lipid parameters after 24 weeks of pregnancy, fasting glycaemia, HbA1c in the second and third trimester of pregnancy, gestational age at delivery, mode of delivery, and baby birth weight were analyzed.

Results: Of the 200 GDM pregnancies, 50 (25%) women delivered LGA newborns, 135 (67.5%) women delivered newborns appropriate for gestational age (AGA), and 15 (7.5%) women delivered newborns small for gestational age (SGA). Maternal triglyceride levels and HbA1c in the second trimester were higher, and HDL-C was significantly lower, in the LGA group than in the AGA group (3.8 ± 1.8 vs. 3.1 ± 1.1 mmol/L, 6.1 ± 1.1 vs. 5.5 ± 0.8%, and 1.3 ± 0.4 vs. 1.6 ± 0.4 mmol/L, p < 0.05). Also, maternal triglyceride levels and HbA1c in the second trimester were significantly higher in the SGA group than in the AGA group (3.8 ± 1.9 vs. 3.1 ± 1.1 mmol/L and 6.8 ± 0.8 vs. 5.5 ± 0.8%, p < 0.05). Maternal triglycerides were independent predictors for delivering LGA newborns in GDM women.

Conclusion: In GDM pregnancies, maternal triglycerides in the second half of pregnancy may indentify women who will deliver LGA newborns. Thus, with good regulation of lipid profile, we can avoid macrosomia from GDM pregnancies.
Anthropometric Parameters in National Footballers in the Republic of Macedonia
Authors: Pluncevic-Gligoroska Jasmina , Todorovska Lidija , Dejanova Beti , Maleska Vesela , Mancevska Sanja , Nikolic Slobodan
Published: December 2014

Objectives: The focus of this study is on anthropometric characteristics of footballers in the Republic of Macedonia, and the aim is to provide normative data for selected anthropometric parameters for adult male footballers in our country.

Material and method: The study included eight hundred (800) adult male footballers, aged 24.06 ± 4.8y (age range 18–35y), who have undertaken routine sport medical examinations over a ten-year period. The football players were divided into six age – specific subgroups (“up to 20”; “up to 22”; “up to 24”; “up to 26”; “up to 28” and “over 28” years). Anthropometric measurements were made by Matiegka's protocols and body composition components were determined.

Results: Average values of body height (178.8 ± 6.7 cm), body weight (77.72 ± 7.9 kg), lean body mass (66.21 ± 6.36 kg), body components (MM% = 53.04; BM% = 17.15; FM% = 14.7%) and a large series of anthropometric measurements which define the footballers' anthropometric dimensions were obtained. The distribution of the adipose tissue regarding the body and limbs showed that the skinfolds were thickest on the lower limbs and thinnest on the arms.

Conclusions: The adult football players in Republic of Macedonia were insignificantly variable in height and body mass from their counter parts from European and American teams. The football players up to 20 year, who played in the senior national football league were lighter and smaller than their older colleagues. The football players aged from 20 to 35 years were insignificantly variable in height, body mass, and anthropometric dimensions of limbs and trunk.
T-Scan III System Diagnostic Tool for Digital Occlusal Analysis in Orthodontics – a Modern Approach
Authors: Trpevska Vesna , Kovacevska Gordana , Benedeti Alberto , Jordanov Bozidar
Published: December 2014

Introduction: This systematic literature review was performed to establish the mechanism, methodology, characteristics, clinical application and opportunities of the T-Scan III System as a diagnostic tool for digital occlusal analysis in different fields of dentistry, precisely in orthodontics.

Methods: Searching of electronic databases, using MEDLINE and PubMed, hand searching of relevant key journals, and screening of reference lists of included studies with no language restriction was performed. Publications providing statistically examined data were included for systematic review. Results: Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only ten met the inclusion criteria. The literature demonstrates that using digital occlusal analysis with T-Scan III System in orthodontics has significant advantage with regard to the capability of measuring occlusal parameters in static positions and during dynamic of the mandible.

Conclusion: Within the scope of this systematic review, there is evidence to support that T-Scan system is rapid and accurate in identifying the distribution of the tooth contacts and it shows great promise as a clinical diagnostic screening device for occlusion and for improving the occlusion after various dental treatments. Additional clinical studies are required to advance the indication filed of this system. Importance of using digital occlusal T-Scan analysis in orthodontics deserves further investigation.
Preparedness for admission of patients with suspected Ebola virus disease in European hospitals: a survey, August-September 2014
Authors: de Jong M D , Reusken C , Horby P , Koopmans M , Bonten M , Chiche J D , Giaquinto C , Welte T , Leus F , Schotsman J , Goossens H ,   on behalf of the PREPARE consortium and affiliated clinical networks
Published: December 2014

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Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013
Authors: Savage E  J , Mohammed H , Leong G , Duffell S , Hughes G
Published: December 2014

A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.
Management of pregnant women infected with Ebola virus in a treatment centre in Guinea, June 2014
Authors: Baggi F M , Taybi A , Kurth A , Van Herp M , Di Caro A , Wölfel R , Günther S , Decroo T , Declerck H , Jonckheere S
Published: December 2014

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Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries
Authors: Brusaferro S , Cookson B , Kalenic S , Cooper T , Fabry J , Gallagher R , Hartemann P , Mannerquist K , Popp W , Privitera G , Ruef C , Viale P , Coiz F , Fabbro E , Suetens C , Varela Santos C ,   National representatives of the Training in Infection Control in Europe (TRICE) project
Published: December 2014

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Synthesis and Crystal Structures of Azolo[b]1,3,4-Thiadiazinium Bromides
Authors: Laus Gerhard , Wurst Klaus , Schottenberger Herwig
Published: December 2014

Three azolo[b]1,3,4-thiadiazinium bromides were prepared from the respective N-amino-N'-methylazolethiones and phenacyl bromide, and their crystal structures were determined. 6-Phenyl-1-methylimidazo[2,1-b]1,3,4-thiadiazinium bromide (1) crystallized as methanol solvate (P21/n), 6-phenyl-1-methyl-1,2,4-triazolo[3,4-b]1,3,4-thiadiazinium bromide (2) as hemi-ethanol solvate (P21/n), and 6-phenyl-1-methyl-1,2,4-triazolo[3,2-b]1,3,4-thiadiazinium bromide (3) solvent-free (P21/c). Interionic contacts were identified.
Preliminary Evaluation of a Regional Atmospheric Chemical Data Assimilation System for Environmental Surveillance
Authors: Lee Pius , Liu Yang
Published: December 2014

We report the progress of an ongoing effort by the Air Resources Laboratory, NOAA to build a prototype regional Chemical Analysis System (ARLCAS). The ARLCAS focuses on providing long-term analysis of the three dimensional (3D) air-pollutant concentration fields over the continental U.S. It leverages expertise from the NASA Earth Science Division-sponsored Air Quality Applied Science Team (AQAST) for the state-of-science knowledge in atmospheric and data assimilation sciences. The ARLCAS complies with national operational center requirement protocols and aims to have the modeling system to be maintained by a national center. Meteorology and chemistry observations consist of land-, air- and space-based observed and quality-assured data. We develop modularized testing to investigate the efficacies of the various components of the ARLCAS. The sensitivity testing of data assimilation schemes showed that with the increment of additional observational data sets, the accuracy of the analysis chemical fields also increased incrementally in varying margins. The benefit is especially noted for additional data sets based on a different platform and/or a different retrieval algorithm. We also described a plan to apply the analysis chemical fields in environmental surveillance at the Centers for Disease Control and Prevention.
A Critical Review of an Authentic and Transformative Environmental Justice and Health Community — University Partnership
Authors: Wilson Sacoby , Campbell Dayna , Dalemarre Laura , Fraser-Rahim Herb , Williams Edith
Published: December 2014

Distressed neighborhoods in North Charleston (SC, USA) are impacted by the cumulative effects of multiple environmental hazards and expansion of the Port of Charleston. The Low Country Alliance for Model Communities (LAMC) built an environmental justice partnership to address local concerns. This case study examines the process of building and sustaining a successful transformative and authentic community-university partnership. We apply the framework established by Community-Campus Partnerships for Health (CCPH), focusing on four of the nine principles of Good Practice of Community Campus Partnerships.