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Pathological Demand Avoidance

Johannes E Plath, Tim Saier, Matthias J Feucht, Philipp Minzlaff, Gernot Seppel, Sepp Braun, Daniel Hatch, Andreas B Imhoff
PURPOSE: To analyze and compare patient expectations of primary and revision shoulder stabilization and to assess the factors associated with patients' expectations. METHODS: Pre-operative patient expectations after shoulder instability repair were prospectively assessed using a self-designed questionnaire. The survey included questions on the expected level and type of return to sports, instability, pain, risk of osteoarthritis, and overall shoulder condition. RESULTS: One-hundred and forty-five patients (99 primary; 46 revision repair) were included...
March 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Haval Surchi, Bahram Jafar-Mohammadi, Aparna Pal, Simon Cudlip, Ashley B Grossman
Pituitary adenomas can be identified pathologically in some 20-25% of autopsy specimens, but only around 1/1000 of the population have clinically significant tumours.Classic bitemporal hemianopia occurs as tumour expands. These visual symptoms are the most common objective manifestations of non-functioning pituitary adenomas, and demand urgent decompression to increase the probability of a complete normalisation of visual function. Delayed diagnosis may lead to irreversible visual loss.The onset of the visual deficit is usually gradual such that many patients might not seek medical consultation for months or even years...
March 1, 2017: Endocrine-related Cancer
Jaspreet Johal, Christian Fisahn, Brittni Burgess, Marios Loukas, Jens Chapman, Rod J Oskouian, R Shane Tubbs
Pathology of the dens, such as fractures, demands precise terminology so that communication between physicians are succinct, diagnoses are accurate, and treatment strategies exact. This review aims to summarize the various terms used to describe the parts of the dens and recommend the ideal terminology. Using standard search engines, English language publications were searched for the many terms used to describe parts of the dens. A multitude of terms was identified with many demonstrating overlaps. Terms identified included apex, tip, apicodental, subdental, dentocentral and odontocentral junctions, peg, waist, base, neck, shaft, shoulder, and stem...
January 17, 2017: Curēus
Zuri Shahidii Kadir, Hatta Sidi, Jaya Kumar, Srijit Das, Marhani Midin, Najwa Baharuddin
Vaginismus is an involuntary muscle contraction of the outer third of vaginal barrel causing sexual penetration almost impossible. It is generally classified under sexual pain disorder (SPD). In Diagnostic and Statistical Manual, 5th edition, it is classified under the new rubric of Genito-Pelvic Pain/Sexual Penetration Disorder. This fear-avoidance condition poses an ongoing significant challenge to the medical and health professionals due to the very demanding needs in health care despite its unpredictable prognosis...
February 22, 2017: Current Drug Targets
Xia Li, Xiaowen Xu, Juan Song, Qingwang Xue, Chenzhong Li, Wei Jiang
T4 polynucleotide kinase (PNK) plays critical roles in regulating DNA phosphorylation modes during the repair of DNA lesions. The aberrant activity of T4 PNK has been proven to be associated with a variety of human pathologies. Sensitive detection of T4 PNK activity is critical to both clinical diagnosis and therapeutics. Herein, a background-eliminated fluorescence assay for sensitive detection of T4 PNK activity has been developed by multifunctional magnetic probes and polymerization nicking reactions mediated hyperbranched rolling circle amplification (HRCA)...
May 15, 2017: Biosensors & Bioelectronics
Simone Schrading, Kevin Strobel, Annika Keulers, Timm Dirrichs, Christiane K Kuhl
OBJECTIVE: Magnetic resonance (MR)-guided vacuum-biopsy is technically demanding and may fail depending on target-lesion size or breast size, and location of lesions within the breast. We developed an MR-guided vacuum-assisted biopsy protocol that collects larger amounts of tissue, aiming at an at least partial or complete ablation of the target-lesion, just as it is intended during surgical (excisional) biopsy. Rationale is to avoid biopsy failures (false-negative results due to undersampling) by collecting larger amounts of tissue...
March 2017: Investigative Radiology
Mohamed Mahmood Nasr
BACKGROUND: The performance of laparoscopic cholecystectomy could be a technical challenge. Procedure success depends on multiple factors namely: hepatobiliary anatomical variations, pathologic changes in the gallbladder and surrounding tissues, pre-operative interventional attempts, the individual surgeon's skill and finally patient co-morbidities. Anticipating the attendant challenges, can help to avoid several known complications associated with this procedure. Searching a more reliable anatomical topography to adopt during laparoscopic cholecystectomy is the basis for a safe surgical technique...
February 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Karina Camasmie Abe, Simone Georges El Khouri Miraglia
Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM) with an aerodynamic diameter <10 μm (PM10), <2.5 μm (PM2.5) and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs...
2016: International Journal of Environmental Research and Public Health
Ramón Cacabelos, Clara Torrellas, Oscar Teijido, Juan Carlos Carril
The practical pharmacogenetics of Alzheimer's disease (AD) is circumscribed to acetylcholinesterase inhibitors (AChEIs) and memantine. However, pharmacogenetic procedures should be applied to novel strategies in AD therapeutics including: novel AChEIs and neurotransmitter regulators, anti-Aβ treatments, anti-tau treatments, pleiotropic products, epigenetic drugs and combination therapies. Genes involved in the pharmacogenetic network are under the influence of the epigenetic machinery which regulates gene expression transcriptionally and post-transcriptionally, configuring the fundamentals of pharmacoepigenomics...
June 2016: Pharmacogenomics
Xiao Hu, Fei-Fei Yang, Yong-Hong Liao
BACKGROUND: Systemic pulmonary delivery is considered to have advantages over oral or intravenous administration for certain drugs. METHODS: In this article, we review the effects of intrinsic drug properties and drug loading carriers on the pharmacokinetic parameters of inhaled drugs in the context of use in systemic pulmonary delivery. RESULTS: The delivery of drugs via inhalation can be advisable to achieve a fast onset of action; enhance the systemic bioavailability of drugs with poor oral absorption, including peptides and proteins; avoid invasive administration and improve patient compliance...
2016: Current Pharmaceutical Design
Senthil Nathan Sambandam, Vishesh Khanna, Arif Gul, Varatharaj Mounasamy
Lesions of the rotator cuff (RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an age-dependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears...
December 18, 2015: World Journal of Orthopedics
Zsuzsanna Ament, James A West, Elizabeth Stanley, Tom Ashmore, Lee D Roberts, Jayne Wright, Andrew W Nicholls, Julian L Griffin
The peroxisome proliferator-activated receptors (PPARs) are ligand activated nuclear receptors that regulate cellular homoeostasis and metabolism. PPARs control the expression of genes involved in fatty-acid and lipid metabolism. Despite evidence showing beneficial effects of their activation in the treatment of metabolic diseases, particularly dyslipidaemias and type 2 diabetes, PPAR agonists have also been associated with a variety of side effects and adverse pathological changes. Agonists have been developed that simultaneously activate the three PPAR receptors (PPARα, γ and δ) in the hope that the beneficial effects can be harnessed while avoiding some of the negative side effects...
June 2016: Free Radical Biology & Medicine
Fazli Subhan, Muhammad Ikram, Adeeb Shehzad, Abdul Ghafoor
Mammalian collagen is a multifactorial biomaterial that is widely used for beneficial purposes in the advanced biomedical technologies. Generally, biomedical applicable collagen is extracted from the mammalian body, but it can also be derived from marine species. Recently, mammalian tissues collagen proteins are considered a great pathological risk for transmitted diseases, because purification of such protein is very challenging and needs efficient tool to avoid structure alteration. Thus, difficult extraction process and high cost decreased mammalian collagen demands for beneficial effects compared to marine collagen...
August 2015: Journal of Food Science and Technology
Elizabeth O'Nions, Judith Gould, Phil Christie, Christopher Gillberg, Essi Viding, Francesca Happé
The term 'pathological demand avoidance' (PDA) was coined by Elizabeth Newson to describe children within the autism spectrum who exhibit obsessive resistance to everyday demands and requests (Newson et al., Arch Dis Child 88:595-600, 2003). Clinical accounts describe avoidance strategies including apparently strategic use of distraction or socially shocking behaviour, and obsessive need for control, reflected in domineering behaviour to peers and adults. Educational and management approaches effective for PDA reportedly differ from those for 'typical' autism spectrum disorders (ASD), and include novelty, humour and flexibility...
April 2016: European Child & Adolescent Psychiatry
K K Watson, D Li, L J N Brent, J E Horvath, J Gonzalez-Martinez, Ruiz-A Lambides, A G Robinson, J H P Skene, M L Platt
An ethological approach to attention predicts that organisms orient preferentially to valuable sources of information in the environment. For many gregarious species, orienting to other individuals provides valuable social information but competes with food acquisition, water consumption and predator avoidance. Individual variation in vigilance behaviour in humans spans a continuum from inattentive to pathological levels of interest in others. To assess the comparative biology of this behavioural variation, we probed vigilance rates in free-ranging macaques during water drinking, a behaviour incompatible with the gaze and postural demands of vigilance...
May 1, 2015: Animal Behaviour
Marko Kerac, Martha Mwangome, Marie McGrath, Rukhsana Haider, James A Berkley
BACKGROUND: Globally, some 4.7 million infants aged under 6 months are moderately wasted and 3.8 million are severely wasted. Traditionally, they have been over-looked by clinicians, nutritionists, and policy makers. OBJECTIVE: To present evidence and arguments for why treating acute malnutrition in infants under 6 months of age is important and outline some of the key debates and research questions needed to advance their care. METHODS: Narrative review...
March 2015: Food and Nutrition Bulletin
Suehana Rahman, Susan V Mallett
Cirrhotic cardiomyopathy is a disease that has only recently been recognised as a definitive clinical entity. In the setting of liver cirrhosis, it is characterized by a blunted inotropic and chronotropic response to stress, impaired diastolic relaxation of the myocardium and prolongation of the QT interval in the absence of other known cardiac disease. A key pathological feature is the persistent over-activation of the sympathetic nervous system in cirrhosis, which leads to down-regulation and dysfunction of the β-adrenergic receptor...
March 27, 2015: World Journal of Hepatology
Adriana Albu, Irina Crăcană, Ileana Prejbeanu
Purpose. Fatigue is a physiological phenomenon which is permanently present at students because of the scholar demands. Excessive demands can cause pathological fatigue phenomenon, which should be avoided. Subjects and method. The study included a group of 203 students from Dimitrie Cantemir Highschool in Iaşi. The teenagers were questioned about the presence of the fatigue phenomenon. Results. Fatigue is rarely present at 62.6% of the questioned students. During the week, this phenomenon appears especially at the beginning (22...
July 2014: Current Health Sciences Journal
J C Bier, E Salmon, A Ivanoiu
Among legislative criteria granting the right to practice euthanasia or assisted suicide, there are systematically four major elements. Precisely, any request must be voluntary, persistent, to be well thought and well informed. Such euthanasia raises numerous difficult questions in case of dementia. It also justifies thinking about possibilities that can offer specific arrangements of anticipated demands in such peculiar cases. Empirical experiences show us that it applies with difficulties in practice. Finally, to avoid that a big majority of these demands would find themselves not applied in practice, it would certainly be necessary to add to it structural valuation of advance care planning, and assure its recognition and development...
September 2014: Revue Médicale de Bruxelles
Clara Bermúdez-Tamayo, Mira Johri, Francisco Jose Perez-Ramos, Gracia Maroto-Navarro, Africa Caño-Aguilar, Leticia Garcia-Mochon, Longinos Aceituno, François Audibert, Nils Chaillet
BACKGROUND: The rate of avoidable caesarean sections (CS) could be reduced through multifaceted strategies focusing on the involvement of health professionals and compliance with clinical practice guidelines (CPGs). Quality improvements for CS (QICS) programmes (QICS) based on this approach, have been implemented in Canada and Spain. OBJECTIVES: Their objectives are as follows: 1) Toto identify clusters in each setting with similar results in terms of cost-consequences, 2) Toto investigate whether demographic, clinical or context characteristics can distinguish these clusters, and 3) Toto explore the implementation of QICS in the 2 regions, in order to identify factors that have been facilitators in changing practices and reducing the use of obstetric intervention, as well as the challenges faced by hospitals in implementing the recommendations...
2014: Implementation Science: IS
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