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Showing 351 to 360 of 373 (0.024 seconds)Spelling suggestions: "subject:"middleaged"" "subject:"middleages""
| 351 |
Exploratory Analysis of Impact of Gabapentin on Incidence of Postoperative Nausea and Vomiting in Patients Undergoing Knee and Hip Arthroplasty With Neuraxial AnesthesiaTeeples, Allison J., Flynn, David, Denslow, Sheri, Hooper, Vallire 01 October 2020 (has links)
The incidence of postoperative nausea and vomiting (PONV) is unknown in neuraxial anesthesia for orthopedic surgery. The effect on PONV of adding gabapentin to an evidence-based antiemetic regimen as part of an opioid-sparing analgesic protocol is also unknown in this population. A retrospective analysis of all adults undergoing hip and knee arthroplasty and receiving neuraxial anesthesia in 2017 was conducted. The overall incidence of PONV was assessed. Additionally, PONV incidence was assessed for all combinations of gabapentin, dexamethasone, and/or ondansetron (in addition to propofol infusion) and compared with propofol alone. The PONV risk ratios were estimated, adjusting for age and PONV risk score. The overall incidence of PONV was 14.0%. The addition of gabapentin to propofol was associated with reduced PONV (multivariable risk ratio [mRR], 0.6; 95% CI, 0.4-1.0) vs propofol alone. Dexamethasone with propofol was associated with reduced PONV (mRR 0.6; 95% CI, 0.4-1.1) vs propofol alone, although not statistically significant. The addition of both gabapentin and dexamethasone to propofol was associated with stronger reduction in PONV (mRR 0.3; 95% CI, 0.1-0.7) vs propofol alone. Adding ondansetron to propofol showed little benefit. Gabapentin and dexamethasone are effective in reducing PONV in patients undergoing knee and hip arthroplasty with neuraxial anesthesia.
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| 352 |
Increased Prevalence of Helicobacter Pylori Antibodies Among NursesWilhoite, S L., Ferguson, D A., Soike, D R., Kalbfleisch, J. H., Thomas, E. 22 March 1993 (has links)
BACKGROUND: Numerous studies have suggested that Helicobacter pylori infection in asymptomatic subjects is transmitted from person to person. Its prevalence is higher in the institutionalized setting. If that is the case, persons involved in patient care should have a higher prevalence of the infection. METHODS: We estimated the prevalence of H pylori antibodies among groups of asymptomatic medical and nursing staff and compared them with volunteer blood donors of similar age and sex. RESULTS: One hundred fifty-eight nurses and aides, 59 residents, 46 senior medical students, and 22 senior nursing students were enrolled in this study. Serum samples were tested for IgG antibodies against H pylori by enzyme-linked immunosorbent assay. Sixty-two (39%) of 158 nurses were found to be positive for antibodies to H pylori compared with 114 (26%) of 441 specimens from the blood donor group. Within the youngest age group (20 to 34 years), 13 (25%) of 51 nurses were positive for H pylori antibodies compared with 19 (13%) of 143 age-matched serum samples from the blood donor group. Within the middle age group (35 to 49 years), 32 (39%) of 83 nurses were positive for H pylori antibodies vs 43 (26%) of 167 age-matched blood donors. In the oldest age group (> 50 years), 17 (71%) of 24 nurses were positive for H pylori antibodies compared with 52 (40%) of 131 age-matched blood donors. Twenty-three (27%) of 86 nurses with 1 to 15 years of occupational exposure were positive for H pylori antibodies compared with 40 (56%) of 72 nurses with more than 15 years of occupational exposure. CONCLUSIONS: Nurses have an increased prevalence of H pylori antibodies that is significantly higher than the comparable prevalence of volunteer blood donors and is evident in the youngest age group. In addition, the increased prevalence is related to a longer duration of patient exposure in the nursing group.
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| 353 |
Effect of Moderate Exercise on Proliferative Responses of Peripheral Blood Mononuclear CellsSmith, J, Chi, D, Salazar, S, Krish, G., Berk, S., Reynolds, S., Cambron, G. 01 June 1993 (has links)
We studied the effects of 30 minutes of exercise on T lymphocyte counts and proliferative responses of peripheral blood mononuclear cells (PBMC) in 25 runners. Exercise resulted in a T lymphocytosis in the immediate post-exercise period in all subjects (p < 0.001), and reduced CD4+/CD8+ ratios in 22/25 subjects (p = 0.001). The change was due primarily to a 2.2-fold increase in CD8+ cells (p < 0.001). Exercise also reduced PBMC mitogenic responses to phytohemagglutinin (PHA) in 13/14 subjects (p = 0.049), and to pokeweed mitogen (PWM) in 11/14 subjects (p = 0.022), but not to concanavalin A. Postrun sera from 5 of 6 subjects inhibited PHA but not PWM responses of resting autologous PBMC with normal CD4+/CD8+ ratios (p < or = 0.05): indomethacin and monocyte depletion blocked the serum inhibition (p = 0.003, p = 0.0006, respectively). We conclude that post-exercise suppression of mitogenic responses to PHA is due to the release of a serum factor(s) capable of inducing prostaglandin synthesis by circulating monocytes, whereas exercise-induced suppression of PWM responses depends primarily on the reversal of CD4+/CD8+ ratios.
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| 354 |
Recognition Performance on Words Interrupted (10 Ips, 50% Duty Cycle) With Two Interruption Patterns Referenced to Word Onset: Young Listeners With Normal Hearing for Pure Tones and Older Listeners With Sensorineural Hearing LossWilson, Richard H., Irish, Staci E. 01 January 2015 (has links)
OBJECTIVE: To determine in an interrupted word paradigm (Maryland CNCs; 10 ips, 50% duty cycle) if different locations of the interruption pattern produce different recognition performances. DESIGN: Repeated measures using two interruption patterns that were complementary halves referenced to word onset; one started with word onset (0-ms), the other started 50 ms later. The hypothesis was that recognition performance would be better on the 0-ms condition than on the 50-ms condition, but there would be some words with the reverse relation. STUDY SAMPLE: Twenty-four young adults with normal hearing for pure tones and 32 older adults (mean = 67 years) with sensorineural hearing loss participated. RESULTS: With the young listeners mean recognition performance on the 0-ms condition (63.1%) was significantly better than the mean performance on the 50-ms condition (47.8%). About twice as many words had better performance on the 0-ms condition. With the older listeners, who were given only stimuli on which performances were > 58% by the young normals, performances on the two conditions were the same. CONCLUSIONS: The hypothesis was supported with the young listeners. The equal performance by the older listeners on the two conditions was attributed to the manner in which the words were selected.
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| 355 |
Factors influencing European consumer uptake of personalised nutrition. Results of a qualitative analysisStewart-Knox, Barbara, Kuznesof, S., Robinson, J., Rankin, A., Orr, K., Duffy, M., Poinhos, R., de Almeida, M.D.V., Macready, A.L., Gallagher, C., Berezowska, A., Fischer, A.R.H., Navas-Carretero, S., Riemer, M., Traczyk, I., Gjelstad, I.M.F., Mavrogianni, C., Frewer, L.J. January 2013 (has links)
The aim of this research was to explore consumer perceptions of personalised nutrition and to compare these across three different levels of "medicalization": lifestyle assessment (no blood sampling); phenotypic assessment (blood sampling); genomic assessment (blood and buccal sampling). The protocol was developed from two pilot focus groups conducted in the UK. Two focus groups (one comprising only "older" individuals between 30 and 60 years old, the other of adults 18-65 yrs of age) were run in the UK, Spain, the Netherlands, Poland, Portugal, Ireland, Greece and Germany (N=16). The analysis (guided using grounded theory) suggested that personalised nutrition was perceived in terms of benefit to health and fitness and that convenience was an important driver of uptake. Negative attitudes were associated with internet delivery but not with personalised nutrition per se. Barriers to uptake were linked to broader technological issues associated with data protection, trust in regulator and service providers. Services that required a fee were expected to be of better quality and more secure. An efficacious, transparent and trustworthy regulatory framework for personalised nutrition is required to alleviate consumer concern. In addition, developing trust in service providers is important if such services to be successful.
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| 356 |
Resveratrol modulates interleukin-1beta-induced phosphatidylinositol 3-kinase and nuclear factor kappaB signaling pathways in human tenocytesBusch, F., Mobasheri, A., Shayan, P., Lueders, C., Stahlmann, R., Shakibaei, M. January 2012 (has links)
No / Resveratrol, an activator of histone deacetylase Sirt-1, has been proposed to have beneficial health effects due to its antioxidant and anti-inflammatory properties. However, the mechanisms underlying the anti-inflammatory effects of resveratrol and the intracellular signaling pathways involved are poorly understood. An in vitro model of human tenocytes was used to examine the mechanism of resveratrol action on IL-1beta-mediated inflammatory signaling. Resveratrol suppressed IL-1beta-induced activation of NF-kappaB and PI3K in a dose- and time-dependent manner. Treatment with resveratrol enhanced the production of matrix components collagen types I and III, tenomodulin, and tenogenic transcription factor scleraxis, whereas it inhibited gene products involved in inflammation and apoptosis. IL-1beta-induced NF-kappaB and PI3K activation was inhibited by resveratrol or the inhibitors of PI3K (wortmannin), c-Src (PP1), and Akt (SH-5) through inhibition of IkappaB kinase, IkappaBalpha phosphorylation, and inhibition of nuclear translocation of NF-kappaB, suggesting that PI3K signaling pathway may be one of the signaling pathways inhibited by resveratrol to abrogate NF-kappaB activation. Inhibition of PI3K by wortmannin attenuated IL-1beta-induced Akt and p65 acetylation, suggesting that p65 is a downstream component of PI3K/Akt in these responses. The modulatory effects of resveratrol on IL-1beta-induced activation of NF-kappaB and PI3K were found to be mediated at least in part by the association between Sirt-1 and scleraxis and deacetylation of NF-kappaB and PI3K. Overall, these results demonstrate that activated Sirt-1 plays an essential role in the anti-inflammatory effects of resveratrol and this may be mediated at least in part through inhibition/deacetylation of PI3K and NF-kappaB.
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| 357 |
Elevated activity and microglial expression of myeloperoxidase in demyelinated cerebral cortex in multiple sclerosisGray, E., Thomas, T. L., Betmouni, S., Scolding, N., Love, S. January 2008 (has links)
No / Recent studies have revealed extensive cortical demyelination in patients with progressive multiple sclerosis (MS). Demyelination in gray matter lesions is associated with activation of microglia. Macrophages and microglia are known to express myeloperoxidase (MPO) and generate reactive oxygen species during myelin phagocytosis in the white matter. In the present study we examined the extent of microglial activation in the cerebral cortex and the relationship of microglial activation and MPO activity to cortical demyelination. Twenty-one cases of neuropathologically confirmed multiple sclerosis, with 34 cortical lesions, were used to assess microglial activation. HLA-DR immunolabeling of activated microglia was significantly higher in demyelinated MS cortex than control cortex and, within the MS cohort, was significantly greater within cortical lesions than in matched non-demyelinated areas of cortex. In homogenates of MS cortex, cortical demyelination was associated with significantly elevated MPO activity. Immunohistochemistry revealed MPO in CD68-positive microglia within cortical plaques, particularly toward the edge of the plaques, but not in microglia in adjacent non-demyelinated cortex. Cortical demyelination in MS is associated with increased activity of MPO, which is expressed by a CD68-positive subset of activated microglia, suggesting that microglial production of reactive oxygen species is likely to be involved in cortical demyelination.
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| 358 |
Cerebral venous outflow resistance and interpretation of cervical plethysmography data with respect to the diagnosis of chronic cerebrospinal venous insufficiencyBeggs, Clive B., Shepherd, Simon J., Zamboni, P. January 2014 (has links)
No / PURPOSE: To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius (AoS) in chronic cerebrospinal venous insufficiency (CCSVI)-positive and -negative healthy individuals using cine phase contrast imaging. MATERIALS AND METHODS: Fifty-one healthy individuals (32 CCSVI-negative and 19 age-matched CCSVI-positive subjects) were examined using Doppler sonography (DS). Diagnosis of CCSVI was established if subjects fulfilled >/=2 venous hemodynamic criteria on DS. CSF flow and velocity measures were quantified using a semiautomated method and compared with clinical and routine 3T MRI outcomes. RESULTS: CCSVI was associated with increased CSF pulsatility in the AoS. Net positive CSF flow was 32% greater in the CCSVI-positive group compared with the CCSVI-negative group (P = 0.008). This was accompanied by a 28% increase in the mean aqueductal characteristic signal (ie, the AoS cross-sectional area over the cardiac cycle) in the CCSVI-positive group compared with the CCSVI-negative group (P = 0.021). CONCLUSION: CSF dynamics are altered in CCSVI-positive healthy individuals, as demonstrated by increased pulsatility. This is accompanied by enlargement of the AoS, suggesting that structural changes may be occurring in the brain parenchyma of CCSVI-positive healthy individuals.
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| 359 |
Jugular venous reflux and white matter abnormalities in Alzheimer's disease: a pilot studyChung, C.P., Beggs, Clive B., Wang, P.N., Bergsland, N., Shepherd, Simon J., Cheng, C.Y., Ramasamy, D.P., Dwyer, Michael G., Hu, H.H., Zivadinov, R. January 2014 (has links)
Yes / To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age- and gender-matched controls. Duplex ultrasonography and 1.5T MRI scanning was applied to quantify cerebral WMCs [T2 white matter (WM) lesion and dirty-appearing-white-matter (DAWM)]. Subjects with severe JVR had more frequently hypertension (p = 0.044), more severe WMC, including increased total (p = 0.047) and periventricular DAWM volumes (p = 0.008), and a trend for increased cerebrospinal fluid volumes (p = 0.067) compared with the other groups. A significantly decreased (65.8%) periventricular DAWM volume (p = 0.01) in the JVR-positive AD individuals compared with their JVR-negative counterparts was detected. There was a trend for increased periventricular and subcortical T2 WMC lesion volumes in the JVR-positive AD individuals compared with their JVR-negative counterparts (p = 0.073). This phenomenon was not observed in either the control or MCI groups. In multiple regression analysis, the increased periventricular WMC lesion volume and decreased DAWM volume resulted in 85.7% sensitivity and 80% specificity for distinguishing between JVR-positive and JVR-negative AD patients. These JVR-WMC association patterns were not seen in the control and MCI groups. Therefore, this pilot study suggests that there may be an association between JVR and WMCs in AD patients, implying that cerebral venous outflow impairment might play a role in the dynamics of WMCs formation in AD patients, particularly in the periventricular regions. Further longitudinal studies are needed to confirm and validate our findings.
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| 360 |
Patient and other factors influencing the prescribing of cardiovascular prevention therapy in the general practice setting with and without nurse assessmentMohammed, Mohammed A., El Sayed, C., Marshall, T. January 2012 (has links)
No / Although guidelines indicate when patients are eligible for antihypertensives and statins, little is known about whether general practitioners (GPs) follow this guidance. To determine the factors influencing GPs decisions to prescribe cardiovascular prevention drugs. DESIGN OF STUDY: Secondary analysis of data collected on patients whose cardiovascular risk factors were measured as part of a controlled study comparing nurse-led risk assessment (four practices) with GP-led risk assessment (two practices). SETTING: Six general practices in the West Midlands, England. PATIENTS: Five hundred patients: 297 assessed by the project nurse, 203 assessed by their GP. MEASUREMENTS: Cardiovascular risk factor data and whether statins or antihypertensives were prescribed. Multivariable logistic regression models investigated the relationship between prescription of preventive treatments and cardiovascular risk factors. RESULTS: Among patients assessed by their GP, statin prescribing was significantly associated only with a total cholesterol concentration >/= 7 mmol/L and antihypertensive prescribing only with blood pressure >/= 160/100 mm Hg. Patients prescribed an antihypertensive by their GP were five times more likely to be prescribed a statin. Among patients assessed by the project nurse, statin prescribing was significantly associated with age, sex, and all major cardiovascular risk factors. Antihypertensive prescribing was associated with blood pressures >/= 140/90 mm Hg and with 10-year cardiovascular risk. LIMITATIONS: Generalizability is limited, as this is a small analysis in the context of a specific cardiovascular prevention program. CONCLUSIONS: GP prescribing of preventive treatments appears to be largely determined by elevation of a single risk factor. When patients were assessed by the project nurse, prescribing was much more consistent with established guidelines.
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