1,576 research outputs found

    Extensive Pulmonary Embolism in late pregnancy associated with Anticardiolipin Antibodies

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    The leading cause of morbidity and mortality during pregnancy and the puerperium is venous thromboembolism. Though uncommon, the risk is five times higher in a pregnant woman than in a non-pregnant woman of similar age.1,2 In pregnancy, all three underlying factors for venous thrombosis are present: hypercoagulability, venous stasis and vascular damage (Virchow's triad). Of these, the most constant predisposing factor is increasing venous stasis due to the pressure of the gravid uterus on the pelvic vasculature. In addition the presence of a thrombophilia, (congenital or acquired) will increase this risk substantially. During pregnancy hypercoagulability is a physiological preparation for the haemostatic challenge of delivery. There are increases in procoagulant factors, such as von Willebrand factor, factor VIII, factor V, and fibrinogen together with an acquired resistance to activated protein C and a reduction in protein S. Increases in plasminogen activator inhibitors impair fibrinolysis. The third factor of this triad, vascular damage, is a possible complication of trophoblastic invasion of the uterine spiral arterioles or of delivery.peer-reviewe

    Estudio prospectivo de profilaxis ambulatoria con sulodexida despu茅s de una artroplastia total de cadera o rodilla

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    La falta de continuidad en el tratamiento profil谩ctico ambulatorio se muestra como una de las causas determinantes en la aparici贸n de complicaciones tromboemb贸licas en el primer mes tras el alta hospitalaria. La dificultad de administraci贸n por parte del paciente de las heparinas de bajo peso molecular y la diferencia de preocupaci贸n entre los m茅dicos de Atenci贸n Primaria y los Servicios especializados por el problema tromboemb贸lico son algunas de las causas de esta discontinuidad. Se realiza un estudio prospectivo sobre 221 pacientes intervenidos de pr贸tesis total de cadera y rodilla con la finalidad de estudiar los resultados obtenidos con el tratamiento profil谩ctico mediante Sulodexida, un f谩rmaco que une a sus propiedades antitromb贸ticas la comodidad de la administraci贸n v铆a oral. Se encontr贸 una respuesta satisfactoria sin aparici贸n de complicaciones tromboemb贸licas en el 98,8% del grupo que complet贸 el tratamiento (n=164), frente al 21% de complicaciones que present贸 el grupo que no complet贸 el estudio.The discontinous thromboprophylaxis is a determinant cause in the presence of thromboembolic complications in the first month after hospital discharge. The difficult administration of the low -molecular- weight heparin by the patient and the different preoccupation for this problem between the Primary Care and the orthopedics specialists are the causes that incite to discontinous thromboprophylaxis. A prospective study was made of 221 patients who undergoing a total hip arthroplasty or a total knee arthroplasty and the objective was to investigate the incidence of venous thrombosis in the patients who were treated with oral sulodexide in the first month after hospital discharge. We analized the efficacy and the secondary effects of sulodexide. There were satisfactory results in 98,8% of patients who were treated with sulodexide (1,2% of venous complications), and 21% of venous complications in the group of patients who did not continue the thromboprophylactic treatment

    Determinants of Counseling for Children in Manhattan After the September 11 Attacks

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    Objective: After the September 11 terrorist attacks, many adults and children received counseling. The authors assessed the prevalence and correlates of counseling for experiences related to the disaster received by children aged four to 18 years living in Manhattan. Methods: From a representative sample of 1,008 adult residents of Manhattan who were living below 110th Street five to eight weeks after the attacks, the authors interviewed 112 parents or primary caretakers about their child鈥檚 level of exposure to the disaster, the extent of loss, receipt of counseling services, and behavioral reaction. Results: Overall, 22 percent of the children had received some form of counseling related to their experiences after the disaster. More than half of the counseling received (58 percent) was delivered in schools. Predictors of counseling in a multivariate model were male sex (odds ratio=5.3), having a parent with current posttraumatic stress disorder related to the attacks (OR=4.3), and having at least one sibling living in the household (OR=3.6). Conclusions: Parents鈥 own level of posttraumatic stress was associated with whether their children received counseling related to the September 11 attacks. This finding has important implications, because parents act as decision makers for their children in seeking health care. After the terrorist attacks, school and health care personnel provided early intervention counseling in Manhattan.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40295/2/Stuber_Determinants of Counseling for Children_2002.pd

    The N-terminal intrinsically disordered domain of mgm101p is localized to the mitochondrial nucleoid.

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    The mitochondrial genome maintenance gene, MGM101, is essential for yeasts that depend on mitochondrial DNA replication. Previously, in Saccharomyces cerevisiae, it has been found that the carboxy-terminal two-thirds of Mgm101p has a functional core. Furthermore, there is a high level of amino acid sequence conservation in this region from widely diverse species. By contrast, the amino-terminal region, that is also essential for function, does not have recognizable conservation. Using a bioinformatic approach we find that the functional core from yeast and a corresponding region of Mgm101p from the coral Acropora millepora have an ordered structure, while the N-terminal domains of sequences from yeast and coral are predicted to be disordered. To examine whether ordered and disordered domains of Mgm101p have specific or general functions we made chimeric proteins from yeast and coral by swapping the two regions. We find, by an in vivo assay in S.cerevisiae, that the ordered domain of A.millepora can functionally replace the yeast core region but the disordered domain of the coral protein cannot substitute for its yeast counterpart. Mgm101p is found in the mitochondrial nucleoid along with enzymes and proteins involved in mtDNA replication. By attaching green fluorescent protein to the N-terminal disordered domain of yeast Mgm101p we find that GFP is still directed to the mitochondrial nucleoid where full-length Mgm101p-GFP is targeted

    Interleukin-1 regulates multiple atherogenic mechanisms in response to fat feeding

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    Background: Atherosclerosis is an inflammatory process that develops in individuals with known risk factors that include hypertension and hyperlipidaemia, influenced by diet. However, the interplay between diet, inflammatory mechanisms and vascular risk factors requires further research. We hypothesised that interleukin-1 (IL-1) signaling in the vessel wall would raise arterial blood pressure and promote atheroma. Methodology/Principal Findings: Apoe(-/-) and Apoe(-/-)/IL-1R1(-/-) mice were fed high fat diets for 8 weeks, and their blood pressure and atherosclerosis development measured. Apoe(-/-)/IL-R1(-/-) mice had a reduced blood pressure and significantly less atheroma than Apoe(-/-) mice. Selective loss of IL-1 signaling in the vessel wall by bone marrow transplantation also reduced plaque burden (p<0.05). This was associated with an IL-1 mediated loss of endothelium-dependent relaxation and an increase in vessel wall Nox 4. Inhibition of IL-1 restored endothelium-dependent vasodilatation and reduced levels of arterial oxidative stress. Conclusions/Significance: The IL-1 cytokine system links atherogenic environmental stimuli with arterial inflammation, oxidative stress, increased blood pressure and atherosclerosis. This is the first demonstration that inhibition of a single cytokine can block the rise in blood pressure in response to an environmental stimulus. IL-1 inhibition may have profound beneficial effects on atherogenesis in man

    Informing investment to reduce inequalities: a modelling approach

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    Background: Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. Objectives: To provide estimates of the impact of a range of interventions on health and health inequalities. Materials and methods: Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a 鈥榣iving wage鈥; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Results: Introduction of a 鈥榣iving wage鈥 generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Conclusions: Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities

    EMU: Rapid prototyping of networking services

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    Due to their performance and flexibility, FPGAs are an attractive platform for the execution of network functions. It has been a challenge for a long time though to make FPGA programming accessible to a large audience of developers. An appealing solution is to compile code from a general-purpose language to hardware using high-level synthesis. Unfortunately, current approaches to implement rich network functionality are insufficient because they lack: (i) libraries with abstractions for common network operations and data structures, (ii) bindings to the underlying 鈥渟ubstrate鈥 on the FPGA, and (iii) debugging and profiling support. This paper describes Emu, a new standard library for an FPGA hardware compiler that enables developers to rapidly create and deploy network functionality. Emu allows for high-performance designs without being bound to particular packet processing paradigms. Furthermore, it supports running the same programs on CPUs, in Mininet, and on FPGAs, providing a better development environment that includes advanced debugging capabilities. We demonstrate that network functions implemented using Emu have only negligible resource and performance overheads compared with natively-written hardware versions

    Adjuvant radiotherapy and chemotherapy in breast cancer: 30 year follow-up of survival

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    BACKGROUND:The long term outcome (more than 15 years) of adjuvant treatment in patients with primary operable breast cancer has rarely been examined.METHODS:A randomised clinical trial of radiotherapy, chemotherapy (28 day cycles of cyclophosphamide, methotrexate and 5-fluorouracil) or both on women with primary operable breast cancer (n = 322) was followed-up for a median of 27 years.RESULTS:260 (81%) patients died, 204 (78%) from breast cancer. Cancer specific survival (SE) at 10 years, 20 years and 30 years was 41 (3)%, 34 (3)% and 33 (3)% respectively. Presence of more than 3 involved lymph nodes increased cancer-specific mortality (HR 1.88, 95% CI 1.34-2.63) after adjustment for age, socio-economic deprivation and adjuvant treatment. Both age (HR 1.63, 95% CI 1.19-2.22) and involved lymph nodes (HR 1.59, 95% CI 1.17-2.14) were significant predictors of all-cause mortality after adjustment for other factors. There was no significant difference in all-cause or cancer-specific survival between patients in each of the 3 treatment arms.CONCLUSIONS:The present study highlights the long term impact of node positive disease but does not indicate that any regimen was associated with significantly better long-term surviva

    Search for squarks and gluinos in events with isolated leptons, jets and missing transverse momentum at s鈭=8 TeV with the ATLAS detector

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    The results of a search for supersymmetry in final states containing at least one isolated lepton (electron or muon), jets and large missing transverse momentum with the ATLAS detector at the Large Hadron Collider are reported. The search is based on proton-proton collision data at a centre-of-mass energy s鈭=8 TeV collected in 2012, corresponding to an integrated luminosity of 20 fb鈭1. No significant excess above the Standard Model expectation is observed. Limits are set on supersymmetric particle masses for various supersymmetric models. Depending on the model, the search excludes gluino masses up to 1.32 TeV and squark masses up to 840 GeV. Limits are also set on the parameters of a minimal universal extra dimension model, excluding a compactification radius of 1/R c = 950 GeV for a cut-off scale times radius (螞R c) of approximately 30