Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study

Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs) caused by anthroposophical medicines (AMEDs) in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code), causality (according to the Uppsala Monitoring Centre WHO criteria), and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6%) experienced 211 ADRs (CTCAE grade 2/3 n = 191, 90.5%, CTCAE grade 4/5 n = 20, 9.5%) of which 57 ADRs (27.0%) were serious. The median age of patients with ADRs (62.1% females) was 72.0 (IQR: 61.0; 80.0). Six patients (0.2%) experienced six ADRs (2.8% of ADRs) caused by eight suspected AMEDs, all of which were mild reactions (grade 2). Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms

Infants’ intentionally communicative vocalisations elicit responses from caregivers and are the best predictors of the transition to language: a longitudinal investigation of infants’ vocalisations, gestures, and word production

What aspects of infants’ prelinguistic communication are most valuable for learning to speak, and why? We test whether early vocalisations and gestures drive the transition to word use because, in addition to indicating motoric readiness, they 1) are early instances of intentional communication and 2) elicit verbal responses from caregivers. In study 1, 11-month-olds (N = 134) were observed to coordinate vocalisations and gestures with gaze to their caregiver’s face at above chance rates, indicating that they are plausibly intentionally communicative. Study 2 tested whether those infant communicative acts that were gaze-coordinated best predicted later expressive vocabulary. We report a novel procedure for predicting vocabulary via multi-model inference over a comprehensive set of infant behaviours produced at 11- and 12-months (n = 58). This makes it possible to establish the relative predictive value of different behaviours that are hierarchically organised by level of granularity. Gaze-coordinated vocalisations were the most valuable predictors of expressive vocabulary size up to 24 months. Study 3 established that caregivers were more likely to respond to gaze-coordinated behaviours. Moreover, the dyadic combination of infant gaze-coordinated vocalisation and caregiver response was by far the best predictor of later vocabulary size. We conclude that practice with prelinguistic intentional communication facilitates the leap to symbol use. Learning is optimised when caregivers respond to intentional vocalisations with appropriate language

Study of nucleon resonances with electromagnetic interactions

Recent developments in using electromagnetic meson production reactions to study the structure of nucleon resonances are reviewed. Possible future works are discussed.Comment: 25 pages, 19 figure

Photoproduction of neutral pion pairs in the Coulomb field of the nucleus

The total cross section for Coulomb photoproduction of neutral pion pairs in the reaction gamma A --> pi0 pi0 A is estimated within the effective chiral lagrangian approach. The amplitude of gamma gamma* --> pi0 pi0 with one off-shell photon is calculated at O(p^6) in the momentum expansion; in addition, nuclear absorption is taken into account. Besides its experimental feasibility, the results of the calculation demonstrate that the reaction gamma A --> pi0 pi0 A is a powerful source of information on the process gamma gamma --> pi0 pi0 close to threshold.Comment: 18 pages, 6 figures, uses epsf, ioplppt.sty, iopl12.sty (included); Added a discussion of main background from double pion photoproduction on nucleon gamma N --> 2pi0 N via baryon resonance exchange mechanis

Minimally invasive strabismus surgery (MISS) for inferior obliquus recession

PURPOSE: To present a novel, minimally invasive strabismus surgery (MISS) technique for inferior obliquus recessions. METHODS: Graded MISS inferior obliquus recessions were performed in 20 eyes of 15 patients by applying two small conjunctival cuts, one at the insertion of inferior obliquus and another where the scleral anchoring of the muscle occurred. RESULTS: The amount of recession was 12.2 +/- 2.3 mm (range 6 to 14 mm). The vertical deviation, which was measured in 25 degrees of adduction, decreased from preoperatively 12.8 degrees +/- 5.6 degrees to 2.7 degrees +/- 2.2 degrees (p 0.1). In one eye (2.5%) the two cuts had to be joined because of excessive bleeding. Binocular vision improved in eight patients, remained unchanged in six patients, and decreased from 30 to 60 arcsec in one patient (p > 0.1). Conjunctival and lid swelling were hardly visible on the first postoperative day in primary gaze position in 10/20 (50%) of eyes. Five of the eyes (25%) had mild and five (25%) moderate visibility of surgery. One patient out of 15 (7%) needed repeat surgery because of insufficient reduction of the sursoadduction within the first 6 months. The dose-effect relationship 6 months postoperatively for an accommodative near target at 25 degrees adduction was 0.83 degrees +/- 0.43 degrees per mm of recession. CONCLUSIONS: This study demonstrates that small-incision, minimal dissection inferior obliquus graded recessions are feasible and effective to improve ocular alignment in patients with strabismus sursoadductorius

Measurement of the diffractive structure function in deep inelastic scattering at HERA

This paper presents an analysis of the inclusive properties of diffractive deep inelastic scattering events produced in $ep$ interactions at HERA. The events are characterised by a rapidity gap between the outgoing proton system and the remaining hadronic system. Inclusive distributions are presented and compared with Monte Carlo models for diffractive processes. The data are consistent with models where the pomeron structure function has a hard and a soft contribution. The diffractive structure function is measured as a function of \xpom, the momentum fraction lost by the proton, of $\beta$, the momentum fraction of the struck quark with respect to \xpom, and of $Q^2$. The \xpom dependence is consistent with the form \xpoma where $a~=~1.30~\pm~0.08~(stat)~^{+~0.08}_{-~0.14}~(sys)$ in all bins of $\beta$ and $Q^2$. In the measured $Q^2$ range, the diffractive structure function approximately scales with $Q^2$ at fixed $\beta$. In an Ingelman-Schlein type model, where commonly used pomeron flux factor normalisations are assumed, it is found that the quarks within the pomeron do not saturate the momentum sum rule.Comment: 36 pages, latex, 11 figures appended as uuencoded fil

Low Q^2 Jet Production at HERA and Virtual Photon Structure

The transition between photoproduction and deep-inelastic scattering is investigated in jet production at the HERA ep collider, using data collected by the H1 experiment. Measurements of the differential inclusive jet cross-sections dsigep/dEt* and dsigmep/deta*, where Et* and eta* are the transverse energy and the pseudorapidity of the jets in the virtual photon-proton centre of mass frame, are presented for 0 < Q2 < 49 GeV2 and 0.3 < y < 0.6. The interpretation of the results in terms of the structure of the virtual photon is discussed. The data are best described by QCD calculations which include a partonic structure of the virtual photon that evolves with Q2.Comment: 20 pages, 5 Figure

Hadron Production in Diffractive Deep-Inelastic Scattering

Characteristics of hadron production in diffractive deep-inelastic positron-proton scattering are studied using data collected in 1994 by the H1 experiment at HERA. The following distributions are measured in the centre-of-mass frame of the photon dissociation system: the hadronic energy flow, the Feynman-x (x_F) variable for charged particles, the squared transverse momentum of charged particles (p_T^{*2}), and the mean p_T^{*2} as a function of x_F. These distributions are compared with results in the gamma^* p centre-of-mass frame from inclusive deep-inelastic scattering in the fixed-target experiment EMC, and also with the predictions of several Monte Carlo calculations. The data are consistent with a picture in which the partonic structure of the diffractive exchange is dominated at low Q^2 by hard gluons.Comment: 16 pages, 6 figures, submitted to Phys. Lett.