435 research outputs found
Efficacy of an intensive outpatient rehabilitation program in alcoholism: Predictors of outcome 6 months after treatment
Treatment of alcohol-dependent patients was primarily focused on inpatient settings in the past decades. The efficacy of these treatment programs has been evaluated in several studies and proven to be sufficient. However, with regard to the increasing costs in public healthcare systems, questions about alternative treatment strategies have been raised. Meanwhile, there is growing evidence that outpatient treatment might be comparably effective as inpatient treatment, at least for subgroups of alcohol dependents. On that background, the present study aimed to evaluate the efficacy of a high-structured outpatient treatment program in 103 alcohol-dependent patients. 74 patients (72%) terminated the outpatient treatment regularly. At 6 months' follow-up, 95% patients were successfully located and personally re-interviewed. Analyses revealed that 65 patients (64%) were abstinent at the 6-month follow-up evaluation and 37 patients ( 36%) were judged to be non-abstinent. Pretreatment variables which were found to have a negative impact (non-abstinence) on the 6-month outcome after treatment were a higher severity of alcohol dependence measured by a longer duration of alcohol dependence, a higher number of prior treatments and a stronger alcohol craving (measured by the Obsessive Compulsive Drinking Scale). Further patients with a higher degree of psychopathology measured by the Beck Depression Inventory (depression) and State-Trait Anxiety Inventory (anxiety) relapsed more often. In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program
Gastrojejunocolic fistula after gastrojejunostomy: a case series
<p>Abstract</p> <p>Introduction</p> <p>Gastrojejunocolic (GJC) fistulae represent a significant post-surgical cause of morbidity and mortality. GJC fistulae represent rare post-surgical complications, and most are associated with gastric surgery. In the past, this complication has been under-recognized because a fistula may form years after surgery.</p> <p>Case presentation</p> <p>We describe two cases of gastrojejunocolic fistula in men aged 67 and 60 who both initially presented with watery diarrhea and weight loss. Upper GI studies with small bowel follow-through or barium contrast enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course was uneventful.</p> <p>Conclusion</p> <p>With surgery, this condition is entirely correctable. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery, and total parenteral nutrition plays a major role in the provision of bowel rest to allow recovery in malnourished patients.</p
Leg disorders in broiler chickens : prevalence, risk factors and prevention
Broiler (meat) chickens have been subjected to intense genetic selection. In the past 50 years, broiler growth rates have increased
by over 300% (from 25 g per day to 100 g per day). There is growing societal concern that many broiler chickens have impaired
locomotion or are even unable to walk. Here we present the results of a comprehensive survey of commercial flocks which
quantifies the risk factors for poor locomotion in broiler chickens.We assessed the walking ability of 51,000 birds, representing 4.8
million birds within 176 flocks.We also obtained information on approximately 150 different management factors associated with
each flock. At a mean age of 40 days, over 27.6% of birds in our study showed poor locomotion and 3.3% were almost unable to
walk. The high prevalence of poor locomotion occurred despite culling policies designed to remove severely lame birds from
flocks. We show that the primary risk factors associated with impaired locomotion and poor leg health are those specifically
associated with rate of growth. Factors significantly associated with high gait score included the age of the bird (older birds), visit
(second visit to same flock), bird genotype, not feeding whole wheat, a shorter dark period during the day, higher stocking density
at the time of assessment, no use of antibiotic, and the use of intact feed pellets. The welfare implications are profound. Worldwide
approximately 261010 broilers are reared within similar husbandry systems.We identify a range of management factors that could
be altered to reduce leg health problems, but implementation of these changes would be likely to reduce growth rate and
production. A debate on the sustainability of current practice in the production of this important food source is required
One-stage laparoscopic-assisted resection of gastrojejunocolic fistula after gastrojejunostomy for duodenal ulcer: a case report
<p>Abstract</p> <p>Introduction</p> <p>Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection.</p> <p>Case presentation</p> <p>A 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.</p> <p>Conclusions</p> <p>Modern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.</p
Folate Deficiency, Hyperhomocysteinemia, Low Urinary Creatinine, and Hypomethylation of Leukocyte DNA Are Risk Factors for Arsenic-Induced Skin Lesions
Background
Arsenic methylation relies on folate-dependent one-carbon metabolism and facilitates urinary As elimination. Clinical manifestations of As toxicity vary considerably among individuals and populations, and poor methylation capacity is thought to confer greater susceptibility.
Objective
After determining that folate deficiency, hyperhomocysteinemia, and low urinary creatinine are associated with reduced As methylation, and that As exposure is associated with increased genomic methylation of leukocyte DNA, we asked whether these factors are associated with As-induced skin lesion risk among Bangladeshi adults.
Methods
We conducted a nested case–control study of 274 cases who developed lesions 2 years after recruitment, and 274 controls matched to cases for sex, age, and water As.
Results
The odds ratios and 95% confidence intervals (CIs) for development of skin lesions for participants who had low folate (\u3c 9 nmol/L), hyperhomocysteinemia (men, \u3e 11.4 μmol/L; women, \u3e 10.4 μmol/L), or hypomethylated leukocyte DNA at recruitment (\u3c median) were 1.8 (95% CI, 1.1–2.9), 1.7 (95% CI, 1.1–2.6), and 1.8 (95% CI, 1.2–2.8), respectively. Compared with the subjects in the first quartile, those in the third and fourth quartiles for urinary creatinine had a 0.4-fold decrease in the odds of skin lesions (p \u3c 0.01).
Conclusions
These results suggest that folate deficiency, hyperhomocysteinemia, and low urinary creatinine, each associated with decreased As methylation, are risk factors for As-induced skin lesions. The increased DNA methylation associated with As exposure previously observed, and confirmed among controls in this study, may be an adaptive change because hypomethylation of leukocyte DNA is associated with increased risk for skin lesions
Melting of a 2D Quantum Electron Solid in High Magnetic Field
The melting temperature () of a solid is generally determined by the
pressure applied to it, or indirectly by its density () through the equation
of state. This remains true even for helium solids\cite{wilk:67}, where quantum
effects often lead to unusual properties\cite{ekim:04}. In this letter we
present experimental evidence to show that for a two dimensional (2D) solid
formed by electrons in a semiconductor sample under a strong perpendicular
magnetic field\cite{shay:97} (), the is not controlled by , but
effectively by the \textit{quantum correlation} between the electrons through
the Landau level filling factor =. Such melting behavior, different
from that of all other known solids (including a classical 2D electron solid at
zero magnetic field\cite{grim:79}), attests to the quantum nature of the
magnetic field induced electron solid. Moreover, we found the to increase
with the strength of the sample-dependent disorder that pins the electron
solid.Comment: Some typos corrected and 2 references added. Final version with minor
editoriol revisions published in Nature Physic
Fractional quantum Hall effect in a quantum point contact at filling fraction 5/2
Recent theories suggest that the excitations of certain quantum Hall states
may have exotic braiding statistics which could be used to build topological
quantum gates. This has prompted an experimental push to study such states
using confined geometries where the statistics can be tested. We study the
transport properties of quantum point contacts (QPCs) fabricated on a
GaAs/AlGaAs two dimensional electron gas that exhibits well-developed
fractional quantum Hall effect, including at bulk filling fraction 5/2. We find
that a plateau at effective QPC filling factor 5/2 is identifiable in point
contacts with lithographic widths of 1.2 microns and 0.8 microns, but not 0.5
microns. We study the temperature and dc-current-bias dependence of the 5/2
plateau in the QPC, as well as neighboring fractional and integer plateaus in
the QPC while keeping the bulk at filling factor 3. Transport near QPC filling
factor 5/2 is consistent with a picture of chiral Luttinger liquid edge-states
with inter-edge tunneling, suggesting that an incompressible state at 5/2 forms
in this confined geometry
Three little pieces for computer and relativity
Numerical relativity has made big strides over the last decade. A number of
problems that have plagued the field for years have now been mostly solved.
This progress has transformed numerical relativity into a powerful tool to
explore fundamental problems in physics and astrophysics, and I present here
three representative examples. These "three little pieces" reflect a personal
choice and describe work that I am particularly familiar with. However, many
more examples could be made.Comment: 42 pages, 11 figures. Plenary talk at "Relativity and Gravitation:
100 Years after Einstein in Prague", June 25 - 29, 2012, Prague, Czech
Republic. To appear in the Proceedings (Edition Open Access). Collects
results appeared in journal articles [72,73, 122-124
Limited Trafficking of a Neurotropic Virus Through Inefficient Retrograde Axonal Transport and the Type I Interferon Response
Poliovirus is an enteric virus that rarely invades the human central nervous system (CNS). To identify barriers limiting poliovirus spread from the periphery to CNS, we monitored trafficking of 10 marked viruses. After oral inoculation of susceptible mice, poliovirus was present in peripheral neurons, including vagus and sciatic nerves. To model viral trafficking in peripheral neurons, we intramuscularly injected mice with poliovirus, which follows a muscle–sciatic nerve–spinal cord–brain route. Only 20% of the poliovirus population successfully moved from muscle to brain, and three barriers limiting viral trafficking were identified. First, using light-sensitive viruses, we found limited viral replication in peripheral neurons. Second, retrograde axonal transport of poliovirus in peripheral neurons was inefficient; however, the efficiency was increased upon muscle damage, which also increased the transport efficiency of a non-viral neural tracer, wheat germ agglutinin. Third, using susceptible interferon (IFN) α/β receptor knockout mice, we demonstrated that the IFN response limited viral movement from the periphery to the brain. Surprisingly, the retrograde axonal transport barrier was equivalent in strength to the IFN barrier. Illustrating the importance of barriers created by the IFN response and inefficient axonal transport, IFN α/β receptor knockout mice with muscle damage permitted 80% of the viral population to access the brain, and succumbed to disease three times faster than mice with intact barriers. These results suggest that multiple separate barriers limit poliovirus trafficking from peripheral neurons to the CNS, possibly explaining the rare incidence of paralytic poliomyelitis. This study identifies inefficient axonal transport as a substantial barrier to poliovirus trafficking in peripheral neurons, which may limit CNS access for other viruses
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