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1.
Nurs Clin North Am ; 56(2): 229-247, 2021 06.
Article in English | MEDLINE | ID: mdl-34023118

ABSTRACT

Sleep disruptions are frequently reported by persons with mood, anxiety, and post-traumatic stress disorders, and co-occur with psychiatric disorders. There is evidence that sleep disorders can predict the likelihood of developing a future psychiatric disorder and exacerbate existing symptoms. Understanding the inter-relationships between sleep and psychiatric disorders is important. The primary goals of this article are to describe the interactions between psychiatric and sleep disorders in the context of sleep disturbances, underscore the bidirectional effects of mental health treatments on sleep disorder outcomes, and provide general recommendations to optimize treatment in the context of sleep disturbances.


Subject(s)
Anxiety/complications , Mood Disorders/complications , Sleep Wake Disorders/etiology , Stress Disorders, Post-Traumatic/complications , Antidepressive Agents/adverse effects , Antidepressive Agents/therapeutic use , Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Anxiety/psychology , Humans , Mood Disorders/psychology , Sleep Wake Disorders/psychology , Stress Disorders, Post-Traumatic/psychology
2.
J Assoc Nurses AIDS Care ; 32(3): 306-321, 2021.
Article in English | MEDLINE | ID: mdl-33449578

ABSTRACT

ABSTRACT: Neurocognitive problems have been endemic to the HIV epidemic since its beginning. Four decades later, these problems persist, but currently, they are attributed to HIV-induced inflammation, the long-term effects of combination antiretroviral therapy, lifestyle (i.e., physical activity, drug use), psychiatric, and age-associated comorbidities (i.e., heart disease, hypertension). In many cases, persons living with HIV (PLWH) may develop cognitive problems as a function of accelerated or accentuated normal aging and lifestyle rather than HIV itself. Nonetheless, such cognitive impairments can interfere with HIV care, including medication adherence and attending clinic appointments. With more than half of PLWH 50 years and older, and 30%-50% of all PLWH meeting the criteria for HIV-associated neurocognitive disorder, those aging with HIV may be more vulnerable to developing cognitive problems. This state of the science article provides an overview of current issues and provides implications for practice, policy, and research to promote successful cognitive functioning in PLWH.


Subject(s)
Aging , Cognitive Dysfunction/complications , Cognitive Dysfunction/virology , Cognitive Reserve/physiology , HIV Infections/psychology , Neurocognitive Disorders/complications , Aged , Antiretroviral Therapy, Highly Active , Cognition/physiology , Cognitive Dysfunction/psychology , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Male , Middle Aged , Neuronal Plasticity , Neuropsychological Tests , Substance-Related Disorders
3.
J Assoc Nurses AIDS Care ; 30(5): e144-e155, 2019.
Article in English | MEDLINE | ID: mdl-31259847

ABSTRACT

Older adults and people living with HIV have been shown to experience disproportionately more olfactory dysfunction. Some neurological studies suggest that olfactory dysfunction may be a precursor to cognitive dysfunction. The purpose of our study was to determine whether olfactory dysfunction was predictive of cognition. In our cross-sectional study, 51 African American and Caucasian men living with HIV (ages ≥ 40 years) were administered a cognitive performance battery and two objective olfactory measures (the University of Pennsylvania Smell Identification Test and the Smell Threshold Test). The strongest cognitive associations to the University of Pennsylvania Smell Identification Test performance were found in the Hopkins Verbal Learning Test, a measure of verbal learning and verbal memory. These findings were consistent with previous research, demonstrating a relationship between decreased olfactory function and poorer cognitive performance. An important clinical implication from these results is the potential use of olfactory dysfunction as a prodromal biomarker for HIV-associated neurocognitive disorder.


Subject(s)
Cognition/physiology , Cognitive Dysfunction/complications , HIV Infections/complications , HIV Infections/psychology , Olfaction Disorders/complications , Smell/physiology , Adult , Black or African American , Aged , Aging , Cross-Sectional Studies , Female , HIV Infections/ethnology , Humans , Male , Middle Aged , Neuropsychological Tests , Pilot Projects , White People
4.
J Healthc Qual ; 41(2): 118-124, 2019.
Article in English | MEDLINE | ID: mdl-30730398

ABSTRACT

INTRODUCTION: Measurement-based care (MBC) is commonly used to manage medical illness, whereas only about 20% of psychiatric care providers use MBC. One aim of the partnership between the Birmingham Veterans Affairs Medical Center (BVAMC) and the University of Alabama at Birmingham School of Nursing (UAB SON) is to provide MBC to Veterans. The goal is to describe the efficacy of MBC in the treatment of Veterans by psychiatric-mental health nurse practitioner (PMHNP) residents. PURPOSE: By teaching PMHNP residents evidence-based assessment, they gain tools to shorten time to remission of depression, anxiety, and posttraumatic stress disorder. METHODS: Residents administered the Patient Stress Questionnaire (PSQ), an MBC tool that assesses depression, anxiety, trauma-related symptoms, and alcohol use, to patients of the Residency Continuity Clinic (RCC). Patient Stress Questionnaire scores from March 2016 to May 2018 were analyzed using paired t tests. RESULTS: Analysis revealed a downward trend in PSQ scores over time, suggesting improvement in psychiatric symptoms. Depressive and anxiety symptoms decreased significantly. CONCLUSIONS/IMPLICATIONS: This quality project highlights the utility of MBC by PMHNP residents in an RCC. Measurement-based care tools can be quickly and easily administered with little impact on workflow. Use of validated screening tools can enhance care, engage patients, and improve patient outcomes.


Subject(s)
Mental Health/standards , Nurse Practitioners/standards , Psychiatric Nursing/standards , Quality Improvement/standards , Stress Disorders, Post-Traumatic/therapy , Veterans Health Services/standards , Veterans , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , United States
5.
J Psychosoc Nurs Ment Health Serv ; 57(6): 30-38, 2019 Jun 01.
Article in English | MEDLINE | ID: mdl-30602051

ABSTRACT

The longstanding partnership between the Birmingham Veterans Affairs Medical Center (BVAMC) and the University of Alabama at Birmingham School of Nursing inspired the establishment of one of the country's first psychiatric-mental health nurse practitioner (PMHNP) residencies and subsequent formation of a Resident Continuity Clinic (RCC). Within the RCC, PMHNP residents deliver evidence-based care that is informed by measurement-based care (MBC) to improve patient outcomes and reduce time to recovery. Determined by the BVAMC Institutional Review Board to be a quality improvement project, PMHNP residents administered the Patient Stress Questionnaire (PSQ), a MBC tool that uses four independently validated screening tools to measure the behavioral health symptoms of depression, anxiety, trauma, and alcohol use. Additional clinical variables of interest included patient use of illicit substances, participation in psychotherapy, and use of psychotropic medications. PSQ scores were reviewed retrospectively via descriptive statistics and nonparametric tests. Analysis demonstrated statistically significant improvements in depression and anxiety. Data also revealed that patients engaged in psychotherapy demonstrated greater improvements on all PSQ screening tools compared to patients not involved in psychotherapy. The results reinforce the value of MBC in psychiatric care and highlight the importance of engaging Veterans in psychotherapy to improve outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 30-38.].


Subject(s)
Advanced Practice Nursing/methods , Psychotherapy/methods , Quality Improvement , Surveys and Questionnaires/statistics & numerical data , Veterans/psychology , Anxiety/psychology , Depression/psychology , Female , Humans , Male , Mass Screening , Middle Aged , United States , United States Department of Veterans Affairs
6.
J Assoc Nurses AIDS Care ; 30(1): 51-72, 2019.
Article in English | MEDLINE | ID: mdl-30586083

ABSTRACT

The synergistic effects of HIV and aging on the brain may compromise cognitive reserve, resulting in HIV-associated neurocognitive disorder. The neuroscience literature suggests that computerized cognitive training programs represent a practical strategy to protect or remediate cognitive functioning in older adults. Such cognitive training programs may hold similar therapeutic benefits for adults living with HIV. This systematic review evaluated the effects of cognitive training interventions in adults living with HIV. This systematic review includes 13 studies that have been conducted or are being conducted. Results suggest that cognitive training may improve the cognitive domain that is the target of training. One case study even demonstrated a reversal of HIV-associated neurocognitive disorder after cognitive training. Although greater evidence is needed to establish treatment guidelines, current evidence suggests that cognitive training improves cognitive function, which translates to more optimal everyday functioning (i.e., driving), improved mood, greater locus of control, and enhanced quality of life.


Subject(s)
Activities of Daily Living/psychology , Cognition/physiology , Cognitive Reserve/physiology , HIV Infections/psychology , Neurocognitive Disorders/diagnosis , Quality of Life , Aged , HIV Infections/complications , Humans , Neurocognitive Disorders/complications , Neurocognitive Disorders/psychology , Neuropsychological Tests
7.
Public Health ; 129(1): 3-16, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25481543

ABSTRACT

In planning, designing, procuring and ensuring delivery of improved services ('commissioning') for the school age population, the outcomes should be students who are healthy to learn and who learn to be healthy. Intuitively, linking education and health development together within the wider learning environment seems a good start to planning school health. However there has been a shortage of either theoretical models that can span different settings or experimental research that demonstrates improved community health. Is there evidence that the wider learning environment provided in a school is valuable in improving health? An initial scoping exercise identified domains of health where there was a promise of health gain. International literature on school health outcomes using the framework of Asset-Based Community Development (ABCD) has been reviewed. It was found that research on a variety of interventions was relevant to schools as an asset for public health. Effective areas for health gain were identified for local planning and evaluation using this community model. However, none of the studies reviewed was originally designed to test schools as assets and most of the research lacked methodological rigour, especially regarding children in low income countries. The ABCD model could help national governments develop resources for both education and health, but there is a global need to generate better quality evidence. Then people who commission for their local communities can make more effective use of these multifaceted assets to improve health and education outcomes for children.


Subject(s)
Health Planning/organization & administration , School Health Services/organization & administration , Child , Global Health , Health Behavior , Health Services Research , Humans , Learning , Models, Theoretical , Poverty , Students/psychology
8.
J Virol Methods ; 208: 66-78, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25102428

ABSTRACT

Arboviruses are medically important pathogens that cause human disease ranging from a mild fever to encephalitis. Laboratory diagnosis is essential to differentiate arbovirus infections from other pathogens with similar clinical manifestations. The Arboviral Diseases Branch (ADB) reference laboratory at the CDC Division of Vector-Borne Diseases (DVBD) produces reference antigens used in serological assays such as the virus-specific immunoglobulin M antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA). Antigen production in cell culture has largely replaced the use of suckling mice; however, the methods are not directly transferable. The development of a cell culture antigen production algorithm for nine arboviruses from the three main arbovirus families, Flaviviridae, Togaviridae, and Bunyaviridae, is described here. Virus cell culture growth and harvest conditions were optimized, inactivation methods were evaluated, and concentration procedures were compared for each virus. Antigen performance was evaluated by the MAC-ELISA at each step of the procedure. The antigen production algorithm is a framework for standardization of methodology and quality control; however, a single antigen production protocol was not applicable to all arboviruses and needed to be optimized for each virus.


Subject(s)
Antigens, Viral/isolation & purification , Bunyaviridae/growth & development , Flaviviridae/growth & development , Reference Standards , Togaviridae/growth & development , Virus Inactivation , Algorithms , Animals , Bunyaviridae/chemistry , Bunyaviridae/physiology , Cell Culture Techniques , Enzyme-Linked Immunosorbent Assay/methods , Flaviviridae/chemistry , Flaviviridae/physiology , Humans , Togaviridae/chemistry , Togaviridae/physiology , Virus Cultivation/methods
9.
Prilozi ; 33(1): 243-63, 2012.
Article in English | MEDLINE | ID: mdl-22983104

ABSTRACT

Because of the relatively frequent occurrence of recurrent caries after a restorative treatment, and because of the huge number of cariogenic microorganisms present in the oral cavity, which present a potential risk factor regarding the development of new carious lesions, attention has increasingly been directed towards the therapeutic antimicrobial effects of restorative materials. The glass ionomer cements distinguish themselves as the most acceptable restorative materials possessing the positive characteristics of fluorine in the processes of remineralisation and antimicrobial action. In addition to the release of fluoride ions, GICs can potentially be used as templates for the release of other active antimicrobial components. The addition of antimicrobial compounds in the glass ionomer cements and analysis of their physical characteristics are very important especially for use in the posterior region of milk teeth. The aim of this study was to analyse the physical characteristics of ChemFlex and Fuji IX, conventional glass ionomer cements incorporated with the antimicrobial components Cetylpyridinium Chloride and Benzalkonium Chloride, through measurements of their setting times, and determination of their compressive strengths. Five samples of each glass ionomer with no antimicrobial compounds added were prepared--to serve as a control group; and collections of five samples of each cement with different concentrations of Cetylpyridinium Chloride and Benzalkonium Chloride--1%, 2% and 3%--added to them were also prepared--a total of 60 samples. The results of the analysis point out that it is possible to incorporate these antimicrobial agents in conventional GICs, and this is especially true when the added amount of the antimicrobial agents is 1%.


Subject(s)
Benzalkonium Compounds/chemistry , Cetylpyridinium/chemistry , Compressive Strength , Glass Ionomer Cements/chemistry , Dental Stress Analysis , Materials Testing , Surface Properties
10.
Zoonoses Public Health ; 58(2): 85-92, 2011 Mar.
Article in English | MEDLINE | ID: mdl-20042069

ABSTRACT

Since 2003, two communities in eastern Arizona have experienced a sustained outbreak of Rocky Mountain spotted fever (RMSF), caused by Rickettsia rickettsii, associated with transmission by Rhipicephalus sanguineus, the brown dog tick; 70 human cases, including eight deaths, were reported from these communities during 2003 through 2008. In both of the affected communities, antibodies to spotted fever group rickettsiae (SFGR) were present in dogs before the notice of the first human cases, suggesting that dogs may serve as useful sentinels for human risk of RMSF in this region. During 2005 and 2006, an exploratory serosurvey was conducted among stray and relinquished dogs presenting to animal control facilities in eastern Arizona located outside the area where human cases had been reported. Antibodies to SFGR were detected in 5.7% (14 of 247) dogs assessed outside the RMSF outbreak area. Animal shelters located in counties that either included or shared large borders with the outbreak area were significantly more likely to have seropositive dogs than facilities in more geographically separated counties (P = 0.01). In addition, stray dogs were significantly more likely to be antibody-positive than relinquished animals (P = 0.01), suggesting that control of stray dog populations should be considered as a means of limiting SFGR transmission in this region. The findings from this study may be extrapolated to suggest that the current risk for human RMSF infection may extend beyond the noted outbreak area. Heightened surveillance for human disease is needed in the region.


Subject(s)
Antibodies, Bacterial/blood , Arachnid Vectors/microbiology , Rhipicephalus sanguineus/microbiology , Rocky Mountain Spotted Fever/epidemiology , Animals , Arizona/epidemiology , Disease Outbreaks , Disease Reservoirs/microbiology , Disease Reservoirs/veterinary , Dog Diseases/epidemiology , Dog Diseases/transmission , Dogs , Humans , Rickettsia rickettsii/immunology , Rocky Mountain Spotted Fever/transmission , Rocky Mountain Spotted Fever/veterinary , Seroepidemiologic Studies , Tick Infestations/epidemiology , Tick Infestations/veterinary , Zoonoses
11.
Arch Intern Med ; 170(20): 1827-31, 2010 Nov 08.
Article in English | MEDLINE | ID: mdl-20696949

ABSTRACT

BACKGROUND: Vena cava filters represent an alternative treatment option for patients with contraindications to anticoagulation, or they might serve as adjunctive treatment for continued emboli despite anticoagulation. The fracture of a filter strut with subsequent end-organ embolization is a rarely reported but potentially life-threatening occurrence. METHODS: We sought to determine the prevalence of fracture and embolization of the Bard Recovery (first generation) and the Bard G2 (second generation) vena cava filters. A retrospective, single-center, cross-sectional study was conducted by evaluating all patients who received either a Bard Recovery or Bard G2 filter from April 2004 until January 2009. A total of 189 patients had undergone implantation: 1 pregnant woman and 35 patients who died were excluded from our study. In addition, 10 patients who had the filter removed were also excluded. Ultimately, 80 patients participated in the trial. Subjects underwent fluoroscopy to assess the filter's integrity. Embolized struts were localized by fluoroscopy. Echocardiography and cardiac computed tomography were performed in patients with fragment embolization to the heart. RESULTS: Thirteen of 80 patients had at least 1 strut fracture (16%). At least 1 strut in 7 of the 28 Bard Recovery filters fractured and embolized (25%). In 5 of these 7 cases, patients had at least 1 fragment embolize to the heart (71%). Three patients experienced life-threatening symptoms of ventricular tachycardia and/or tamponade, including 1 patient who experienced sudden death at home. Six of 52 Bard G2 filters fractured (12%). In 2 of these 6 cases, the patients had asymptomatic end-organ fragment embolization. CONCLUSION: The Bard Recovery and Bard G2 filters had high prevalences of fracture and embolization, with potentially life-threatening sequelae.


Subject(s)
Cardiac Tamponade/etiology , Foreign-Body Migration/complications , Heart Injuries/etiology , Pulmonary Embolism/prevention & control , Vena Cava Filters , Vena Cava, Inferior/surgery , Adult , Aged , Cardiac Tamponade/epidemiology , Cardiac Tamponade/surgery , Device Removal , Female , Fluoroscopy , Follow-Up Studies , Foreign-Body Migration/epidemiology , Foreign-Body Migration/surgery , Heart Injuries/epidemiology , Heart Injuries/surgery , Humans , Male , Middle Aged , Prevalence , Prognosis , Prosthesis Design , Prosthesis Failure , Retrospective Studies , Tomography, X-Ray Computed , Vena Cava, Inferior/diagnostic imaging , Young Adult
12.
Epidemiol Infect ; 138(12): 1811-22, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20353622

ABSTRACT

Although pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking. Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand. Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine. Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died. A recognized pathogen was identified in 42·5% of episodes. Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children. The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100,000 per year) and in persons aged ≥50 years, influenza virus A (38·8/100,000 per year). These data can help guide health policy towards effective prevention strategies.


Subject(s)
Bacteria/classification , Bacteria/isolation & purification , Pneumonia, Bacterial/epidemiology , Pneumonia, Viral/epidemiology , Viruses/classification , Viruses/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Bacterial/blood , Antibodies, Viral/blood , Antigens, Bacterial/urine , Child , Child, Preschool , Female , Humans , Incidence , Infant , Lung/pathology , Male , Middle Aged , Nasopharynx/microbiology , Nasopharynx/virology , Pneumonia, Bacterial/microbiology , Pneumonia, Viral/virology , Polymerase Chain Reaction , Radiography, Thoracic , Serologic Tests , Sputum/microbiology , Thailand/epidemiology , Virus Cultivation , Young Adult
14.
Prilozi ; 30(1): 191-204, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19736541

ABSTRACT

UNLABELLED: (Full text is available at http://www.manu.edu.mk/prilozi). OBJECTIVES: The study was aimed at determining the effectiveness of fluoride-releasing materials (conventional and resin-modified glass-ionomers, compomer and fluoride-releasing composite resin) in inhibiting demineralization of restored teeth in an artificial caries medium. METHODS: A total of 72 teeth (36 deciduous and 36 permanent) were used and Class V cavities were prepared on each tooth. These cavities were restored with or without conditioning (except for the composite, where all specimens were conditioned). The teeth were then stored in artificial saliva for periods of 1, 6, 12 and 18 months before being exposed to an acidic artificial caries gel and examined by SEM. RESULTS: In the absence of a restoration, teeth were found to undergo enamel demineralization. Conventional glass-ionomer cements were found to inhibit this significantly. The resin-modified glass-ionomer generally had little effect, except for the18 month specimens, which also showed distinct zones of inhibition. The compomer showed no inhibition, and the fluoride-releasing composite resin showed only limited signs of inhibition. CONCLUSIONS: Glass-ionomers, both conventional or resin-modified, are more effective at protecting the tooth against further decay than either compomers or fluoride-releasing composites, with the best protection of all being provided by conventional glass-ionomers. The nature of the tooth had no influence on these outcomes. Key words: Dental restoratives, artificial caries, electron microscopy, fluoride release.


Subject(s)
Dental Enamel/ultrastructure , Fluorides, Topical/administration & dosage , Glass Ionomer Cements , Tooth Demineralization/prevention & control , Cariostatic Agents/administration & dosage , Dental Cavity Preparation , Humans , In Vitro Techniques , Materials Testing , Microscopy, Electron, Scanning , Saliva, Artificial
15.
J Womens Health (Larchmt) ; 18(10): 1567-76, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19764843

ABSTRACT

OBJECTIVE: Efforts to improve health care outcomes in the United States have led some organizations to recommend specific hospital settings or case volumes for complex medical diagnoses and procedures. But there are few studies of the effect of setting and volume on maternal outcomes, particularly in complicated conditions, such as diabetes. Our objective was to estimate the effect of hospital setting and volume on childbirth morbidity and length of stay in pregnancies complicated by type 2 and gestational diabetes. METHODS: We analyzed Maryland hospital discharge data during 1999-2004. The dependent variables were primary cesarean delivery, episiotomy, a composite variable for severe maternal morbidity, and hospital length of stay. The independent variables were hospital setting (community, non-teaching hospitals, community, teaching hospitals, and academic medical centers) and tertiles of annual hospital diabetes delivery volume. Multivariable regression analysis was used to assess the relation of hospital setting with each outcome, adjusting for hospital volume and maternal case mix. RESULTS: 5,507 deliveries with type 2 (15%) and gestational (85%) diabetes were analyzed. Primary cesarean delivery rates among women with any diabetes did not vary across settings. After adjustment for volume and patient case mix, the likelihood of severe maternal morbidity was higher among deliveries at academic centers compared to community, non-teaching hospitals (odds ratio [OR], 2.1; 95% confidence interval: 1.0, 4.2). Academic centers had a protective effect (OR, 0.3; 95% CI: 0.2, 0.7) and community teaching hospitals had a borderline protective effect (OR, 0.8; 95% CI: 0.7, 1.0) on episiotomy, compared to community, non-teaching hospitals. Length of stay was greater at academic centers and community, teaching hospitals compared to community, non-teaching hospitals (5.4 days, 3.5 days vs. 2.8 days, respectively). We did not identify an independent association between hospital diabetes volume and clinical outcomes after adjustment for case mix. CONCLUSIONS: Among women with type 2 and gestational diabetes, hospital setting is associated with a higher likelihood of severe maternal morbidity and length of stay, independent of volume. Patient case mix accounts for some of the variation across settings. The volume-outcome relationship found with other complex medical conditions or procedures was not found among diabetic pregnancies. Further investigations are needed to explain variations in outcomes across hospital settings and volumes.


Subject(s)
Delivery, Obstetric/statistics & numerical data , Diabetes Mellitus, Type 2/epidemiology , Diabetes, Gestational/epidemiology , Health Facility Size/statistics & numerical data , Obstetric Labor Complications/epidemiology , Pregnancy Outcome/epidemiology , Academic Medical Centers/statistics & numerical data , Adult , Causality , Cesarean Section/statistics & numerical data , Comorbidity , Confidence Intervals , Female , Hospitals, Community/statistics & numerical data , Hospitals, Teaching/statistics & numerical data , Humans , Infant, Newborn , Length of Stay/statistics & numerical data , Maryland/epidemiology , Odds Ratio , Pregnancy , Retrospective Studies , Risk Factors , Young Adult
17.
J Clin Microbiol ; 46(9): 2856-61, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18632903

ABSTRACT

We detected infection with a Bartonella species (B. henselae or B. vinsonii subsp. berkhoffii) in blood samples from six immunocompetent patients who presented with a chronic neurological or neurocognitive syndrome including seizures, ataxia, memory loss, and/or tremors. Each of these patients had substantial animal contact or recent arthropod exposure as a potential risk factor for Bartonella infection. Additional studies should be performed to clarify the potential role of Bartonella spp. as a cause of chronic neurological and neurocognitive dysfunction.


Subject(s)
Bartonella Infections/microbiology , Bartonella , Cognition Disorders/microbiology , Nervous System Diseases/microbiology , Adolescent , Adult , Bartonella henselae , Female , Humans , Male , Middle Aged , Young Adult
18.
Ultramicroscopy ; 108(12): 1586-94, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18602756

ABSTRACT

A system that allows the collection of the low loss spectrum and the core loss spectrum, covering different energy regions, at each pixel in a spectrum image is described. It makes use of a fast electrostatic shutter with control signals provided by the spectrum imaging software and synchronisation provided by the CCD camera controller. The system also allows simultaneous collection of the X-ray spectrum and the signals from the imaging detectors while allowing the use of the existing features of the spectrum imaging software including drift correction and sub-pixel scanning. The system allows acquisition of high-quality spectra from both the core and the low loss regions, allowing full processing of the EELS data. Examples are given to show the benefits, including deconvolution, absolute thickness mapping and determination of numbers of atoms per unit area and per unit volume. Possible further developments are considered.

19.
Radiat Prot Dosimetry ; 128(2): 169-79, 2008.
Article in English | MEDLINE | ID: mdl-17611199

ABSTRACT

Radon is known to cause lung cancer in humans; however, there remain uncertainties about the effects associated with residential exposures. This case-control study of residential radon and lung cancer was conducted in five counties in New Jersey and involved 561 cases and 740 controls. A year long alpha-track detector measurement of radon was completed for approximately 93% of all residences lived in at the time of interview (a total of 2,063). While the odds ratios (ORs) for whole data were suggestive of an increased risk for exposures >75 Bq m(-3), these associations were not statistically significant. The adjusted excess OR (EOR) per 100 Bq m(-3) was -0.13 (95% CI: -0.30 to 0.44) for males, 0.29 (95% CI: -0.12 to 1.70) for females and 0.05 (95% CI: -0.14 to 0.56) for all subjects combined. An analysis of radon effects by histological type of lung cancer showed that the OR was strongest for small/oat cell carcinomas in both males and females. There was no statistical heterogeneity of radon effects by demographic factors (age at disease occurrence, education level and type of respondent). Analysis by categories of smoking status, frequency or duration did not modify the risk estimates of radon on lung cancer. The findings of this study are consistent with an earlier population-based study of radon and lung cancer among New Jersey women, and with the North American pooling of case control radon seven studies, including the previous New Jersey study. Several uncertainties regarding radon measurements and assumptions of exposure history may have resulted in underestimation of a true exposure-response relationship.


Subject(s)
Air Pollutants, Radioactive/adverse effects , Air Pollution, Indoor/adverse effects , Carcinogens, Environmental/adverse effects , Environmental Exposure/adverse effects , Lung Neoplasms/etiology , Neoplasms, Radiation-Induced/etiology , Radon/adverse effects , Aged , Case-Control Studies , Female , Housing , Humans , Lung Neoplasms/epidemiology , Male , Middle Aged , Neoplasms, Radiation-Induced/epidemiology , New Jersey/epidemiology , Odds Ratio , Risk Factors
20.
Clin Pharmacol Ther ; 83(5): 692-701, 2008 May.
Article in English | MEDLINE | ID: mdl-17687267

ABSTRACT

The purpose of this study was to compare ganglionic blockade with trimethaphan (TMP) and an alternative drug strategy using combined muscarinic antagonist (glycopyrrolate, GLY) and alpha-2 agonist (dexmedetomidine, DEX). Protocol 1: incremental phenylephrine was administered during control and combined GLY-DEX, or control and TMP on two control combined GLY and DEX or TMP infusion on two randomized days. Protocol 2: muscle sympathetic nerve activity (MSNA) and the baroreflex MSNA relationship was determined before and after GLY-DEX. Blood pressure was higher with GLY-DEX (99+/-3 mm Hg) and lower with TMP (78+/-3 mm Hg) relative to control (GLY-DEX: 90+/-2 mm Hg; TMP: 91+/-2 mm Hg; P<0.05). Incremental phenylephrine increased pressure during GLY-DEX (P<0.01 vs control) and TMP (P<0.01 vs control) to a similar degree. Both GLY-DEX and TMP infusion inhibited norepinephrine release (P<0.01 vs control). GLY-DEX inhibited baseline MSNA (P<0.05) and baroreflex changes in MSNA (P<0.01). We conclude that the GLY-DEX alternative drug strategy can be used as a reasonable alternative to pharmacologic ganglionic blockade to examine autonomic cardiovascular control.


Subject(s)
Cardiovascular System/drug effects , Dexmedetomidine/administration & dosage , Ganglionic Blockers/administration & dosage , Glycopyrrolate/administration & dosage , Trimethaphan/administration & dosage , Adrenergic alpha-Agonists/administration & dosage , Adult , Autonomic Nerve Block/methods , Baroreflex/drug effects , Baroreflex/physiology , Cardiac Output/drug effects , Cardiovascular System/innervation , Catecholamines/metabolism , Female , Heart Rate/drug effects , Humans , Male , Muscarinic Antagonists/administration & dosage , Phenylephrine/administration & dosage , Sympathetic Nervous System/drug effects
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