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PubMedDate not supplied

Cessation of long-term naltrexone administration: longitudinal follow-ups.

Longitudinal follow-ups of the cessation of long-term Naltrexone administration (1 year of drug therapy) were conducted with a young woman (in her early 30s) with profound mental retardation who had previously displayed dramatic decreases in her self-injurious behaviors (SIB) both during, and for a period of at least 6 months following termination of drug treatment. After 2 and 4 years, post-Naltrexone therapy, the subject continued to exhibit near-zero rates of SIB episodes despite significant turnovers in her direct care staff by the 2-year follow-up, and changes in her physical/living environment and fellow residents by 4-year follow-up. These findings provide further support to the idea that long-term Naltrexone administration may result in highly durable reductions in SIB long after treatment ends and argue against certain aspects of the subject's environment affecting her rates of SIB significantly. These results are discussed in light of the endogenous opiate system theories of SIB. A functional analysis and discussion of the effectiveness of behavioral treatments for her few remaining SIB episodes are also provided.

Adult↗
PubMed2003

Comparison of continuous infusion versus midwife administered top-ups of epidural bupivacaine for labour analgesia: effect on second stage of labour and mode of delivery.

Using a population-based study we retrospectively compared the effect of continuous versus intermittent top-up epidural analgesia on the outcome of labour at the University Hospital of Wales. We analysed the labour outcome of 410 primigravid deliveries over an 18-month period during a change in delivery suite protocol. Data were retrieved from the Cardiff Births Survey and the sample was analysed in two groups: group 1 (n = 201) received a continuous infusion of 0.1% bupivacaine plus fentanyl 2 microg/mL and group 2 (n = 209) received intermittent top-ups of the same solution. Outcome measures were the number of operative deliveries and the proportion of those deliveries that were due to prolongation of the second stage of labour. There were no significant differences in terms of group characteristics, women undergoing assisted vaginal delivery (group 1: 83 vs. group 2: 70, OR 0.8 CI 0.5-1.2), caesarean section (group 1: 59 vs. group 2: 61, OR 1.0 CI 0.6-1.5), and women with prolonged second stage (group 1: 50 vs. group 2: 47, OR 1.1 CI 0.6-1.8). The presumed reduction in motor blockade associated with intermittent top-up epidural regimes did not affect the outcome of labour.

Journal Article↗
PubMed2003

Application of activation methods on the Dubna experimental transmutation set-ups.

High spallation neutron fluxes were produced by irradiating massive heavy targets with proton beams in the GeV range. The experiments were performed at the Dubna High Energy Laboratory using the nuclotron accelerator. Two different experimental set-ups were used to produce neutron spectra convenient for transmutation of radioactive waste by (n,x) reactions. By a theoretical analysis neutron spectra can be reproduced from activation measurements. Thermal-epithermal and fast-super-fast neutron fluxes were estimated using the 197Au, 238U (n,gamma) and (n,2n) reactions, respectively. Depleted uranium transmutation rates were also studied in both experiments.

Journal Article↗
PubMed2002

Hemodynamics in extrahepatic portal vein obstruction and its changes during long-term follow-ups.

Thirty-six patients with extrahepatic portal vein obstruction (EHO) were studied. Twenty-one patients, whose age at onset was under 20 years old, were thought to be primary EHO. Ten of 15 patients over 21 years old, had a history of abdominal diseases, and were thus considered to be secondary EHO; only 5 were primary EHO. EHO was classified into three categories, based on selective celiac-superior mesenteric arteriography, and intraoperative trans-splenic and superior mesenteric venography: the hilar obstruction of portal vein, the portal trunk obstruction, and the portal trunk-splenic vein obstruction. Both primary and secondary EHO cases were found to have extended their obstructed region over time by progressing from hepatic hilum to portal trunk obstruction followed by splenic vein obstruction. On the other hand, based on retrograde portography, EHO was classified into the absence of intrahepatic portal obstruction (portal trunk type) and the intrahepatic obstruction (portal branch type) and the portal branch type tended to predominate. Changes of intra- and extra-hepatic portal obstruction were examined by comparing various angiographies of the 14 patients available for between 1 and 26 years of long-term follow-up. While EHO tended to progress with time, no patient showed progress of a intrahepatic portal vein obstruction. From these results, EHO patients are expected to show continuous progression of EHOs during long-term follow-ups, and to have high recurrence rates of gastrointestinal varices after various treatments due to the persistent portal hypertension. However, effective hepatic flow is likely to be maintained because collateral circulation to the liver develops, and intrahepatic portal vein obstruction does not progress, resulting in a good prognosis for EHO.

Journal Article↗
PubMed2006

Multiple Coordination of CO on Molybdenum Nanoparticles: Evidence for Intermediate Mox(CO)y Species by XPS and UPS.

CO chemisorption on the metallic molybdenum nanoparticles supported on the thin alumina film was investigated by X-ray photoelectron spectroscopy (XPS) and ultraviolet photoelectron spectroscopy (UPS). A binary compound of molybdenum and CO is found to be formed on the surface upon CO dose, accompanied with a positive binding energy shift of the Mo 3d doublet and a localized Mo 4d valence band. A loose packing of the metallic molybdenum favors the formation of this intermediate Mox(CO)y species. The formation of the Mox(CO)y species implies that the property of the metallic molybdenum nanoparticles on the thin alumina film is much different from that of the bulk molybdenum, indicating a significant nanometer size effect.

Journal Article↗
PubMed2006

Electronic structure of the surface of the ionic liquid [EMIM][Tf(2)N] studied by metastable impact electron spectroscopy (MIES), UPS, and XPS.

The near-surface electronic structure of the room-temperature ionic liquid (RT-IL) 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([EMIM][Tf(2)N]) has been investigated with the combination of the electron spectroscopies metastable impact electron spectroscopy (MIES), ultraviolet photoelectron spectroscopy (UPS (HeI and HeII)), and monochromatized X-ray photoelectron spectroscopy (XPS). We find that the top of the valence band states originates from states of the cation (see also ref 1). The ultimately surface-sensitive technique MIES proves that the surface layer consists of both cations and anions. The temperature dependence of the spectra has been measured between about 160 and 610 K. Information on the glass transition and the possibility for low-temperature distillation of [EMIM][Tf(2)N] at reduced pressures is derived from the present results.

Journal Article↗
PubMed2002

Fusobacterium nucleatum in endodontic flare-ups.

OBJECTIVE: The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated. STUDY DESIGN: Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only non-painful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked. RESULTS: Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale > or = 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum. CONCLUSION: F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups.

Acute Disease↗
PubMed1992

Continuous extradural analgesia: comparison of midwife top-ups, continuous infusions and patient controlled administration.

We have compared three techniques used to provide extradural analgesia during the first stage of labour: 0.25% plain bupivacaine 10 ml demand top-ups delivered by the midwife; continuous infusion of 0.125% plain bupivacaine 10 ml h-1; and patient-controlled extradural analgesia (PCEA) delivering 3-ml boluses of 0.25% bupivacaine. Each technique produced comparable analgesia achieving equivalent maternal satisfaction, with no difference in mode of delivery and no complications. This regimen for PCEA proved a viable alternative for continuous extradural analgesia and was popular with the mothers, midwives and anaesthetists.

Adolescent↗
PubMed1999

Comparison of midwife top-ups, continuous infusion and patient-controlled epidural analgesia for maintaining mobility after a low-dose combined spinal-epidural.

We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW, n = 43) or patient-controlled epidural analgesia (group PCEA, n = 44), to maintain analgesia throughout labour. All epidural solutions contained 0.1% bupivacaine and fentanyl 2 micrograms ml-1. Motor block was assessed by the mother's ability to straight leg raise (SLR). Four hours after combined spinal-epidural analgesia, 88.1% of women could SLR in group MW, 83.7% in group PCEA and 57.8% in group Cl (P = 0.002). Total use of bupivacaine was highest in group Cl (mean 11.3 (SD 3.3) mg h-1) compared with group MW (7.5 (3.1) mg h-1) and group PCEA (9.1 (2.1) mg h-1) (P < 0.001). Analgesia was similar between groups and overall satisfaction was equally high.

Adolescent↗
PubMed1995

The "ups" and "downs" of getting published.

One stumbling block to writing is the variety of emotional reactions a prospective author must negotiate: the "ups" and "downs" of publishing. An impressive publishing track record does not necessarily mean an author will avoid anxiety, self-doubt or the fear of rejection. A conceptual schema outlines the phases in the publishing process and the associated potentially problematic emotional reactions.

Adaptation, Psychological↗
PubMed1988

Continuous epidural infusion of 0.075% bupivacaine for pain relief in labour. A comparison with intermittent top-ups of 0.5% bupivacaine.

Seventy-three women who requested epidural analgesia during labour were randomly allocated in a prospective study to receive either a continuous epidural infusion of 0.075% bupivacaine at a rate of 12-18 ml/hour (38 mothers) or intermittent top-ups of 0.5% bupivacaine (35 mothers). Both groups received an initial dose of 6-8 ml bupivacaine 0.5%. Patients were asked to score their pain using a 10-cm linear scale prior to insertion of the epidural, 30 minutes after its insertion and hourly thereafter. The quality of analgesia in the continuous infusion group was significantly better than in the intermittent top-up group (p less than 0.025). There was no significant difference in the total dose of bupivacaine given to the two groups.

Adolescent↗
PubMed1984

Some characteristics of regular and irregular attenders for dental check-ups.

Previous surveys of dental care have shown that a substantial proportion of people do not attend dentists regularly. Reasons given for such non-attendance included fear as well as other negative attitudes. Recent studies have attributed fear of dentistry to painful traumatic experiences. The purpose of this study was to compare regular and irregular or non-attenders for dental check-ups on a number of variables, including sex and age, self and family dental anxiety, and previous dental experience. A sample of 531 subjects of both sexes and ranging in age from 16 to 78 years was made available by two large organizations in London and surveyed during office hours. Dental anxiety appeared as a significant factor in non-attendance but there was little support for a simple conditioning hypothesis to explain dental anxiety. Attenders and non-attenders differed markedly in their perception of dentists but there was no difference between the groups as to sex and age.

Adolescent↗
PubMed2001

A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Preliminary results and methodological issues.

This article is an initial report from a review of alcohol and drug treatment studies with follow-ups of 2 years or more. The goals of the review are to examine the stability of substance use outcomes and the factors that moderate or mediate these outcomes. Results from 12 studies that generated multiple research reports are presented, and methodological problems encountered in the review are discussed. Substance use outcomes at the group level were generally stable, although moderate within-subject variation in substance use status over time was observed. Of factors assessed at baseline, psychiatric severity was a significant predictor of outcome in the highest percentage of reports, although the nature of the relationship varied. Stronger motivation and coping at baseline also consistently predicted better drinking outcomes. Better progress while in treatment, and the performance of pro-recovery behaviors and low problem severity in associated areas following treatment, consistently predicted better substance use outcomes.

Alcoholism↗
PubMed1984

A clinical trial of co-trimazine (sulfadiazine + trimethoprim) in flare-ups of chronic bronchitis.

The authors treated acute flare-ups of chronic bronchitis with a combination of sulfadiazine (SDZ) and trimethoprim (TMP) (cotrimazine). They treated thirty patients for a week, with daily dosages of 900 mg SDZ and 300 mg TMP, in an open trial in comparison with ampicillin 2 g daily. The result of treatment (course and duration of the acute episode, fever, cough, dyspnoea, sputum amount and description, chest sounds, ESR, and WBC count), tested by suitable statistical methods, showed that cotrimazine had excellent therapeutic activity and was readily tolerated; over-all results compared closely with those obtained with ampicillin. In their concluding remarks the authors state that in addition to being effective in the morbid condition selected for trial, cotrimazine offers some advantages over similar combinations of TMP and other sulfonamides, both because of the intrinsic physicochemical and pharmacological properties of SDZ and because of its lower dosage in this combination.

Acute Disease↗
PubMed2004

Fewer accidents and better maintenance with active wheelchair check-ups: a randomized controlled clinical trial.

OBJECTIVE: To investigate whether active intervention using a compiled checklist for wheelchair check-ups increases user satisfaction and/or decreases accidents, near accidents and pressure sores. DESIGN: A randomized controlled trial comparing active intervention versus standard intervention for prescribed, manually propelled wheelchairs. SETTING: Patients within primary health care of Borås and Bollebygd municipalities, a mixed urban and rural population. SUBJECTS: Users of manually propelled wheelchairs over 16 years of age. INTERVENTIONS: The accident rate, extent of pressure sores, number and extent of repairs, reconditioning, adjustments as well as user satisfaction were measured initially and at one year. In the standard intervention, the user and carer were encouraged to initiate contact when necessary. In the active intervention, an occupational therapist performed a scheduled, thorough check-up of the wheelchair, following a compiled checklist for safety, comfort and positioning, manoeuvrability and transportation. RESULTS: Of 253 registered wheelchair users, 216 were suitable and randomized. In the active intervention group, 99% (95% confidence interval 96-100%) of the inspected wheelchairs required maintenance. The incidence of accidents was unchanged in the standard intervention group, but decreased to 'no accidents' in the active intervention group (p = 0.03). User satisfaction was not affected by the active intervention. CONCLUSION: Most wheelchair users are unable to determine on their own when adjustments are needed. An active check-up on manually propelled wheelchairs seems to reduce accidents. More information is available at http://www.wheelchair.se

Accident Prevention↗
PubMed2001

Relationships between serum (ZZ)-bilirubin, its subfractions and biliverdin concentrations in infants at 1-month check-ups.

In 150 infants, including those with breast milk jaundice, who were brought to our hospital for their 1-month check-ups, the serum concentrations of (ZZ)-bilirubin, its subfractions and biliverdin were measured by high-performance liquid chromatography and the relationships among them investigated. (ZZ)-Bilirubin was found to have the highest serum concentration, followed by (ZE)-bilirubin, accounting for 14.0 (geometric mean) % of (ZZ)-bilirubin. Biliverdin had a serum concentration of 0.95% of (ZZ)-bilirubin. There was only a small amount of total (di- and mono-) glucuronosyl bilirubin, 0.42% of (ZZ)-bilirubin. (ZE)-Bilirubin, (EZ)-bilirubin, (EZ)-cyclobilirubin. biliverdin, diglucuronosyl bilirubin and monoglucuronosyl bilirubin (C-8 and C-12) showed positive logarithmic correlations with (ZZ)-bilirubin (R2=0.16 or above, P<0.05). (ZE)-Bilirubin showed a significant positive logarithmic correlation with (ZZ)-bilirubin (R2=0.863, P<0.0001). Furthermore, (EZ)-cyclobilirubin, the most important photoisomer in phototherapy for neonatal hyperbilirubinaemia, was detected in very small amounts in approximately half of the neonates (84 of 150) when they were in conditions of only weak ambient light. The relationship between total glucuronosyl bilirubin and (ZZ)-bilirubin concentrations fitted a model of saturation kinetics of bilirubin UDP-glucuronosyltransferase.

Bilirubin↗