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PubMed1993

Approaches to modelling overdispersion in the analysis of migration.

"In this paper the modelling of overdispersion in generalised Poisson and multinomial models of migration flows and rates is considered, and its importance within the wider question of substantive model specification is shown. It is argued that substantive specification and the modelling of overdispersion are closely interrelated. Simplified ways of estimating the form of overdispersion--moments methods and pseudo-likelihood--are considered wherever possible. Overdispersion is set within the broader context of correlation effects which relate to migration--correlation across different destinations, between spatially adjacent origins and destinations, and between different time periods. The data used to illustrate the modelling development [concern England and Wales and] are drawn from the Office of Population Censuses and Surveys Longitudinal Study, the decennial Census, and the National Health Service Central Register."

Demography↗
PubMed1989

Provincial out-migration patterns of Canadian elderly: characterization and explanation.

"Interprovincial migration patterns of Canada's elderly are examined and compared with their nonelderly counterparts, by using data from Revenue Canada's income tax file for a fifteen-year period (1966/67-1980/81)." The results indicate that departure rates and patterns of destination choice are broadly similar for both groups, although "destination choice of the elderly was relatively sensitive...to environmental factors, whereas that of the nonelderly was relatively sensitive to labor-market variables...."

Adult↗
PubMed1983

[A log-linear analysis of interprovincial migratory flows: Canada, 1961-1983].

"This article presents an in-depth analysis of spatial-temporal characteristics of interprovincial migration in Canada carried out with longitudinal data obtained from the family allowance file. The methodology used calls on the log-linear model underlying the notion of the contingency table. This model permits a simple representation of the observed data, with the aid of parameters typical of the many possible interactions between the variables in question (variables of origin, destination and period in the present case)." The relative influence of the selected variables on migration is first assessed. "Second, this influence is further specified with the aid of a detailed investigation of the parameters that are relative to the quasi-independence variance, that is to say, the variance where only the effect of interaction between the three variables is ignored. Together with the suggestion that the variables of origin and destination are not independent (a result that confirms the need to emphasize interregional streams in the study of migration), this investigation sets forth some conclusions about the temporal variations of interprovincial migration." (summary in ENG, SPA)

Americas↗
PubMed2002

Beyond implantable first generation cardiac prostheses for treatment of end-stage cardiac patients with clinical results in a multicenter.

After 30 years of research and development effort for both ventricular assist device (VAD) and total artificial heart (TAH) in the United States, they have been demonstrating effectiveness in the bridge to transplantation and destination therapy. Smaller size, long-term durable second generation and third generation blood pumps are now being tested in animals and moving to clinical applications. These are now combined with genetic engineering, tissue engineering and regenerative medical therapy techniques to provide newer treatment methodologies for end-stage cardiac patients. In Japan, heart transplantation was restarted in 1999, but to date only 13 transplants have been performed. Shortage in donor hearts is hindering the prevalence of heart transplantation. Over a dozen of end-stage cardiac patients are waiting for heart transplantation in hospital with a paracorporeal pneumatic VAD. Although implantable VADs have been imported from the USA, they have not acquired a wide clinical use yet because of their large size and high cost. There is a great need for development of a compact, low cost, totally implantable VAD and TAH in Japan to improve the quality of life of end-stage cardiac patients. This paper reviews the current status of the first generation pulsatile VAD and TAH as a bridge to transplantation and destination therapy around the world, followed with a review of the second and third generation blood pumps beyond the limitations of the first generation systems. Future recommendations are also discussed to improve the systems in Japan.

Animals↗
PubMed2003

RNA localization and its role in the spatially restricted protein synthesis.

RNA localization is an evolutionarily conserved phenomenon that occurs in uni- and multi-cellular animal and plant species. Localized RNA plays a role in the establishment of cell polarity and/or the determination of cell fate. In recent years, it became evident that the major function of RNA localization is the creation of a high concentration of proteins in specific cellular compartments. The movement of RNA involves interactions between targeting signals within the RNA molecule, cytoskeleton, and molecular motors. Translocating RNA must be translationally silent, and on-site translation at the destination site requires a de-repression mechanism. This is probably achieved by sequestering RNA and the regulators of translation within the multiprotein RNP complexes that co-translocate all the components to the ultimate destination within the cell.

Animals↗
PubMed1992

[Incidence of Fusarium toxins in corn and milling byproducts].

The incidence of Fusarium toxins-trichothecenes and zearalenone in 100 samples of whole grains as well as their distribution in the by-products (arising of 32 whole corn samples) of the wet-grinding of corn were studied, the samples coming from the central and northern areas of the Santa Fe Province, Argentina. The analyses were carried out by thin-layer chromatography. A 33% of the samples was found to be contaminated by deoxynivalenol (DON), its amount ranging from traces to 1,200 micrograms/Kg; 15% of the samples contained T-2 toxin from 900 to 2,400 micrograms/Kg and only traces of zearalenone were detected in one sample. Only few samples (7%) included diacetoxiscirpenol (DAS), nivaleno (NIV) and neosolaniol (NS) and 7% of the samples evidenced contamination by more than one mycotoxin. It is worth noticing that DON was found to be contaminating only those by-products destined to human consumption. Conversely, T-2 toxin was found in by-products destined to both human and animal consumption.

Food Contamination↗
PubMed1976

The clearance rate of maternal plasma prehormones of placental estrogen formation.

A method has been established for the determination of the placental clearance of maternal plasma prehormones by placental estrogen formation during human pregnancy. Utilizing this concept, the placental clearance is calculated as the product of the metabolic clearance rate from maternal plasma of the prehormone and its fractional conversion to estrogen by the placenta. This value equals the volume of maternal plasma cleared of that prehormone by the irreversible formation of its estrogenic product hormone per unit of time. The placental clearance rate technique can be performed by intravenous infusion of isotope-labeled prehormone and product, and the metabolic clearance rate as well as the transfer constant can be measured by techniques employing plasma values or by a combination of plasma and urinary methods. Utilizing this type of study, the placental clearance of plasma prehormones has been observed to be increased initially in women destined to develop pregnancy-induced hypertension but declines prior to the onset of hypertension and continues to decline until delivery is effected. Moreover, the administration of diuretics and/or the institution oental clearance of plasma prehormones from the maternal compartment in normal gravidas, in those destined to develop pregnancy-induced hypertension, and in gravidas who are hypertensive from any cause.

Androstenedione↗
PubMed1992

Travel and ciguatera fish poisoning.

BACKGROUND: Ciguatera fish poisoning is a distinctive clinical syndrome associated with the consumption of contaminated marine fish. It is endemic in many popular travel destinations, including the Caribbean and Pacific Islands, where travelers are at risk. METHODS: Clinical review of 23 patients (60% were travelers) with ciguatera fish poisoning in whom consultation was provided between 1987 and 1990. RESULTS: Seven patients acquired ciguatera fish poisoning during international travel to the following destinations: Bahamas (n = 4), Dominican Republic (n = 1), British Virgin Islands (n = 1), and United States (n = 1). Suspected fish included grouper, red snapper, and amberjack. Two patients required emergency care, and four patients developed chronic symptoms. Severity was associated with chronicity, duration of peak symptoms, and worsening of symptoms with sexual activity. Chronicity was associated with severity, long latency period, and duration of peak symptoms. The three patients with complete resolution were scuba divers. Amitriptyline was the drug most often providing benefit for chronic symptoms. CONCLUSIONS: Ciguatera fish poisoning is a health risk to travelers to endemic regions, and their risk likely equals that of indigenous population groups. Barracuda should never be eaten, and travelers should exercise caution when considering other fish dishes, notably, grouper and red snapper.

Animals↗
PubMed2003

Cortical development and focal cortical dysplasia.

A brief survey of cortical development is presented, focusing on neuronal migration and its alterations. Corticogenesis is achieved through ordered temporospatial steps, via the formation of transient structures, and successive waves of cell proliferation and migration (followed by cell differentiation and maturation), and apoptotic cell death. The appearance of the proliferative ventricular zone and marginal zone, and of the superficial primordial plexiform layer, is followed by the formation of the prospective layer I, of the subplate, whose neurons are destined to die, and of the cortical plate that will give rise to layers II-VI. Cells arising in the ventricular zone migrate radially using radial glia as a scaffold, and are destined to form pyramidal cells. Cortical interneurons are mainly generated in the ganglionic eminence and migrate along axonal substrates following tangential routes. Disorders of this complex process lead to a wide range of alterations, and focal derangements of cortical organization have been grouped under the term focal cortical dysplasia (FCD). As the result of a neuropathological revision of FCD cases with intractable epilepsy, a novel classification comprising three subgroups of FCD has been introduced, and is supported by electroclinical and neuroimaging data, as well as by the postsurgical outcome of patients: i). architectural dysplasia, characterized by altered cortical lamination; ii). cytoarchitectural dysplasia, with the occurrence of giant neurons besides cortical dyslamination; iii). Taylor-type cortical dysplasia, in which altered cortical lamination is consistently associated with the occurrence of giant, dysmorphic and ectopic neurons, and frequently with the so-called balloon cells.

Cell Movement↗
PubMed1992

[Identification of alcoholism and therapeutic proposals: a study in a general hospital].

Alcoholism is a frequent condition in patients admitted to general hospitals. The rate of identification of patients suspected to be alcoholic, the therapeutic measures proposed to such patients and their destination at hospital discharge were among the issues studied in the general wards of a department of internal medicine of an hospital in the French-speaking region of Switzerland. The Michigan Alcoholism Screening Test (MAST) was utilized systematically among all patients aged 20-75 years who where admitted consecutively to the department. Two cohorts matched for age and sex were thus formed: 102 alcoholics (MAST greater than or equal to 8) and 102 non-alcoholics (MAST less than or equal to 4). A diagnosis of alcoholism or of a syndrome of alcohol dependence was found in only 50% of all exit reports of the alcoholic cohort, whereas alcohol-related problems were identified on a verbal basis by the attending physician in 89% of cases. Therapeutic measures were proposed to 69% of female alcoholics and to 43% of male alcoholics, more frequently among patients with the highest MAST scores. In addition, at hospital discharge, alcoholic patients were more likely to be sent to a destination other than their place of residence than were the non-alcoholic patients. This study illustrates the low rate of identification and subsequent treatment of alcoholism among hospitalized patients. It also suggests that hospital stays should be used more frequently to increase the systematic identification of alcohol problems, increase awareness of alcoholism and provide information to both patients and those caring for them.

Adult↗
PubMed1992

Chemoradiotherapy in locally advanced bladder carcinoma.

Bladder carcinoma represents the fifth leading cause of cancer in the United States. For patients with muscle-invasive tumors, radical cystectomy has been the treatment of choice, yet over 50% of such treated patients are destined to develop recurrent disease. In order to minimize morbidity in patients with invasive disease, bladder-sparing techniques using radiotherapy alone, or with chemotherapy, have been investigated. While it is clear that durable complete remission can be achieved in some patients, the results to date require additional follow-up to determine the optimal cohort of patients destined to benefit from this approach. It is hoped that ongoing prospective trials will delineate this population.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

[The risk of contracting hepatitis A or hepatitis B run by visitors to the Mediterranean and Eastern Europe].

Hepatitis A and B continue to represent a risk for travelers. Those traveling to tropical countries are usually aware of this risk, while those visiting a Mediterranean country often are not. This investigation presents a destination-related risk assessment and vaccination recommendations for travellers, on the basis of incidences and prevalences of hepatitis A and hepatitis B. For hepatitis B, the WHO classification based on HBsAg prevalence has been selected. For hepatitis A, countries have been categorized as low-, moderate- or high-risk. A comparison of infection risk with the numbers of airline passengers showed that in particular the large number of travelers to Tunisia, Turkey and Egypt, in conjunction with hygienic conditions in those countries, represent a source of imported hepatitis A. With regard to destinations in the Mediterranean and Eastern Europe, too, the risk of contracting hepatitis A or hepatitis B is not always negligible, so that vaccination may need to be recommended.

Egypt↗
PubMed2004

[The elderly traveler].

In recent years, the number of senior citizen travelers has been increasing. As a result of this trend, the general practitioner is every more frequently being confronted with the problem of counseling his elderly patients. A particularly important point is that underlying illnesses and long-term medication must be adapted to the destination, traveling time and style of traveling. Since considerable immunization deficits can be found among senior citizens, the application of prophylactic vaccination prior to the jou rney presents an ideal opportunity to bring the patient's immunization status up to date in terms of generally recommended vaccinations. Should chemoprophylaxis be necessary, consideration must always be given to drug interactions. By making appropriate recommendations in terms of health-related and destination-related dos and don'ts, the risk of developing health problems while traveling can be minimized.

Age Factors↗
PubMed1992

Chemotherapy for muscle-infiltrating bladder cancer.

Successful integration of chemotherapy into the management of patients with invasive bladder tumors is critical to improve survival. With currently available treatment programs, only a modest improvement in survival can be anticipated. Thus, the routine use of chemotherapy for all patients with invasive bladder cancers cannot be recommended outside of the protocol setting. Research must focus on improving the proportion of patients who achieve complete remissions to therapy, because only complete responders have the opportunity to enjoy long-term survival. Effective salvage regimens need to be developed, along with a better understanding of the mechanisms of resistance to treatment. Equally important will be the ability to define which cases are destined to metastasize, for whom chemotherapy will be essential, as well as those who are not destined to develop metastatic disease, for whom chemotherapy is unnecessary. The choice of a neoadjuvant versus an adjuvant approach remains controversial. The ability to determine response in vivo, as well as the potential for bladder preservation, remains the primary benefit of neoadjuvant therapy. However, chemotherapy alone cannot replace definitive therapy for most patients, because the complete response proportions to chemotherapy alone remain under 30%. In other cases, postoperative adjuvant therapy may represent a better strategy, with the need for treatment based on pathologic as opposed to clinical grounds. Patients with nodal involvement at the time of surgery would be an appropriate group for whom therapy should be routinely recommended. It must be emphasized, however, that neither the neoadjuvant nor adjuvant approaches have been shown to definitively improve survival. This can only be demonstrated through randomized trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Gastric mucosal cell homeostatic physiome. Critical role of ER-initiated membranes restitution in the fidelity of cell function renewal.

Homeostatic cell physiology is preserved through the fidelity of the cell membranes restitution. The task is accomplished through the assembly of the precisely duplicated segments of the cell membranes, and transport to the site of their function. Here we examined the mechanism that initiates and directs the restitution of the intra- and extracellular membranes of gastric mucosal cell. The homeostatic restitution of gastrointestinal epithelial cell membrane components was investigated by studying the lipidomic processes in endoplasmic reticulum (ER) and Golgi. The biomembrane lipid synthesis during the formation of transport vesicles in the systems containing isolated organelle and the cell-specific cytosol (Cyt) from rat gastric mucosal epithelial cells was assessed. The results revealed that lipids of ER transport vesicle and the transmembrane and intravesicular cargo are delivered en bloc to the point of destination. En bloc delivery of proteins, incorporated into predetermined in ER lipid environment, ensures fidelity of the membrane modification in Golgi and the restitution of the lipid and protein elements that are consistent with the organelle and the cell function. The mechanism that maintains apical membrane restitution is mediated through the synthesis of membrane segments containing ceramide (Cer). The Cer-containing membranes and protein cargo are further specialized in Golgi. The portion of the vesicles destined for apical membrane renewal contains glycosphingolipids and phosphatidylinositol 3-phosphate. The vesicles containing phosphatidylinositol 4-phosphate are directed to endosomes. Our findings revealed that the preservation of the physiological equilibrium in cell structure and function is attributed to (1) a complete membrane segment synthesis in ER, (2) its transport in the form of ER-transport vesicle to Golgi, (3) the membrane components-defined maturation of lipids and proteins in Golgi, and (4) en bloc transfer of the new segment of the membrane to the cell apical membrane or intracellular organelle.

Animals↗
PubMedDate not supplied

Travel medicine 2005.

Travel Medicine is a rapidly evolving field of medicine that is becoming ever more important in this era of globalization. Traditionally, medical preparation for individuals traveling to countries outside the United States has focused on traveler's diarrhea prevention and treatment, malaria prevention, and travel vaccination. Now, other concerns such as travel safety must also be considered. New developments in the area of travel medicine include the use of azithromycin instead of quinolones for diarrhea acquired in Southeast Asia. Azithromycin may also be the best option for children and patients who cannot take quinolones regardless of destination. In addition, rifaximin, a non-absorbable antibiotic, has recently been marketed for traveler's diarrhea. The best malaria prophylaxis options currently include atovaquone-proguanil (Malarone) in addition to chloroquine, mefloquine, and doxycycline. Hepatitis A is the most important travel vaccine, and a new combined hepatitis A and B vaccine (Twinrix) is useful for travelers needing protection against both types of hepatitis. A vaccine for typhoid is now available in either oral or injectable versions. Other important vaccines to consider when traveling internationally are those for Japanese encephalitis, influenza, meningitis, rabies, varicella and yellow fever vaccines. These may be warranted depending on duration of travel and destination risk.

Diarrhea↗
PubMed2005

Stage I nonseminomatous germ cell tumors: the case for management by risk stratification.

For patients with clinical stage I nonseminomatous germ cell tumor (NSGCT), the therapeutic options after orchiectomy are retroperitoneal lymphadenectomy, surveillance, and chemotherapy. Ideally the option selected will be based on an individualized assessment of the estimated risk of progression based on prognostic factors, so called risk-adapted treatment, to reduce overall burden of therapy while maintaining survival. It is possible to identify patients at low risk of progression who can be followed by active surveillance initially. Prognostic factors for high risk, while well defined, do not identify all patients at risk and those that are destined to progress, can usually be salvaged with delayed therapy. Most centres recommend either surgery or primary chemotherapy for those defined as being at high risk for progression. Prognostic factors for high risk however, while well defined, do not identify all patients at risk and those that are destined to progress, can usually be salvaged with delayed therapy.

Adult↗
PubMed2004

Stroke rehabilitation pathways and procedures in Italy.

AIM: Rehabilitation pathways and procedures after first stroke vary widely. We wanted to determine in what ways first stroke rehabilitation in Italian rehabilitation centers are similar and in line with the Italian Ministry of Health guidelines and international reports. METHODS: Data from the study, Cerebral Ictus and Rehabilitation: Clinical Indicators and Outcomes, of the Italian Cooperative Research (ICR(2)), on 997 inpatients in 18 rehabilitation centers were analyzed and the rehabilitation procedures were compared. To do this, we compared the variables: onset admission interval, length of stay, intensity of treatment and discharge destination. Statistical analyses were performed using the Kruskal-Wallis test, the post hoc Mann-Whitney U test and the chi squared test. RESULTS: Major differences among the centers were found for onset of admission, length of stay, intensity of treatment and discharge destination, whereas the clinical characteristics and the functional outcomes of the study population were similar. CONCLUSIONS: Our results emphasize the importance of better integration between the acute treatment phase and the rehabilitation teams in reducing the onset admission interval of first acute stroke patients. To define optimal intensity of treatment and length of stay, randomized multicenter studies will be needed.

Journal Article↗