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Kleffner I, Boentert M, Gess B, Humberg A, Sevimli S, Khazaei M, Halfter H, Young P. Die Bedeutung von G-CSF für Proliferation und Antiapoptose in primären Ratten-Schwann-Zellen. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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152
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Kürten J, Jansen S, Schirmacher A, Young P, Wersching H, Flöel A. Ist die durch TMS induzierte kortikale Plastizität abhängig vom Val66Met Polymorphismus des Brain Derived Neurotrophic Factor-Gens? Akt Neurol 2009. [DOI: 10.1055/s-0029-1238377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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153
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Borchert A, Kurlemann G, Young P, Schilling M. Sonografie peripherer Nerven bei gesunden Kindern und jungen Erwachsenen: Erhebung von Referenzwerten und altersgruppenabhängiger Vergleich mit der Elektroneurografie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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154
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Kleffner I, Deppe M, Mohammadi S, Schiffbauer H, Stupp N, Lohmann H, Young P, Ringelstein E. Diffusion tensor imaging demonstrates fiber impairment in Susac's syndrome. J Neurol Sci 2009. [DOI: 10.1016/j.jns.2009.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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155
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Bell-Syer SE, Hart R, Crawford F, Torgerson DJ, Young P, Tyrrell W, Williams H, Russell I. A systematic review of oral treatments for fungal infections of the skin of the feet. J DERMATOL TREAT 2009; 12:69-74. [PMID: 12243661 DOI: 10.1080/095466301317085336] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To synthesize the evidence for the effectiveness and cost-effectiveness of oral treatments for fungal infections of the skin of the feet. DESIGN Systematic review. INTERVENTIONS Oral treatments for fungal infections. METHODS Ten electronic databases, four journals and the bibliographies of all review papers identified were searched. The authors also wrote to international pharmaceutical companies and all podiatry schools in the UK. The studies selected were randomized trials of clinically diagnosed fungal skin infections of the foot that confirmed cure by culture and microscopy. Two reviewers independently selected trials and abstracted data using a structured tool including 12 recognized quality criteria. RESULTS Of 26 trials identified, 12 met the inclusion criteria and evaluated five different treatments. Single placebo-controlled trials showed that terbinafine and itraconazole were both effective. Two trials showed that terbinafine cures 50% more patients than griseofulvin. Four trials compared terbinafine with itraconazole, one showed that terbinafine given for 2 weeks had a better cure rate than 2 weeks of itraconazole, but the other three showed that it was no better than 4 weeks of itraconazole. CONCLUSIONS There is significant evidence that terbinafine is more effective than griseofulvin, though more costly. There is weak evidence that terbinafine may be more cost-effective than itraconazole. Firm recommendations about the choice between terbinafine and the azoles need further research.
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Affiliation(s)
- S E Bell-Syer
- Department of Health Studies and Centre for Health Economics, University of York, UK.
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156
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Abstract
Vocal cord dysfunction (VCD), is characterized by a paradoxical adduction of the vocal cords during inspiration, and occurs predominantly in young women. Common symptoms are cough, wheezing, episodic dyspnea, and inspiratory stridor. The true incidence and course of the disease are unknown, and it is usually self limited. It can coexist with, or mimic refractory asthma. Psychological disorders were thought to be the principal cause, subsequently multiple organic diseases have also been reported, like gastroesophageal reflux disease (GERD). Diagnosis is made by clinical suspicion and direct observation. The Gold standard for diagnosis is laryngoscopy with visualization of the paradoxical motion of the vocal cords when the patient is symptomatic. Speech therapy and psychotherapy have been used extensively without any prospective study. We report two cases of VCD associated with GERD, both with excellent respond to treatment.
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Affiliation(s)
- P Young
- Servicio de Clínica Médica, Hospital Británico, Buenos Aires, Argentina.
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Borchert A, Schwartz O, Kurlemann G, Young P, Schilling M. Diagnostischer Nutzen der hochauflösenden Nervensonografie versus Neurografie bei Kindern mit der Erkrankung Charcot-Marie-Tooth Typ 1A. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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158
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Abstract
Although endogenous retroviruses are ubiquitous features of all mammalian genomes, the process of initial germ line invasion and subsequent inactivation from a pathogenic element has not yet been observed in a wild species. Koala retrovirus (KoRV) provides a unique opportunity to study this process of endogenisation in action as it still appears to be spreading through the koala population. Ongoing expression of the endogenous sequence and consequent high levels of viraemia have been linked to neoplasia and immunosuppression in koalas. This apparently recent invader of the koala genome shares a remarkably close sequence relationship with the pathogenic exogenous Gibbon ape leukaemia virus (GALV), and comparative analyses of KoRV and GALVare helping to shed light on how retroviruses in general adapt to a relatively benign or at least less pathogenic existence within a new host genome. (Part of a multi-author review).
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Affiliation(s)
- R Tarlinton
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, United Kingdom.
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161
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Abstract
Ascites is rare in patients with multiple myeloma (MM). It may be due to diverse mechanisms, most frequently because of an increased permeability of the peritoneum or because of portal hypertension due to liver infiltration. Myelomatous ascites occurs more frequently in patients having Ig-G or Ig-A paraprotein and their prognosis is poor. It is submitted the case of a female patient aged 50 years with IgA-kappa MM, who evolved with cardiac failure (CF), plasma cells leukemia and ascites of mixed cause, because of peritoneal infiltrate of myelomatous cells, hepatic compromise and CF. A review of the different causes of ascites in patients with MM is performed. There are also summarized all myelomatous ascites cases published in the literature. Our report presents the first case of myelomatous ascites in a patient with plasma cells leukemia.
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Affiliation(s)
- P Young
- Departamento de Medicina Interna, Hospital Británico de Buenos Aires, Argentina.
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Reinhold-Keller E, Horneff G, Schäfer R, Young P. Differenzialdiagnose akraler Schmerzen: Junger Mann mit akralen Schmerzen, Fieberschüben und Hörverlust. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1027710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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165
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May MJ, Halvorson C, Perry T, Weber F, Young P, Silbernagel C. Photoconductive detectors with fast temporal response for laser produced plasma experiments. Rev Sci Instrum 2008; 79:10E304. [PMID: 19044466 DOI: 10.1063/1.2955614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Processes during laser plasma experiments typically have time scales that are less than 100 ps. The measurement of these processes requires x-ray detectors with fast temporal resolution. We have measured the temporal responses and linearity of several different x-ray sensitive photoconductive detectors (PCDs). The active elements of the detectors investigated include both diamond (natural and synthetic) and GaAs crystals. The typical time responses of the GaAs PCDs are approximately 60 ps, respectively. Some characterizations using x-ray radiation from a synchrotron radiation source are presented.
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Affiliation(s)
- M J May
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, California 94550, USA
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166
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Boentert M, Young P. Transthyretin-assoziierte hereditäre Amyloidosen. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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167
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Borchert A, Schwartz O, Kurlemann G, Young P, Schilling M. Diagnostischer Nutzen hochauflösender Nervensonographie versus Neurographie bei der hereditären Polyneuropathie Typ I (CMT1A). Akt Neurol 2008. [DOI: 10.1055/s-0028-1086577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Biehl K, Gregor N, Reichelt D, Koutsilieri E, Young P, Evers S, Arendt G, Husstedt I. Kognition, Liquorparameter, Dopaminmetabolismus und Demenzmarker in verschiedenen Stadien der HIV-Infektion. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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169
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Arora A, Santhirapala R, Carter J, Young P. 274. Testing of a Novel Device for Prevention of Misconnection of Local Anaesthetic Infusions to Intravenous Cannulae. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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170
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171
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Dziewas R, Waldmann N, Böntert M, Hor H, Müller T, Okegwo A, Ringelstein EB, Young P. Increased prevalence of obstructive sleep apnoea in patients with Charcot-Marie-Tooth disease: a case control study. J Neurol Neurosurg Psychiatry 2008; 79:829-31. [PMID: 18559462 DOI: 10.1136/jnnp.2007.137679] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Obstructive sleep apnoea (OSA) has previously been described in a large family suffering from Charcot-Marie-Tooth disease type 1 (CMT1). In the present study, we used a case control design to establish whether this suggested link between OSA and CMT1 may also be found when studying genetically non-related patients. 12 patients with CMT1 and 24 control patients matched for age, sex and body mass index (BMI) were included in the study. Neurological disability was graded with a previously established 6 point score. All patients underwent overnight polysomnography. The mean apnoea-hypopnoea index (AHI) of patients with CMT1 was 10.5 (16.3) which was significantly higher than that of the control group (1.5 (1.3)). Five out of 12 patients with CMT1 had an AHI > or =10/h compared with 1 of 24 control patients (p<0.01). In patients with CMT1, a significant correlation between AHI and neurological disability was found (Spearman r = 0.62; p = 0.031) while BMI and age were not related to AHI. CMT1, in particular CMT1A, predisposes with disease progression to the development of OSA. Pathophysiologically, one may assume that CMT1 related pharyngeal neuropathy increases the collapsibility of the upper airway which in turn leads to recurring obstructive respiratory events.
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Affiliation(s)
- R Dziewas
- Department of Neurology, University Hospital of Münster, Albert-Schweitzer-Strasse 33, 48129 Münster, Germany.
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Trimarchi H, Duboscq C, Genoud V, Lombi F, Muryan A, Young P, Schwab M, Castanon M, Rodriguez-Reimundes E, Forrester M, Pereyra H, Campolo-Girard V, Seminario O, Alonso M, Kordich L. Plasminogen activator inhibitor-1 activity and 4G/5G polymorphism in hemodialysis. J Vasc Access 2008; 9:142-147. [PMID: 18609532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Chronic insufficiency alters homeostasis, in part due to endothelial inflammation. Plasminogen activator inhibitor-1 (PAI-1) is increased in renal disease, contributing to vascular damage. We assessed PAI-1 activity and PAI-1 4G/5G polymorphism in hemodialysis (HD) subjects and any association between thrombotic vascular access (VA) events and PAI-1 polymorphism. METHODS Prospective, observational study in 36 HD patients: mean age: 66.6 +/- 12.5 yr, males n=26 (72%), time on HD: 28.71 +/- 22.45 months. Vascular accesses: 10 polytetrafluoroethylene grafts (PTFEG), 22 arteriovenous fistulae (AVF), four dual lumen catheters (CAT). Control group (CG): 40 subjects; mean age: 60.0 +/- 15 yrs, males n=30 (75%). Group A (GA): thrombotic events (n=12), and group B (GB): No events (n=24). Groups were no different according to age (69.2 +/- 9.12 vs. 65.3 +/- 14.5 yrs), gender (males: 7; 58.3% vs. 18; 81.8%), time on HD (26.1 +/- 14.7 vs. 30.1 +/- 38.7 months), causes of renal failure. Time to follow-up for access thrombosis: 12 months. RESULTS PAI-1 levels in HD: 7.21 +/- 2.13 vs. CG: 0.42 +/- 0.27 U/ml (p<0.0001). PAI-1 4G/5G polymorphic variant distribution in HD: 5G/5G: 6 (17%), 4G/5G: 23 (64%); 4G/4G: 7 (19%) and in CG: 5G/5G: 14 (35%); 4G/5G: 18 (45%); 4G/4G: 8 (20%). C-reactive protein (CRP) in HD: 24.5 +/- 15.2 mg/L vs. in CG 2.3 +/- 0.2 mg/L (p<0.0001). PAI-1 4G/5G variants: GA: 5G/5G: 3; 4G/5G: 8; 4G/4G: 1; GB: 5G/5G: 3; 4G/5G: 15; 4G/4G: 6. Thrombosis occurred in 8/10 patients (80%) with PTFEG, 3/22 (9%) in AVF, and 1/4 (25%) in CAT. Among the eight PTFEG patients with thrombosis, seven were PAI 4G/5G. CONCLUSIONS PAI-1 levels were elevated in HD patients, independent of their polymorphic variants, 4G/5G being the most prevalent variant. Our data suggest that in patients with PTFEG the 4G/5G variant might be associated with an increased thrombosis risk.
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Affiliation(s)
- H Trimarchi
- Nephrology Unit, British Hospital of Buenos Aires, Argentina.
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173
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Moser K, Biglan KM, Ross CA, Langbehn DR, Aylward E, Stout JC, Queller S, Carlozzi N, Duff K, Beglinger LJ, Paulsen JS, Tomusk A, Lifer S, Hastings S, Dawson J, Walker B, Whitlock K, Johnson S, Pacifici R, Hersch S, Dorsey ER, Katz R, Tempkin T, Wheelock V, Schwartz G, Corey-Bloom J, Mattis P, Feigin A, Young P, McArthur DL, Perlman S, Higginson C, Carr L, Sigvardt K, Chirieac MC, Shinaman A, Shoulson I, Kane AE, Peavy GM, Goldstein JL, Jacobson MW, Lessig S, Wasserman L, Kayson EP, Tang C, Zgaljardic D, Ma Y, Dhawan V, Guttman M, Eidelberg D, Peng S, Kingsley P, Rosas HD, Gevorkian S, Oakes D, Matson W, Massood T, Latourelle J, Mysore JS, Fossale E, Gillis T, Gusella JF, MacDonald ME, Myers RH, Yastrubetskaya O, Preston J, Chiu E, Goh A, Oster E, Bausch J, Kayson E, Quaid K, Sims S, Swenson M, Harrison J, Moskowitz C, Stepanov N, Suter G, Westphal B, Johnson SA, Langbehn D, Paulsen J, Nopoulos P, Beglinger L, Johnson H, Magnotta V, Pierson R, Lipe H, Bird TD, McCusker EA, Lownie A, Lechich AJ, Montas S, Duckett A, Klager J, Sandler S, Pae A, Apostol BL, Simmons DA, Zuccato C, Illes K, Pallos J, Casale M, Kathuria S, Cattaneo E, Marsh JL, Thompson LM, Patzke H, Chesworth R, Li Z, Rahil G, Wang J, Smith J, Huet FL, Shapiro G, Leit S, Beaulieu P, Raeppel F, Fournel M, Sainte-Croix H, Nolan SJ, Albayya FP, Barbier A, Besterman J, Ahlijanian MK, Deziel R, Aubeeluck A, Buchanan H, Ross C, Biglan K, Landwehrmeyer B, Whitlock KB, Carlozzi NE, Mickes L, Lee J, Kim RY, Toro B, Fine E, Cahill T, Johnson D, Goldstein J, Peavy G, Jacobson M, Goodman LV, Como PG, Cha JH, Beck C, Adams M, Chadwick G, Blieck EA, McCallum C, Deuel L, Clarke A, Stewart R, Adams WH, Paulson H, Fiedorowicz JG, Hanson JM, Ramza N, Priller J, Ecker D. Inaugural Huntington Disease Clinical Research Symposium Organized by the Huntington Study Group. Neurotherapeutics 2008. [DOI: 10.1016/j.nurt.2007.10.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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174
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Abstract
BACKGROUND Charcot-Marie-Tooth disease (CMT) comprises a large variety of different forms of motor and sensory neuropathies. The most frequent are demyelinating forms (CMT1) and axonal forms (CMT2). The molecular basis of several CMT forms has been clarified during the last 15 years. Since muscle wasting and sensory disturbance are the main features of these syndromes, treatments aim to improve motor impairment and sensory disturbances. Specific treatment trials are rare. OBJECTIVES The objective was to review systematically all randomised and quasi-randomised studies of any treatment for CMT. SEARCH STRATEGY We searched the Cochrane Neuromuscular Disease Group Trials Register, MEDLINE (January 1966 to August 2007), EMBASE (January 1980 to August 2007), LILACS (January 1982 to August 2007) for randomised controlled trials of treatment for CMT. SELECTION CRITERIA We included randomised and quasi-randomised trials of any treatment for people with CMT. Where a study aimed to evaluate the treatment of general neuromuscular symptoms of people with peripheral neuropathy including CMT, we included the study if we were able to identify the effect of treatment in the CMT group. Observational studies and case reports on the treatment of people with CMT were not included. DATA COLLECTION AND ANALYSIS Two review authors (PY and TBB) extracted the data, assessed study quality and performed data extraction independently. MAIN RESULTS Only one trial with only eight participants met all the inclusion criteria and provided the primary outcome measure for this review. In this trial, four participants treated with neurotrophin-3 had more improvement after six months on the Neuropathy Impairment Score, mean difference -9.50 (95% CI -13.77 to -5.23), than those four treated with placebo. Small trials of exercise training, creatine monohydrate, orthoses and purified bovine brain ganglioside injections (Cronassial) showed no significant benefit in people with genetically undefined CMT1 or CMT2. AUTHORS' CONCLUSIONS Small trials of exercise, creatine, purified brain gangliosides, and orthoses have been performed. None showed significant benefit. A very small trial of neurotrophin-3 showed possible minor benefit which needs to be replicated in a larger trial. None of the two trials were large enough to detect moderate benefit or harm. Larger RCTs are needed for any form of pharmacological intervention as well as as for any form of physical intervention. Outcome measures should include a validated composite scale such as the Charcot-Marie-Tooth neuropathy scale.
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Affiliation(s)
- P Young
- University of Münster, Department of Neurology, Albert-Schweitzer-Str.33, Münster, Germany, 48129.
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175
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Trimarchi H, Young P, Finquelievich J, Agorio I, Jordan R, Forrester M, Bruetman JE, Finn BC, Pellegrini D, Lombi F, Campolo-Girard V, Efron E. [Disseminated histoplasmosis in a kidney transplant patient]. Nefrologia 2008; 28:571-572. [PMID: 18816230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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176
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Finn BC, Young P, Bruetman JE, Forrester M, Lombi F, Campolo Girard V, Pereyra H, Trimarchi H. [Hypokalemia, distal renal tubular acidosis, and Hashimoto's thyroiditis]. Nefrologia 2008; 28:569-570. [PMID: 18816228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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177
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Abstract
BACKGROUND Lymphangiosarcoma is a highly malignant tumor with a poor prognosis. Anthracyclines constitute the form of chemotherapy most commonly used in these patients. Unfortunately, they are poorly tolerated. We report a case of lymphangiosarcoma in an elderly woman with good response to liposomal doxorubicin, an anthracycline with lower toxicity. CASE REPORT A 70 year-old-woman with a previous history of post-mastectomy lymphedema presented a painful and bleeding lymphangiosarcoma on the arm and the chest. Because of the wide extent of the tumor, surgery was not performed. The patient was treated with liposomal doxorubicin 50 mg/m2. Marked tumor regression was observed after the first course of chemotherapy. After 5 courses, 90% regression of tumor mass was seen. Pain and bleeding also stopped. Two months after the final course of liposomal doxorubicin, relapse occurred and the patient died. DISCUSSION A dramatic response to liposomal doxorubicin was noted in the present case, as previously reported in a patient with an angiosarcoma of the scalp. Liposomal doxorubicin could be considered for the treatment of lymphangiosarcoma, particularly in elderly patients.
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Affiliation(s)
- E Verdier
- Clinique Dermatologique, CHU, Rouen, France.
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178
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Kleffner I, Deppe M, Mohammadi S, Schiffbauer H, Stupp N, Lohmann H, Young P, Ringelstein EB. DIFFUSION TENSOR IMAGING DEMONSTRATES FIBER IMPAIRMENT IN SUSAC SYNDROME. Neurology 2007; 70:1867-9. [DOI: 10.1212/01.wnl.0000280580.95671.01] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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179
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Abstract
Night sweats has been defined as drenching sweats that require the patient to change bed clothes. In current studies night sweats appear in 30% of non-obstetric patients and affects approximately 60% of pregnant women. Differential diagnoses include infections, malignancy, medications, hot flashes and panic attacks, making of each patient a challenge. We present two patients with night sweating. After excluding systemic diseases the diagnosis of gastroesophageal reflux was made, with excellent response to anti-reflux treatment. The presentation of our two patients coupled with a deep literature review, underscores the importance of gastroesophageal reflux as a cause of night sweating.
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Affiliation(s)
- P Young
- Servicio de Clínica Médica, Hospital Británico, Buenos Aires, Argentina
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180
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Young P, Finn BC, Bruetman JE. [Graves disease, sign and symptoms]. An Med Interna 2007; 24:505-508. [PMID: 18271657 DOI: 10.4321/s0212-71992007001000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Graves disease is by far the most common cause of hyperthyroidism. Is an immunologic disorder and it is distinguished clinically from other forms of hyperthyroidism by the presence of diffuse thyroid enlargement, ophthalmopathy, and occasionally pretibial myxedema. In this paper we summarize the prolific life of Robert Graves and we also describe the signs and symptoms of hyperthyroidism. In today s medicine, were technology plays a very important role, we would like to remark the value of anamnesis and physical exam as some of the most useful tools.
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Affiliation(s)
- P Young
- Servicio de Clínica Médica, Hospital Británo, Buenos aires, Argentina.
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Abstract
OBJECTIVE To compare the sensitivity and specificity of Chlamydophila abortus antibody assays, to find a suitable serological assay for testing sheep for export. DESIGN Comparison of results from known positive and negative sheep populations. PROCEDURE Fifty-five positive and fifty negative sera were analysed by four enzyme linked immunosorbent assays (ELISA), three using recombinant antigens based on the chlamydial polymorphic outer membrane proteins (POMP90-3, POMP90-4, POMP80-90) and one using a synthetic peptide based on chlamydial major outer membrane proteins (MOMP-P). They were also analysed by complement fixation tests (CFT) using crude antigens from chlamydia isolated from an Australian sheep, a Californian parakeet and a Texan turkey. Assay sensitivity and specificity were expressed as point estimates and 95% confidence intervals. Results were compared using McNemar's test for paired samples. RESULTS ELISA sensitivity ranged from 70 to 98% and complement fixation test sensitivity from 60 to 96%; with POMP90-3 > POMP90-4 > CFT (parakeet) > CFT (turkey) > POMP80-90 > MOMP-P > CFT (sheep). There was no significant difference from POMP90-3 to POMP80-90 (P > 0.05). ELISA specificity ranged from 88 to 100% and CFT specificity was 100% for all three antigens; with CFT and POMP90-4 > MOMP-P > POMP80-90 > POMP90-3. There was no significant difference from CFT to POMP80-90 (P > 0.05). Changing the CFT cut-off from 1:32 to 1:4 substantially reduced the specificity with little improvement in sensitivity. CONCLUSION Assays using POMP90-4, POMP80-90, CFT (parakeet) and CFT (turkey) had equivalent sensitivity and specificity; none of the ELISAs were more specific than any CFT. The POMP80-90 ELISA is recommended as an alternative to CFT (parakeet) but as its specificity is not ideal the search for a more specific assay should continue.
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Affiliation(s)
- L M E McCauley
- Primary Industries Research Victoria, Department of Primary Industries, Attwood, VIC 3049, Australia.
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Warnecke T, Duning T, Schwan A, Lohmann H, Epplen JT, Young P. A novel form of autosomal recessive hereditary spastic paraplegia caused by a new SPG7 mutation. Neurology 2007; 69:368-75. [PMID: 17646629 DOI: 10.1212/01.wnl.0000266667.91074.fe] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hereditary spastic paraplegia (HSP) is a clinically and genetically heterogeneous neurodegenerative disorder characterized by progressive spastic paraparesis of the lower limbs. OBJECTIVE To identify the genotype and characterize the phenotype in a family with a novel form of complicated autosomal recessive hereditary spastic paraparesis (ARHSP). METHODS Six subjects of a Turkish family were examined by clinical evaluation, detailed neuropsychological testing, neurophysiologic studies, MRI, diffusion tensor imaging (DTI), and mutation analysis of SPG7 gene. RESULTS Three individuals were affected by a juvenile-onset form of complicated ARHSP due to the missense mutation c.2075G>C in exon 15 of the SPG7 gene in the homozygous state, substituting serine with threonine at codon 692. As additional clinical features, cerebellar syndrome, supranuclear palsy, and cognitive impairment, particularly disturbance of attention and executive functions, were found. MRI showed cerebellar atrophy and mild frontal cerebral atrophy. DTI revealed bilateral disturbance of white matter integrity in corticospinal tracts, frontal lobes, and the midbrain. CONCLUSIONS The new SPG7 gene mutation leads to a novel complicated autosomal recessive hereditary spastic paraparesis phenotype that widens the spectrum of different brain systems that are optionally affected in hereditary spastic paraplegia (HSP). In this novel phenotype, spastic paraparesis is related to cerebral damage of corticospinal tracts. Impairment of attention and executive functions is due to white matter loss in frontal lobes. Furthermore, supranuclear palsy is caused by white matter damage in the midbrain. This multisystem affection, which was detected by the use of diffusion tensor imaging, may reflect a mitochondrial dysfunction that contributes to the underlying pathogenesis of SPG7-HSP.
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Affiliation(s)
- T Warnecke
- Department of Neurology, University Hospital of Münster, Münster, Germany
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183
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Young P, Stemmelin GR, Trimarchi H. Bilateral pulmonary nodules due to extramedullary hematopoiesis. Eur J Intern Med 2007; 18:347. [PMID: 17574117 DOI: 10.1016/j.ejim.2007.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2006] [Revised: 01/10/2007] [Accepted: 02/08/2007] [Indexed: 10/23/2022]
Affiliation(s)
- P Young
- Department of Internal Medicine, Hospital Británico de Buenos Aires, Argentina
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184
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Wu X, Spencer S, Fiveash J, Brezovich I, Duan J, Shen S, Young P. SU-FF-T-372: Registration of Frameless High-Field MRI to Low-Field Frame-Based MRI Images in Leksell Gamma-Knife (LGK) Radiosurgery. Med Phys 2007. [DOI: 10.1118/1.2761097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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185
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Verdier E, Auquit-Auckbur I, Young P, Corven C, Chomant J, Courville P, Vera P, Milliez PY, Joly P. Complications liées à l’exérèse du ganglion sentinelle dans le mélanome. Ann Dermatol Venereol 2007; 134:439-42. [PMID: 17507841 DOI: 10.1016/s0151-9638(07)89210-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Side-effects occurring after sentinel lymph node excision in malignant melanoma patients have been poorly evaluated to date. The aim of the present study was to assess the side-effects of sentinel lymph node excision in this population. PATIENTS AND METHODS All consecutive malignant melanoma patients undergoing sentinel lymph node excision between March 2000 and December 2002 were included in this retrospective study. Patients with a metastatic sentinel node subsequently undergoing lymph node dissection were excluded. Median follow-up of patients was 12.6 +/- 8.8 months. Complications were classified as "early" (i.e. occurring the month following surgery), or "late" (after this time). RESULTS Forty malignant melanoma patients (17 males, 23 females) with a normal histologic examination of their sentinel lymph node were included. They belonged to a series of sixty-one melanoma patients undergoing lymph node excision. Fourteen complications were observed in ten patients. Two early complications were seen: hematoma (n=1) and deep venous thrombosis with pulmonary embolism (n=1). Twelve late complications were observed: mild lymphoedema (n=5), hypertrophic scars (n=2), painful scars (n=4), and one chronic seroma (n=1). Many complications (33%) were observed after excision in the inguinal area. DISCUSSION The complications of sentinel lymph node excision must be considered in determining the benefit/risk ratio of this technique.
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Affiliation(s)
- E Verdier
- Clinique Dermatologique, Hôpital Charles Nicolle, Rouen Cedex, France
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186
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Abstract
BACKGROUND The number of patients referred to French University dermatology departments for skin cancers has increased continuously for many years. The aim of this study was to assess the management and number of patients who died in our dermatology department over a 10-year period. PATIENTS AND METHODS All cases of patients who died in our dermatology department from 1992 to 2002 were retrospectively assessed. Demographic data, past history, main diagnosis, duration of hospitalisation and main treatment given were recorded. RESULTS The number of patients who died increased from 9 per year at the beginning of the study period to 25 per year at the end of this study. The mean age of patients remained unchanged at 66.5 years old. Forty-nine percent of patients in this study had metastatic melanoma, with no significant modification during the study period. Morphine-based drugs were used (mainly orally) in 41 percent of patients at the beginning of the study and in 56 percent (mainly via subcutaneous infusions) at the end of the study. Forty-five percent of patients were managed in close collaboration with the palliative care unit. CONCLUSION This study showed a three-fold increase in the number of patients referred for end-of-life care in a dermatology department during a 10-year period. Most of these patients had disseminated malignant melanoma. Major changes in patient management occurred during this period.
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187
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Partridge M, Ownby D, Hamilton R, Young P, Ford J. Maturation of the IgE and IgG response to Imported Fire Ant Venom during natural exposure. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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188
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Evans L, Blunt M, Arunachalam C, Young P. Comparison of the LoTrach and the Portex Soft Seal cuff: tracheal wall pressure and fluid leakage in a benchtop study and a clinical study. Crit Care 2007. [PMCID: PMC4095269 DOI: 10.1186/cc5375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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189
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Young P, Beresford-West T, Tabor G, Chang J. NEW TOOLS FOR GENERATING NUMERICAL MODELS FROM SCAN DATA. J Biomech 2007. [DOI: 10.1016/s0021-9290(07)70153-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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190
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Gess B, Halfter H, Kleffner I, Wood PM, Wanner IB, Young P. Inhibition of N-cadherin and beta-catenin function reduces axon-induced Schwann cell proliferation. Akt Neurol 2007. [DOI: 10.1055/s-2007-987509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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191
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Xuan VB, Young P, Limbert G, Chang J. 3D IMAGING TECHNIQUES FOR BIOMATERIAL CHARACTERISATION. J Biomech 2007. [DOI: 10.1016/s0021-9290(07)70155-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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192
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Boentert M, Teismann I, Warnecke T, Young P. HMSN X – mehr als „nur“ eine periphere Neuropathie. Akt Neurol 2007. [DOI: 10.1055/s-2007-988055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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193
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Nattkämper H, Lohmann C, Young P. Quantifikation des Untergangs von Motoneuronen bei demyelinisierenden Neuropathien: Retrograde Fluoreszenzmarkierung des N. ischiadicus in vivo an Tiermodellen der HMSN (IZKF Münster, Projektnr. You3/016/06). Akt Neurol 2007. [DOI: 10.1055/s-2007-988053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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194
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Lohmann C, Nattkämper H, Young P. Analyse der differentiellen Genexpression in Neuronen bei demyelinisierenden hereditären Neuropathien: Kombination von Laser-Mikrodissektion und Affymetrix-GeneChip-Analyse (IZKF Münster, Projektnr. You3/016/06). Akt Neurol 2007. [DOI: 10.1055/s-2007-988052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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195
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Kleffner I, Ringelstein EB, Stupp N, Niederstadt TU, Young P. Neurological picture. Susac's syndrome: effective combination of immunosuppression and antiplatelet treatment. J Neurol Neurosurg Psychiatry 2006; 77:1335. [PMID: 17110748 PMCID: PMC2077432 DOI: 10.1136/jnnp.2006.095596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- I Kleffner
- Department of Neurology, University of Muenster, Albert-Schweitzer-Str. 33, 48129 Muenster, Germany.
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196
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Abstract
BACKGROUND We report a case of necrolytic migratory erythema in a patient with Waldmann's disease. PATIENTS AND METHODS A 55-year-old male patient with a history of Waldmann's disease was hospitalized for a rash on the trunk and limbs comprising annular polycyclic lesions with peripheral scaling evocative of necrolytic migratory erythema. High-protein and fatty-acid-supplemented parenteral feeding led to rapid improvement of the patient's cutaneous lesions. DISCUSSION Waldmann's disease is characterized by intestinal lymphatic abnormalities leading to exudative intestinal disease causing protein loss in the bowel lumen and deficient fatty acid absorption. The pathogenesis of necrolytic migratory erythema is not fully understood. Increased serum glucagon does not appear to be the only mechanism involved. The occurrence of necrolytic migratory erythema in a patient with Waldmann's disease supports the current physiopathological hypothesis of the role of decreased plasma protein and amino acid levels in necrolytic migratory erythema.
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Affiliation(s)
- S Baricault
- Clinique Dermatologique, CHU de Rouen, France
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197
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Young P, Green D, Hillier I, Burton N. Assessment of quantum mechanical continuum models of solvation: the prediction of tautomer equilibria, partition coefficients and amine basicity. Mol Phys 2006. [DOI: 10.1080/00268979300102421] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- P. Young
- a Chemistry Department , University of Manchester , Manchester , M13 9PL , UK
| | - D.V.S. Green
- a Chemistry Department , University of Manchester , Manchester , M13 9PL , UK
| | - I.H. Hillier
- a Chemistry Department , University of Manchester , Manchester , M13 9PL , UK
| | - N.A. Burton
- a Chemistry Department , University of Manchester , Manchester , M13 9PL , UK
- b Computing Centre , University of Manchester , Manchester , M13 9PL , UK
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198
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Ong SSC, Chan SY, Ewer AK, Jones M, Young P, Kilby MD. Laser Ablation of Foetal Microcystic Lung Lesion: Successful Outcome and Rationale for Its Use. Fetal Diagn Ther 2006; 21:471-4. [PMID: 16912498 DOI: 10.1159/000093891] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Accepted: 11/16/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A foetus with an echodense, microcystic lung lesion complicated by non-immune hydrops has a high mortality rate. Because of the limited treatment options available, laser ablation was offered in an attempt to reduce the size of the lesion and reduce hydrops fetalis. METHODS AND RESULTS A 25-year-old nulliparous woman presented at 21 weeks gestation. Ultrasound revealed a male foetus with a large microcystic right sided lung lesion that completely occupied the right hemithorax causing marked mediastinal deviation. The foetus was hydropic with polyhydramnios. Percutaneous laser ablation of the large microcystic lung lesion was performed under direct ultrasound control. At a power setting of 45 W, and using a 400 microm Nd:YAG laser fibre, the core of the lesion was photocoagulated in pulses lasting 5 s at 5 s intervals. The total target dose was 1683 J. This led to a marked but temporary reduction in amniotic fluid volume. The patient was commenced on sulindac and amniodrainage was performed at 27 weeks as reaccumulation of the polyhydramnios occurred. Pre-eclampsia complicated the pregnancy at 38 weeks gestation and an emergency caesarean section was performed. The baby underwent a thoracotomy and lobectomy at 48 h of age, made a good recovery, and is currently well 8 weeks post-delivery. CONCLUSIONS In cases of cystic lung lesion complicated by hydrops, laser ablation should be considered as a treatment option.
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Affiliation(s)
- S S C Ong
- Department of Fetal Medicine, Division of Reproduction and Child Health, Birmingham Women's Hospital, Birmingham, UK
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199
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Lyne KJ, Moxon S, Sinclair I, Young P, Kirk C, Ellison S. Analysis of a care planning intervention for reducing depression in older people in residential care. Aging Ment Health 2006; 10:394-403. [PMID: 16798632 DOI: 10.1080/13607860600638347] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Approximately 40% of older people in residential care have significant symptoms of depression. A training and care-planning approach to reducing depression was implemented for 114 depressed residents living in 14 residential care homes in North Yorkshire, UK. Care staff were offered brief mental health training by community mental health teams for older people. They were then assigned to work individually with residents in implementing the care-planning intervention, which was aimed at alleviating depression and any health, social or emotional factors that might contribute to the resident's depression. Clinically significant improvements in depression scores were associated with implementation of the care-planning intervention as evidenced by changes in scores on the Geriatric Mental State Schedule-Depression Scale. There was evidence of an interaction between the power of the intervention and degree of dementia. These improvements were not accounted for by any changes in psychotropic medication. The training was highly valued by care staff and heads of homes, and they considered that the care-planning intervention represented an improvement in quality of care for all residents, irrespective of levels of dementia. Staff also reported improvements in morale and increased confidence in the caring role as a result of their participation. The limitations of this study are discussed. On the basis of a growing body of evidence, it is argued that there is an urgent need for a suitably powered randomised controlled trial and economic evaluation, to test the cost-effectiveness of personalised care planning interventions aimed at reducing depression in older people in residential care.
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Affiliation(s)
- K J Lyne
- Psychology Services, Selby and York Primary Care Trust, York, UK.
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200
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Young P, Finn BC, Pellegrini D. [Einstein's sign and other signs of aortic aneurysm]. An Med Interna 2006; 23:345-6. [PMID: 17067237 DOI: 10.4321/s0212-71992006000700011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Einstein's sign is a syndrome similar to an acute cholecystitis caused by the rupture of an abdominal aortic aneurysm. In this paper we describe the evolution of the disease that the physicist suffered till it led him to death. We also revise other signs which could be found in some patients with ruptured or dissected abdominal aortic aneurysm.
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Affiliation(s)
- P Young
- Servicio de Clínica Médica, Hospital Británico, Buenos Aires, Argentina
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