Gallstone ileus: post cholecystectomy Wills, V L; Smith, R C
Australian and New Zealand journal of surgery,
September 1994, Letnik:
64, Številka:
9
Journal Article
Recenzirano
A case of gallstone ileus occurring 5 months after laparoscopic cholecystectomy is presented. The possible aetiology is discussed and the literature regarding consequences of intraperitoneal stone ...spillage reviewed.
AORTIC INTIMAL SARCOMA: A CASE REPORT Wills, Vanessa L.; Graham, John C.; Eckstein, Robert P.
Australian and New Zealand Journal of Surgery,
July 1997, Letnik:
67, Številka:
7
Journal Article
AORTIC INTIMAL SARCOMA: A CASE REPORT Wills, Vanessa L.; Graham, John C.; Eckstein, Robert P.
Australian and New Zealand Journal of Surgery,
07/1997, Letnik:
67, Številka:
7
Report
Background: Low birth weight (LBW) is an important public health problem in undernourished populations.Objective: We tested whether improving women's dietary micronutrient quality before conception ...and throughout pregnancy increases birth weight in a high-risk Indian population.Design: The study was a nonblinded, individually randomized controlled trial. The intervention was a daily snack made from green leafy vegetables, fruit, and milk (treatment group) or low-micronutrient vegetables (potato and onion) (control group) from ≥90 d before pregnancy until delivery in addition to the usual diet. Treatment snacks contained 0.69 MJ of energy (controls: 0.37 MJ) and 10–23% of WHO Reference Nutrient Intakes of β-carotene, riboflavin, folate, vitamin B-12, calcium, and iron (controls: 0–7%). The primary outcome was birth weight.Results: Of 6513 women randomly assigned, 2291 women became pregnant, 1962 women delivered live singleton newborns, and 1360 newborns were measured. In an intention-to-treat analysis, there was no overall increase in birth weight in the treatment group (+26 g; 95% CI: −15, 68 g; P = 0.22). There was an interaction (P < 0.001) between the allocation group and maternal prepregnant body mass index (BMI; in kg/m2) birth-weight effect: −23, +34, and +96 g in lowest (<18.6), middle (18.6–21.8), and highest (>21.8) thirds of BMI, respectively. In 1094 newborns whose mothers started supplementation ≥90 d before pregnancy (per-protocol analysis), birth weight was higher in the treatment group (+48 g; 95% CI: 1, 96 g; P = 0.046). Again, the effect increased with maternal BMI (−8, +79, and +113 g; P-interaction = 0.001). There were similar results for LBW (intention-to-treat OR: 0.83; 95% CI: 0.66, 1.05; P = 0.10; per-protocol OR = 0.76; 95% CI: 0.59, 0.98; P = 0.03) but no effect on gestational age in either analysis.Conclusions: A daily snack providing additional green leafy vegetables, fruit, and milk before conception and throughout pregnancy had no overall effect on birth weight. Per-protocol and subgroup analyses indicated a possible increase in birth weight if the mother was supplemented ≥3 mo before conception and was not underweight. This trial was registered at www.controlled-trials.com/isrctn/ as ISRCTN62811278.
Middle school students with social and behavioral concerns need additional support. The current study investigated the effects of Class-Wide Function-related intervention teams adapted for middle ...school contexts (CW-FIT MS) and self-management (SM) in a sixth-grade reading class. CW-FIT MS was implemented, subsequently, for students with data indicating additional support was needed, and a self-management component was added to intensify the intervention (CW-FIT MS w/ SM). A single-subject multiple baseline design was implemented across four student participants, and the on-task student behavior as well as the teacher-student relationship were examined to assess the effects of the intervention. Results indicated improved on-task behavior for three of four students with the implementation of the self-management intervention, demonstrating promising maintenance effects. Preliminary data showed an overall improvement in the teacher-student relationship. Both teachers and students reported positive perceptions about the intervention, consistent with earlier findings in CW-FIT MS studies. Limitations and areas for future research are addressed.
Hedgehog-interacting protein (HHIP) sequesters Hedgehog ligands to repress Smoothened (SMO)-mediated recruitment of the GLI family of transcription factors. Allelic variation in HHIP confers risk of ...chronic obstructive pulmonary disease and other smoking-related lung diseases, but underlying mechanisms are unclear. Using single-cell and cell-type-specific translational profiling, we show that HHIP expression is highly enriched in medial habenula (MHb) neurons, particularly MHb cholinergic neurons that regulate aversive behavioral responses to nicotine. HHIP deficiency dysregulated the expression of genes involved in cholinergic signaling in the MHb and disrupted the function of nicotinic acetylcholine receptors (nAChRs) through a PTCH-1/cholesterol-dependent mechanism. Further, CRISPR/Cas9-mediated genomic cleavage of the
gene in MHb neurons enhanced the motivational properties of nicotine in mice. These findings suggest that HHIP influences vulnerability to smoking-related lung diseases in part by regulating the actions of nicotine on habenular aversion circuits.
Disruptive student behavior is a significant challenge in schools and a predictor of student failure. Effective classroom management is a crucial skill that middle level teachers must acquire to ...foster student engagement and learning. This qualitative study explored the experiences and perceptions of 35 middle level teachers in both general education and special education settings regarding effective classroom management techniques. Eight focus group interviews were conducted with 25 general education teachers and 10 special education teachers at one of five middle schools in Kansas, Missouri, or Utah. Focus group transcripts were analyzed using iterative qualitative content analysis to identify themes and subthemes. Findings revealed that effective classroom management includes teachers' use of appropriate positive and negative reinforcement, student buy-in to reward systems, positive immediate feedback to students, teachers' consistent follow-through with consequences, and positive teacher-student relationships. We also report similarities and differences between middle level general education and special education teachers' perceptions. Limitations and areas for future research are addressed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background: Exposure to airborne particulate matter (PM), a major component of air pollution, has been associated with increases in both exacerbations of and hospitalizations for asthma. We have ...previously shown that exposure to ambient PM collected in urban Baltimore (AUB) induces airway hyperresponsiveness (AHR), eosinophilic and neutrophilic inflammation, and the recruitment of T cells. However, the mechanism(s) by which it induces these features of asthma remains unknown. Objective: We investigated whether T lymphocytes play a role in AUB-induced AHR. Methods: We compared the effects of AUB exposure on the allergic phenotype in wild-type (WT) BALB/c mice and in mice deficient in recombinase-activating gene-1 (Rag1-/-) that lack mature lymphocytes. Results: We found that exposure of WT mice to AUB induced AHR concomitant with increases in the numbers of bronchoalveolar lavage (BAL) fluid lymphocytes, eosinophils, neutrophils, and mucus-containing cells in the lungs of WT mice. Interestingly, we show for the first time that these effects were associated with significant elevation in interleukin (IL)-17A, IL-17F, and T-helper 2 cell (TH2) (IL-13, IL-5) cytokine levels in lung cells, as well as reductions in the levels of the suppressive cytokine IL-10. Interestingly, Rag1-/- mice failed to develop AUB-induced AHR; however, AUB-induced BAL fluid cellularity, and mucus cell changes were only partially inhibited in Rag1-/- mice. Conclusions: Taken together, our results suggest that AUB exposure increases the patho-physiological features of asthma via activation of lymphocyte-dependent pathways. These results provide a plausible biological mechanism for the strong association between PM exposure and the increased severity of asthma.
Abstract
Introduction
Previous studies have shown that prescription sleep medications are associated with suicide ideation. In this study we seek to identify the risk of off-label or illicit use of ...sedatives/hypnotics to predict suicidal ideation.
Methods
Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) Study, including N=1,003 working-age adults. For the present study, the data on off-label or illicit stimulants and sedatives were examined. Suicide ideation was assessed by whether participant reported any ideation in the past 2 weeks (PHQ, Item #9). Covariates included age, sex, education, race/ethnicity, and smoking. Additional models included adjustment for insomnia severity (ISI), daytime sleepiness (ESS), sleep duration (NHANES), psychiatric health (PHQ4), and general stress (PSS).
Results
In adjusted models examining sedatives/hypnotic use, higher likelihood of suicidal ideation was associated with any use (OR=1.77, 95%CI1.26,2.47), recent use (OR=2.71, 95%CI1.77,4.15), desire to use (OR=2.14, 95%CI2.74,6.26),problematic use (OR=7.39, 95%CI3.32,16.47), role limitations (OR=7.94, 95%CI3.39,18.59), others expressing concern (OR=4.38, 95%CI(2.29,8.41), and inability to control use (OR=7.15, 95%CI3.60,14.20). Similarly, models examining stimulant use showed that higher likelihood of suicide ideation was associated with history of use (OR=1.81, 95%CI2.01,3.93), recent use (OR=4.44, 95%CI2.63,7.49), desire to use (4.82, 95%CI2.78,8.34), problematic use (OR=17.04, 95%CI5.67,51.24), role limitations (OR=9.07, 95%CI3.47,23.68), others expressing concern (OR=17.26, 95%CI(7.48,39.84), and inability to control use (OR=6.44, 95%CI3.26,12.71). When sleep and mental health variables were added to the model, results were attenuated but remained significant at the p<.05 level.
Conclusion
Illicit use of substances that both promote sleep or arousal are associated with suicidal ideation, over and above contributions of sleep disturbance and mood/stress. It is possible that these behaviors represent self-medication attempts or an adverse effect of these drugs. Further research on these problematic associations is recommended.
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