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31.
Stan Kutcher Michael Aman Sarah J Brooks Jan Buitelaar Emma van Daalen J?rg Fegert Robert L Findling Sandra Fisman Laurence L Greenhill Michael Huss Vivek Kusumakar Daniel Pine Eric Taylor Sam Tyano 《European neuropsychopharmacology》2004,14(1):11-28
Researchers and clinicians worldwide share concerns that many youngsters with attention-deficit/hyperactivity disorder (ADHD) and/or disruptive behaviour disorders (DBDs) do not receive appropriate treatment despite availability of effective therapies. At the request of Johnson and Johnson (sponsor), 11 international experts in child and adolescent psychiatry were selected by Professor Stan Kutcher (chair) to address these concerns. This paper describes the experts' consensus conclusions, including treatment practice suggestions for physicians involved in the early treatment of youngsters with ADHD (or hyperkinetic disorder, in countries preferring this classification) and/or DBDs internationally: suggested first-line treatment for ADHD without comorbidity is psychostimulant medication aided by psychosocial intervention. For ADHD with comorbid conduct disorder (CD), psychosocial intervention combined with pharmacotherapy is suggested. For primary CD, suggested first-line treatment is psychosocial intervention, with pharmacotherapy considered as an 'add-on' when aggression/impulsivity is marked and persistent. Pharmacotherapy requires careful titration; full-day coverage is the suggested goal. Regular long-term follow-up is recommended. 相似文献
32.
Infectious Disease in a Warming World: How Weather Influenced West Nile Virus in the United States (2001–2005)
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Jonathan E. Soverow Gregory A. Wellenius David N. Fisman Murray A. Mittleman 《Environmental health perspectives》2009,117(7):1049-1052
Background
The effects of weather on West Nile virus (WNV) mosquito populations in the United States have been widely reported, but few studies assess their overall impact on transmission to humans.Objectives
We investigated meteorologic conditions associated with reported human WNV cases in the United States.Methods
We conducted a case–crossover study to assess 16,298 human WNV cases reported to the Centers for Disease Control and Prevention from 2001 to 2005. The primary outcome measures were the incidence rate ratio of disease occurrence associated with mean weekly maximum temperature, cumulative weekly temperature, mean weekly dew point temperature, cumulative weekly precipitation, and the presence of ≥ 1 day of heavy rainfall (≥ 50 mm) during the month prior to symptom onset.Results
Increasing weekly maximum temperature and weekly cumulative temperature were similarly and significantly associated with a 35–83% higher incidence of reported WNV infection over the next month. An increase in mean weekly dew point temperature was significantly associated with a 9–38% higher incidence over the subsequent 3 weeks. The presence of at least 1 day of heavy rainfall within a week was associated with a 29–66% higher incidence during the same week and over the subsequent 2 weeks. A 20-mm increase in cumulative weekly precipitation was significantly associated with a 4–8% increase in incidence of reported WNV infection over the subsequent 2 weeks.Conclusions
Warmer temperatures, elevated humidity, and heavy precipitation increased the rate of human WNV infection in the United States independent of season and each others’ effects. 相似文献33.
Background
Only limited data exist on the costs of genital herpes (GH) in the USA. We estimated the economic burden of GH in the USA using two different costing approaches. 相似文献34.
35.
Magnetic resonance (MR) imaging was performed on 14 patients with histologically proved osteosarcoma (mean age, 14.4 years). There was excellent correlation of intramedullary tumor extent as determined with MR imaging and pathologic examination (r = 99%). This was facilitated by the presence of a chemical shift artifact at the tumor-marrow interface on the T1-weighted images. The correlation between CT and pathologic findings was not as good (r = 84%). In a single patient, however, a 10-cm length of sclerotic bone was incorrectly interpreted as being tumor. If this case is excluded, the correlation between CT and pathologic findings improves significantly (r = 96%). T2-weighted images were optimal in demonstrating soft-tissue bulk and breach of the epiphysis or cortex. Vascular involvement was also readily defined. The T2 value of the tumor soft-tissue component decreased in patients who were deemed to have responded well to therapy. Two patients with very high T2 values after chemotherapy developed wide-spread metastatic disease and died. Phosphorus-31 MR spectroscopy of five patients with osteosarcoma showed elevated levels of phosphomonoesters (PMEs), inorganic phosphate (Pi), and phosphodiesters (PDEs). PME and PDE peak areas decreased in three patients after chemotherapy, while Pi peak areas increased. 相似文献
36.
While avid accumulation of gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) occurs initially in most cases of primary Ewing sarcoma, uptake after therapy is less well defined. Thirty patients with Ewing sarcoma who underwent Ga-67 and bone scintigraphy at diagnosis, at completion of therapy, and at relapse from 1978 to 1988 were evaluated. All 30 patients showed less primary site Ga-67 activity following therapy. Twenty-three of 28 patients who underwent corresponding bone scintigraphy showed less uptake, but residual activity was usually more intense than with Ga-67. Avid reaccumulation of Ga-67 occurred in four of five patients with primary site relapse, while patients who underwent bone scintigraphy showed less change. It was concluded that a greater decrease in Ga-67 than in Tc-99m MDP uptake often occurs in patients successfully treated for primary Ewing sarcoma. Information obtained at Ga-67 scintigraphy is most likely to be helpful if results of bone scintigraphy remain abnormal or if occult relapse is suspected. 相似文献
37.
M Fisman 《Medical hypotheses》1990,33(3):163-167
Alzheimer's disease is a frequent cause of dementia in the elderly. The prevalence and incidence increase with aging. It is hypothesised that the age related decline in liver size and lysosomal function results in decreased clearance as well as decreased or altered proteolysis of the Alzheimer precursor protein, and results in the deposition of A4 protein in cerebral blood vessels and brain with congophilic angiopathy and senile/amyloid plaque formation. 相似文献
38.
Patricia Ann Firby MSc DipEd RGN RCNT RNT DipNurs Lecturer Karen A Luker PhD BNurs RGN RHV DN Cert Professor of Community Nursing Ann-Louise Caress BNurs RGN RHV DN Cert Research Assistant 《Journal of advanced nursing》1991,16(8):987-995
Computers have only recently begun to find a place in the everyday work of health care staff. The use of computer-assisted learning (CAL) in patient education is in its infancy. However, the medium appears to offer several advantages to patients. The successful integration of the medium into clinical practice requires the acceptance and support of staff members. Little research exists to date which examines staff responses to the introduction of CAL into their workplace. This small study (n = 14) aims to explore the reactions of staff to the introduction of an experimental CAL package for use in the education of renal patients on continuous ambulatory peritoneal dialysis (CAPD). The opinions of staff members to CAL are probed and their views ascertained regarding the usefulness of CAL to both staff and patients. Results suggest that, despite their initial reservations about CAL, staff were generally positive about the medium. 相似文献
39.
Image processing and volume rendering have been applied to magnetic resonance (MR) images to produce three-dimensional views of the surface of the brain. Four healthy volunteers and 17 patients with a variety of disorders underwent MR imaging of the head, and these images were processed and subjected to volume rendering. The resulting three-dimensional views depict abnormalities of the brain surface, as well as important landmarks of normal brain surface anatomy such as precentral, postcentral, superior temporal, and inferior frontal gyri, which are difficult to identify on cross-sectional images. 相似文献
40.