Higher Activity Scores Research Articles

Key attributes of patient centered medical homes associated with patient activation of diabetes patients

BackgroundApproximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation. This study’s objective is to determine the relative importance of the PCMH constructs or domains to patient activation among individuals living with diabetes.MethodsThis study is a cross-sectional analysis of 1253 primary care patients surveyed with type II diabetes. The dependent variable, patient activation, was assessed using the Patient Activation Measure (PAM). Independent variables included 7 PCMH domains- organizational access, integration of care, comprehensive knowledge, office staff helpfulness, communication, interpersonal treatment and trust. Ordered logistic regression was performed to determine whether each PCMH domain was independently associated with patient activation, followed by a final ordered logistic regression that included all the PCMH domains in a single adjusted model.ResultsUsing the full adjusted model, the odds of patients reporting higher activation scores (PAM) were found to be significant in the domains that represented organizational access (OR 1.56, 95% CI 1.31–1.85) and comprehensive knowledge (OR 1.44, 95% CI 1.13–1.85).ConclusionsMany practices have struggled with the challenge to develop fully functional patient-centered medical homes. In an effort to become more patient-centered, this study aimed to address what factors activated diabetic patients to adhere to diabetes management plan. Understanding these factors can help identify PCMH attributes that practices can prioritize and improve upon to assist their patients in improving health outcomes.Trial registrationStudy was not a clinical trial; therefore it was not registered.

Analysis and follow-up of type 1 choroidal neovascularisation with optical coherence tomography–angiography after antiangiogenic treatment

Abstract Aim To describe the characteristics of type 1 choroidal neovascularisation (CNV) in age-related macular degeneration (ARMD) using two different optical coherence tomography angiography (OCT-A) devices sequentially during a standard protocol of three intravitreal injections of an anti-vascular endothelial growth factor (anti-VEGF). Methods The study included 6 eyes with naive neovascular ARMD. Macular OCT-A images were acquired using AngioPlex Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Inc., Dublin, USA) and DRI OCT Triton SS-OCT Angio (Topcon, Medical Systems, Inc., Oakland, NJ, USA). The macular OCT-A scan covered an area of 3 mm × 3 mm. Distinct morphological patterns and quantifiable features of the neovascular membranes were studied on en face projection images, which were taken at different stages of the follow-up. Results Treatment response could be estimated using the OCT-A criteria of CNV activity. Higher activity scores before treatment resulted in a greater decrease in the membrane area. The estimated net decline in area ranged from 83.5% to 1.4%. The OCT-A performed one-week after treatment revealed the greatest area reductions. Conclusions OCT-A provides new possibilities for the non-invasive assessment of features of neovascular networks and CNV structural morphology. Newly described activity criteria can also guide therapeutic decisions, and help in evaluating responses. Quantitative and qualitative information can be provided with this technique. However, further software development and future investigation are essential to define the role of this tool on a daily basis.

Factor structure of the Brief Psychiatric Rating Scale – Expanded (BPRS-E) in a large hospitalized sample

Meta-analytically derived models of the BPRS-E factor structure were tested on a large (n = 33,903) hospitalized sample using confirmatory factor analysis. A modified four factor model (Positive symptoms, Negative symptoms, Affect, and Activation) containing 12 core BPRS-E symptoms based on the meta-analytic models had excellent model fit. An additional five factor, 15 core symptom model, which added a Disorganization factor consistent with the pentagonal model of schizophrenic symptoms also had support with generally good fit. These factors demonstrated acceptable reliability as measured by coefficient alpha (M = 0.77). These factors were compared across three major diagnostic classes and indicated clinically relevant differences between these groups such as depressed patients having higher Affect scores (d = 1.03), manic-mixed episode patients having higher Activation scores (d = 0.83) and schizophrenic patients having higher Positive Symptom scores (d = 0.89) providing evidence for the validity of these factors. Further exploratory factor analyses provided support for the factors of Positive symptoms, Negative symptoms, Affect, and Activation with additional smaller and less robust factors corresponding to Resistance emerging as a fifth factor and Disorganization emerging as a sixth factor.

Análisis y seguimiento con angiografía por tomografía de coherencia óptica de neovascularización coroidea tipo 1 en degeneración macular tras tratamiento antiangiogénico

AimTo describe the characteristics of type 1 choroidal neovascularisation (CNV) in age-related macular degeneration (ARMD) using two different optical coherence tomography angiography (OCT-A) devices sequentially during a standard protocol of three intravitreal injections of an anti-vascular endothelial growth factor (anti-VEGF). MethodsThe study included 6 eyes with naïve neovascular ARMD. Macular OCT-A images were acquired using AngioPlex Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Inc., Dublin, USA) and DRI OCT Triton SS-OCT Angio (Topcon, Medical Systems, Inc. Oakland, NJ, USA). The macular OCT-A scan covered an area of 3×3mm. Distinct morphological patterns and quantifiable features of the neovascular membranes were studied on en face projection images, which were taken at different stages of the follow-up. ResultsTreatment response could be estimated using the OCT-A criteria of CNV activity. Higher activity scores before treatment resulted in a greater decrease in the membrane area. The estimated net decline in area ranged from 83.5% to 1.4%. The OCT-A performed one-week after treatment revealed the greatest area reductions. ConclusionsOCT-A provides new possibilities for the non-invasive assessment of features of neovascular networks and CNV structural morphology. Newly described activity criteria can also guide therapeutic decisions, and help in evaluating responses. Quantitative and qualitative information can be provided with this technique. However, further software development and future investigation are essential to define the role of this tool on a daily basis.

Pathologic Impact of Insulin Resistance and Sensitivity on the Severity of Liver Histopathology in Pediatric Non-Alcoholic Steatohepatitis.

PurposeInsulin resistance (IR) has an important role in the development of non-alcoholic steatohepatitis (NASH). We aimed to analyze the association between liver histopathology and IR in pediatric patients with NASH.Materials and MethodsIn 24 children with non-alcoholic fatty liver disease (NAFLD), we investigated whether the hepatic pathologic characteristics have relations with following three biochemical indices; IR index including homeostasis model assessment of IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and insulin sensitivity indices-free fatty acid (ISI-FFA).ResultsAmong 24 patients, 16 (66.6%) had a high NAFLD activity score (NAS), which is diagnostic of NASH. Higher serum triglyceride level was significantly correlated with a high NAS. Higher steatosis grades were significantly associated with low insulin sensitivity (p=0.023). In addition, severe lobular inflammation was associated with higher IR: HOMA-IR (p=0.014) and QUICKI (p=0.023). Severe fibrosis correlated with low insulin sensitivity and high IR indexes: ISI-FFA (p=0.049), HOMA-IR (p=0.028), and QUICKI (p=0.007).ConclusionPatients with high IR had more severe lobular inflammation and hepatic fibrosis. Analyses of biochemical and endocrine parameters can be applied to determine the severity of the hepatic pathologic status in patients with NASH, especially in children who cannot undergo a liver biopsy.

UCBT Using Myeloablative Conditioning Regimen without ATG Has Similar Survival but Better Life Quality Compared with Upbsct for Adults with Primary Acute Leukemia-a Multicenter Study in China

ObjectiveData regarding the outcome of unrelated cord-blood transplantation (UCBT) with myeloablative conditioning regimen without ATG comparing with unrelated peripheral blood stem cell transplantation (UPBSCT) for adults with primary acute leukemia.MethodsFrom Jan 2010 to Dec 2014, 175 consecutive adult patients with primary acute leukemia (AL), who had no HLA-compatible related donors who were eligible for a single UCBT (79 patients) or UPBSCT (96 patients). The two groups all received a TBI/CY2 and BU/CY2 based myeloablative conditioning regimen which plus fludarabine (FLU), etoposide (VP-16) or cytarabine (Ara-c). The GVHD prophylaxis regimens of UCBT were cyclosporine A (CsA) and mycophenolate mofetil (MMF) and UPBSCT were CsA, Methotrexate (MTX) and antithymocyte globulin (ATG).ResultsThere was no significant difference for the patients characteristics between the UCBT and UPBSCT group except for UCBT patients were younger. Although the UCBT patients received lower doses of nucleated and CD34 positive cells and more patients were HLA mismatched, the two groups acquired the similar percentage of hematopoiesis engraftment rate (97.4% vs 100%, p=0.497) but the granulocyte and platelet recovery was slower in UCBT group. The incidence of bacterial or invasive fungal infection in the UCBT group and the UPBSCT group had no significant difference (46.8% vs 52.6%, P=0.572) may be attributed to the omission of ATG in UCBT group. TRM by three years was 21.0% and 16.9% in the UCBT and UPBSCT cohorts (P=0.46). The 3-year cumulative incidence of relapse was similar between the UCBT group and the UPBSCT group (26.3% vs 27.1%, P=0.75). The grade II to IV acute graft-versus-host disease (aGVHD) and severe aGVHD (grades III and IV) incidence was similar between the two groups (24.7% vs 33.0%, P=0.40), (13.3% vs 8.7%, P=0.28)]. Compared with the UPBSCT cohort, the UCBT cohort had a significantly lower rate of chronic graft-versus-host disease (cGVHD) (20.7% vs 44.0%, p=0.003) or extensive cGVHD (5.6% versus 17.5%, P=0.04). The overall survival (63.2% vs 64.1%, P=0.996) and leukemia free survival (57.5% vs 59.8%, P=0.824) had no significant difference between the two groups. The performance status observed in patients surviving 3 years was measured using the Karnofsky performance score. The UCBT recipients had obviously higher activity scores than UPBSCT recipients (94.5% vs 83.5%, p=0.03).ConclusionWhen use intensive myeloablative conditioning regimen without ATG, UCBT can reach similar survival with UPBSCT and may have better life quality. Primary acute leukemia patients who lack an HLA-matched sibling donor can select UCBT or the UPBSCT of equal status. DisclosuresNo relevant conflicts of interest to declare.

Correlates of Patient Activation and Acute Care Utilization Among Multimorbid Patients.

Patient activation and self-management have been associated with improved patient outcomes, including decreased re-hospitalization; however, little research has identified factors that predict patient activation in the multimorbid hospitalized patient. This descriptive correlational study included 200 patients with three or more chronic diseases discharged to home post-hospitalization. Standard multiple regression was used to identify correlates of patient activation. Multimorbid patients with lower activation scores had more acute care utilization (re-hospitalization and emergency department visits) 30 days post-discharge than patients with higher activation scores. Predictors of patient activation were health literacy (p = .013), satisfaction with social role (p = .014), and involvement in chronic illness care (p = .001). Care transition programs focusing on health literacy, role satisfaction, and promoting patient-centered care may improve patient outcomes for multimorbid patients.

Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation

PurposeCrohn’s disease is a type of inflammatory bowel disease affecting estimated 4 million people worldwide. Therapy stratification of Crohn’s disease (CD) is mainly based on the inflammatory activity being assessed by endoscopic biopsy and clinical criteria. Cross-sectional imaging allows for the assessment of structural characteristics of the entire gastrointestinal tract including small bowel loops and may provide potential non-invasive image-based biomarkers for the inflammatory activity of CD. The aim of this study was to explore the predictive value of Computed Tomography-based morphologic patterns for inflammatory activity in CD. Material and methods42 patients diagnosed with CD were included in a retrospective study (13 male, 29 female, median age 32 years). Abdominal CT imaging was carried out on symptomatic patients at a single institution 0–10 days prior to endoscopic biopsy or surgery using a protocol optimized for the characterization of structural bowel alterations. Image data were initially reviewed independently by three radiologists and discrepancies were settled in consensus with a focus on mesenteric fat stranding and combing, mesenteric adenopathy, mesenteric abscess, intraperitoneal free fluid, fistula, skip lesions, highest wall thickness and the localization of the affected bowel. The extent of inflammatory activity in the bowel wall was determined subsequently by histological analysis. ResultsAll intestinal and extraintestinal CT findings except the mesenteric comb sign showed a tendency towards higher extent or prevalence in patients with high histological inflammatory activity score, especially median bowel wall thickness (6.0mm vs. 3.5mm), mesenteric abscesses (32% vs. 0%) and mesenteric adenopathy (94% vs. 45%). Spearman rank order correlation coefficient indicated a significant correlation of bowel wall thickness (r=0.40, p<0.05), mesenteric adenopathy (r=0.54, p<0.05), mesenteric abscess (r=0.33, p<0.05) and mesenteric fat stranding (r=0.33, p<0.05) with the histological inflammatory activity score. ConclusionCT-based biomarkers including wall thickness, mesenteric fat stranding, mesenteric lymphadenopathy and mesenteric abscess positively correlated with the histological inflammatory activity score and therefore provided additional information for therapy stratification in symptomatic patients with CD, particularly as most of these biomarkers are hidden from endoscopy.

Higher Preoperative Patient Activation Associated With Better Patient-reported Outcomes After Total Joint Arthroplasty.

Despite widely reported success associated with hip and knee replacements, some patients remain dissatisfied with their outcomes. Patient activation, an individual's propensity to engage in adaptive health behaviors, has been measured as a potentially important factor contributing to health outcomes, cost, and patient experience of care. However, to our knowledge, it has not been studied in patients undergoing total joint arthroplasties (TJAs). We wanted to determine whether patients with higher activation scores would experience (1) greater resolution of pain and improved activity, (2) greater improvements in postoperative physical and mental health, and (3) greater patient satisfaction after primary THA or TKA. We approached 174 patients and enrolled 135 who were undergoing primary THA or TKA at one of two hospitals between January 2013 and May 2014. Patient Activation Measure (PAM) scores were obtained preoperatively and patient-reported outcomes were assessed and completed for 125 patients pre- and postoperatively at the 6- or 12-month visit. We assessed pain and activity with the Hip Disability and Osteoarthritis Outcome Score (HOOS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and University of California Los Angeles (UCLA) activity scores. We measured physical and mental health by calculating SF12v2® scores and measured patient satisfaction with the Hip and Knee Satisfaction Scale (HKSS). Linear regression models were used to test the association between baseline PAM and postoperative patient-reported outcomes. Overall, patients with a higher baseline PAM score experienced better pain relief using the HOOS/KOOS pain scores (R2=0.311, p=0.048) and symptoms using the HOOS/KOOS symptom scores (R2=0.272, p=0.021). In addition, higher PAM scores were associated with better postoperative mental health using the SF12v2® (R2=0.057, p<0.001), but were not associated with higher physical health (R2=0.176, p=0.173). Finally, higher PAM scores were associated with having greater postoperative satisfaction after surgery using the HKSS questionnaire (R2=0.048, p=0.023). Higher preoperative patient activation was associated with better pain relief, decreased symptoms, improved mental health, and greater satisfaction after TJA. Future efforts should be aimed at studying if improving patient activation before surgery results in better patient-reported outcomes after elective THA or TKA. Level II, prognostic study.

IL-17, IL-6 and IFN-γ in Systemic Sclerosis Patients.

Systemic sclerosis (Ssc) is an autoimmune disease characterized by cutaneous and visceral fibrosis and its pathogenesis is incompletely understood. T helper cells are key regulators of the immune response and they seem to be involved in Ssc clinical manifestations. The aim of the study is to determine key cytokines secreted by Th1 (IFN-γ), Th2 (IL-6) and Th17 (IL-17) in Ssc patients and correlate them with specific manifestations of Ssc patients. 35 consecutive Ssc patients and 20 age and sex matched controls were recruited. Serum IL-17, IFN-γ and IL-6 were determined using ELISA method. Serum IL-17 and IL-6 levels were not significantly different in Ssc patients and controls. Serum IFN-γ levels were higher in Ssc patients when compared to controls. Higher serum IFN-γ levels associated with pulmonary hypertension. After adjusting for gender and age, IL-17 levels remained independently associated with some clinical manifestations of Ssc patients (telangiectasia and high activity score of Ssc). Th17 and Th1 cell responses are active in Ssc patients as their cytokines associated with higher disease activity scores and pulmonary manifestations. Th17 and Th1 specific activity and homing within Ssc patients still needs to be defined and determined in order to target them as potential future therapeutic targets in Ssc patients.

Nailfold videocapillaroscopy micro-haemorrhage and giant capillary counting as an accurate approach for a steady state definition of disease activity in systemic sclerosis.

IntroductionNailfold videocapillaroscopy (NVC) in systemic sclerosis (SSc) is a procedure commonly used for patient classification and subsetting, but not to define disease activity (DA). This study aimed to evaluate whether the number of micro-haemorrhages (MHE), micro-thrombosis (MT), giant capillaries (GC), and normal/dilated capillaries (Cs) in NVC could predict DA in SSc.MethodsEight-finger NVC was performed in 107 patients with SSc, and the total number of MHE/MT, GC, and the mean number of Cs were counted and defined as number of micro-haemorrhages (NEMO), GC and Cs scores, respectively. The European Scleroderma Study Group (ESSG) index constituted the gold standard for DA assessment, and scores ≥3.5 and =3 were considered indicative of high and moderate activity, respectively.ResultsNEMO and GC scores were positively correlated with ESSG index (R = 0.65, P <0.0001, and R = 0.47, P <0.0001, respectively), whilst Cs score showed a negative correlation with that DA index (R = −0.30, P <0.001). The area under the curve (AUC) of receiver operating characteristic plots, obtained by NEMO score sensitivity and specificity values in classifying patients with ESSG index ≥3.5, was significantly higher than the corresponding AUC derived from either GC or Cs scores (P <0.03 and P <0.0006, respectively). A modified score, defined by the presence of a given number of MHE/MT and GC, had a good performance in classifying active patients (ESSG index ≥3, sensitivity 95.1%, specificity 84.8%, accuracy 88.7%).ConclusionsMHE/MT and GC appear to be good indicators of DA in SSc, and enhances the role of NVC as an easy technique to identify active patients.

Validation of the French version of two on high-activity knee questionnaires

IntroductionSelf-administered quality-of-life questionnaires are valuable evaluation tools in orthopedic surgery. The conventional questionnaires are limited by a substantial ceiling effect. We wished to validate a French translation of two English questionnaires for high-activity patients: the High-Activity Arthroplasty Score (HAAS) and the Activity Scale for Arthroplasty Patients (ASAP). One hundred patients operated on for knee replacement were selected. The answers to both questionnaires were analyzed and compared to the Oxford Knee Score (OKS) and to the scoring system of the American Knee Society (AKS). HypothesisThere is no correlation between the results of both high-activity questionnaires and of the two conventional scoring systems. ResultsAll questions were easily understood. The mean scores of the HAAS and ASAP questionnaires were 8.2±3.0 and 30.7±9.6, respectively. The distributions were not considered normal. There was no floor effect, but there was a limited ceiling effect (0% and 14%, respectively). The internal coherence of both questionnaires was satisfactory. There was a significant correlation between the high-activity scores and the conventional scores. DiscussionBoth high-activity questionnaires in our French translation can potentially measure the overall function of a patient after knee replacement as accurately as the index English version. It is self-administered, easy to use, can collect patients’ answers by postage mailing, and involves no ceiling effect. All these points should allow its routine use for evaluation after knee replacement. The HAAS evaluation seems to be superior to the ASAP evaluation. Level of evidenceCase-control study, level III.

Association between self-reported physical activity and indicators of body composition in Malaysian adolescents

BackgroundObesity and lack of physical activity are fast becoming a concern among Malaysian adolescents. ObjectiveThis study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat. Subjects and methods1361 school-going 13year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012. Results10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI. ConclusionThis study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.

Revealing pharmacodynamics of medicinal plants using in silico approach: A case study with wet lab validation

BackgroundExploration of therapeutic mechanism is an integral part of medicinal plant based drug discovery for better understanding of pharmacological behavior of these agents. But, its study using conventional hit and trial wet laboratory experiments proves to be very tedious, time consuming and expensive, thus encouraging development of in silico techniques. Hence, an in silico technique has been devised using a computer software Prediction of Activity Spectra for Substances (PASS) to study pharmacodynamics of medicinal plants. The technique has been presented with a case study using Ficus religiosa L. (Moraceae) in which its anticonvulsant mechanism has been elucidated with PASS and further validated experimentally. MethodsPentylenetetrazol (PTZ)-induced convulsion test was used to study the anticonvulsant effect of standardized bark extract of F. religiosa. Thereafter, structure of all the reported bioactive metabolites in the bark was subjected to PASS software to obtain biological activity spectrum of each compound. The mechanism signifying anticonvulsant effect was selected from the spectrum and was further validated using in vitro test. Results and discussionThe extract showed significant anticonvulsant effect in PTZ test. PASS analysis showed a high activity score for GABA aminotransferase (GABA-AT) inhibitory effect of the bioactive metabolites present in the bark. In vitro GABA-AT enzyme assay results were in concordance with the predicted mechanism by PASS for the observed anticonvulsant effect, as the extract showed potent inhibition of the enzyme. The results of present study showed the in silico technique to be useful for elucidation of unknown therapeutic mechanisms of medicinal plants.

Personality Variation in Little Brown Bats

Animal personality or temperament refers to individual differences in behaviour that are repeatable over time and across contexts. Personality has been linked to life-history traits, energetic traits and fitness, with implications for the evolution of behaviour. Personality has been quantified for a range of taxa (e.g., fish, songbirds, small mammals) but, so far, there has been little work on personality in bats, despite their diversity and potential as a model taxon for comparative studies. We used a novel environment test to quantify personality in little brown bats (Myotis lucifugus) and assess the short-term repeatability of a range of behaviours. We tested the hypothesis that development influences values of personality traits and predicted that trait values associated with activity would increase between newly volant, pre-weaning young-of-the-year (YOY) and more mature, self-sufficient YOY. We identified personality dimensions that were consistent with past studies of other taxa and found that these traits were repeatable over a 24-hour period. Consistent with our prediction, older YOY captured at a fall swarming site prior to hibernation had higher activity scores than younger YOY bats captured at a maternity colony, suggesting that personality traits vary as development progresses in YOY bats. Thus, we found evidence of short-term consistency of personality within individuals but with the potential for temporal flexibility of traits, depending on age.

Periprosthetic bone mineral density after total hip arthroplasty with an AMIStem or Quadra femoral component performed by a minimally invasive anterior approach (AMIS): a prospective randomized clinical dual-energy X-ray absorptiometry study

This prospective 12 months of dual-energy X-ray absorptiometry (DEXA) study evaluated differences in periprosthetic bone mineral density in 40 patients undergoing cementless total hip arthroplasty (THA) by a minimally invasive anterior approach (AMIS), using Medacta AMIStem or Quadra stems. Both stems are straight rectangular. AMIStem shows reduced lateral flare and length in comparison to Quadra. The main goal of the study is to verify if bone mineral density is equivalent following THA with the AMIStem and Quadra femoral components. Forty patients were randomly allocated to the Quadra and AMIStem groups. Three patients were lost to follow-up because they moved to another town, and revision surgery was performed on one patient due to periprosthetic fracture after a car accident. Patients were examined clinically and underwent DEXA preoperatively and at 1 week, 6 weeks, 6 months, and 1 year after THA. Patients enrolled had no preexisting lower limb arthroplasty and no osteoporosis. Harris hip score increased significantly for Quadra stem 5.3 ± 14.1 and AMIStem 41.0 ± 13.4. The high-activity hip score increased significantly for Quadra stem 3.8 ±2.2 and AMIStem 4.1 ± 2.4. Considering 0.15 mg/cm2 as an acceptable difference, bone mineral density for AMIStem and Quadra groups was statistically equivalent. A limited remodeling process with slight bone loss in the proximal calcar region R7, as expected after implantation of uncemented components, was observed for both stems. The study demonstrates that the two stems are statistically equivalent in all zones at all time points investigated.

AB0618 Comparison of mycophenolate mofetil and intravenous cyclophosphamide as induction therapy in korean patients with lupus nephritis

ObjectivesAlthough intravenous cyclophosphamide (IVC) pulses are generally accepted as standard therapy for induction treatment of active proliferative lupus nephritis (LN), several clinical trials have suggested that mycophenolate mofetil (MMF) is...

The proteolytic activity of selected lactic acid bacteria in fermenting cow's and camel's milk and the resultant sensory characteristics of the products

The aim of this study was to evaluate the proteolytic activities of 14 strains of lactic acid bacteria and their impact on sensory characteristics of the resultant fermented cow and camel milk. The results showed that Lactobacillus rhamnosus PTCC 1637 and Lactobacillus fermentum PTCC 1638 had high protease activity and high mean values for sensory quality in fermented cow's and camel's milk. Lactobacillus plantarum PTCC 1058 revealed high protease activity and sensory scores in camel milk. Consequently, milk fermentation using such strains might be recommended for the development of dairy products containing bioactive peptides.

Seizures in systemic sclerosis

The aim of this study was to evaluate the frequency of seizures in systemic sclerosis (SSc) and to determine the clinical and laboratory features associated with their occurrence. Thirty-four SSc patients (ACR criteria) were analyzed by a standard interview, physical examination, and review of medical charts. Risk factors for seizures, clinical manifestations, associated co-morbidities and current treatment were evaluated. We identified 3 (8.8 %) SSc patients with seizures. A higher median age [61 (35-64) vs. 48 (27-71) years, p = 0.0005] and higher activity score [4.75 (4.5-5.0) vs. 2.5 (0-5-5) years, p = 0.006] were observed in SSc patients with seizures. No other clinical or laboratory feature was associated with the occurrence of seizure in this cohort. This study demonstrated a higher prevalence of seizures in SSc when compared to general population. Seizures were associated with older age and higher activity score in this cohort.

Risk factors for burns at home in Kurdish preschool children: a case-control study

BackgroundIt is globally reported that young children are at a higher risk of burns but little is known about the individual risk factors. This study was undertaken in 2008 to...