951 resultados para weight at 8 months


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Background: Brachial plexus birth palsy (BPBP) most often occurs as a result of foetal-maternal disproportion. The C5 and C6 nerve roots of the brachial plexus are most frequently affected. In contrast, roots from the C7 to Th1 that result in total injury together with C5 and C6 injury, are affected in fewer than half of the patients. BPBP was first described by Smellie in 1764. Erb published his classical description of the injury in 1874 and his name became linked with the paralysis that is associated with upper root injury. Since then, early results of brachial plexus surgery have been reasonably well documented. However, from a clinical point of view not all primary results are maintained and there is also a need for later follow-up results. In addition most of the studies that are published emanate from highly specialized clinics and no nation wide epidemiological reports are available. One of the plexus injuries is the avulsion type, in which the nerve root or roots are ruptured at the neural cord. It has been speculated whether this might cause injury to the whole neural system or whether shoulder asymmetry and upper limb inequality results in postural deformities of the spine. Alternatively, avulsion could manifest as other signs and symptoms of the whole musculoskeletal system. In addition, there is no available information covering activities of daily living after obstetric brachial plexus surgery. Patients and methods: This was a population-based cross-sectional study on all patients who had undergone brachial plexus surgery with at least 5 years of follow-up. An incidence of 3.05/1000 for BPBP was obtained from the registers for this study period. A total of 1706 BPBP patients needing hospital treatment out of 1 717 057 newborns were registered in Finland between 1971 and 1997 inclusive. Of these BPBP patients, 124 (7.3%) underwent brachial plexus surgery at a mean age of 2.8 months (range: 0.4―13.2 months). Surgery was most often performed by direct neuroraphy after neuroma resection (53%). Depending on the phase of the study, 105 to 112 patients (85-90%) participated in a clinical and radiological follow-up assessment. The mean follow up time exceeded 13 years (range: 5.0―31.5 years). Functional status of the upper extremity was evaluated using Mallet, Gilbert and Raimondi scales. Isometric strength of the upper limb, sensation of the hand and stereognosis were evaluated for both the affected and unaffected sides then the differences and their ratios were calculated and recorded. In addition to the upper extremity, assessment of the spine and lower extremities were performed. Activities of daily living (ADL), participation in normal physical activities, and the use of physiotherapy and occupational therapy were recorded in a questionnaire. Results: The unaffected limb functioned as the dominant hand in all, except four patients. The mean length of the affected upper limb was 6 cm (range: 1-13.5 cm) shorter in 106 (95%) patients. Shoulder function was recorded as a mean Mallet score of 3 (range: 2―4) which was moderate. Both elbow function and hand function were good. The mean Gilbert elbow scale value was 3 (range: -1―5) and the mean Raimondi hand scale was 4 (range:1―5). One-third of the patients experienced pain in the affected limb including all those patients (n=9) who had clavicular non-union resulting from surgery. A total of 61 patients (57%) had an active shoulder external rotation of less than 0° and an active elbow extension deficiency was noted in 82 patients (77%) giving a mean of 26° (range: 5°―80°). In all, expect two patients, shoulder external rotation strength at a mean ratio 35% (range: 0―83%) and in all patients elbow flexion strength at a mean ratio of 41% (range: 0―79%) were impaired compared to the unaffected side. According to radiographs, incongruence of the glenohumeral joint was noted in 15 (16%) patients, whereas incongruence of the radiohumeral joint was found in 20 (21%) patients. Fine sensation was normal for 34/49 (69%) patients with C5-6 injury, for 15/31 (48%) with C5-7 and for only 8/25 (32%) of patients with total injury. Loss of protective sensation or absent sensation was noted in some palmar areas of the hand for 12/105 patients (11%). Normal stereognosis was recorded for 88/105 patients (84%). No significant inequalities in leg length were found and the incidence of structural scoliosis (1.7%) did not differ from that of the reference population. Nearly half of the patients (43%) had asynchronous motion of the upper limbs during gait, which was associated with impaired upper limb function. Data obtained from the completed questionnaires indicated that two thirds (63%) of the patients were satisfied with the functional outcome of the affected hand although one third of all patients needed help with ADL. Only a few patients were unable to participate in physical activities such as: bicycling, cross-country skiing or swimming. However, 71% of the patients reported problems related to the affected upper limb, such as muscle weakness and/or joint stiffness during the aforementioned activities. Incongruity of the radiohumeral joints, extent of the injury, avulsion type injury, age less than three months of age at the time of plexus surgery and inexperience of the surgeon was related to poor results as determined by multivariate analyses. Conclusions: Most of the patients had persistent sequelae, especially of shoulder function. Almost all measurements for the total injury group were poorer compared with those of the C5-6 type injury group. Most of the patients had asymmetry of the shoulder region and a shorter affected upper limb, which is a probable reason for having an abnormal gait. However, BPBP did not have an effect on normal growth of the lower extremities or the spine. Although, participation in physical activities was similar to that of the normal population, two-thirds of the patients reported problems. One-third of the patients needed help with ADL. During the period covered by this study, 7.3% BPBP of patients that needed hospital treatment had a brachial plexus operation, which amounts to fewer than 10 operations per year in Finland. It seems that better results of obstetric plexus surgery and more careful follow-up including opportunities for late reconstructive procedures will be expected, if the treatment is solely concentrated on by a few specialised teams.

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Background: This multicentre, open-label, randomized, controlled phase II study evaluated cilengitide in combination with cetuximab and platinum-based chemotherapy, compared with cetuximab and chemotherapy alone, as first-line treatment of patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods: Patients were randomized 1:1:1 to receive cetuximab plus platinum-based chemotherapy alone (control), or combined with cilengitide 2000 mg 1×/week i.v. (CIL-once) or 2×/week i.v. (CIL-twice). A protocol amendment limited enrolment to patients with epidermal growth factor receptor (EGFR) histoscore ≥200 and closed the CIL-twice arm for practical feasibility issues. Primary end point was progression-free survival (PFS; independent read); secondary end points included overall survival (OS), safety, and biomarker analyses. A comparison between the CIL-once and control arms is reported, both for the total cohorts, as well as for patients with EGFR histoscore ≥200. Results: There were 85 patients in the CIL-once group and 84 in the control group. The PFS (independent read) was 6.2 versus 5.0 months for CIL-once versus control [hazard ratio (HR) 0.72; P = 0.085]; for patients with EGFR histoscore ≥200, PFS was 6.8 versus 5.6 months, respectively (HR 0.57; P = 0.0446). Median OS was 13.6 for CIL-once versus 9.7 months for control (HR 0.81; P = 0.265). In patients with EGFR ≥200, OS was 13.2 versus 11.8 months, respectively (HR 0.95; P = 0.855). No major differences in adverse events between CIL-once and control were reported; nausea (59% versus 56%, respectively) and neutropenia (54% versus 46%, respectively) were the most frequent. There was no increased incidence of thromboembolic events or haemorrhage in cilengitide-treated patients. αvβ3 and αvβ5 expression was neither a predictive nor a prognostic indicator. Conclusions: The addition of cilengitide to cetuximab/chemotherapy indicated potential clinical activity, with a trend for PFS difference in the independent-read analysis. However, the observed inconsistencies across end points suggest additional investigations are required to substantiate a potential role of other integrin inhibitors in NSCLC treatment.

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Shrimp are among the more common causes of immediate hypersensitivity reactions to food. To characterize better the allergenic substances within shrimp, extracts from heated shrimp were systematically examined with solid-phase radioimmunoassay and sera from patients clinically sensitive to shrimp. Two heat-stable protein allergens, designated as Sa-I and Sa-II, were identified from boiled shrimp (Penaeus indicus) extracts. Sa-I was isolated by ultrafiltration, Sephadex G-25, and diethylaminoethyl-Sephacel chromatography, whereas Sa-II, the major allergen, was purified by successive chromatography on diethylaminoethyl-Sephacel, Bio-Gel P-200, and Sepharose 4B columns. Sa-I, which was homogeneous by polyacrylamide gel electrophoresis (PAGE), elicited a single band on sodium dodecyl sulfate-PAGE corresponding to a molecular weight of 8.2 kd. Sa-II was also found to be homogeneous by PAGE, crossed immunoelectrophoresis, and immunoblotting. On sodium dodecyl sulfate-PAGE, it elicited a single band with a molecular weight of 34 kd. Sa-II was found to contain 301 amino acid residues and was particularly rich in glutamate/glutamine and aspartate/asparagine. Solid-phase radioimmunoassay-inhibition studies revealed that Sa-I and Sa-II share 54% of the allergenic epitopes, suggesting that Sa-I may be a fragment of Sa-II.SDS-PAGE, Sodium dodecyl sulfate-polyacrylamide gel electrophoresis; MW, Molecular weight; BSA, Bovine serum albumin; DEAE, Diethylaminoethyl; SPRIA, Solid-phase radioimmunoassay; CIE, Crossed immunoelectrophoresis .

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Strength and stiffness properties of municipal solid waste (MSW) are important in landfill design. This paper presents the results of comprehensive testing of shear strength properties of mechanically biologically treated municipal solid waste (MBT-MSW) in laboratory. Changes in shear strength of MSW as a function of unit weight and particle size were investigated by performing laboratory studies on the MSW collected from Mavallipura landfill site in Bangalore. Direct shear tests, small scale and large scale consolidated undrained and drained triaxial tests were conducted on reconstituted compost reject MSW samples. The triaxial test results showed that the MSW samples exhibited a strain-hardening behaviour and the strength of MSW increased with increase in unit weight. Consolidated drained tests showed that the mobilized shear strength of the MSW increased by 40% for a unit weight increase from 7.3 kN/m(3) to 10.3 kN/m(3) at 20% strain levels. The mobilized cohesion and friction angle ranged from 5 to 9 kPa and 8 degrees to 33 degrees corresponding to a strain level of 20%. The consolidated undrained tests exhibited reduced friction angle values compared to the consolidated drained tests. The friction angle increased with increase in the unit weight from 8 degrees to 55 degrees in the consolidated undrained tests. Minor variations were found in the cohesion values. Relationships for strength and stiffness of MSW in terms of strength and stiffness ratios are developed and discussed. The stiffness ratio and the strength ratio of MSW were found to be 10 and 0.43. (c) 2015 Elsevier Ltd. All rights reserved.

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Background: Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive genetic disease characterized by the lack of reaction to noxious stimuli and anhidrosis. It is caused by mutations in the NTRK1 gene, which encodes the high affinity tyrosine kinase receptor I for Neurotrophic Growth Factor (NGF). -- Case Presentation: We present the case of a female patient diagnosed with CIPA at the age of 8 months. The patient is currently 6 years old and her psychomotor development conforms to her age (RMN, SPECT and psychological study are in the range of normality). PCR amplification of DNA, followed by direct sequencing, was used to investigate the presence of NTRK1 gene mutations. Reverse transcriptase (RT)-PCR amplification of RNA, followed by cloning and sequencing of isolated RT-PCR products was used to characterize the effect of the mutations on NTRK1 mRNA splicing. The clinical diagnosis of CIPA was confirmed by the detection of two splice-site mutations in NTRK1, revealing that the patient was a compound heterozygote at this gene. One of these alterations, c.574+1G > A, is located at the splice donor site of intron 5. We also found a second mutation, c.2206-2 A > G, not previously reported in the literature, which is located at the splice acceptor site of intron 16. Each parent was confirmed to be a carrier for one of the mutations by DNA sequencing analysis. It has been proposed that the c.574+1G > A mutation would cause exon 5 skipping during NTRK1 mRNA splicing. We could confirm this prediction and, more importantly, we provide evidence that the novel c.2206-2A > G mutation also disrupts normal NTRK1 splicing, leading to the use of an alternative splice acceptor site within exon 17. As a consequence, this mutation would result in the production of a mutant NTRK1 protein with a seven aminoacid in-frame deletion in its tyrosine kinase domain. --Conclusions: We present the first description of a CIPA-associated NTRK1 mutation causing a short interstitial deletion in the tyrosine kinase domain of the receptor. The possible phenotypical implications of this mutation are discussed.

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Thirteen hundred and seventy-three striped bass, Marone saxatilis, were collected from the San Francisco Bay-Delta area to correlate host diet with parasitic infections and to determine the prevalence, intensity, longevity, and persistence of larval Anisakis sp. nematodes and the metacestode Lacistorhynchus tenuis. There is an increase in the prevalence and intensity of Anisakis sp. and in the intensity of L. tenuis with increase of age of the host. These increases are probably related to the diet and the persistence of tbe parasites. The infections of both species are overdispersed. San Francisco Bay striped bass are an incompatible host for both species of parasites. Degenerated Anisakis sp. will remain in lhe host for at least 8 months and L. tenuis metacestodes for 22 months. The occurrence of several other species of parasites and a tumor are also reported. (PDF file contains 10 pages.)

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During inflammation and infection, hematopoietic stem and progenitor cells (HSPCs) are stimulated to proliferate and differentiate into mature immune cells, especially of the myeloid lineage. MicroRNA-146a (miR-146a) is a critical negative regulator of inflammation. Deletion of the gene encoding miR-146a—expressed in all blood cell types—produces effects that appear as dysregulated inflammatory hematopoiesis, leading to a decline in the number and quality of hematopoietic stem cells (HSCs), excessive myeloproliferation, and, ultimately, to exhaustion of the HSCs and hematopoietic neoplasms. Six-week-old deleted mice are normal, with no effect on cell numbers, but by 4 months bone marrow hypercellularity can be seen, and by 8 months marrow exhaustion is becoming evident. The ability of HSCs to replenish the entire hematopoietic repertoire in a myelo-ablated mouse also declines precipitously as miR-146a-deficient mice age. In the absence of miR-146a, LPS-mediated serial inflammatory stimulation accelerates the effects of aging. This chronic inflammatory stress on HSCs in deleted mice involves a molecular axis consisting of upregulation of the signaling protein TRAF6 leading to excessive activity of the transcription factor NF-κB and overproduction of the cytokine IL-6. At the cellular level, transplant studies show that the defects are attributable to both an intrinsic problem in the miR-146a-deficient HSCs and extrinsic effects of miR-146a-deficient lymphocytes and non-hematopoietic cells. This study has identified a microRNA, miR-146a, to be a critical regulator of HSC homeostasis during chronic inflammatory challenge in mice and has provided a molecular connection between chronic inflammation and the development of bone marrow failure and myeloproliferative neoplasms. This may have implications for human hematopoietic malignancies, such as myelodysplastic syndrome, which frequently displays downregulated miR-146a expression.

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Enxertos ósseos homólogos congelados têm sido documentados apresentando bons resultados clínicos como substituto ao material autógeno nas reconstruções alveolares. Entretanto, dados referentes à incorporação e remodelação destes enxertos não estão disponíveis na literatura. Este estudo tem por objetivo determinar um período ótimo de espera para instalação de implantes em rebordos reconstruídos com enxertos ósseos homólogos em bloco no que se refere à incorporação e reabsorção. 24 pacientes foram submetidos à reconstrução alveolar óssea homóloga previamente à instalação de implantes. Os indivíduos foram alocados randomicamente em um de 3 grupos de acordo com o tempo de espera para o segundo estágio cirúrgico (4, 6 e 8 meses). Análises tomográficas, histológicas e histomorfométricas foram utilizadas a fim de determinar o grau de reabsorção e incorporação dos enxertos nos diferentes intervalos de tempo para cada grupo. Os dados de reabsorção sofrida pelos enxertos demonstraram diferenças estatisticamente significativas para os três intervalos de espera. Da mesma forma, parâmetros histomorfométricos como contagem de osteócitos e quantificação de remanescentes de osso homólogo nas biópsias apresentaram diferenças significativas entre os grupos. De acordo com os dados do presente trabalho, no que diz respeito à remodelação e incorporação, o período mais favorável à instalação dos implantes a curto prazo após recontruções com enxertos homólogos é de 4 meses.

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Medir a espessura da parede vesical (EPV) através da ultrassonografia, correlacioná-la com os parâmetros urodinâmicos e avaliar o papel destes parâmetros para lesão do trato urinário superior. Avaliar também o papel das alterações da forma da bexiga nos resultados de injeção de toxina botulínica tipo-A (BTX-A) no detrusor em pacientes com lesão medular traumática (LMT). Trata-se de dois estudos. O primeiro é um estudo transversal de 272 pacientes com LMT submetidos à ultrassonografia renal e de bexiga e estudo urodinâmico. A parede anterior da bexiga foi medida e comparada com os dados urodinâmicos. A cistografia foi realizada em 57 pacientes. O segundo foi um estudo prospectivo avaliando os resultados da injeção de BTX-A no detrusor em 27 pacientes considerando os achados urodinâmicos (pré e pós procedimento) e as deformidades da bexiga (cistografia). A média da EPV foi de 3,94 mm e foi estatisticamente maior em pacientes com hiperatividade detrusora neurogênica associada à dissinergia vesicoesfincteriana (HDN/DVE), em comparação com aqueles sem DVE (p<0,001). Essa média também foi maior em pacientes com complacência < 20 mL/cmH2O, comparada aos pacientes com complacência &#8805; 20 mL/cmH2O (p<0,001). A média da pressão detrusora máxima (Pdet Max) foi estatisticamente maior nos pacientes com refluxo vesicoureteral (RVU) em comparação com aqueles sem RVU (100,7 vs 61,2 cmH2O respectivamente, p=0,022). Pacientes com complacência < 20 mL/cmH2O apresentaram prevalência de hidronefrose 4,2 vezes maior, comparada aos pacientes com complacência &#8805; 20 mL/cmH2O. Não houve associação estatística entre EPV e hidronefrose ou RVU. Vinte e sete pacientes foram submetidos à injeção de BTX-A no detrusor. A média de tempo de continência urinária foi de 8 meses. Nove pacientes (33,3%) tinham forma vesical alterada e 8 casos (29,6%) tinham divertículos. A capacidade cistométrica máxima, Pdet max, volume reflexo e complacência não apresentaram diferença significativa na presença de divertículos ou alteração da forma. O aumento da EPV está associado à complacência < 20 mL/cmH2O e HDN/DVE em pacientes com LMT. No entanto, não houve relação entre a EPV e hidronefrose ou RVU. Baixa complacência e HDN/DVE são os principais fatores de risco para dano ao trato urinário superior. A presença de divertículos ou alteração da forma vesical não influenciou nos resultados após injeção de BTX-A no detrusor.

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NOAA’s National Centers for Coastal Ocean Science (NCCOS)-Center for Coastal Monitoring and Assessment’s (CCMA) Biogeography Branch, National Park Service (NPS), US Geological Survey, and the University of Hawaii used acoustic telemetry to quantify spatial patterns and habitat affinities of reef fishes around the island of St. John, US Virgin Islands. The objective of the study was to define the movements of reef fishes among habitats within and between the Virgin Islands Coral Reef National Monument (VICRNM), the Virgin Islands National Park (VIIS), and Territorial waters surrounding St. John. In order to better understand species’ habitat utilization patterns among management regimes, we deployed an array of hydroacoustic receivers and acoustically tagged reef fishes. Thirty six receivers were deployed in shallow near-shore bays and across the shelf to depths of approximately 30 m. One hundred eighty four individual fishes were tagged representing 19 species from 10 different families with VEMCO V9-2L-R64K transmitters. The array provides fish movement information at fine (e.g., day-night and 100s meters within a bay) to broad spatial and temporal scales (multiple years and 1000s meters across the shelf). The long term multi-year tracking project provides direct evidence of connectivity across habitat types in the seascape and among management units. An important finding for management was that a number of individuals moved among management units (VICRNM, VINP, Territorial waters) and several snapper moved from near-shore protected areas to offshore shelf-edge spawning aggregations. However, most individuals spent the majority of their time with VIIS and VICRNM, with only a few wide-ranging species moving outside the management units. Five species of snappers (Lutjanidae) accounted for 31% of all individuals tagged, followed by three species of grunts (Haemulidae) accounting for an additional 23% of the total. No other family had more than a single species represented in the study. Bluestripe grunt (Haemulon sciurus) comprised 22% of all individuals tagged, followed by lane snappers (Lutjanus synagris) at 21%, bar jack (Carangoides ruber) at 11%, and saucereye porgy (Calamus calamus) at 10%. The largest individual tagged was a 70 cm TL nurse shark (Ginglymostoma cirratum), followed by a 65 cm mutton snapper (Lutjanus analis), a 47 cm bar jack, and a 41 cm dog snapper (Lutjanus jocu). The smallest individuals tagged were a 19 cm blue tang (Acanthurus coeruleus) and a 19.2 cm doctorfish (Acanthurus chirurgus). Of the 40 bluestriped grunt acoustically tagged, 73% were detected on the receiver array. The average days at large (DAL) was 249 (just over 8 months), with one individual detected for 930 days (over two and a half years). Lane snapper were the next most abundant species tagged (N = 38) with 89% detected on the array. The average days at large (DAL) was 221 with one individual detected for 351 days. Seventy-one percent of the bar jacks (N = 21) were detected on the array with the average DALs at 47 days. All of the mutton snapper (N = 12) were detected on the array with an average DAL of 273 and the longest at 784. The average maximum distance travelled (MDT) was ca. 2 km with large variations among species. Grunts, snappers, jacks, and porgies showed the greatest movements. Among all individuals across species, there was a positive and significant correlation between size of individuals and MDT and between DAL and MDT.

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Minced fish prepared from the fillets of the sciaenid fish (Lutjanus sp.) was washed with cold water (<10 °C) three times. The washed muscle was pressed through a piece of fine cloth to a moisture content around 80%. The pressed cake (Surimi) was ground with 2.5% sodium chloride and 3% tapioca starch. The mixed material was shaped in the form of a cake and left for one hour for the gel to set. The cakes were then steamed. The cooled cakes were cut into pieces of 1 cm length x 1 cm width x 0.5 cm thick. The pieces were either dried in an electrical oven at 50°C or dried in sun to a moisture content of 11-12%. Biochemical, bacteriological and organoleptic evaluation revealed that the cakes were in very good acceptable form for 8 months. The cakes could be rehydrated by soaking in water at ambient temperature for half an hour and boiling in water for 10 minutes.

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A limno-biological investigation was conducted in Chanda beel over a period of 8 months from June ‘95 to January ‘96. The floodplain showed temporal spatial and vertical variation in physico-chemical as well as biological conditions. During study period, physico-chemical parameters were within the suitable range for fish culture. Plankton population was higher in true beel areas. Both phytoplankton and zooplankton showed direct relationship among themselves. Presence of several indication plankton genera showed that the floodplain was eutrophic in nature.

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A procedure has been worked out to (hot) smoke eel fillets. Some of the important factors such as size of the fillets, brining, pre-drying, source of smoke, smoking period, final drying have been studied. Best quality of smoked product is obtained on smoking eel fillets with a mixture of coconut-husk and sag saw-dust in 1:1 proportion for 15 hours. Optimum moisture level of the final product was fixed in the range of 30 to 35% and it had a storage life of about 8 months at room temperature.

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The results of two sets of experiments on mono-culture of grass carp (Ctenopharyngodon idella) and mixed culture of carps (grass carp 50 : catla 20 : rohu 15 : mrigal 15) fed exclusively with vegetable leaves are reported. The experiments were conducted with two replicates each in 0.02 ha ponds of Wastewater Aquaculture Division of the Central Institute of Freshwater Aquaculture, Rahara during 1991-93. Monoculture of grass carp stocked at 1000/ha demonstrated an average net production of 21.0 kg/ 0.02 ha/8 months (1501 kg/ha/yr). Mixed culture of carps stocked at 5000 /ha recorded an average net production of 22.5 kg/0.02 ha/8 months (1903.7 kg/ha/yr). Field studies revealed that water bind weed (Ipomoea aquatica) is the most preferred feed of grass carp amongst vegetable leaves followed by amaranths (Amaranthus gangeticus and Amaranthus viridis), cauliflower (Brassica oleracia var. votrytis) and cabbage (Brassica oleracia var. capitata) leaves. Through selection of highly productive leaf vegetables and suitable crop planning on fallow fish pond dykes, round the year feeding programme of grass carp has been explored. Recycling of sewage effluent for vegetable production and utilisation of vegetable leaves for fish production is considered an ideal way of integrated resource management for low cost production.

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The present study was initiated in conjunction with a project to utilize some of these small tanks as fishponds by introducing desirable species like Tilapia mossambica Peters and harvesting them at the end of a single season which may vary from 4-8 months depending on the reservoir. Two reservoirs Timbirigaswewa and Dalukanawewa were chosen for this study. Both of these are in the Polonnaruwa area (Fig. 1). Timbirigaswewa (Fig 4) is as all rain fed tank of about 30 acres while Dalukanawewa (Fig. 2) is stream fed with an acreage of just over 100.