1,721,163 research outputs found
Long-term outcome of epilepsy in patients with Prader-Willi syndrome.
Full text linkPrader-Willi syndrome is a multisystemic genetic disorder that can be associated with epilepsy. There is insufficient information concerning the clinical and electroencephalographic characteristics of epilepsy and the long-term outcome of these patients. The aim of this study is to describe seizure types, electroencephalographic patterns and long-term seizure outcome in Prader-Willi syndrome patients suffering from epilepsy. We retrospectively studied 38 patients with Prader-Willi syndrome and seizures. Results of neuroimaging studies were obtained for 35 individuals. We subdivided these patients into two groups: group A, 24 patients, without brain lesions; and group B, 11 patients, with brain abnormalities. All patients were re-evaluated after a period of at least 10 years. Twenty-one patients (55.2 %) were affected by generalized epilepsy and 17 patients (44.8 %) presented focal epilepsy. The most common seizure type was generalized tonic-clonic seizure. The mean age at seizure onset was 4.5 years (ranged from 1 month to 14 years). In the follow-up period, seizure freedom was achieved in 32 patients (84.2 %). Seizure freedom was associated with electroencephalographic normalization, while the six children presenting drug-resistant epilepsy showed persistence of electroencephalographic abnormalities. Group B patients showed a higher prevalence of drug-resistant epilepsy. Patients with Prader-Willi syndrome were frequently affected by generalized seizures. Most of the patients had a favorable evolution, although, patients with brain abnormalities presented a worse outcome, suggesting that the presence of these lesions can influence the response to antiepileptic therapy
Role of higher dietary carbohydrate intake in cataract development
No full textWe read with great interest the article by Chiu et al., who examined the cross-sectional associations between total carbohydrate intake, dietary glycemic index (dGI), and the risk of cortical and nuclear cataracts. The main result is that the highest quartiles of carbohydrate intake correspond with a 2.13-fold risk of developing cortical cataract. There are some points in the paper that should to be clarified, to avoid the false perception that a higher dietary carbohydrate intake, per se, is responsible for cataract development.
Although experimental evidence has suggested an association between nutrition and lens opacities, a defined role for dietary differences and cataract formation has not yet been ascertained. For example, a dietary deficiency of antioxidants and reactive oxygen scavengers may be involved in the pathogenesis of the idiopathic human senile cataract, as well as in some experimental cataracts and in cataracts in developing countries. On the contrary, studies performed in subjects living in industrialized countries have failed to demonstrate significant differences in the blood levels of nutrients or metabolites between cataractous and controls subjects.
The same is true of high carbohydrate intake. Normal persons exposed to the highest carbohydrate intake do not develop diabetes or diabetes complication, such as cataract, since the blood glucose test results (A1C test, fasting plasma glucose test, and/or oral glucose tolerance test [OGTT]) remain within the normal range. The situation is different in diabetic patients and in patients with reduced tolerance to glucose. Before developing type 2 diabetes, individuals are in a disease stage called prediabetes, in which blood glucose levels are higher than normal, but are not yet high enough to be diagnosed as diabetic. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during the prediabetes period, which is characterized by impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Both IFG and IGT exhibit elevated glucose levels that are not sufficient to be classified as diabetes, but that represent the development of insulin resistance. Achieving glycemic control in patients with prediabetes through lifestyle and pharmacologic interventions can effectively prevent or delay the development of diabetes and its associated complications (cataract.
The prevalence of prediabetes in adults aged ≥18 years varies by age, sex, and race/ethnicity, and there is a considerable discordance between the indicators used to measure the risk. The first step, however, is to identify patients at risk. Although patients can be identified with an OGTT or a fasting plasma glucose (FPG) screening, a normal FPG does not preclude an elevated OGTT and, therefore, the presence of prediabetes. Thus, the risk of developing prediabetes is always underestimated.
In the study by Chiu et al., the problem related to the prediabetes status was not considered at all, although they declared that “diabetes is a strong confounder of the associations that were of interest to us.” In fact, they looked only at a prior diagnosis of diabetes, which was responsible for the exclusion of only 121 (4.66%) diabetic persons of 2594 participants. Ravikumar et al., in a recently published cross-sectional study on the prevalence and risk factors of diabetes in a community-based study in North India, found that the prevalence of diabetes was 15.7% (95% CI, 13.9–16.9) with a similar percentage for prediabetes (15.4%; 95% CI, 14.3–17.1). On the other hand, Twigg et al., in a study performed in Australian adults to evaluate the presence of impaired fasting glucose/glycemia and/or impaired glucose tolerance, found that prediabetes affected approximately 16.4% of their recruited subjects. This percentage would significantly affect the results reported by Chiu et al.
In conclusion, we believe that carbohydrate intake, per se, is not responsible for cataract development in normal individuals. The situation is different in the presence of reduced glucose tolerance. Thus, rather than to glucose intake, the relationship should be made to prediabetes status, which accounted for a percentage higher than diabetes itself in the Australian population
“Love Can’t Be Taken to the Hospital. If It Were Possible, It Would Be Better”: Patients’ Experiences of Being Cared for in an Intensive Care Unit
No full textIn this study, we aimed to explore the experiences of being cared for in an intensive care unit (ICU) through patients’ memories. We adopted a convergent parallel mixed-method design. We interviewed 100 patients shortly after their ICU discharge. Content analysis revealed 14 categories and 49 codes grouped according to themes corresponding to ICU Memory tool core components (factual events, feelings, delusions). The most critical patients reported mostly fragmented or delusional memories, the less critically-ill more factual memories. All experiences were recounted with strong feelings. ICU was identified as a hostile, stressful environment. Positive experiences were mainly associated with a sense of safety promoted by the nurses. Negative experiences were related to privacy and dignity violations, lack of empathy, not being understood, delays/lack of obtaining support, and total control by the health care staff. Removing any avoidable sources of stress and ensuring personalized, dignified care represent a key aim for ICU interprofessional teams
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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