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Sample records for 5-year retrospective review

  1. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    Power, Sarah, E-mail: sarahpower28@yahoo.co.uk; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  2. Insertion of balloon retained gastrostomy buttons: a 5-year retrospective review of 260 patients.

    Power, Sarah

    2013-04-01

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review.

  3. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

    Fadzillah Mohd-Tahir; Norhayati, A.; Ishak Siti-Raihan; Ibrahim, M.

    2012-01-01

    Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospit...

  4. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

    Fadzillah Mohd-Tahir

    2012-01-01

    Full Text Available Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27% were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41% cases of positive isolates. Of these, in eleven cases (23.40% patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34% cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future.

  5. A 5-year retrospective review of fungal keratitis at hospital universiti sains malaysia.

    Mohd-Tahir, Fadzillah; Norhayati, A; Siti-Raihan, Ishak; Ibrahim, M

    2012-01-01

    Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27%) were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41%) cases of positive isolates. Of these, in eleven cases (23.40%) patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34%) cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future. PMID:23304138

  6. Suicidal Drug Overdoses in New Mexico: A 5-year Retrospective Review.

    Szymanski, Linda J; Aurelius, Michelle B; Szymanski, Sarah A; Lathrop, Sarah L

    2016-05-01

    To better understand the changing toxicology trends in suicidal drug overdoses in the setting of an increased national trend of multidrug overdoses, a retrospective review of electronic records from New Mexico's Office of the Medical Investigator database was performed between 2008 and 2012 to assess the drug type and current risk factors in suicide deaths. Information on demographics, circumstances, suicide risk factors, toxicology findings, and death certificates was collected and analyzed. Three hundred and forty-two suicide cases of suicide overdoses were identified. Decedents were predominantly female (61.8%). Scene investigation revealed risk factors including suicide ideation (47.4%), previous suicide attempts (38%), and suicide note (38%). Psychiatric illness was present in 72% of cases, with depression being the most common illness. Chronic pain was seen in 27.2% of cases. Most deaths were attributed to multiple drugs (76%). Utilizing the toxicology information will assist in creating public awareness and provide a framework to support targeted efforts to attempt to prevent future suicides. PMID:27122402

  7. Planned and unplanned complex suicides: a 5-year retrospective study.

    Racette, Stéphanie; Sauvageau, Anny

    2007-03-01

    The notion of planned and unplanned complex suicides first appeared in 1974 by Marcinkowski and, since then, no systematic study of complex suicides has been published in the English forensic literature. Here, the authors present a 5-year retrospective study of complex suicides. Nineteen complex suicides were reviewed: five unplanned and 14 planned, including the first case of an unplanned complex suicide in a woman. All cases were analyzed in terms of gender, age, methods of suicide, the presence of a suicide note, and past suicide attempts, and statistically compared with a 50-case sample of simple suicides. A further comparison was established with compiled data from the literature. Similarities were revealed regarding incidence of complex suicides, male gender predominance, and types of methods used. In contrast, results showed a higher average age for planned complex suicide victims. Finally, the authors discuss the application of the complex suicide definition. PMID:17316249

  8. A 5-year retrospective clinical study of the Dentium implants

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo; Shin, Sang-Wan

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), ...

  9. The role of scintigraphy and ultrasound in the imaging of neonatal hypothyroidism: 5-year retrospective review of single-centre experience

    Congenital hypothyroidism (CH), as indicated by an elevation of capillary thyroid-stimulating hormone (TSH) at newborn screening, is a preventable cause of mental retardation with varying aetiology; it can be transient or permanent. Radionuclide assessment is currently the gold standard for imaging CH. This study aimed to (i) review the different scintigraphic patterns and correlate them with TSH levels/patient outcomes, (ii) assess the role of sonography in neonates with apparent agenesis as indicated by scintigraphy and (iii) develop a diagnostic investigative algorithm. The technetium thyroid scans of 83 consecutive patients (49 females, average age 32 days) with CH scanned between 2005 and 2009 were retrospectively reviewed. Two nuclear medicine physicians blinded to the clinical details interpreted the scans in consensus. Scintigram appearances were categorised into five groups. Patients scintigraphically diagnosed with thyroid agenesis were evaluated with ultrasound. TSH values and scintigraphic and sonographic findings were correlated with patients' final diagnosis. Based on scintigraphy, 14, 13 and 19 patients out of 83 were assessed as having normal thyroid sites with normal, increased and decreased uptake, respectively. Twenty-two of 83 patients had no uptake, and 15 of 83 patients had ectopic uptake. Higher median TSH levels were seen in no-uptake and ectopic uptake subgroups. Eighteen of 22 patients with no uptake were evaluated with ultrasound. Three of the 18 patients had a normal thyroid gland, and three of 18 patients had a hypoplastic thyroid. Scintigram findings in patients with congenital hypothyroidism fall into five major categories, which have therapeutic implications (lifelong thyroxine in agenesis versus trial of stopping thyroxine in other subgroups). Sonographic demonstration of thyroid tissue in patients scintigraphically diagnosed with thyroid agenesis has major management implications.

  10. A Study on Mental Disorders: 5-year Retrospective Study

    Celine, Thalappillil Mathew; Antony, Jimmy

    2014-01-01

    Background: “Mental disorder” is the most common used term in the modern life and the main reason behind this may be the mechanical way of life or stress and strain among youth. Aim: To find the pattern of mental disorders of hospitalized patients in a medical college hospital from 1st April 2005 to 31st March 2010. Settings and Design: A retrospective study conducted among the patients admitted with mental disorders in a medical college hospital from 1st April 2005 to 31st March 2010. Materi...

  11. 75 FR 66724 - Endangered and Threatened Species; 5-Year Review

    2010-10-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... (NOAA), Commerce. ACTION: Notice of availability of a 5-year review for the U.S. Distinct Population... electronic message to Shelley.norton@noaa.gov . Electronic copies of the 5-year review are available...

  12. Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

    Grema Umar Sambo; Aminu Bakari; Musa Thomas Samdi; Garba Mohammed Mainasara; Joseph Yohanna; Abdullahi Musa Kirfi

    2015-01-01

    Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from Jul...

  13. PERIPARTUM HY STERECTOMY: A LIMITING FACTOR FOR PROCREATIVE POTENTIAL & SAFE - MOTHERHOOD: A 5 YEARS RETROSPECTIVE STUDY

    Agnes Vijaya

    2015-09-01

    Full Text Available BACKGROUND : The term hysterectomy means surgical removal of uterus it can be either along with cervix or adnexae through different routes. The most commonly performed major elective gynecological surgery. The term Peripartum hysterectomy is used when performed either mostly by emergency as a maternal life saving measure within 24 hours after vaginal or abdominal delivery or as electively when indicated. OBJECTIVE : To study the incidence of peripartum hysterectomy ; to analyze its causes, risk factors, complications and feto - maternal morbidity and mortality at newly established tertiary care teaching hospital. PLACE OF STUDY : Rajiv Gandhi Institute of Medical Sciences (RIMS, Kadapa, YSR district, Andhra Pradesh, South India. DESIGN AND DURATION : Retrospective study of 5 years period, Jan . ’2010 to Dec . ’2014. MATERIALS AND METHODS : 42 cases of peripartum hysterectomised patients medical records reviewed for characteristics of current pregnancy and delivery, indications for peripartum hysterectomy, operative and post - operative complications, maternal and perinatal outcome evaluated. RESULTS : 42 cases of peripartum hysterectomy identified out of 32398 total deliveries (1.3 in 1000. Among them 23 cases was Laparotomy for rupture uterus, Caesarean hysterectomy in 12 cases, followed by vaginal delivery in 6 cases and for chronic ectopic pregnancy with bilateral T.O. mass in 1 case (P2 L2 +Bil. T. with chronic ectopic for failed tubectomy. No Live Children in 9 cases & 1 Live Child in 19 cases were identified and 2 or more Live Children in 14 cases. CONCLUSIONS : The incidence of peripartum hysterectomy is similar to the data found in studies of other Asian countries. Most frequent indication being rupture uterus leading to high perinatal, maternal mortality and morbidity limiting the child bearing capacity (Procreative Potential. To reduce this high incidence of peripartum hysterectomy effective MCH services to be exercised at all the

  14. Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

    S. OZER

    2011-06-01

    Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

  15. Circumcision: a refined technique and 5 year review.

    S. C. Tucker; Cerqueiro, J.; Sterne, G.D.; Bracka, A.

    2001-01-01

    The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe w...

  16. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Masood Mohd; Yusof Norashikin; Hassan Mohamed Ibrahim; Jaafar Nasruddin

    2012-01-01

    Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health O...

  17. Metamemory prediction accuracy for simple prospective and retrospective memory tasks in 5-year-old children.

    Kvavilashvili, Lia; Ford, Ruth M

    2014-11-01

    It is well documented that young children greatly overestimate their performance on tests of retrospective memory (RM), but the current investigation is the first to examine children's prediction accuracy for prospective memory (PM). Three studies were conducted, each testing a different group of 5-year-olds. In Study 1 (N=46), participants were asked to predict their success in a simple event-based PM task (remembering to convey a message to a toy mole if they encountered a particular picture during a picture-naming activity). Before naming the pictures, children listened to either a reminder story or a neutral story. Results showed that children were highly accurate in their PM predictions (78% accuracy) and that the reminder story appeared to benefit PM only in children who predicted they would remember the PM response. In Study 2 (N=80), children showed high PM prediction accuracy (69%) regardless of whether the cue was specific or general and despite typical overoptimism regarding their performance on a 10-item RM task using item-by-item prediction. Study 3 (N=35) showed that children were prone to overestimate RM even when asked about their ability to recall a single item-the mole's unusual name. In light of these findings, we consider possible reasons for children's impressive PM prediction accuracy, including the potential involvement of future thinking in performance predictions and PM. PMID:24698432

  18. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    Kemal Özgür Demiralp

    2015-01-01

    Full Text Available Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P<0.05. Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P<0.05. Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials.

  19. Leprosy scenario at a tertiary level hospital in Delhi: A 5-year retrospective study

    Namrata Chhabra

    2015-01-01

    Full Text Available Background: Leprosy has been officially eliminated from India since December, 2005; still, there are districts and blocks reporting high prevalence indicating ongoing transmission. The present study aimed at determining the current clinical profile of leprosy from a tertiary level hospital in Delhi. Materials and Methods: A retrospective, record-based study was carried out on patients diagnosed and registered in the leprosy clinic of a tertiary level teaching hospital in East district of Delhi (April 2007 to March 2012. Data regarding demographic details, clinical features, treatment started and complications was analyzed. Results: A total of 849 patients were registered over a 5-year period, with M: F ratio of 2.3:1. 9.3% were children (ͳ14 years. 54.3% patients were immigrants from adjoining states. Multibacillary leprosy was the most common clinical type (86.9%. Borderline tuberculoid leprosy was the most frequent morphologic type, seen in 56.3% followed by borderline-borderline (1.5%, borderline lepromatous (24.9%, lepromatous leprosy (8.1%, pure neuritic (8.1%, histoid and indeterminate leprosy (0.5% each. 37.4% patients presented in reaction (Type I in 30.4% cases and Type II in 7% cases. WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases. Conclusion: Our study offers insight into the current status of the disease in an area of otherwise low prevalence. It is seen that despite statistical elimination, multibacillary disease, leprosy reactions and deformities are commonly seen as presenting manifestations, in contrast to national projected trends. Delhi′s unique demography with a high degree of migrant workers, presenting to our center (near border location could be a possible contributing factor towards these aberrations. It highlights the need for continuation of targeted leprosy control activities and active case detection.

  20. Specialist pediatric palliative care prescribing practices: A large 5-year retrospective audit

    Anuja Damani

    2016-01-01

    Full Text Available Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010-2014 to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%, and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription

  1. Outcomes and indications for intervention in non-operative management of paediatric liver trauma: A 5 year retrospective study

    Aim: To determine the applicability of accurate computed tomography (CT) evaluation and embolization as non-operative management for liver trauma in a paediatric population. Material and methods: A retrospective observational study of 37 children (mean age 10.5 years) with hepatic trauma (28 blunt, 9 penetrating) admitted to a trauma referral centre over a 5 year period. All patients were evaluated with CT and scored with an Association for the Surgery of Trauma score. Inpatient information was reviewed for demographics, associated injuries, modes of management, efficacy and complications of management, and outcome. Statistical analysis was performed. Results: There were seven contusions, two grade I, two grade II, nine grade III, and 17 grade IV liver lacerations. Only two patients (grade IV, penetrating) underwent surgery for the management of bowel perforation. All children had non-surgical treatment of their liver trauma: three cases (grade IV) had primary angiography due to CT evidence of active bleeding and embolization was performed in two of these. Seven patients (two grade III, five grade IV) had angiography during the follow-up for evidence of a complicating pseudoaneurysm and embolization was performed in six of them. Embolization was successful in all the children; one minor complication occurred (cholecystitis). Endoscopic retrograde cholangiopancreatography (ERCP) plus stenting was performed in two cases for a bile leak. All 37 children had a positive outcome. Conclusion: The present study demonstrates that non-operative management of hepatic trauma is applicable to children and may have a higher success rate than in adults

  2. A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

    Kiralj Aleksandar I

    2015-01-01

    Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF

  3. Confirmed adult dengue deaths in Singapore: 5-year multi-center retrospective study

    Narayanan Rajmohan L

    2011-05-01

    Full Text Available Abstract Background Dengue re-emerges in Singapore despite decades of effective vector control; the infection predominantly afflicts adults. Severe dengue not fulfilling dengue hemorrhagic fever (DHF criteria according to World Health Organization (WHO 1997 guideline was increasingly reported. A new WHO 2009 guideline emphasized warning signs and a wider range of severe dengue manifestations. We aim to evaluate the utility of these two guidelines in confirmed adult dengue fatalities. Methods We conducted a multi-center retrospective chart review of all confirmed adult dengue deaths in Singapore from 1 January 2004 to 31 December 2008. Results Of 28 adult dengue deaths, median age was 59 years. Male gender comprised 67.9% and co-morbidities existed in 75%. From illness onset, patients presented for admission at a median of 4 days and death occurred at a median of 12 days. Intensive care admission was required in 71.4%. Probable dengue was diagnosed in 32.1% by WHO 1997 criteria and 78.6% by WHO 2009. The earliest warning sign was persistent vomiting at a median of 1.5 days. Hematocrit change ≥20% concurrent with platelet count Conclusions In our adult fatal dengue cohort, WHO 2009 criteria had higher sensitivity in diagnosing probable dengue and severe dengue compared with WHO 1997. As warning signs, persistent vomiting occurred early and hematocrit change ≥20% concurrent with platelet count

  4. Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: a 5-year review.

    O'Sullivan, S S

    2012-02-03

    OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91\\/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.

  5. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    Kemal Özgür Demiralp; Nihat Akbulut; Sebnem Kursun; Didem Argun; Nilsun Bagis; Kaan Orhan

    2015-01-01

    Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (

  6. A 5-year Review of Malaria Surveillance in Kuching, Sarawak

    Kamaliah, MD; Haironi, Y and Kamaliah MD

    2010-01-01

    Malaria is endemic in Sarawak contributing to the highest incidence rate in Malaysia. Kuching division consists of three main areas, namely Kuching district, Lundu and Bau. This review aims to highlight the trends of malaria over the past five years in terms of demographic characteristics and vector control programmes and to identify factors that contribute to the difficulty in malaria control programme in this state. Materials and Methods: This is a descriptive review of malaria cases based...

  7. Implementation of cerebral microdialysis at a community-based hospital: A 5-year retrospective analysis

    Chen, Jeff W; Rogers, Shana L.; Gombart, Zoe J.; Adler, David E.; Cecil, Sandy

    2012-01-01

    Background: Cerebral microdialysis (MD) provides valuable information about brain metabolism under normal and pathologic conditions. The CMA 600 microdialysis analyzer received US Food and Drug Administration (FDA) approval for clinical use in the United States in 2005. Since then, cerebral MD has been increasingly utilized nationally in the multimodal monitoring of traumatic brain injury (TBI), stroke, aneurysmal subarachnoid hemorrhage, and brain tumors. We describe a 5-year, single-institu...

  8. Find out more about CERN's 5-yearly review

    HR Department

    2015-01-01

    Everything you have ever wanted to know about the Organization’s five-yearly review and how it impacts each and every one of us.   For the past two years, the mammoth task of the Organization’s five-yearly review has been under way, developing clear measures and proposals aimed at creating a positive and socially progressive work environment for all CERN contributors. At the end of November, the proposed measures received strong support from all delegates at the Tripartite Employment Conditions Forum (TREF) and they will be tabled for recommendation and approval at the Finance Committee and Council on 16 and 17 December. Preparation for the implementation of these measures is in full swing and detailed information will be made available in the admin e-guide and on the HR website as soon as all details are finalised. How does this affect each and every one of us at CERN? What are the implications? To answer your questions, the annual HR public meeting, to be held on 11 February 20...

  9. Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

    Grema Umar Sambo

    2015-01-01

    Full Text Available Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from July, 2009 to July, 2014. Results: There were 1067 patients who had ear, nose, and throat surgeries within the period under review, out of which 68 were ear surgeries. Prevalence was 6.37%, there were 25 (37% males and 43 (63% females, male: female 1:1.7. Age ranged from 1 to 58 years, mean age 21 ± 6 years. Chronic suppurative otitis media was the most common diagnosis 39 (57.4% and indication for tympanoplasty 31 (46.6%. Meatocanaloplasty was the least with 2 (2.9%, mastoidectomy 7 (10.3%, myringotomy and grommet insertion 11 (16.2%, excisional biopsy 7 (10.3%, foreign body removal 4 (5.90%, tympanomastoidectomy 3 (4.40%, and pinnaplasty 3 (4.40%. Forty-one (60.3% achieved resolution of symptoms while 8 (11.8% had persistence of symptoms. One (1.5% had revision surgery. The success rate is about 60.3% within the period under review. Postoperative complications (facial nerve paralysis, persistence discharge from the mastoid cavity, worsened deafness, postauricular fistula were seen in 14 (20.6%. While 4 (5.9% were lost to follow-up. Conclusion: Ear surgeries are still underdeveloped when compared to nose and throat surgeries in our center. Complication (chronic suppurative otitis media was the most common indication for ear surgery. Provision of adequate training facilities, especially in the field of otology and review of the training curriculum for otorhinolaryngology residency in Nigeria is indispensable.

  10. A study of mandibular fractures over a 5-year period of time: A retrospective study

    Ashish Vyas

    2014-01-01

    Full Text Available Objective: This study aims to evaluate and compare with the existing literature on the etiology, pattern, gender, and anatomical distribution of mandibular fractures. Materials and Methods: The data of 225 cases were analyzed over a period of 5 years between March 2009 and November 2013. Of this 110 were unilateral, 23 bilateral, 18 symphysis and 74 multiple fractures. Results: Males are more affected than females.The peak incidence rate is occurring in 30-35 years of age group. The most common fracture site is parasymphysis and least common site is ramus of mandible. The most common etiological factor is road traffic accident (RTA (45.3% followed by falls (42.6%, assaults (8.9%, sport injuries (2.2%, and gunshot wounds (0.89%. Conclusion: Thus, we conclude that RTA is the leading cause of mandibular fractures and males are more affected. The most common site is parasymphysis fracture in association with angle fracture. We observed that gender was significantly associated with body and angle fracture (P = 0.04 and significant relationship between etiology with multiple site fracture such as (parasymphysis-angle, (body-condyle, (body-angle, and (symphysis-condyle was observed (P ≤ 0.05.

  11. The South American Land Data Assimilation System (SALDAS) 5-Year Retrospective Atmospheric Forcing Datasets

    deGoncalves, Luis Gustavo G.; Shuttleworth, William J.; Vila, Daniel; Larroza, Elaine; Bottino, Marcus J.; Herdies, Dirceu L.; Aravequia, Jose A.; De Mattos, Joao G. Z.; Toll, David L.; Rodell, Matthew; Houser, Paul

    2008-01-01

    The definition and derivation of a 5-year, 0.125deg, 3-hourly atmospheric forcing dataset for the South America continent is described which is appropriate for use in a Land Data Assimilation System and which, because of the limited surface observational networks available in this region, uses remotely sensed data merged with surface observations as the basis for the precipitation and downward shortwave radiation fields. The quality of this data set is evaluated against available surface observations. There are regional difference in the biases for all variables in the dataset, with biases in precipitation of the order 0-1 mm/day and RMSE of 5-15 mm/day, biases in surface solar radiation of the order 10 W/sq m and RMSE of 20 W/sq m, positive biases in temperature typically between 0 and 4 K, depending on region, and positive biases in specific humidity around 2-3 g/Kg in tropical regions and negative biases around 1-2 g/Kg further south.

  12. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Masood Mohd

    2012-11-01

    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  13. A DOUBLE-CENTER RETROSPECTIVE 5 YEARS SURVEY OF 385 CABG CASES COMPARING GENDER CHARACTERISTICS

    A. A. Karimi

    1999-06-01

    Full Text Available Coronary artery disease is one of the leading causes of morbidity and mortality especially in the indusirialzcd societies. This retrospective study was carried out on 385 patients who were referred to Shariati and Jamaran Hospitals from 1992 till 1997 and who underwent coronaty artery bypass grafting. The objective was to obtain a descriptive analysis of the important factors in this population and to draw a comparison betweent the two genders and to draw genders regarding these variables. The data were obtained from patients' files, angiography and operation notes; 82.9% of the study population were of male. The mean age of women was higher than men by 2.2years. The most common risk factors among the male gender were found to be smoking, hyperlipedemia, hypercholesterolemia and hypertension. Except for smoking which was omitted in women, all other risk factors showed a comparative low prevalence in this gender. Most patients (93.37% fell in group II and III of functional class as per NYHA classification and the most frequent signs and symptoms on admission being chest pain (81.5% and dyspnea (11.2%. The affected vessels in order of frequency were the left anterior descending, the right coronary and the circumflex arteries respectively. The average number of grafts utilized were 3 in the entire population. Overall mortality recorded was 2.1%.

  14. A RETROSPECTIVE 5 YEAR STUDY OF PPTCT PROGRAMME AT TERTIARY CARE CENTRE

    Saritha

    2015-06-01

    Full Text Available BACKGROUND: Mother to child transmission of HIV is a major cause of paediatric HIV. MTCT prevention strategies include comprehensive antenatal, postnatal and paediatric health services, voluntary counselling and testing (VCT, antiretroviral prophylaxis; counselling and support for safe infant feeding and optimal obstetrical practices. OBJECTIVES: The present retrospective study is undertaken to evaluate the effectiveness of implementation of PPTCT Programme in a tertiary care hospital. METHODOLOGY: All pregnant women attending antenatal OP and labour room were counselled and tested for HIV. All positive patients were again counselled and ART therapy started. Spouses of all positive women counselled and tested. Modification of labour and delivery practices was followed . All the babies born to positive mothers received Nevirapine prophylaxis and babies were tested at 6, 12 and 18 months. Mothers were counselled regarding breast feeding and tubectomy was advised for all patients. RESULTS: A total number of 36113 antenatal women counselled and 97.90% of them gave consent for testing. Seropositivity in these women was 0.91%. Most of these patients were primi or second gravida, majority of them were young, belonging to age group of 20 - 24 yrs. 61.84% of spouses were found to b e seropositive. Most of these women (67.72% were delivered through vaginal route. LSCS was done for obstetric indication in 32.27% of cases. Majority of mothers opted for replacement feeding (78.96%. Seropositivity of babies born to these mothers was 3.0 7%.This has shown downward trend from 2010 to 2015. CONCLUSIONS: The PPTCT programme is effective and has reduced the rate of transmission from mother to child and with present triple drug therapy a further reduction is expected.

  15. 77 FR 5491 - Endangered and Threatened Species; Initiation of 5-Year Review for Sei Whales

    2012-02-03

    ...; Initiation of 5-Year Review for Sei Whales AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...; request for information. SUMMARY: NMFS announces a 5-year review of sei whales (Balaenoptera borealis... of any such information on sei whales that has become available since that has become available...

  16. Viral infections, prevalence and costs: A5-year, hospital based, retrospective observational study in shiraz, iran

    Many patients suffering from viral infections attend to health care centers. Data gathered from viral infections is limited to specific cases such as AIDS, viral hepatitis and Influenza. There is a significant lack of reliable documentation about other viral infections. In this study the prevalence and related costs of viral infections in hospitals of Shiraz University of Medical Sciences were reviewed. In this cross-sectional study the data were extracted from files of 1319 patients with viral infection admitted in two university hospitals during a five year period (1999-2004). The frequencies of different viral infections along with their demographic data were analyzed. The mean age of the patients was 29.24 with the range of 90 years. Hospitalization days were 8636 in 40 different wards in two hospitals. US$ 30.84 was the daily mean cost for each admitted patient. Viral meningitis was most frequent (14.2%) and 8.4% of patients died during hospitalization. This study confirms the necessity of expanding management programs for viral infections especially hepatitis B in youths in Iran. Unspecified viral infections cost much more than specified viral diseases. Viral infection costs can be reduced by finding more sensitive and specific diagnostic methods. (author)

  17. Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

    Zernikow Boris

    2012-05-01

    Full Text Available Abstract Background Prevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period. Methods Demographic variables, pain characteristics and psychometric measures were assessed at the first evaluation. Subgroup analysis for sex, age and pain location was conducted and multivariate logistic regression applied to identify parameters associated with extremely high impairment. Results The retrospective study consisted of 2249 children assessed at the first evaluation. Tension type headache (48%, migraine (43% and functional abdominal pain (11% were the most common diagnoses with a high rate of co-occurrence; 18% had some form of musculoskeletal pain disease. Irrespective of pain location, chronic pain disorder with somatic and psychological factors was diagnosed frequently (43%. 55% of the children suffered from more than one distinct pain diagnosis. Clinically significant depression and general anxiety scores were expressed by 24% and 19% of the patients, respectively. Girls over the age of 13 were more likely to seek tertiary treatment compared to boys. Nearly half of children suffered from daily or constant pain with a mean pain value of 6/10. Extremely high pain-related impairment, operationalized as a comprehensive measure of pain duration, frequency, intensity, pain-related school absence and disability, was associated with older age, multiple locations of pain, increased depression and prior hospital stays. 43% of the children taking analgesics had no indication for pharmacological treatment. Conclusion Children with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of

  18. Relationship between indication for tooth extraction and outcome of immediate implants: a retrospective study with 5 years of follow-up

    Tarazona Alvarez, Beatriz; Tarazona Álvarez, Pablo; Peñarrocha Oltra, David; Peñarrocha Diago, María

    2014-01-01

    Objectives: The aims of this retrospective study were to evaluate the survival rate of a series of immediate implants after 3 years of follow-up and to study the relationship between survival and indication for tooth extraction. Study Design: A retrospective study of patients treated with immediate implants between January 2003 and December 2008 was carried out. All patients receiving at least one post-extraction implant and a minimum follow-up of 5 years were included. Results: After 60 mont...

  19. A 5-year Review of Darning Technique of Inguinal Hernia Repair

    Olasehinde, Olalekan O; Adisa, Adewale O.; Elugwaraonu A Agbakwuru; Amarachukwu C Etonyeaku; Kolawole, Oladapo A; Arinze O Mosanya

    2015-01-01

    Context: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. Aims: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. Study Design: A descriptive retrospective study. Patients and Methods: Clinical records of all patients who had inguinal hernia repair using the Darning technique between Janu...

  20. A unique trend of murder-suicide in the Jamnagar region of Gujarat, India (a retrospective study of 5 years).

    Gupta, B D; Gambhir Singh, O

    2008-05-01

    Jamnagar region, Gujarat state, enjoys a relatively low incidence of homicide in India. In the 5 year period from 2000 to 2004, 8 mothers committed 13 murders involving 3 male and 10 female victims and in every case it was followed by suicide of the assailant mothers. During the study the annual incidence of murder-suicide was about 1.8 cases. All the assailants were mothers and the victims were their small children in the age group of 6 months to 7 years. Five incidents took place in rural areas and three in urban areas. It was prevalent only in low socio-economic families. Methods both for killing and suicide were either burning or drowning. All the mothers were legally married and living with the family. Family and family related matters were the main motives for killing. In one case there was history of depression of the mother due to her previous miscarriage. Alcohol consumption or drug abuse was not seen even in a single case. All cases fell in the altruistic category of filicide-suicide. PMID:18423359

  1. IRSN review 2011/2014. Openness to society - Review of actions, 5 years after the chart

    After having recalled the commitments defined by the Charter for Openness to Society adopted by the IRSN in 2009, this report proposes a review of undertaken and performed actions in terms of access to information, of openness to partnership (notably with local information commissions or CLIs, and also with other local actors), of influence of the openness on the Institute work orientation, and of internal culture of openness

  2. 77 FR 61573 - Endangered and Threatened Species; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley...

    2012-10-10

    ...; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley, Leatherback, and Hawksbill Sea Turtles AGENCY... reviews of Kemp's ridley (Lepidochelys kempii), olive ridley (Lepidochelys olivacea), leatherback... currently under active review. This notice announces our active review of the Kemp's ridley, olive...

  3. Clinical outcome of 215 transmucosal implants with a conical connection: a retrospective study after 5-year follow-up.

    Lopez, M A; Andreasi Bassi, M; Confalone, L; Gaudio, R M; Lombardo, L; Lauritano, D

    2016-01-01

    The purpose of this retrospective clinical study was to evaluate the survival rate (i.e. SVR – fixtures still in place at the end of the observation period) and success rate (i.e. SCR - bone resorption around implant neck) of an implant system characterized by cylindrical and tapered implants, both types of implant being equipped with a conical connection with an internal octagon (COC), both implant types having a 1.8 mm smooth neck, positioned above the bone crest level. A total of 65 subjects received 215 COCs between January 1996 and October 2011. All COCs were placed and restored by three experienced dental surgeons. The mean follow-up was 84±44 months. The patients involved in the study were both male (30) and female (35), of whom 30 were smokers (less than 20 cigarettes/day) and none was diabetic. The implants differed in terms of diameter and length, and were inserted both in the mandible (97) and in the maxilla (118). Sixty-seven implants were single tooth rehabilitations, and 148 prosthetic bridges. Fourteen had guided bone regeneration (GBR), and 10 were placed in post-extractive sites. Forty of the implants were provided with passing-screw abutments and 175 with full-screw abutments. The data were analyzed using descriptive statistics. None of the implants failed before prosthetic restoration, resulting in an SVR=100% after loading. The radiographic and clinical data revealed well-maintained, hard and soft tissue around the COCs, with an SCR=92.6%. Cox regression analyses did not detect any variables with statistical impact on the clinical outcome. In conclusion, Shiner XT implants are reliable tools for oral rehabilitation. PMID:27469549

  4. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    Di Lorenzo R

    2016-01-01

    Full Text Available Rosaria Di Lorenzo,1 Nina Cimino,2 Elena Di Pietro,3 Gabriella Pollutri,4 Vittoria Neviani,5 Paola Ferri2 1Service of Psychiatric Diagnosis and Treatment, Department of Mental Health, AUSL Modena, Modena, 2School of Nursing, University of Modena and Reggio Emilia, 3School of Neuro-Psychiatry, 4School of Psychiatry, University of Modena and Reggio Emilia, 5 “The Medlar”, Villa Igea Hospital, Modena, Italy Background: Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods: This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT, and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18 who had acute hospitalizations (n=140 in SPDT and had been successively transferred to “The Medlar” (n=83, from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results: Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient -2.28, 95% confidence interval [CI]: -3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic

  5. 77 FR 16538 - Endangered and Threatened Species; Initiation of 5-Year Review for the North Atlantic Right Whale...

    2012-03-21

    ...; Initiation of 5-Year Review for the North Atlantic Right Whale and the North Pacific Right Whale AGENCY... review of North Atlantic right whale (Eubalaena glacialis) and North Pacific right whale (Eubalaena... of any such information on these whales that has become available since the last status review...

  6. A 5-year review of darning technique of inguinal hernia repair

    Olalekan O Olasehinde

    2015-01-01

    Full Text Available Context: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. Aims: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. Study Design: A descriptive retrospective study. Patients and Methods: Clinical records of all patients who had inguinal hernia repair using the Darning technique between January 2007 and December 2011 in our institution were obtained. Details of sociodemographic data, intraoperative findings and postoperative complications were reviewed. Statistical Analysis Used: simple frequencies, proportions and cross-tabulations. Results: A total of 132 patients whose ages ranged from 15 to 84 years (mean = 49.4 years with a male: female ratio of 12:1 were studied. Majority of the hernias were right sided (68.9%, mostly indirect (81.8%. The procedures were for emergencies in 17 (12.9% cases whereas the rest (87.1% were done electively. Most procedures, 110 (83.3% were performed under local anesthesia. Surgical site infection was the most common complication occurring in six patients (4.5%, while four patients (3% had chronic groin pain. At a mean follow-up period of 15 months there were two recurrences (1.5% both occurring in patients with bilateral hernias (P = 0.001. Conclusions: The Darning technique of inguinal hernia repair is a safe and effective method for inguinal hernia repair in our setting.

  7. 75 FR 53272 - Endangered and Threatened Species; Initiation of 5-Year Review of the Eastern Distinct Population...

    2010-08-31

    ... requesting information related to that review (75 FR 37385). A notice correcting the email address and fax number to which comments and information should be sent was published July 7, 2010 (75 FR 38979). Written... of 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY:...

  8. A retrospective study of 5-year outcomes of radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication therapy

    The favorable response rate of radiotherapy for localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication has been demonstrated. However, there are limited data available on the long-term outcomes. The aim of this retrospective study was to evaluate the long-term outcomes of radiotherapy for localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication. Thirty-four consecutive patients with localized gastric mucosa-associated lymphoid tissue lymphoma that were refractory to eradication were treated with radiotherapy (a total dose of 30 Gy). The response and adverse events of radiotherapy were retrospectively analyzed as short-term outcomes, and recurrence-free, overall and disease-specific survival rates were calculated as long-term outcomes. Thirty-three (97.1%) patients achieved complete remission and radiotherapy was well tolerated. One patient underwent emergency gastrectomy due to severe hematemesis. Of the 34 patients during the median follow-up period of 7.5 (1.2-13.0) years, one patient had local recurrence after 8.8 years, one patient underwent surgery for bowel obstruction secondary to small bowel metastasis after 5.1 years and one patient had pulmonary metastasis after 10.9 years. Pathologically, all three recurrences revealed mucosa-associated lymphoid tissue lymphoma without any transformation to high-grade lymphoma. None died of gastric mucosa-associated lymphoid tissue lymphoma. The 5-year recurrence-free survival rate was 97.0%. The 5-year overall survival rates and disease-specific survival rates were 97.0 and 100%, respectively. Radiotherapy in patients with localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication can achieve excellent overall survival. However, long-term surveillance is necessary to identify late recurrences. (author)

  9. Juvenile osteochondritis dissecans: a 5-year review of the natural history using clinical and MRI evaluation

    Although MRI prognostic features for juvenile osteochondritis dissecans (JOCD) have been determined, the natural history of JOCD on serial MRI has not been fully documented. To document the natural history of JOCD on serial MRI and to correlate this with arthroscopy and clinical outcome over a 5-year follow-up. Twenty-one knees in 19 patients (15 boys, 4 girls; age range 5-15 years) with JOCD underwent MRI and clinical follow-up over 5 years. Lesions were classified as stable or unstable on MRI and compared with clinical and arthroscopic data. On 5-year follow-up, 17 of 19 patients were asymptomatic and 2 of 19 had minimal pain. Fourteen arthroscopies were performed on 11/21 knees. One of twenty-one had fragment fixation. On initial MRI, eight knees had marked fragmentation, high signal at the fragment/bone interface and incomplete defects in the hyaline cartilage (MRI stage III-stable), but no tear. Of these, five had arthroscopy, all confirming intact cartilage. One of twenty-one knees was unstable (MRI stage IVb) with a detached osteochondral fragment, requiring surgery. Despite extensive subchondral bone changes on MRI, all cases with intact cartilage (95%) improved with conservative treatment. Early MRI allows prompt diagnosis and institution of conservative treatment. This results in healing and avoidance of surgery in most patients. (orig.)

  10. Foundation Trusts: A Retrospective Review

    Chris Bojke; Maria Goddard

    2010-01-01

    There is limited research evidence on foundation trusts (FTs) and much of the available material is in the form of commentary or the regular reports from Monitor. Comparative research is made difficult through lack of a counter-factual and robust methods are required to overcome bias. Summary points from the literature and from some initial analysis of Monitor reports that we have undertaken for this review are given below. Future policy and research issues are highlighted in the main report.

  11. 77 FR 13562 - Request for Comments on the 5-Year Review of NOAA's Policy on Partnerships in the Provision of...

    2012-03-07

    ... Administration publishes this notice to request comments on NOAA's Policy on Partnerships in the Provision of... National Oceanic and Atmospheric Administration Request for Comments on the 5-Year Review of NOAA's Policy...), National Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Notice...

  12. The retrospective analysis of a 5-year clinical application of ITI implants%ITI种植体5年临床应用回顾性分析

    黄勇

    2016-01-01

    Objective To retrospectively study a 5-year clinical application of ITI implants. Methods 379 ITI implants were im-planted in 216 patients. In a 6-month follow-up, the repair conditions were observed by X-ray and clinical examinations, evaluated by the Wheeler survival standard, and statistically analyzed by the life table method. Results Among the 11 failed implants,2 failed during the healing period and were considered as early failures. The survival rate was 96. 98%. Conclusion After 5 years, the sur-vival rate of the implant is higher when using ITI dental implant repair for the patients with dentition defects.%目的 回顾性研究ITI种植体5年来在我院的临床应用效果.方法 对216例患者植入ITI种植体379颗,修复完成后6个月复诊,观察方法 为X线检查和临床检查,采用Wheeler存留标准评估,用生存分析的寿命表法统计.结果 种植体失败11颗,其中2颗在愈合期内,累计存留率达96.98%.结论 采用ITI种植体对牙列缺失、牙列缺损患者进行修复治疗5年后,种植体存留率较高.

  13. [Research review on apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years].

    Song, Feng-Jun; Zhang, Hong; Zheng, Shi-Li; Fang, Jun-Hui; Liu, Hai-Fei

    2011-10-01

    The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index. PMID:22043698

  14. Pilocytic astrocytoma: a retrospective review

    Purpose: The principle objective of this study is to determine the role of radiation therapy in the management of pilocytic astrocytoma. The specific aims are to assess the results of surgical resection +/- radiation therapy, the dose-response relationships for local tumor control, and the prognostic indicators. Materials and methods: Between Jan. 1970 and Dec. 1995, 60 patients with pilocytic astrocytomas (27 cerebellum, 23 hypothalmus/brain stem, 4 temporal, 3 frontal, and 3 occipital) were seen. All pathologic slides were reviewed and confirmed. Of these, 30 patients had surgery only (8 subtotal resections and 22 total resections), 8 had biopsy followed by radiotherapy (6) or chemotherapy (2), 21 had surgery and postoperative radiotherapy (20 subtotal resections and 1 total resection) and 1 was observed only. The radiation dose was 40.6 Gy/31fr/44ds to 60.2 Gy/35fr/49ds (mean = 52.1 Gy). Results: The overall 5- and 10-year actuarial survival rate was 93% and 93%, and the relapse-free survival rate was 86% and 80%, respectively. Eight patients developed local recurrence and one had leptomeningeal spread. Two patients receiving chemotherapy (vincristine + carboplatin) had persistent but stable disease. The one patient who was observed eventually required surgical resection 25 months later. Subtotal resection without RT: The local recurrence rate was 38% ((3(8))) if no RT was given after subtotal resection. Only 2 of the 3 recurrences were salvaged. All 22 patients who had tumor totally resected had local tumor control. Subtotal resection/biopsy only plus RT: Radiation therapy was effective in controlling the gross disease in 75% ((15(20))) of patients with subtotal resection, and 100% ((6(6))) of patients with biopsy only. In 14 patients receiving a tumor dose ≥ 51 Gy, 13 (93%) had local control, in comparison, to (11(15)) (73%) receiving a tumor dose <51 Gy had tumor control. Location of tumor: Sixty-three percent ((17(27))) of patients with tumor in cerebellum

  15. Henoch schonlein purpura--a 5-year review and proposed pathway.

    Louise Watson

    Full Text Available Henoch Schonlein Purpura (HSP is the commonest systemic vasculitis of childhood typically presenting with a palpable purpuric rash and frequently involving the renal system. We are the first group to clinically assess, critically analyse and subsequently revise a nurse led monitoring pathway for this condition.A cohort of 102 children presenting with HSP to a secondary/tertiary level UK paediatric hospital over a five year period, were monitored using a nurse led care pathway. Using this cohort, the incidence (6.21 cases per 100,000 children per year and natural disease course of HSP nephritis (46% initial renal inflammation; 9% subsequent renal referral; 1% renal biopsy and immunosuppression was determined. Older patients were at higher risk of requiring a renal referral (renal referral 12.3 (8.4-13.5 years vs. normal outcome 6.0 (3.7-8.5 years; p<0.01. A normal urinalysis on day 7 had a 97% (confidence interval 90 to 99% negative predictive value in predicting a normal renal outcome.Using this data and existing literature base, The Alder Hey Henoch Schonlein Purpura Pathway was developed, a revised pathway for the screening of poor renal outcome in HSP. This is based on a six-month monitoring period for all patients presenting with HSP, which importantly prioritises patients according to the urine findings on day 7 and thus intensively monitors those at higher risk of developing nephritis. The pathway could be easily adapted for use in different settings and resources.The introduction of a standardised pathway for the monitoring of HSP will facilitate the implementation of disease registries to further our understanding of the condition and permit future clinical trials.

  16. A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

    Chisholm-Burns, Marie A.; Spivey, Christina; Martin, Jennifer R.; Wyles, Christina; Ehrman, Clara; Schlesselman, Lauren S.

    2012-01-01

    Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates.

  17. Review of patients treated by carcinoma INCA basal in the last 5 years

    Full text: Objective: To evaluate the results based on the different stages with different options therapeutic and evaluate the final dose in radiotherapy for the management of these patients. Methodology: We conducted a retrospective analysis of 66 patients treated HC Basal cell carcinoma between the period from January 1, 2007 and June 30, 2011. Results: For stages T1 and T2 treated with surgery alone, was quantified one relative frequency (fr)of SVLE 0.81 (31/39). For RT -treated patients, there were no in the sample for T1 and T2 was quantified one fr. SVLE of 1 (3/3) at doses > 60 Gy. For those with positive margins who received postoperative adjuvant RT quantified one fr. SVLE of 1 (8 /8) For patients with T3 disease surgery was performed more average dose radiotherapy 54.2 Gy. obtaining a fr. SVLE 0.5 (2/ 4). In patients with T4 disease with surgery more RT (2) non-responders complete. The dose delivered was in the range of 50 to 60 Gy. The other two did not complete treatment. Conclusions: For the early stages results are comparable both in surgery RT as exclusive. For those operated with positive margins benefit from radiation treatment adjuvant with a minimum dose of 60 Gy. In the later stages there is a benefit in most radiotherapy combination of surgery, dose can be delivered mayores.REVISIÓ

  18. Ectopic pregnancy: A 5 year review of cases at Nnamdi Azikiwe University Teaching Hospital (NAUTH Nnewi

    G O Udigwe

    2010-01-01

    Full Text Available Background: Ruptured ectopic pregnancy continues to be a common life threatening emergency in our environment as well as a public health problem. Objective:This is to study the incidence, clinical presentation, risk factors and the management of cases that presented in our centre over a five year period. Methods:This is a retrospective study of cases of ectopic gestations managed in the gynaecological unit of NAUTH Nnewi from January 1 st , 2002 to December 31 st , 2006. Information was obtained from the case notes, theatre and labour ward registers. Results: During the period, a total of 2,746 deliveries were recorded while 556 gynaecological patients were admitted. Thirty six patients had ectopic gestations accounting for 1.3% of all deliveries and 6.5% of all gynaecological admissions. The peak age group was 26-30 years (44.4%; 28(77.7% were married and 20 (55.6% attained secondary school as their highest level of education. All 36(100% of the patients were symptomatic at presentation. Abdominal pain, amenorrhoea and syncopal attack were the most common symptoms at presentation. Also, multiple sexual partners 27(75%, previous abortions 25(69.4% and previous sexually transmitted infections 10(27.8% were the most common risk factors present in the patients. Abdominal paracentesis 32(88.9%, ultrasound 8(22.2% and urine pregnancy tests 7(19.4% were most commonly utilized for diagnosis. None of the cases was diagnosed before rupture. Open abdominal surgery was the treatment employed in all the patients. Conclusion:Ectopic pregnancy is still a major challenge in gynaecological practice in our centre. Most cases present late making tubal conservation treatment inapplicable. This has far reaching implications in a society where there is high premium on child bearing.

  19. Light-footed clapper rail (Rallus longirostris levipes) 5-Year Review

    US Fish and Wildlife Service, Department of the Interior — The U.S. Fish and Wildlife Service Service is required by section 4c2 of the Endangered Species Act of 1973, as amended Act to conduct a review of each listed...

  20. COUNCIL DECISIONS ON THE 5-YEARLY REMUNERATION REVIEW, AJUSTMENTS FOR 2001 AND CHANGES TO THE STAFF RULES AND REGULATIONS

    Human Resources Division

    2001-01-01

    As announced by the Director-General in December last year, Council approved the package of measures concerning the 5-yearly remuneration review, recommended by the TREF Restricted Group, as well as the adjustments for 2001 related to salaries and pensions. These measures, as summarised below, enter into force on 1 January 2001, subject to later implementation of some items. Related changes to the Staff Rules and Regulations will be published as soon as possible in the mean time, changes which were annexed to the Council Resolution can be viewed on the HR Division Web site. 1. Scale of basic salaries (Annex R A 1 of the Staff Regulations) : increased by 4.32% resulting from the 5-yearly Review, and by 0.6% which corresponds to the salary adjustment for 2001. This includes the increases in social insurance contributions indicated below. 2. Scale of stipends of Fellows (Annex R A 2 of the Staff Regulations) : increased by 1.52% resulting from the 5-yearly Review, and by 0.6% which corresponds to the adjustment ...

  1. Congenital cystic lesions of lung in the paediatric population: A 5-year single institutional study with review of literature

    Shibsankar Barman

    2015-01-01

    Full Text Available Background: The aim was to evaluate the clinical presentation, investigation modalities, operative management, pathology, outcome (morbidity and mortality and short term follow-up of congenital cystic lesions of the lung. Materials and Methods: This is a retrospective study. Study period was 5 years (December 2008-November 2013 in the Department of paediatric surgery, Nil Ratan Sircar Medical College. Study population: Total number = 10 patients. Age range: 2 days-7 years. (Neonate-4. Male and female ratio = 1:1. Result: Among 10 cases of lung cyst four having congenital lobar emphysema, four having congenital pulmonary airway malformation, one sequestration and one teratoma. All patients have undergone surgical excision in terms of lobectomy or excision of the lesion. Post-operative histopathology confirmed the diagnosis. Recovery was uneventful. Conclusion: Although our experience is limited, operative management of lung cysts seems to be safe with rewarding results. However we are yet to encounter many of the other varieties of the cysts found in the lung, which may be associated with other congenital anomalies and have an impact on prognosis.

  2. PREVENTION OF PARENT TO CHILD TRANSMISSION OF HIV : A RETROSPECTIVE STUDY OF 5 YEARS IN A TERTIARY CENTRE , GUNTUR, SOUTH INDIA

    Potharaju

    2015-02-01

    Full Text Available OBJECTIVE: Mother to child transmission of HIV is a major route of HIV infection in children. The objective of this study is to analyze the response to implementation of PPTCT programme, the response of the spouses of the seropositive antenatal women to undergo HIV testing, mode of delivery and breast feeding practices adopted by the ser o positive postnatal women and the status of infants after delivery at 18 months. METHODS : This retrospective study was done in the Department Of Obstetrics and Gynecology, Guntur Medical College, Guntur, A.P, India and data collected from April 2009 to march 2014, a period of 5 years was studied. PPTCT centre was established in our institution in 2003. The practice in our institution is that all pregnant women attending the Antenatal clinic or Labour Room are counseled for HIV testing, and tested as per NACO guidelines. Babies born to HIV s e ropositive women are followed up to 18 months for confirmatory testing. RESULTS : The number of antenatal women counseled who opted for HIV testing were 99.4% and women who tested seropositive was 1.6 %, 1.3%, 0.9%, 0.84%, 0.6% for the years 2009 - 10, 10 - 11, 11 - 12, 12 - 13, 13 - 14 respectively showing a declining trend in the prevalence of HIV in antenatal women. 94.6% of women attended the post - test counseling . Spouses of ser o positive antenatal women who opted for testing was 52.5% and seropositivity in the spouses tested was 65.87% during the study period. Of the 767 seropositive women who delivered, 542(70.66% had vaginal delivery 225(29.33% had LSCS for obstetric indication. Of the 767 seropositive women who delivered 719(93.7% had live births, 28(3.65% had intrauterine fetal demise and 20(2.6% newborns died in the perinatal period. The number of seropositive women opting for exclusive replacement feeding was 54.4% during the study period April 2009 to March 2014. Confirmatory test for infants was done at 18 months and of the 136 infants tested, 14 were

  3. Iodine and Mental Development of Children 5 Years Old and Under: A Systematic Review and Meta-Analysis

    Grace S. Marquis

    2013-04-01

    Full Text Available Several reviews and meta-analyses have examined the effects of iodine on mental development. None focused on young children, so they were incomplete in summarizing the effects on this important age group. The current systematic review therefore examined the relationship between iodine and mental development of children 5 years old and under. A systematic review of articles using Medline (1980–November 2011 was carried out. We organized studies according to four designs: (1 randomized controlled trial with iodine supplementation of mothers; (2 non-randomized trial with iodine supplementation of mothers and/or infants; (3 prospective cohort study stratified by pregnant women’s iodine status; (4 prospective cohort study stratified by newborn iodine status. Average effect sizes for these four designs were 0.68 (2 RCT studies, 0.46 (8 non-RCT studies, 0.52 (9 cohort stratified by mothers’ iodine status, and 0.54 (4 cohort stratified by infants’ iodine status. This translates into 6.9 to 10.2 IQ points lower in iodine deficient children compared with iodine replete children. Thus, regardless of study design, iodine deficiency had a substantial impact on mental development. Methodological concerns included weak study designs, the omission of important confounders, small sample sizes, the lack of cluster analyses, and the lack of separate analyses of verbal and non-verbal subtests. Quantifying more precisely the contribution of iodine deficiency to delayed mental development in young children requires more well-designed randomized controlled trials, including ones on the role of iodized salt.

  4. Adolescent death: a 15-year retrospective review.

    Batalis, Nick I; Collins, Kim A

    2005-11-01

    Adolescents comprise an eclectic mix of people vitally important to society yet long-term comprehensive studies on the circumstances of their deaths are lacking in the pediatric forensic literature. The authors reviewed all forensic cases referred to the Medical University of South Carolina Forensic Pathology section over the fifteen years between January 1989 and December 2003. In accordance with the World Health Organization (WHO) definition of adolescents, only decedents 10-19 years of age were included. The authors examined the cause and manner of death, age, gender, and race of the victims in all cases. The toxicology results, perpetrator, death scenario and location, and victim traits were analyzed when available. For all adolescents, the most common manner of death was accident followed by homicide, suicide, natural, and undetermined. Within the adolescent population two distinct groups, 10-14 years old and 15-19 years old, were identified. Though both groups were similar in that they experienced a high number of accidental deaths, decedents of older age group suffered a higher percentage of violent deaths while decedents of the younger group were more likely to die of natural causes. Many of the accidental deaths in this review were preventable, including deaths due to motor vehicle collisions and drowning. In deaths due to homicide, the perpetrator was often known to the victim, whether as an acquaintance or family member. Toxicology testing was often positive in decedents of the older age group, while only rarely positive in decedents of the younger age group. With a solid understanding of the circumstances, it may be possible to predict, and hopefully prevent, future cases of adolescent death. The authors present their findings in this 15-year retrospective study to better aid forensic pathologists, death investigators, law enforcement, and epidemiologists. PMID:16382843

  5. Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population.

    Alicino, C; Giacobbe, D R; Durando, P; Bellina, D; DI Bella, A M; Paganino, C; Del Bono, V; Viscoli, C; Icardi, G; Orsi, A

    2016-09-01

    Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints were the development of severe CDI and 30-day mortality. The annual incidence of CDI/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ 2 for trend, P < 0·001). The median age of patients with CDI was 81 years. As many as 81% and 89% of these patients had comorbid conditions and previous exposure to antibiotics, respectively. In the multivariate analysis of risk factors for severe CDI, previous therapy with histamine 2 blockers and low serum albumin were associated with severe CDI, while diabetes appeared to be protective. In the multivariate model of risk factors for 30-day mortality, high leukocyte count, low serum albumin, and increased serum creatinine were unfavourably associated with outcome. Strict adherence to infection control measures was of utmost importance to counteract the increasing incidence of CDI in our hospital, particularly because of the advanced age of the patients and their very high frequency of chronic conditions and use of antibiotics, which readily predispose them to the development of CDI. PMID:27193828

  6. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

    Thamkhantho Manopchai

    2011-01-01

    Full Text Available Abstract Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+ among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times, and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count P = 0.043. There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

  7. Retrospective Cohort Study Comparing Neonatal Outcomes of Women Treated with Glyburide or Insulin in Gestational Diabetes: A 5-Year Experience in a South Indian Teaching Hospital

    Jiji Elizabeth Mathews

    2011-01-01

    Full Text Available Objective: To assess the effectiveness of glyburide in preventing complications of gestational diabetes in neonates as compared to insulin. Materials and Methods: Information from birth register, maternal and neonatal records were obtained. Five hundred and seventy-seven gestational diabetics with moderate hyperglycemia i.e., with highest fasting plasma glucose value of ≤130 mg/dl and/or highest post-prandial value of ≤250 mg/dl treated with insulin or glyburide were included from a cohort of 769 women needing additional therapy to initial diet therapy during a 5-year period. Thus neonatal outcomes of 303 women treated with insulin and 274 women treated with glyburide were compared. Results: Baseline plasma glucose levels in the group treated with insulin were higher. The mean birth weight (SD of the neonates in women treated with insulin was 3021.3 g (604.19 as compared to 3104.6 g (499.35, P = 0.07 in the group treated with glyburide. Neonatal outcomes such as hypoglycemia (4.9%, 3.6%, P = 0.44, hypocalcemia (1.3%, 0.7%, P = 0.48, polycythemia (1.7%, 0.7%, P = 0.31, macrosomia (11.6%, 8.7%, P = 0.26, congenital anomalies (2.1%, 2.3%, P = 0.87, birth trauma (1.4%, 1.2%, P = 0.79 were similar in both groups. Neonates of women treated with insulin were more likely to have hyperbilirubinemia (11.5%, 6.5%, P = 0.03. Conclusion: Neonatal outcomes of women treated with glyburide were comparable to those in women treated with insulin. More number of neonates of mothers treated with insulin had hyperbilirubinemia compared to neonates of mothers treated with glyburide (11.5%, 6.5% P = 0.03.

  8. RETROSPECTIVE AND PROSPECTIVE STUDY OF MANAGEMENT AND OUTCOME OF BLUNT ABDOMEN TRAUMA IN TERTIARY HEALTH CENTER IN LAST 5 - YEAR 2009 - 2014

    Raikwar

    2015-05-01

    Full Text Available AIMS: 1. To study the incidence of various intra - abdominal and extra - abdominal injuries in blunt abdominal trauma in tertiary health care center in five year (2009 - 14 . 2 . To study the relationship between mode of injury , severity of injury and clinical presentation and its outcome , mortality and morbidity. 3 . To study modalities for evaluating the abdomen after blunt abdominal trauma. 4 . To evaluate the major indication for operation in each cases . 5 . To study of outcome , mortality and morbidity . SETTINGS AND DESIGN: This study carried out in the Department of Surgery , MGM Medical College , M.Y. Hospital Indore and Trauma Department , M.Y. Hospital Indore both retrospectively and prospectively in patients with Blunt abdominal trauma over the period of from 2009 to 2014 with co - operation of the staff of Medicolegal section , Central record room and residents looking after the admitted pat ients. MATERIALS AND METHODS: On admission to hospital patient’s name , age , sex , address , registration number and date and time of admission , length of delay in treatment taken noted and mode of trauma also noted. Patient’s presenting complaint , detail his tory and time of trauma noted. RESULTS: During this study total 250 admission were included 170 ( P rospective and 80 ( R etrospective. There were over all 201 males (80.4% and 49 female (19.6%. Mortality was maximum due to RTA 64.52%. Highest number of ca ses (65 in the third decade i.e. 26%. Among these injuries hemoperitoneum was found in 94 cases i.e.37.6%. Small intestine (ileal>jejunal injury 45 cases i.e. , 18% was most common hollow viscous injury. In solid organ injury there was maximum incidence o f liver injury 34 cases. i.e. , 13.6% . CONCLUSION: This study concludes that young males are more prone to trauma and maximum blunt trauma is asso ciated with RTA. Almost half of patients required laparotomy and found injury to liver and small intestine in max cases. Overall

  9. Metaplastic carcinoma of the breast: A retrospective review

    Purpose: Metaplastic carcinoma of the breast represents a rare and heterogeneous group of malignancies that accounts for less than 1% of all breast cancers. The purpose of this study is to better characterize the clinical management of this disease including the role of radiation therapy after surgery. We compared patients that have been treated with either modified radical mastectomy (MRM) or breast-conserving surgery (BCS). Methods and Materials: We performed a retrospective review of 43 patients with metaplastic breast cancer who were evaluated in our regional radiation oncology department between 1987 and 2002. Twenty-one patients were treated with an MRM and 22 with BCS. Five patients from the MRM group received adjuvant radiation, as did 19 patients from the BCS group. Univariate and multivariate analysis of pathologic and treatment-related factors was performed. Local control, disease-free, and overall survival rates were calculated by the Kaplan-Meier method and compared for the two groups. Results: Mean follow-up for all patients was 44.2 months. Mean tumor size was 3.4 cm. Four patients (9%) had positive estrogen receptors and 20 (25%) had positive nodes. The overall 5-year projected local recurrence-free (88% vs. 85%, p = 0.86), disease-free (55% vs. 84%, p = 0.13), and overall survivals (80% vs. 89%, p = 0.58) were not significantly different for both groups. The only tumor parameter significantly associated with overall survival was nodal status. Conclusion: Our study suggests that breast conservation appears to be a reasonable treatment option for women with metaplastic breast cancer, achieving equal survival to mastectomy. The use of adjuvant radiation seems essential for achieving high local control rates after conservation therapy. Further studies will be needed to determine the impact of chemotherapy on survival outcomes

  10. Perennial nonallergic rhinitis: a retrospective review.

    Enberg, R N

    1989-12-01

    Forty-six of 152 consecutive adult rhinitis patients had perennial nonallergic rhinitis (PNR). Eighty-five percent of those with PNR presented with nasal congestion, whereas 15% presented with rhinorrhea. Their mean age was 40.5 years (range = 21-77), and 74% were female. Patients with perennial nonallergic rhinitis in this series were characterized by ocular pruritus or burning, 28%; frontal headache, 22%; symptoms consistent with asthma, 33%; an unremarkable nasal mucosa, 96%; the absence of nasal polyps, 100%; nasal eosinophilia (greater than or equal to 5%), 10%; nasal neutrophilia (greater than or equal to 25%), 22%; numerous nasal bacteria, 12%; sinusitis, 6%; and a geometric mean IgE of 26.4 U/mL. This experience suggests that PNR is a common problem in a general allergy practice. Nasal obstruction, usually more difficult to treat than rhinorrhea, is the dominant symptom. Unexpected findings were frequent conjunctivitis and nasal neutrophilia. PMID:2480728

  11. Erythema Nodosum Epidemiology: 5-Years Retrospective Study

    Arife Öz; Kenan Aydoğan; Şaduman Balaban Adım; Belçin İzol; Hayriye Sarıcaoğlu; Emel Bülbül Başkan; Şükran Tunalı

    2012-01-01

    Objective: Erythema nodosum (EN) is the most common type of septal panniculitis. Although triggering factors of EN are drugs, infections, malignancies, inflammatory diseases however disease is idiopathic in 32-72%. Factors are changing from region to region and from country to country. In this study, our aim was to investigate the etiologic factors and to evaluate the clinic and laboratory findings of EN. Methods: Sixty-six patients who were histopathologically diagnosed as EN in our depar...

  12. Erythema Nodosum Epidemiology: 5-Years Retrospective Study

    Arife Öz

    2012-09-01

    Full Text Available Objective: Erythema nodosum (EN is the most common type of septal panniculitis. Although triggering factors of EN are drugs, infections, malignancies, inflammatory diseases however disease is idiopathic in 32-72%. Factors are changing from region to region and from country to country. In this study, our aim was to investigate the etiologic factors and to evaluate the clinic and laboratory findings of EN. Methods: Sixty-six patients who were histopathologically diagnosed as EN in our department between 2005 and 2010 were included to this study. Demographic data and treatment were evaluated. Results: Fifty-two of 66 patients had underlying etiologic factors (Group 1 and 14 of were idiopatic (Group 2. Most common etiologic factor was Behçet’s disease (n=15, and followed by drug (n=13, sarcoidosis (n=10, upper respiratory tract infection (n=6, autoimmune disease (n=4, pregnancy (n=2, tuberculosis (n=2 in decreasing frequencies. In our study malignancy and inflammatory bowel disease are not appointed. Conclusion: Behcet’s disease is a rare cause of EN. In other studies in our country the idiopatic group was in majority. In our study because of finding the common etiologic factor as Behçet’s disease due to being of Behçet’s disease high prevalance (11-42/10000 in our country and existence of Behçet’s disease center in our faculty (Turk J Dermatol 2012; 6: 87-90

  13. 75 FR 18233 - Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews of 10 Southeastern Species

    2010-04-09

    ... review of three species that are currently listed as threatened: Gopher tortoise (Gopherus polyphemus... Office (phone 601/321-1127, e-mail daniel_drennen@fws.gov ). For the gopher tortoise, contact...

  14. Spectrum of central nervous system tumours-a single center histopathological review of 761 cases over 5 years

    The incidence of central nervous system (CNS) tumours has rapidly increased over the past few years. There is no accurate nationwide CNS tumour epidemiology in Pakistan that makes policy making for tumour screening and early treatment difficult. The purpose of this study was to provide the spectrum of CNS tumours in a premier diagnostic and referral centre of Pakistan. Methods: This cross-sectional study was carried out at Histopathology Department, Armed Forces Institute of Pathology over a period of 5 years. A total of 761 cases patients who were diagnosed with CNS tumours on histopathology, both benign and malignant, belonging to both genders, between the ages of 1-85 years, from 11.2009 to 31.12.2013 were included in the study. Results: Seven CNS tumour categories were as follows; tumours of neuroepithelial tissue (56.0%), tumours of the meninges (28.3%), tumour of the sellar region (2.6%), germ cell tumour (0.1), tumour of cranial and paraspinal nerves (5.4%), lymphomas and haematopoietic neoplasm (2.4%), metastatic tumours (4.9%), where histological types by age and gender showed great variability. Astrocytic tumours were the commonest neuroepithelial tumours (69.4%). Glioblastoma multiform forming the largest subtype of neuroepithelial tumours (40.4%) with a mean age at diagnosis being 47.1 years. Overall, males exceeded females in number of most of the CNS tumour types, however meningeal tumours were more frequently noted in females. Conclusions: Neuroepithelial tumours are commonest tumour and comprise more than half of all operated CNS tumours in our setup, followed by meningeal tumours. Glioblastoma multiforme is largest subtype of neuroepithelial tumour, and comprising 40.4% of all. (author)

  15. Parental Influences on the Diets of 2-5-Year-Old Children: Systematic Review of Interventions

    Peters, Jacqueline; Sinn, Natalie; Campbell, Karen; Lynch, John

    2012-01-01

    During the early years, parents have a major influence on their children's diets, food choices and development of eating habits. However, research concerning the influence of parental feeding practices on young children's diets is limited. This paper presents a systematic review of intervention studies with parents of preschool children. The aim…

  16. 76 FR 76386 - Endangered and Threatened Species; 5-Year Reviews for 4 Distinct Population Segments of Steelhead...

    2011-12-07

    ... Pacific salmon ESUs and steelhead DPSs in California, Oregon, Washington, and Idaho (75 FR 13082). Both... Reviews for 4 Distinct Population Segments of Steelhead in California AGENCY: National Marine Fisheries... Viable Salmonid Population framework, which relies on evaluating four key population...

  17. Viral Hepatitis: Retrospective Review in a Canadian Pediatric Hospital

    Carolina Jimenez-Rivera; Paulina Cybulska; Andy Ni

    2010-01-01

    Introduction. Clinical presentation of viral hepatitis ranges from mild symptoms to fulminant hepatitis. Our aim is to describe clinical presentation and outcomes of children with viral hepatitis from the Eastern Ontario/Western Quebec regions of Canada. Methods. Retrospective chart review of children diagnosed with viral hepatitis at our institution from January 1, 1998, to December 31, 2007. Results. There were 261 charts reviewed, only 64 had a confirmed viral etiology: 34 (53%) hepatitis ...

  18. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

    2013-04-01

    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs. PMID:22772159

  19. Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: Review of technical incidents and morbidity after 5 years of use

    RIPERT, Thomas; AZEMAR, Marie Dominique; MENARD, Johann; BAYOUD, Younes; Messaoudi, Rabah; Duval, François; Staerman, Frédéric

    2010-01-01

    Abstract OBJECTIVE To report on technical incidents, and early and late complications, occurring on high-intensity focused ultrasound (HIFU) treatment of patients with localized prostate cancer. PATIENTS AND METHODS We performed a retrospective review of patients who were treated by Ablatherm? in our centre. We recorded all technical incidents, treatment discontinuations, and early (< 1 month) and late complications. RESULTS A total of 74 HIFU procedures were perfor...

  20. TLC/HPTLC with Direct Mass Spectrometric Detection: A Review of the Progress Achieved in the Last 5 Years

    Schiller, Jurgen; Fuchs, Beate; Teuber, Kristin; Nimptsch, Ariane; Nimptsch, Kathrin; Süß, Rosmarie

    Thin-layer chromatography (TLC) is a widely used, fast and inexpensive method. Even minor constituents of complex mixtures can be often characterized. Unfortunately, the unambiguous assignment of the spots to defined compounds is often difficult because common staining methods normally reveal only (at best) a substance class, not a specific compound. For instance, in the case of phospholipids, the lipid class, but not the detailed fatty acyl composition, can be determined (normal phase TLC). Nowadays mass spectrometry (MS) seems to be the most suitable method for analyte characterization due to its high sensitivity and mass accuracy. This became possible by the invention of soft ionization methods such as matrix-assisted laser desorption and ionization time-of-flight (MALDI-TOF) MS and electrospray ionization (ESI) although many further desorption techniques are available nowadays. This review summarizes the so far available knowledge about direct TLC/MS couplings and gives an overview about selected compounds that could be successfully analyzed.

  1. Review of retrospective dosimetry techniques for external ionising radiation exposures

    The current focus on networking and mutual assistance in the management of radiation accidents or incidents has demonstrated the importance of a joined-up approach in physical and biological dosimetry. To this end, the European Radiation Dosimetry Working Group 10 on 'Retrospective Dosimetry' has been set up by individuals from a wide range of disciplines across Europe. Here, established and emerging dosimetry methods are reviewed, which can be used immediately and retrospectively following external ionising radiation exposure. Endpoints and assays include dicentrics, translocations, premature chromosome condensation, micronuclei, somatic mutations, gene expression, electron paramagnetic resonance, thermoluminescence, optically stimulated luminescence, neutron activation, haematology, protein biomarkers and analytical dose reconstruction. Individual characteristics of these techniques, their limitations and potential for further development are reviewed, and their usefulness in specific exposure scenarios is discussed. Whilst no single technique fulfils the criteria of an ideal dosemeter, an integrated approach using multiple techniques tailored to the exposure scenario can cover most requirements. (authors)

  2. Counterfeit medicines in Peru: a retrospective review (1997–2014)

    Medina, Edwin; Bel, Elvira; Suñé, Josep María

    2016-01-01

    Objective To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997–2014) of health monitoring and enforcement. Design A retrospective review of drug alerts. Setting A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Eligibility criteria Drug alerts related to c...

  3. Dermatologic manifestation of hyperandrogenism: a retrospective chart review.

    Clark, Charlotte M; Rudolph, Jennifer; Gerber, Donald A; Glick, Sharon; Shalita, Alan R; Lowenstein, Eve J

    2014-01-01

    Several studies have described a wide spectrum of hyperandrogenism diseases, many of which are difficult to distinguish from each other. In order to better understand diseases of hyperandrogenism, the authors performed a retrospective study of the cutaneous features and metabolic findings in women with hyperandrogenism. A retrospective chart analysis compiled by three dermatologists in both academic and private settings was performed, including patients presenting with > or = 2 manifestations of hyperandrogenism. Relevant dermatologic and associated manifestations and laboratory and imaging study findings were reviewed. Moderate to severe acne was the most common manifestation. Other common manifestations that patients first presented with include hirsutism, acanthosis nigricans, androgenic alopecia, and skin tags. Oligomenorrhea was the most common systemic presenting sign. Statistical analysis of various clinical markers revealed correlations with hyperandrogenemia. Acanthosis nigricans and hirsutism were found to be useful clinical markers for hyperandrogenism, whereas androgenic alopecia was not. This study provides some insights into the presentation and diverse manifestations seen in hyperandrogenism. PMID:24933845

  4. Moving forward monitoring of the social determinants of health in a country: lessons from England 5 years after the Marmot Review

    Peter O. Goldblatt

    2016-02-01

    Full Text Available Background: England has a long history of government-commissioned reviews of national inequalities. The latest review, the Marmot Review, was commissioned by a government headed by the same party (the Labour Party that had introduced the National Health Service in 1948, but the review was implemented by a coalition of different parties (Conservatives and Liberal Democrats. At the same time, a government reform of health services took place, and the monitoring of the existing inequality strategy was changed. Objectives: This paper examines the lessons that can be learned about indicators for monitoring social determinants of health inequalities from the Marmot Review and recent health inequality strategies in England. Design: The paper provides a narrative review of key findings on the collection, presentation, and analysis of routine data in England in the past 5 years, comparing what has been learned from the Marmot Review and other evaluations of the first health inequality strategy in England. Results: The emphasis on monitoring has progressively shifted from monitoring a small number of targets and supporting information to frameworks that monitor across a wide range of determinants of both the causes of ill-health and of health service performance. As these frameworks become ever larger, some consideration is being given to the key indicators. Conclusions: Although the frameworks used in England for monitoring health inequality strategies have developed considerably since the first strategy began, lessons continue to be learned about how monitoring could be improved. Many of these are applicable to countries initiating or reviewing their strategies.

  5. Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

    Yiotakis Ioannis E

    2009-08-01

    Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

  6. Fukushima, 5 years after

    This publication proposes an overview of the situation in Fukushima (in the plant and in its region), 5 years after the accident. As far as the plant is concerned, several issues are addressed: the withdrawal of fuel from decay pools, the management of contaminated waters, and the situation of reactors 1, 2 and 3. The radiological impact for operators is discussed in terms of radioactivity level, of occurrence of leukaemia, and of storage of radioactive wastes. The next part comments the slow return of populations and the recovery of agriculture, notably with respect to decontamination advances, and to waste management. Current perspectives for the Japanese nuclear industry are then addressed: creation of a new and stronger safety authority, and situation of the various other reactors (some are planned to be restarted, some will be dismantled, and new reactors are still being built). The last part addresses the rehabilitation of areas devastated by the tsunami, with temporary housing, urban planning comprising possibilities for the population to quickly find a shelter, and works on the coast for a better protection against tsunamis

  7. Characterization of tinnitus in different age groups: A retrospective review

    Jamil Al-Swiahb

    2016-01-01

    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  8. Retrospective Economic and Outcomes Analyses Using Non-US Databases: A Review

    Lizheng Shi; Wu, Eric Q.; Meredith Hodges; Andrew Yu; Howard Birnbaum

    2007-01-01

    Retrospective database analyses pose a series of methodological challenges, some of which are unique to their data sources, particularly in countries outside the US. This study aimed to qualitatively review the methodological challenges of using non-US databases to conduct retrospective economic and outcomes research studies. We conducted a MEDLINE search to obtain a sample of literature published after the year 2000 on retrospective analyses using non-US databases. We reviewed all relevant c...

  9. Deep neck abscess. A 42-case retrospective review

    We reviewed 42 cases of deep neck abscess drained surgically or treated conservatively between February 2001 and August 2008, based on age, gender, primary focus, main symptom, abscess location, systemic disease, pathogenic bacteria, hospital treatment, hospitalization length, complications and long-term hospitalization. Of the 42, 26 were men and 16 women aged 14 to 80 (central age: 54.5 years). Abscess was caused most by tonsil inflammation (38.1%). Main symptom were sore throat (54.8%) and neck swelling (35.7%). Abscesses were found in the supra- and infrahyoid region in 30 cases and extended to the mediastinum in 2. Of the 42, 14 (33.3%) had hypertension and 11 (26.2%) diabetes mellitus (DM). Inflammation was due to aerobic bacteria (mainly Streptococcus milleri) in 23 cases (54.8%) and to anaerobic bacteria (mainly Peptostreptococcus) in 11 cases (26.2%). Flexible fiberscopic examination was important in evaluating pharyngeal and laryngeal mucosal disorders and enhanced computed tomography was useful in both diagnosis and postoperative observation. Of the 42, 38 required surgical drainage and 4 were cured using needle aspiration and antibiotics. Of the 38 undergoing surgery-tracheostomy was required in 22. Hospitalization for those with tracheostomy and DM was longer than in those without these factors. Complications included 2 cases each of, mediastinal abscess, sepsis, disseminated intravascular coagulation (DIC), acute renal failure, severe pneumonia, upper digestive tract bleeding and swallowing disorder. Early surgical drainage and intravenous antibiotic administration are thus essential for treating deep neck abscesses. (author)

  10. Counterfeit medicines in Peru: a retrospective review (1997–2014)

    Medina, Edwin; Bel, Elvira; Suñé, Josep María

    2016-01-01

    Objective To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997–2014) of health monitoring and enforcement. Design A retrospective review of drug alerts. Setting A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Eligibility criteria Drug alerts related to counterfeit medicines. Results A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. Conclusions Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru. PMID:27044580

  11. Complications of chronic suppurative otitis media: a retrospective review.

    Yorgancılar, E; Yildirim, M; Gun, R; Bakir, S; Tekin, R; Gocmez, C; Meric, F; Topcu, I

    2013-01-01

    The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach. PMID:22249835

  12. Prognostic Factors of Primary Intraosseous Squamous Cell Carcinoma (PIOSCC): A Retrospective Review

    Wenguang, Xu; Hao, Shen; Xiaofeng, Qi; Zhiyong, Wang; Yufeng, Wang; Qingang, Hu; Wei, Han

    2016-01-01

    Objectives To delineate clinical and pathological features and determine the prognostic factors of primary intraosseous squamous cell carcinoma (PIOSCC). Materials and methods Patients diagnosed with PIOSCC, attending the department of oral and maxillofacial surgery, Nanjing stomatological hospital between 2005 and 2015, were identified and retrospectively reviewed for clinical and pathological characteristics. Therapeutic modalities were measured and related follow-up data recorded, in order to determine prognostic factors of PIOSSC. Results A total of 77 patients with PIOSCC were included in the study. Mean age at diagnosis was 58.8 years, (range, 37−81 years). Of the 77 patients, there were 58 men and 19 women. The most common location of disease was the mandible (71.42%), particularly the posterior mandible. The common presenting symptoms included jaw swelling (79.2%) and ulceration (42.65%). The estimated 2-year and 5-year overall survival were 68.9% and 38.8%, respectively. Univariate analysis identified the following as negative prognostic factors: histological grade, N classification, nodal status and treatment modalities. However, multivariate analysis determined positive nodal status, high histological grade and advanced N classification as the independent significant prognostic factors. Conclusion Our results demonstrate several clinical and pathological features of PIOSCC and identify important prognostic factors associated with overall survival in PIOSCC. These prognostic factors include nodal status, histological grade, N classification, and treatment modalities, all of which are important for patient counseling and may be useful for the development of new treatment approaches. PMID:27074366

  13. Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: retrospective review

    Full text: To determine the overall survival and gastrointestinal toxicity for patients treated with salvage definitive chemo-radiotherapy after primary surgery for locoregional relapse of oesophageal carcinoma. A retrospective review of 525 patients who had a resection for oesophageal or oesophagogastric carcinoma at Princess Alexandra Hospital identified 14 patients treated with salvage definitive radiotherapy or chemo-radiotherapy, following localized recurrence of their disease. We analysed the patient and treatment characteristics to determine the median overall survival as the primary end point. Gastrointestinal toxicity was examined to determine if increased toxicity occurred when the stomach was irradiated within the intrathoracic radiotherapy field. The median overall survival for patients treated with curative intent using salvage definitive chemo-radiotherapy was 16 months and the 2-year overall survival is 21%. One patient is in clinical remission more than 5 years after therapy. Age <60 years old and nodal recurrence were favourable prognostic factors. Treatment compliance was 93% with only one patient unable to complete the intended schedule. Fourteen per cent of patients experienced grade 3 or 4 gastrointestinal toxicity. Salvage definitive chemo-radiotherapy should be considered for good performance status patients with oesophageal carcinoma who have a locoregional relapse after primary surgery. The schedule is tolerable with low toxicity and an acceptable median survival

  14. A Review of the Literature on the Social and Environmental Factors Which Influence Children (Aged 3-5 Years) to Be Obese/Overweight and the Accuracy of Parental Perceptions

    McMullan, Julie; Keeney, Sinead

    2014-01-01

    Objective: This article aims to review the previously published literature on the social and environmental factors which influence children (aged 3-5 years) to be obese/overweight and the accuracy of parental perceptions. Obesity levels are on the increase in today's society and habits are being passed from parents to children, with family…

  15. The current status of community-acquired pneumonia management and prevention in children under 5 years of age in India: a review.

    Yadav, Krishna Kumar; Awasthi, Shally

    2016-06-01

    India has the highest number of global deaths of children under 5 years of age. In the year 2015, it was reported that there were 5.9 million deaths of children under 5 years of age globally, of which 1.2 million (20%) occurred in India alone. Currently, India has an under 5 mortality rate of 48 per 1000 live births. Community-acquired pneumonia contributes to about one sixth of this mortality. Fast breathing is the key symptom of community-acquired pneumonia. The World Health Organization recently categorized community-acquired pneumonia in children under 5 years of age into two, pneumonia, and severe pneumonia. Fast breathing with or without chest in-drawing is categorized as pneumonia and fast breathing with any of danger signs as severe pneumonia. Because effective vaccines against two of the common organisms causing community-acquired pneumonia, namely Streptococcus pneumoniae and Haemophilus influenzae type b, are available, there should be urgent and phased introduction into the Indian Universal Immunization Programme. Several preventable risk factors of community-acquired pneumonia such as lack of exclusive breast feeding for first 6 months of life, inappropriate complimentary feeding, iron deficiency anemia, malnutrition, and indoor air pollution should be adequately addressed. The community should be aware about the signs and symptoms of community-acquired pneumonia and its danger signs so that delay in qualified care seeking can be avoided. To achieve the sustainable development goal of ⩽25 under five deaths per 1000 live births by 2030, a multipronged approach is the need of the hour. PMID:27536353

  16. Review and comparison of content growth in word definition of Persian speaking children with 4.5 to 7.5 years of age

    Maryam Malekian; Tahereh Sima Shirazi; Talieh Zarifian; Pouria Rezasoltani

    2014-01-01

    Background and Aim: Word definition is one of the complicated language skills that require education and linguistic awareness. In this study , comparison was made in word definition ability of children between ages of 4.5 to 7.5 years.Methods: This study was cross-sectional and descriptive-analytical in nature . Participants included 107 girls and boys who where in age group 1 (54-65 months), age group 2 (66-77 months), and age group 3 (78-90 months). They were selected by multistage sampling...

  17. Developmental milestones record - 5 years

    ... view (but may not understand them) Has improved math skills Questions others, including parents Strongly identifies with ... milestones for children - 5 years References Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, ...

  18. Sustained High Quality of Life in a 5-Year Long Term Follow-up after Successful Ablation for Supra-Ventricular Tachycardia. Results from a large Retrospective Patient Cohort

    Axel Meissner, Irini Stifoudi, Peter Weismüller, Max-Olav Schrage, Petra Maagh, Martin Christ, Thomas Butz, Hans-Joachim Trappe, Gunnar Plehn

    2009-01-01

    Full Text Available Introduction: The ablation of supraventricular tachycardias (SVT using radiofrequency energy (RF is a procedure with a high primary success rate. However, there is a scarcity of data regarding the long term outcome, particularly with respect to quality of life (QoL. Methods and Results: In this retrospective single-center study, 454 patients who underwent ablation of SVT between 2002 and 2007 received a detailed questionnaire addressing matters of QoL. The questionnaire was a modified version of the SF-36 Health Survey questionnaire and the Symptom Checklist – Frequency and Severity Scale. After a mean follow up of 4.5±1.3 years, 309 (68.1% of the contacted 454 patients (269 female, 59.2%, mean age 58+/-6.5 completed the questionnaire. Despite of 27% of relapses in the study group, 91.7% considered the procedure a long-term success. The remainder of patients experienced no change in (3.7% or worsening of (4.7% symptoms. There were no significant differences between the various types of SVT (p=1. QoL in patients with Atrio-Ventricular Nodal Reentry Tachycardia (AVNRT and Atrio-Ventricular Reentry Tachycardia (AVRT improved significantly (p<0.0005 respectively p<0.043, whereas QoL in patients with Ectopic Atrial Tachycardia (EAT showed a non-significant trend towards improvement. Main symptoms before ablation, such as tachycardia (91.5%, increased incidence of tachycardia episodes over time (78.1%, anxiety (55.5% and reduced physical capacity in daily life (52% were significantly improved after ablation (p<0.0001. Conclusion: The high acute ablation success of SVT persists for years in long term follow up and translates into a significant improvement of QoL in most patients.

  19. Ovarian metastasis in colorectal cancer: retrospective review of 180 cases

    Omranipour R

    2009-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Routine oophorectomy in women with colorectal cancer is under debate, the aim of this study is to determine incidence, clinicopathologic features and prognostic factors of ovarian involvement in primary colorectal cancer (CRC and to clear the role of prophylactic oophorectomy."n"nMethods: Data from primary CRC women treated between years 1990 and 2004 were retrieved and clinical and pathologic features of those who had undergone oophorectomy during CRC surgery were reviewed."n"nResults: One hundred eighty cases (mean age 47.5 years were included. In 120(66.6%, ovaries were preserved and 60(33.3% cases underwent bilateral oophorectomy in addition to primary CRC resection. Reasons for oophorectomy were prophylactic in 22(36.6%, abnormal morphology in 35(58.3%, and undetermined in 3(5% cases. There were five metastatic carcinomas, eight primary ovarian tumors and 47 normal ovaries in pathologic evaluation. No complication directly related to oophorectomy was noted. Patients with ovarian metastases had higher stages of tumor. Ovarian metastases were not related to menstrual status, CRC location, size, differentiation, and mucin production, as well as abnormal morphology of ovary. The global prevalence of

  20. T-condylar fracture delayed for 10 days in a 5-year-old boy: a case report and review of the literature

    Shashidhar B Kantharajanna; Vijay Goni; Pebam Sudesh; Nirmal Raj Gopinathan

    2013-01-01

    T-condylar fracture is rare in paediatric age group,especially in skeletally immature children less than 9 years old,with very few cases reported in available literature.We present such a case in a 5 year old child that was initially managed as a supracondylar fracture at another centre before referral to us,10 days after the injury.The child was diagnosed as having a displaced T-condylar fracture on plain radiograph.Open reduction and internal fixation with K-wires was performed.At 2 years follow-up,the child had good range of motion at elbow with 5°of cubitus varus.With this background we discuss the pertinent principles of management of T-condylar fractures in skeletally immature children.

  1. 76 FR 17572 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-03-30

    ... X 48 CFR Chapter 10 Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 AGENCY... issued Executive Order 13563, ``Improving Regulation and Regulatory Review,'' which sets forth principles... Regulatory Review,'' which outlines the following guiding principles: Consistent with law, agencies...

  2. 76 FR 32330 - Reducing Regulatory Burden; Retrospective Review Under Executive Order 13563

    2011-06-06

    ... Subtitle A and Chapters II, III, IV, X, and XIII Reducing Regulatory Burden; Retrospective Review Under.... SUMMARY: In accordance with Executive Order 13563, ``Improving Regulation and Regulatory Review,'' the... reviews will make its regulatory program more effective and flexible and reduce unnecessary burdens on...

  3. 76 FR 10526 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-02-25

    ... Regulation and Regulatory Review,'' on January 18, 2011. He stated that our ``regulatory system must protect... Chapter 14 50 CFR Chapters I and IV Reducing Regulatory Burden; Retrospective Review Under E.O. 13563... response to the President's Executive Order 13563 on improving regulation and regulatory review....

  4. 76 FR 13549 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-03-14

    ... range of statutes, including, but not limited to the Endangered Species Act, 16 U.S.C. 1531, et seq... 0648-XA282 Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 AGENCY: National Oceanic... Regulation and Regulatory Review. The purpose of NOAA's review is to make the agency's regulatory...

  5. P14.03MEDULLOBLASTOMA IN MOROCCO: A RETROSPECTIVE REVIEW

    Hami, H.; Ayoujil, A.; Habib, F.; Soulaymani, A.; Mokhtari, A.; Quyou, A.

    2014-01-01

    INTRODUCTION: Medulloblastoma is the most common malignant brain tumor in children. The aim of this study is to describe the epidemiological characteristics of medulloblastoma in Morocco. METHODS: This is a descriptive retrospective study of cases diagnosed and treated for medulloblastoma between 1994 and 2004 at Al Azhar Oncology Center in Rabat. RESULTS: There were 23 cases diagnosed with medulloblastoma at Al Azhar Oncology Center, accounting for 7.8% of all brain tumors reported during th...

  6. Gastrostomias e fundoplicaturas: estudo retrospectivo de 5 anos em pacientes pediátricos no Hospital Municipal Jesus/RJ Gastrostomy and fundoplication: a 5-year retrospective study at pediatric patients in Hospital Municipal Jesus/RJ

    Lisieux Eyer de Jesus

    2003-04-01

    Full Text Available OBJETIVO: Analisar o quadro clínico, morbi-mortalidade e resultados da fundoplicatura gastroesofágica em crianças, com ênfase em portadores de encefalopatias crônicas. MÉTODO: Foram estudados retrospectivamente os prontuários de 55 pacientes em série, submetidos a fundoplicaturas e/ou gastrostomias por 5 anos (1994-1999, analisando manifestações clínicas, características epidemiológicas e evolução pós-operatória. Análises estatísticas, quando pertinentes, utilizaram o método do qui-quadrado. RESULTADOS: Manifestações respiratórias, pacientes com menos de seis meses e encefalopatas predominaram. Opistótono esteve relacionado a formas graves. A mortalidade até 30 dias foi de 7,3%, significativamente maior em cardiopatas congênitos. Complicações imediatas da cirurgia foram basicamente atelectasias e pneumonias (14,6%, relacionadas estatisticamente à desnutrição grave, e infecções da ferida (5,5%. O índice de recorrência de Doença do Refluxo Gastro-Esofagiano foi de 14,5%. O índice de pneumonias caiu de 65,5% em pré-operatório para 16,5% em pós-operatório tardio. Em média houve melhora nutricional a longo prazo, embora com ampla variação individual. CONCLUSÃO: É essencial manter um alto índice de suspeita para Doença do Refluxo Gastro-Esofagiano em lactentes e crianças encefalopatas com manifestações respiratórias. Nestes grupos a indicação cirúrgica é mais freqüente e bastante segura, exceto em presença de desnutrição grave e cardiopatia congênita. Opistótono é marcador de doença grave. Os resultados da cirurgia a longo prazo são favoráveis em crianças encefalopatas.BACKGROUND: To study clinical characteristics, mortality, morbidity and results of fundoplicature with or without gastrostomy in children, emphasizing neurologically impaired patients. METHODS: We studied retrospectively medical documents of 55 successive patients operated on in a period of five years (1994

  7. Review and comparison of content growth in word definition of Persian speaking children with 4.5 to 7.5 years of age

    Maryam Malekian

    2014-10-01

    Full Text Available Background and Aim: Word definition is one of the complicated language skills that require education and linguistic awareness. In this study , comparison was made in word definition ability of children between ages of 4.5 to 7.5 years.Methods: This study was cross-sectional and descriptive-analytical in nature . Participants included 107 girls and boys who where in age group 1 (54-65 months, age group 2 (66-77 months, and age group 3 (78-90 months. They were selected by multistage sampling method and recruited from nurseries and primary schools in 1, 7, and 17 municipal districts of Tehran . Word definition task was performed on each subject. The reliability was assessed by two independent values and the validity was determined by the content. Kruskal- Wallis and Mann-Whitney U statistical methods were used for analysis.Results: Mean score of the content in word definition was significantly increased by age (p=0.001. In the second and third age groups there was no significant difference in the content of word definition. The most response that used in all ages was the functional response. With increasing age, error rate (p=0.002 and identical (p=0.003 responses significantly decreased; however, percentage use of combination II (p<0.001 responses significantly increased.Conclusion: By increasing age, quality of definitions in terms of content is improved and definitions change from functional and concrete responses to c ombination II definitions.

  8. 5 Years'Retrospective Analysis of Suicide in Hospitalized Psychiatric Patients%住院精神病患者自杀行为的5年回顾分析

    汪毅; 甘明远

    2015-01-01

    Objective:To study the clinical characteristics of suicide in hospitalized psychiatric pa-tients.Methods:All suicide incidents recorded from January 1,2002 to December 31,2006 were retro-spectively analyzed by looking up the illness record,interview,and investigating the suicide environment. Results:We had collected 31 hospitalized psychotics who had suicide behavior,among them,male was 16 and female was 15.The average age was 45 years old,the youngest was 24 and the oldest was 68.Diagno-sis of schizophrenia was the most(64.5%),followed by affective disorders(13.0 %).Hospital stays less than one month was thirteen persons(41.9%),more than three months was fourteen persons(45.2%), and between them was four persons(12.9%) .Most suicide happened at the ward restrooms and the toi-let.The most common methods of suicide was hanging(41.9%)and eating foreign body(25.8%).Sui-cide taken place between 0am~8am was 12(38.7%),8am-4pm was 11(35.5%)and 4pm-12pm was 8(25.8%).They tried to kill themselves more often at day off than weekdays(χ2 =13.520,P=0.000). In all 31 cases only one person dead.Inpatient suicide rate was 24.98‰.Conclusion:Patients suffering from both schizophrenia and depressed mood appeared to be at particular risk.The first few days of admis-sion and three months later should be recognized as the period of highest risk.The most common method of suicide behavior of hospitalized psychiatric patients is hanging.This study demonstrates a high suicide rate of psychiatric inpatient(24.98‰)in the hospital in China.%目的:了解住院精神病患者自杀行为的临床特征。方法:对2002年1月1日-2006年12月31日在我院住院治疗期间发生自杀行为的患者,以查阅病历、访谈和实地考察自杀环境获取资料进行回顾性分析。结果:共收集到住院期间发生自杀行为患者3l人。男性16人,女性15人,年龄24~68岁,平均年龄45岁。住院时间<1个月者13人(41.9%),1~3个月者4人

  9. The procedure success rate and medium-term curative effect of percutaneous transhepatic cholangic drainage: a review of 5-year clinical practice

    Objective: To improve the procedure success rate and the medium-term curative effects of Percutaneous Transhepatic Cholangic Drainage (PTCD). Methods: Four hundred and twenty-eight cases of obstructive.jaundice resulting from various etiologies underwent PTCD, including internal and external catheter drainage in 326 cases, simply external drainage in 49 cases, single stent placement in 29 cases and double-stent placement in 14 cases. A retrospective analysis of the procedure success rate and the medium-term curative effects were made. And the strategy, which ensured the procedure success rate and the medium-term curative effects, was discussed. Results: In 428 cases, success rate in 331 cases of evidently dilated biliary tract was 96.7% (320/331). Success rate in 97 cases of non-dilated biliary tract or segmental dilatation of bile duct was 55.7% (54/97). The observed medium-term curative effects of PTCD were noted as the followings: CR 25.9%, PR 55.8%, and DR 18.5%. Conclusions: PTCD is an important approach to alleviate jaundice. A rational drainage track is essential for the medium-term curative effects. The synthetical curative effects correlate with multiple factors, such as the timing of the interventions and the etiology of obstructive jaundice. Careful pre-operative study of the cases and accurate selection of candidates help to improve the curative effects. (authors)

  10. Bronquiectasias en adultos: Características clínicas Experiencia de 5 años 1998-2003 RETROSPECTIVE EVALUATION OF BRONCHIECTASIS CHARACTERISTICS IN ADULTS AT A CHILEAN GENERAL HOSPITAL: A 5 YEARS EXPERIENCE (1998-2003

    Jaime Cereceda P.

    2005-09-01

    Full Text Available Para conocer las características actuales de las bronquiectasias en adultos en nuestro medio se revisan los 18 casos de esta patología comprobados por TAC helicoidal de tórax en el Hospital Regional de Concepción entre 1998-2003. La edad promedio de los pacientes fue de 44 ± 13,9 años; 10 hombres y 8 mujeres. Las etiologías más frecuentes de bronquiectasias fueron tuberculosis pulmonar (44,4% y neumonía aguda (38,8%. Los síntomas más relevantes fueron tos crónica (88,8%, expectoración persistente (77,7% y hemoptisis (44,8%. La espirometría reveló alteración ventilatoria obstructiva tanto en fumadores (VEF1/CVF = 58% como en no fumadores (VEF1/CVF = 68%. La bacteriología de expectoración detectó Hemophilus influenzae (16,6%, Neisseria catharralis (15%, Pseudomona aeruginosa (13%, Streptococcus pneumoniae (15,4% y Candida albicans (4%. La TAC de tórax demostró lesiones bilobares (72%, multilobares (16,6% y unilobares (11,1%. La realidad de las bronquiectasias en nuestro medio es que no difiere significativamente de lo descrito en la literaturaIn order to know the actual characteristics of bronchiectasis in an adult population, we reviewed 18 cases with this pathology confirmed by spiral CT at a general hospital (Hospital Regional de Concepción, Chile, between 1998-2003. Ten patients were males and 8 females, their mean age was 44 ± 13.9 years old. Most common etiologies of bronchiectasis were pulmonary tuberculosis (44.4% and acute pneumonia (38.8%; main sypmtoms were chronic cough (88.8%, persistent sputum (77.7% and hemoptysis (44.4%. Spirometry detected airway obstruction in smokers (FEV1/FVC = 58% and in non smokers (FEV1/FVC = 68%. Microbiological sputum exams showed Hemophilus influenzae (16.6%, Neisseria catharralis (15%, Pseudomona aeruginosa (13%, Streptococcus pneumoniae (15.4% and Candida albicans (4%. Spiral CT showed the following distribution of bronchiectasis: unilobular lesion 11.1%, bilobar 72% and

  11. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  12. A clinico-pathological study of orbito-ocular tumors at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria: A 5-year review

    Dominic Chinda

    2012-01-01

    Full Text Available Background: Orbito-ocular tumors are a common cause of morbidity and mortality in our environment. Patients often present late with unsightly fungating tumors resulting in difficult management and poor outcome. The aim of the study was to determine the clinical profile, diagnostic work-up, treatment and histo-pathological types of orbito-ocular tumors seen at Ahmadu Bello University Teaching Hospital, Shika-Zaria from June 2006 to June 2011. Materials and Methods: A retrospective analysis of all patients who presented to the eye clinic with orbito-ocular tumors during the study period was made. Information extracted incwudes patient demographics, clinical diagnoses, radiological and sonological reports, surgery performed, and histology reports as well as adjuvant chemotherapy and radiotherapy where indicated. Results: A total of 54 patients were managed during the study period. Those without histology reports were excluded from the study. Forty-nine patients were included for analysis. There were 29 male and 20 female patients giving a male to female ratio of 1.8:1. Their age range was 1.5-74 years with a mean of 22 years. Eighteen of the patients had retinoblastoma, eleven had squamous cell carcinoma, two had Kaposi′ sarcoma, and one case of nasopharyngeal carcinoma. There were 2 patients with pre-malignant conditions and 10 patients with benign lesions. Thirty-two of the patients had exenterations, sixteen had excisional biopsies, and one had enucleation. Seventy eight percent of the tumors were malignant. Conclusion: Most of the orbito-ocular tumors seen in this study were malignant. Delayed hospital presentation is a characteristic feature. Retinoblastoma and squamous cell carcinoma are the most common orbito-ocular tumors.

  13. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    Angalakuditi M; Gomes J.

    2011-01-01

    Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR), pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription dat...

  14. 76 FR 13532 - Reducing Regulatory Burden; Retrospective Review Under Executive Order 13563

    2011-03-14

    ... 610 of the Regulatory Flexibility Act, SBA does not intend to include these two sets of regulations in... ADMINISTRATION 13 CFR Chapter 1 Reducing Regulatory Burden; Retrospective Review Under Executive Order 13563... implementation of Executive Order 13563, ``Improving Regulation and Regulatory Review,'' the Small...

  15. 76 FR 15859 - Reducing Regulatory Burden; Retrospective Review under E.O. 13563

    2011-03-22

    ... Chapters 5 and 61 Reducing Regulatory Burden; Retrospective Review under E.O. 13563 AGENCY: Office of... Executive Order (EO) 13563, ``Improving Regulation and Regulatory Review.'' E.O. 132563 was signed by... preliminary plan, consistent with law and its resources and regulatory priorities, under which the agency...

  16. The visibility of cancer on previous mammograms in retrospective review

    AIM: To study how many tumours were visible in restrospect on mammograms originally reported as normal or benign in patients coming to surgery with proven breast cancer. The effect of making the pre--operative mammogram available was also assessed. MATERIALS AND METHODS: Three hundred and twenty initial mammograms of consecutive new breast cancer cases were analysed by a group of radiologists in the knowledge that all patients were later diagnosed with breast cancer. The films were read twice, first without and then with the later (pre-operative) mammograms available. The parenchymal density in the location of the tumour was classified as fatty, mixed or dense, and the tumours were classified as visible or not visible. The reasons for the invisibility of the tumour in the earlier examination were analysed. RESULTS: Fourteen per cent (45) of cancers were retrospectively visible in earlier mammograms without the pre-operative mammograms having been shown, and 29% (95) when pre-operative mammograms were shown. Breast parenchymal density decreased with age and the visibility of tumours increased with age. When considered simultaneously, the effect of age (over 55 vs under 55) was greater (OR = 2.9) than the effect of density (fatty vs others) (OR = 1.5). The most common reasons for non-detection were that the lesion was overlooked (55%), diagnosed as benign (33%) or was visible only in one projection (26%). Growing density was the most common (37%) feature of those lesions originally overlooked or regarded as benign. CONCLUSIONS: Tumours are commonly visible in retrospect, but few of them exhibit specific signs of cancer, and are recognized only if they grow or otherwise change. It is not possible to differentiate most of them from normal parenchymal densities. Saaremaa, I. (2001)

  17. Low birth weight, very low birth weight and extremely low birth weight in African children aged between 0 and 5 years old: a systematic review.

    Tchamo, M E; Prista, A; Leandro, C G

    2016-08-01

    Low birth weight (LBWAcademic Search Complete in the following databases: PubMed, Scopus and Scholar Google. Quantitatives studies that investigated the association between LBW, VLBW, ELBW with growth, neurodevelopmental outcome and mortality, published between 2008 and 2015 were included. African studies with humans were eligible for inclusion. From the total of 2205 articles, 12 articles were identified as relevant and were subsequently reviewed in full version. Significant associations were found between LBW, VLBW and ELBW with growth, neurodevelopmental outcome and mortality. Surviving VLBW and ELBW showed increased risk of death, growth retardation and delayed neurodevelopment. Post-neonatal interventions need to be carried out in order to minimize the short-term effects of VLBW and ELBW. PMID:27072315

  18. Encapsulating Peritoneal Sclerosis – A 5 Year Experience

    Spence, Robert; Gillespie, Scott; Loughrey, Maurice; Gardiner, Keith

    2013-01-01

    Title Encapsulating peritoneal sclerosis – A 5 year experience Aim Encapsulating peritoneal sclerosis (EPS) is a rare, life-threatening condition, characterised by a progressive, intra-abdominal inflammatory process resulting in fibrotic visceral constriction. We report the aetiology, management, and outcome of EPS in Belfast. Method All patients diagnosed with EPS in Belfast over the past 5 years are included. Presentation, aetiology, imaging, pathology, and outcome are retrospectively analy...

  19. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis

    Thienvibul, Chitprapassorn; Vachiramon, Vasanop; Chanprapaph, Kumutnart

    2015-01-01

    Background. Acute generalized exanthematous pustulosis (AGEP) is an acute pustular eruption characterized by widespread nonfollicular sterile pustules. The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented with AGEP between August 2008 and November 2012 in a tertiary center in Thailand. Results. Nineteen patients with AGEP were included. AGEP was generally distributed in seventeen patients (89.5%) and localized in two (10.5%). Fever and neutrophilia occurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%), comprising of antibiotics (73.6%), proton pump inhibitors (10.5%), nonsteroidal anti-inflammatory drugs (5.3%), and herbal medicine (5.3%). Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first report of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens (topical corticosteroid, systemic corticosteroid, and supportive treatment) regarding the time from drug cessation to pustules resolution (P = 0.171). Conclusions. We have highlighted the presentation of AGEP among Asians. We found high association with systemic drugs. Carbapenems were one of the leading culprit drugs. Finally, a localized variant was observed. PMID:26783390

  20. 75 Years of the International Labour Review: A Retrospective.

    Thomas, Albert; And Others

    1996-01-01

    Contains 18 articles published in International Labour Review from 1921-1975 that discuss the International Labour Organisation, international labor movement and law, economics and the labor market, family security, full employment, population growth, industrial welfare, trade policy and employment growth, and income expectations and rural-urban…

  1. Optimization of machining techniques – A retrospective and literature review

    Aman Aggarwal; Hari Singh

    2005-12-01

    In this paper an attempt is made to review the literature on optimizing machining parameters in turning processes. Various conventional techniques employed for machining optimization include geometric programming, geometric plus linear programming, goal programming, sequential unconstrained minimizationtechnique, dynamic programming etc. The latest techniques for optimization include fuzzy logic, scatter search technique, genetic algorithm, Taguchi technique and response surface methodology.

  2. Histological review of skin cancers in African Albinos: a 10-year retrospective review

    Skin cancer is rare among Africans and albinism is an established risk for skin cancer in this population. Ultraviolet radiation is highest at the equator and African albinos living close to the equator have the highest risk of developing skin cancers. This was a retrospective study that involved histological review of all specimens with skin cancers from African albinos submitted to The Regional Dermatology Training Center in Moshi, Tanzania from 2002 to 2011. A total of 134 biopsies from 86 patients with a male to female ratio of 1:1 were reviewed. Head and neck was the commonest (n = 75, 56.0%) site affected by skin cancers. Squamous cell carcinoma (SCC) was more common than basal cell carcinoma (BCC) with a ratio of 1.2:1. Only one Acral lentiginous melanoma was reported. Majority (55.6%) of SCC were well differentiated while nodular BCC (75%) was the most common type of BCC. Squamous cell carcinoma is more common than basal cell carcinoma in African albinos

  3. Retrospective review of 21 cases of neuroendocrine tumors and review of literature

    Objective: literature review and case histories. Neuroendocrine tumors (Nets) are considered rare and comprise a group very heterogeneous with different prognosis and evolution. They represent less than 1% of all malignant tumors and most originate from the gastrointestinal tract in enterocromoafines cells are widely distributed in the same: in the stomach, duodenum, pancreas, small, colon and rectum. Carcinoid tumors Gastrointestinal represent over 70% of all tumors (Nets) in humans. And frequently they are finding their debut as disseminated disease, coinciding our review. 21 records were retrospectively analyzed between 1995 and June 2010. No significant difference in gender, of these 9 patients were 12 female and male sex. Ages ranged from 36 years to 83 years, with an average of 63 years. The locations were distributed as follows: 6 patients with small bowel tumor, 2 with blind tumor, 2 esophageal tumor , 1 patient with pancreatic tumor, 1 patient with stomach tumor, 2 patients with retroperitoneal disease in which failed to define the primary, 2 patients with tumor in breast, 3 patients with lung tumor, 1 patient with piriform sinus tumor and 1 patient with parotid tumor. Of the 21 patients, only 4 sometime had functional syndrome characterized by diarrhea and flushing. The treatments that received these patients were also very heterogeneous. From these patients, only one died in 2008 and the others are still alive, some in control and other treatment. Because of the number of patients seen and the therapeutic variability the statistical analysis no was done

  4. Radiation therapy for retinoblastoma: a retrospective review of 120 patients

    Purpose: To characterize the patient population and treatment outcomes in patients with Retinoblastoma (RB) referred for External Beam Orbital Radiotherapy (EBORT) to King Faisal Specialist Hospital and Research Centre (KFSH and RC), Riyadh, Saudi Arabia from 1976 to 1993. Methods and Materials: A retrospective study of 120 patients with RB affecting a total of 192 eyes. Patients were divided into three groups. Group A are 60 patients (64 eyes) treated with EBORT to the intact eye to preserve vision. Reese-Ellsworth (RE) Staging was: 1: 12%; 2: 10%; 3: 12%; 4: 23%; and 5: 43%. Twenty-eight patients (47%) also received Vincristine, Adriamycin, and Cyclophosphamide chemotherapy (C/T). Mean follow-up, per patient, was 48.5 months. Standard treatment until 1992 was 45 Gy in 12 fractions of 3.75 Gy, three times weekly over 18 days. Assuming the α/β ratio for early effects and tumor control at 10, Tk = 21 days, Tpot = 5 days, then the Biological Equivalent Dose (BED) was 62 Gy10 for early effects, and 101 Gy3 for late effects. Group B are 28 patients (28 eyes) treated for curative intent with EBORT to the orbit for locally advanced disease, usually after enucleation (24 eyes). Nineteen patients (83%) also had C/T. Mean follow-up was 22.6 months. Group C are 37 patients with advanced disease treated with radiotherapy for palliation. Seventeen (46%) also received C/T. Mean follow-up was 11.7 months. Results: Group A-following EBORT useful vision was retained in RE Stage 1 to 5: 7 of 7, 6 of 6, 4 of 8, 10 of 15, and 7 of 28 eyes, respectively. There was no significant difference between patients who received adjuvant chemotherapy and those who did not. Complications included cataract (27%), retinopathy (25%), vitreous hemorrhage (19%), and orbital deformities (11%). In Group B the local control rate was 71%. In Group C, 10 (27%) of the 37 patients were alive at last contact, and 27 (73%) were either terminal or dead of disease. None of Group A or B patients had positive

  5. 76 FR 20568 - HHS Plan for Retrospective Review Under Executive Order 13563

    2011-04-13

    ..., particularly social media and regulations.gov . Comments might also suggest ways to increase open exchanges of... quantify, including equity, human dignity, fairness, and distributive impacts. Coordination with Other... to promote periodic retrospective review of existing significant rules to determine if they...

  6. 76 FR 18954 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-04-06

    ... Chapter 109 48 CFR Chapter 9 Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 AGENCY... ``Regulatory Burden RFI,'' by any of the following methods: Federal eRulemaking Portal: http://www.regulations... for Legislation, Regulation, and Energy Efficiency, U.S. Department of Energy, Office of the...

  7. Dorgan's lateral cross-wiring of supracondylar fractures of the humerus in children: A retrospective review.

    Queally, Joseph M

    2010-06-01

    The currently accepted treatment for displaced supracondylar humeral fractures in children is closed reduction and fixation with percutaneous Kirschner wires. The purpose of this study was to retrospectively review a novel cross-wiring technique where the cross-wire configuration is achieved solely from the lateral side, thereby reducing the risk of ulnar nerve injury.

  8. 77 FR 55833 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    2012-09-11

    ... AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review..., 2012, to listen to stakeholder comments on potential approaches for providing Consumer Confidence... meeting to give EPA time to process your request. Background Consumer Confidence Reports are a key part...

  9. 77 FR 57566 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    2012-09-18

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...) 250-8793. Correction In the Federal Register of September 11, 2012, in FR Doc. FRL-9726- 8; on...

  10. Vesicovaginal Fistula-A-5 Year Review

    Vineet Kaur

    2002-01-01

    Full Text Available A rctrospective analysis of 25 patients who underwent surgery for vesicovaginal fistula is herebyreported. The mean age ofpatients was 38.48 ± 10.72 years. Gynaecological surgery was the leadingfactor in etiology in 60% cases followed by obstetrical trauma in 32% and road traffic accident in8%. The primary presenting complaint was leaking of urine per vagina and the mean duration ofsymptoms was 41.81 months ± 9.90. Fistulas due to gynaecological surgical trauma were seen onthe vault. while anterior vaginal wall was involved in obstetrical trauma. 84% of patients had singlefistula, in remaining 16% two to three fistulas were demonstrated. In 20 patients. transvaginal repairwas done, remaining 5 patients underwent repair via abdominal route. Success rate of 80% wasreported in Ollr series.

  11. Metastatic Brain Tumors: A Retrospective Review in East Azarbyjan (Tabriz

    Zinat Miabi

    2011-02-01

    Full Text Available A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran. Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%, followed by lung (40.3%, kidney (7.7%, colorectal (4.6%, lymphoma (3.1% and melanoma (1.5%. Most patients were presented with features of increased intracranial pressure (headaches and vomiting, seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%. Twenty cases (15.5% had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%.

  12. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  13. Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature.

    Medsinge, A; Gajdosova, E; Moore, W; Nischal, K K

    2016-04-01

    PurposeTo assess the outcome of early therapeutic penetrating keratoplasty (PKP) for corneal melt leading to perforation in children.MethodsCase notes of all the consecutive patients presenting with acute corneal perforation that underwent urgent therapeutic PKP between 2000 and 2010 to the practice of one of the authors, both NHS at Great Ormond Street Hospital for Children and private, were retrospectively reviewed. Onset of perforation, underlying cause, medical and surgical treatment, pre- and post-operative visual acuity, graft clarity, length of follow-up, and post-operative complications were recorded.ResultsFour eyes of four consecutive patients (mean age of 9.5 years and median 8.5 years, range 4-17 years) were treated for acquired acute onset corneal perforations. There were three females and one male. Etiologies included herpes simplex keratitis secondary to immune recovery disease post bone marrow transplantation, acanthamoeba keratitis, recessive dystrophic epidermolysis bullosa, and blepharokeratoconjunctivitis with acne rosacea. Pre-operative visual acuity ranged from hand movements to 6/150. All the patients had severe anterior chamber inflammation. All eyes improved in visual acuity ranging from 6/9 to 6/18 with clear grafts at last follow-up. There was no recurrence of melt or perforation. Mean follow-up was 67 months (median 44 months).ConclusionPKP during the acute phase together with aggressive medical therapy and close follow-up may achieve good visual outcomes in children with corneal melt with perforation and should be considered. Waiting may sometimes allow the marked inflammatory response seen in children to cause irreversible structural and/or functional damage. PMID:26821761

  14. Substandard and falsified medicines in the UK: a retrospective review of drug alerts (2001–2011)

    Almuzaini, Tariq; Sammons, Helen; Choonara, Imti

    2013-01-01

    Objective: To determine the extent of substandard and falsified medicines in the UK. Design: A retrospective review of drug alerts and company-led recalls. Setting: The Medicines and Healthcare Products Regulatory Agency (MHRA) website search for drug alerts issued between 2001 and 2011. Eligibility criteria: Drug alerts related to quality defect in medicinal products. Main outcome measure: Relevant data about defective medicines reported in drug alerts and co...

  15. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Slothower Molly P; Anbar Ran D

    2006-01-01

    Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if...

  16. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study

    Soop, Michael; Fryksmark, Ulla; Köster, Max; Haglund, Bengt

    2009-01-01

    Objectives To estimate the incidence, nature and consequences of adverse events and preventable adverse events in Swedish hospitals. Design A three-stage structured retrospective medical record review based on the use of 18 screening criteria. Setting Twenty-eight Swedish hospitals. Population A representative sample (n = 1967) of the 1.2 million Swedish hospital admissions between October 2003 and September 2004. Main Outcome Measures Proportion of admissions with adverse events, the proport...

  17. A retrospective review of telehealth services for children referred to a paediatric nephrologist

    Trnka, Peter; White, Megan M.; Renton, William D.; McTaggart, Steven J.; Burke, John R.; Smith, Anthony C.

    2015-01-01

    Background Telemedicine has emerged as an alternative mode of health care delivery over the last decade. To date, there is very limited published information in the field of telehealth and paediatric nephrology. The aim of this study was to review our experience with paediatric telenephrology in Queensland, Australia. Methods A retrospective audit of paediatric nephrology telehealth consultations to determine the nature of the telehealth activity, reasons for referral to telehealth, and to co...

  18. The Effect of Rapid Response Teams on End-of-Life Care: A Retrospective Chart Review

    Benjamin Tam; Mary Salib; Alison Fox-Robichaud

    2014-01-01

    BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care.OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes.METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The ...

  19. Survival analysis of Y-90 radiosynovectomy in the treatment of haemophilic synovitis of the knee: a 10-year retrospective review.

    Turkmen, C; Kilicoglu, O; Dikici, F; Bezgal, F; Kuyumcu, S; Gorgun, O; Taser, O; Zulfikar, B

    2014-01-01

    Despite recent advances including new therapeutic options and availability of primary prophylaxis in haemophiliacs, haemophilic synovitis is still the major clinical problem in significant patient population worldwide. We retrospectively reviewed our 10-year experience with Y-90 radiosynovectomy to determine the outcome in the knee joints of patients with haemophilic synovitis. Between 2002 and 2012, 82 knee joints of 67 patients with haemophilic synovitis were treated with Y-90 radiosynovectomy. The mean age was 16.8 ± 7.8 years (range: 5-39 years). The mean follow-up period was 39.6 ± 25.6 months (range: 12-95 months). Failure of therapy represented re-bleeding after a radiosynovectomy was used as an end point in patient time to progression (TTP) analysis. The median TTP was calculated as 72.0 ± 3.6 months (95% CI 64.8-79.1 months) in Kaplan-Meier analysis. The 1, 3 and 5-year survival rates were 89%, 73% and 63% respectively. Longer TTP (hazard ratio for progression, 2.5; P = 0.00) was evident in patients who have greater reduction in bleeding frequency within 6 months after radiosynovectomy. We did not find a relationship between the TTP and the following variables: age, type and severity of haemophilia, the presence or absence of inhibitor, the radiological score, range of motion status of joints and the pretreatment bleeding frequency. We concluded that Y-90 radiosynovectomy in knee joint represents an important resource for the treatment of haemophilic synovitis, markedly reducing joint bleeding and long-term durability, irrespective of the radiographic stage and inhibitor status. PMID:23937560

  20. 76 FR 23520 - Periodic Review of Existing Regulations; Retrospective Review Under E.O. 13563

    2011-04-27

    ... 2008 (73 FR 75625, December 12, 2008). We currently conduct this review of pending proposed rules about... needs and to take advantage of and support advances in innovation. The goal of this review of existing... possible in your comments. To support its efforts to support innovation, FDA is particularly interested...

  1. Pattern of Rheumatic Fever in Egyptian Children Younger Than 5 Years

    Ibrahim, L. A.; Fattouh, A. M.; Hamza, H. S.; Attia, W. A.

    2013-01-01

    Aims: Acute rheumatic fever (ARF) is common between 5-15 years, uncommon with different presentation 25 in children below 5 years. The aim of this study is to assess the frequency and characterize the pattern of 26 presentation of rheumatic fever (RF) in Egyptian children younger than 5 years. Study Design: Retrospective study. Place and Duration of the Study: Pediatric department, cardiology division, Cairo University Children’s Hospital, 5 years follow up. Methodology: We retrospectiv...

  2. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  3. A retrospective chart review to identify perinatal factors associated with food allergies

    Karpa Kelly

    2012-10-01

    Full Text Available Abstract Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02 were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005. Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  4. Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review

    A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease

  5. Sudden cardiac death while playing Australian Rules football: a retrospective 14 year review.

    Parsons, Sarah; Lynch, Matthew

    2016-06-01

    Australian Rules football is a sport which evolved from Gaelic football and which is played by a large number of predominantly male participants in a number of countries. The highest participation rates are in the southern states of Australia. A retrospective review over a period of 14 years identified 14 cases of sudden cardiac death that occurred in individuals while playing the sport. All were male and ranged in age from 13 to 36 years with a mean and median age of 23 years. A spectrum of cardiac causes was identified including coronary artery atherosclerosis, myocarditis, anomalous coronary artery anatomy, arrhythmogenic right ventricular cardiomyopathy, and healed Kawasaki disease. In 5 cases the heart was morphologically normal raising the possibility of a channelopathy. No traumatic deaths were identified. Some of the individuals had experienced symptoms prior to the fatal episode and the role of pre participation screening in reducing mortality is discussed. PMID:26972904

  6. Review of translocations detected by fish for retrospective biological dosimetry applications

    Several European laboratories have combined their research efforts to arrive at a consensus view on using fluorescence in situ hybridisation (FISH) for retrospective dosimetry. The aim of this review is to report these views and to highlight some areas where further work is needed. Translocations in the stable cells should be measured only in the cells that contain the full complement of the painted material. Two-way and one-way translocations should be combined with equal weight. The control level of translocations has a strong dependence on age, which has now been measured and the system has been calibrated. In conclusion, the technique works and a lifetime dose to the bone marrow from low-linear energy transfer radiation of 0.5 Gy above normal background levels can be measured for any individual. The main application is considered to provide an independent verification of lifetime doses to individuals who might form a part of an epidemiological study. (authors)

  7. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

    Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

    2013-01-01

    Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation. PMID:23470141

  8. Preventive Health Perspective in Sports Medicine: The Trend at the Use of Medications and Nutritional Supplements during 5 Years Period between 2003 and 2008 in Football

    Kavukcu, Ethem; Burgazlı, Kamil Mehmet

    2013-01-01

    Objective: To assess the prevalence of medication and nutritional supplement use in male Football Super League players and to observe the long term changes of players' attitudes during 5 years period (4 seasons). Study Design: Retrospective study. Material and Methods: Review and analysis of 4176 doping control forms -declaration reports- about players' medication intake including; Super League, UEFA Cup and the UEFA Champions League matches. Team p...

  9. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    Angalakuditi M

    2011-06-01

    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  10. Pathology of Haemonchus contortus in New World camelids in the southeastern United States: a retrospective review.

    Edwards, Erin E; Garner, Bridget C; Williamson, Lisa H; Storey, Bob E; Sakamoto, Kaori

    2016-03-01

    Most small ruminant farms in tropical climates are plagued by Haemonchus contortus, a hematophagous, abomasal parasite. Heavy burdens of this parasite can cause anemia, hypoproteinemia, weight loss, and mortality in susceptible animals. Haemonchus contortus is becoming a major health concern in New World camelids as well, namely llamas (Llama glama) and alpacas (Vicugna pacos), yet little research has been conducted regarding its prevalence or pathology in these species. Herein, we present a retrospective review of llamas and alpacas that were admitted to The University of Georgia Veterinary Teaching Hospital and Athens Diagnostic Laboratory between the years 2002 and 2013. Antemortem fecal egg count (FEC) estimates performed on 30 alpacas were negatively correlated with hematocrit, hemoglobin, and red blood cell count. Total protein was not significantly correlated with FEC. On postmortem examination, 55 of 198 camelids, including 2 from the aforementioned antemortem review, were infected with H. contortus, with llamas (42.6%) having a significantly higher infection rate than alpacas (22.2%). In 15.7% of the total cases, the parasite was the major cause of death. Common gross lesions included peritoneal, thoracic, and pericardial effusions, visceral pallor, subcutaneous edema, and serous atrophy of fat. Histologic lesions included centrilobular hepatic necrosis, hepatic atrophy, lymphoplasmacytic inflammation of the mucosa of the third gastric compartment (C3), extramedullary hematopoiesis in both the liver and spleen, and the presence of nematodes in C3. Our study emphasizes the importance of H. contortus diagnosis and herd monitoring in New World camelids, particularly llamas. PMID:26965230

  11. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  12. Pulsatile lavage for pressure ulcer management in spinal cord injury: a retrospective clinical safety review.

    Bogie, Kath M; Ho, Chester H

    2013-03-01

    Pressure ulcers are major complications of reduced mobility and/or sensation. Pulsatile lavage therapy delivers localized hydrotherapy directly to the wound utilizing a pulsatile pressurized stream of normal saline. The purpose of this study was to evaluate the clinical safety of pulsatile lavage therapy, provided daily at the bedside, in routine management of Stage III and Stage IV pressure ulcers. Charts from 28 male patients with Stage III and Stage IV pressure ulcers and spinal cord injury (SCI) or spinal cord disorders (SCD) were retrospectively reviewed for documentation of adverse events/safety concerns. Mean therapy duration was 46 days (SD 37 days, range 6-152 days). Treatment was interrupted for 6 days in one patient due to minor wound bleeding. No other adverse events, including backsplash injuries, were documented. The results of this chart review suggest pulsatile lavage therapy can be administered at the patient's bedside without adverse events if appropriate protocols are followed. Additional research to confirm the efficacy and effectiveness of this treatment modality in a broader subject population is warranted. PMID:23475450

  13. The first 5 years after the dissertation.

    Hodges, L C; Poteet, G W

    1992-01-01

    To succeed in academia, nursing faculty members must devote the first 5 years following the dissertation to achieving a standard to tenure characteristic of the profession. Most institutions in the country adhere to the American Association of University Professors' guidelines for tenure. These guidelines mandate excellence in teaching, scholarship, and service. A fourth characteristic, leadership, is increasingly considered in tenure decisions. The expectations of an academic career in nursing serve as the foundation for a framework to evaluate the likelihood of success in a particular setting. A detailed 5-year plan for achieving tenure is proposed. PMID:1634654

  14. A 5-year experience of the changing management of ectopic pregnancy.

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée

    2016-07-01

    This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability. PMID:27012598

  15. Normal paediatric bone marrow: magnetic resonance imaging appearances from birth to 5 years

    Bone marrow (BM) assessment is an important aspect of paediatric MRI, with the marrow cavity visible on almost every clinical MR examination. In practice, however, assessment for marrow infiltration in paediatric patients can be challenging. Our aim was to review the MRI appearance of normal BM from 0 to 5 years. Consecutive body MR examinations over 7 years were retrospectively reviewed in patients aged 0–5 years. Patients with anticipated BM abnormality were excluded. All patients had imaging of the spine and/or pelvis with T1-weighted (T1)±T2 with fat saturation, post-contrast T1-weighted, diffusion-weighted or out-of-phase sequences. Nineteen patients were included: nine (47%) infants, 11 (58%) boys, mean age 18.2 months (range 1 day to 3 years and 10 months). On T1 imaging, 69% infant marrow sites and 24% in children >1 year were isointense, the remainder were hyperintense. One hundred per cent BM was T2 fat saturation hyperintense. Enhancement following contrast was seen in 16% of BM sites. Restricted diffusion was seen in 100% infant BM and 50% BM in children >1 year. On out-of-phase imaging, no signal loss was seen in infants, and 21% BM in children >1 year showed signal loss. Due to normal age-related differences in BM histology, MRI for marrow assessment in infants and young children can be misleading and may mimic marrow infiltration.

  16. Retrospective review on obstetric cases of critically ill and dead patients in Dongguan.

    Shen, Li-Han; Fang, Yun-Yong; Zheng, Yan-Bing; Xiao, Li-Juan; Huang, Su-Ran; Liu, Xi-Zhen; Cai, Li-Hua

    2015-03-01

    This retrospective analysis was set to understand the epidemiological status of the critically ill obstetric patients in Dongguan city, Guangdong, China. Understanding the risk factors for the death cases can provide scientific evidences for future preventive strategies to decrease the maternal mortality rate. This retrospective included the statistical data and clinical data on the cases of critically ill and dead obstetric patients admitted to Dongguan People's Hospital and Dongguan Maternal & Child Health Hospital from September 1st, 2009 to August 31st, 2013. Data included numbers of the critically ill maternal and obstetric women, common obstetric and maternal comorbidities and complications in the critically ill patients, the basic characteristics of maternal and obstetric deaths, records of regular prenatal examinations, the time intervals between onset of acute symptoms and ICU admission, blood purification, and the acute physiology and chronic health evaluation II (APACHE II) score. During the 5-year period, there were increasing trend of critically ill pregnant and obstetric patients, and the prevalence rate of critically ill obstetric patients was 8.99-9.28 %. The most common obstetric causes of admission were massive postpartum hemorrhage (63.54 %), followed by pregnancy-associated hypertension (15.85 %) and placenta previa (8.92 %). The most common non-obstetric causes of admission were acute heart failure (1.98 %). In the observed period, 20 critically ill obstetric patients died in these two hospitals (mortality rate 0.24 %, 20/8,129). The mean age of dead women was (30.3 ± 6.6) years old and mean gestational age was (30.1 ± 9.3) weeks. 75 % of the patient had more than two pregnancies. Over 90 % of the patients received education below junior high school level. 85 % of the patients were non-Dongguan natives and regular prenatal care rate was only 15 % on dead cases. The most common causes of death were pregnancy-associated hypertension, acute

  17. Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review

    Das Dilip Kumar

    2012-12-01

    Full Text Available Abstract Background The incidence and mortality from necrotizing fasciitis (NF are increasing in New Zealand (NZ. Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this and other predisposing and precipitating factors and to document NF microbiology, complications and interventions in NZ. Methods We conducted a retrospective review of 299 hospital charts of patients discharged with NF diagnosis codes in eight hospitals in NZ between 2000 and 2006. We documented and compared by ethnicity the prevalence of predisposing and precipitating conditions, bacteria isolated, complications and interventions used. Results Out of 299 charts, 247 fulfilled the case definition. NF was most common in elderly males. Diabetes was the most frequent co-morbid condition, followed by obesity. Nearly a quarter of patients were taking non-steroidal anti-inflammatory drugs (NSAID. Traditional Samoan tattooing was an uncommon cause. Streptococcus pyogenes and Staphylococcus aureus were the two commonly isolated bacteria. Methicillin-resistant Staphylococcus aureus was implicated in a relatively small number of cases. Shock, renal failure, coagulation abnormality and multi-organ dysfunction were common complications. More than 90% of patients underwent surgical debridement, 56% were admitted to an intensive care unit (ICU and slightly less than half of all patients had blood product transfusion. One in six NF cases had amputations and 23.5% died. Conclusion This chart review found that the highest proportion of NF cases was elderly males with co-morbidities, particularly diabetes and obesity. Tattooing was an uncommon precipitating event. The role of NSAID needs further exploration. NF is a serious disease with severe complications, high case fatality and considerable use of health care resources.

  18. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review

    Sami Akbulut; Mahmut Tas; Nilgun Sogutcu; Zulfu Arikanoglu; Murat Basbug; Abdullah Ulku; Heybet Semur; Yusuf Yagmur

    2011-01-01

    AIM: To document unusual findings in appendectomy specimens.METHODS: The clinicopathological data of 5262 pa-tients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies per-formed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English lan-guage studies published between 2000 and 2010 on unusual findings in appendectomy specimens.RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltra-tions, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two pa-tients who were diagnosed with tuberculous appendi-citis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed.CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appen-dectomy specimens should be sent for routine histo-pathological examination.

  19. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  20. Patterns of skin disease in a sample of the federal prison population: a retrospective chart review

    Gavigan, Geneviève; McEvoy, Alana; Walker, James

    2016-01-01

    Background: Dermatology in vulnerable populations is under-researched. Our objective was to analyze the most commonly referred skin diseases affecting the Correctional Service Canada inmates in Ontario. Methods: An observational, cross-sectional, retrospective chart review of inmate patients seen from 2008 until 2013 was performed. Two groups of patients were included in the analysis: those assessed in-person, and those evaluated by e-consult. Results: In the in-person patient group, the 3 most common diagnoses were acne, psoriasis and other superficial mycoses. For the e-consult group, the 3 most frequent diagnoses were acne, psoriasis and rosacea. There was a clear bias toward more inmates being seen in-person where the service was provided (Collins Bay Institution) than from other correctional institutions in Eastern Ontario. Interpretation: Most of the skin diseases that affected the incarcerated population studied were common afflictions, similar to those affecting the general population, which is in agreement with other studies. Future studies investigating skin diseases in male and female inmates across Canada would bestow more generalizable data. PMID:27398381

  1. Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach.

    Wehman, Paul; Brooke, Valerie; Brooke, Alissa Molinelli; Ham, Whitney; Schall, Carol; McDonough, Jennifer; Lau, Stephanie; Seward, Hannah; Avellone, Lauren

    2016-01-01

    Over the past few decades, there has been an increase in prevalence of children with autism spectrum disorders (ASD), and those children are now becoming young adults in need of competitive integrated employment (CIE). Customized employment (CE) is one pathway to employment that has been successful for other individuals with developmental disabilities (DD), though research has been very limited on the effectiveness with individuals with ASD. This paper provides a retrospective review of 64 individuals with ASD who came to our program from 2009 to 2014 for supported employment services as referred by the state vocational rehabilitation services agency. Employment specialists engaged in situational assessment, discovery, job development, customized job descriptions, on-site training and support, positive behavioral supports, and job retention techniques. The employment specialists were responsible for tracking their actual time spent working directly with or for the jobseeker with autism spectrum disorders (ASD). All vocational rehabilitation clients with ASD served during this time successfully secured CIE, and maintained their employment with ongoing supports, with intensity of support time decreasing over time. The majority (63/64, 98.4%) of individuals successfully secured CIE through the use of supported employment, in 72 unique employment positions. Of the majority of the individuals who secured employment, 77% (50) individuals indicated that they had never worked before and additional 18% (12) reported having short intermittent histories of employment. Despite this lack of employment experience, in all cases the jobseeker directed the job search and ultimately the job selection. PMID:26855048

  2. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    Cindy L. Lamerson

    2012-01-01

    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  3. Cerebrospinal fluid cytomorphologic findings in 41 intracranial tumors: a retrospective review

    Maria José Sá

    1995-06-01

    Full Text Available The main objective of this retrospective review of clinical and cerebrospinal fluid (CSF data from 41 patients with intracranial tumors diagnosed between 1975 and 1989, is to report the role that the finding of neoplastic cells in CSF plays, specially when cerebral CT-scanning and MRI were not currently done. Another objective is to study the CSF proteic abnormalities in cerebral tumors. CSF cell count, cytomorphologic pictures obtained after sedimentation and protein findings are described. Tumor cells were seen in 12 cases (29%: medulloblastomas - 6, meningeal carcinomatosis - 3, multiforme glioblastoma - 1, ependymoma -1, cerebral metastasis -1; in two cases it was an unexpected finding. We noticed that tumoral localization next to the ventricles favoured cell exfoliation. Although pleocytosis was rare and uncorrelated with the presence of neoplastic cells, pathological cytomorphologic pictures appeared in most of the cases including all "positive" ones. Our results stress that the appearance of neoplastic cells in CSF remains helpful specially when it is an unexpected finding.

  4. Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

    Baker, Joseph F

    2012-12-01

    Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +\\/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.

  5. MULTIPLE SCLEROSIS ASSOCIATED WITH ANAEMIC SYNDROME: A RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW

    Nadezhda S. Deleva

    2012-02-01

    Full Text Available An association of MS with different anaemic syndromes, most often pernicious and Vit. B12 deficiency anaemia has been reported in the literature. Accordingly, the coincidence of anaemia with MS has been considered to impact seriously on clinical presentation, therapeutic strategy and patient´s quality of life. Objective: To perform a retrospective analysis of 18 cases with anaemic syndrome as a factor of comorbidity in patients with MS. Material and methods: 18 MS patients (15 women and 3 men with RRMS (13, PPMS (2, and SPMS (3 diagnosed according to McDonald criteria were included in the present study. Average age was 36.4±8.5 (22-42 years, average disease duration 10.6±6.8 (4-18 years and means EDSS - 3.5±2.5 points (2-6. All individuals underwent clinical, MRI and hematological examinations. Results: The study group included patients with pernicious (n=8, Vitamin B12 (n=6, and iron (n=3 deficiency anaemia, as well as with β-thalassemia (n=1. In 12 patients anaemic syndrome proceeded MS and in 6 evolved during the course of the desease.Conclusion: Our own notices and literature review suggests a possible causative relation between MS and anaemic syndrome. The role of this coincidence on clinical presentation, necessity of additional treatment, and patient´s quality of life is discussed.

  6. Factors associated with car seat test failure in late preterm infants: A retrospective chart review

    Smith, Ryan W; Mohamed, Adel; Young, Jennifer; Jefferies, Ann; Shah, Vibhuti

    2016-01-01

    BACKGROUND: Professional organizations recommend car seat testing of preterm infants before discharge from hospital. Late preterm infants (LPIs, 340/7 to 366/7 weeks’ gestational age) are at the greatest risk for failure, despite often being well. OBJECTIVE: To determine the incidence of car seat testing failure in LPIs and associative factors. METHODS: A retrospective chart review was performed of inborn LPIs admitted to all levels of newborn care between July 1, 2012 and June 30, 2013. Data collected included maternal demographics, labour and delivery history, and neonatal course. Data were analyzed using backward logistic regression. RESULTS: A total of 511 charts were reviewed and 367 LPIs were eligible for inclusion. Of the 313 LPIs tested (mean [± SD] gestational age 36 weeks ±6 days and birth weight 2614±405 g), 80 (26%) failed (95% CI 21% to 31%). Most failed due to desaturations (≥2) of <88% for ≥10 s (n=33 [41%]). Multiple gestation was associated with failure (adjusted OR 2.45 [95% CI 1.44 to 4.18]; P=0.001), and there was a trend toward statistical significance for the variable postnatal age (0.996 [95% CI 0.99 to 1.00]; P=0.05). Infants who passed their car seat test had higher postnatal ages than those who failed (mean difference 39.4 h [95% CI 12.7 h to 66.0 h]; P=0.004). CONCLUSION: Twenty-six percent of LPIs failed car seat testing. Ideally, infants should be tested after an appropriate transitional period. The authors identified factors that may be important in designing future, prospective studies in this area. Future research should evaluate the clinical significance of car seat testing and resource utilization. PMID:26941555

  7. Retrospective review of pediatric patients with acute lymphoblastic leukemia: A single center experience

    Khalid Safoorah

    2010-10-01

    Full Text Available Objective: We reviewed the clinical details and treatment outcome of children with newly diagnosed acute lymphoblastic leukemia (ALL to determine the significance of already established prognostic factors in our patients. Setting: A tertiary care hospital in Karachi, Pakistan. Study Design: This is a retrospective study. Materials and Methods: Children diagnosed with ALL were evaluated over a period of 17 years (January 1, 1989 to December 31, 2006. Data was collected by reviewing the medical records of the patients and the prognostic factors analyzed by us include age, gender, white blood cell count, central nervous system and mediastinal involvement at presentation, morphology and immunophenotype of the blast cells, and response to induction therapy. Results: There were 46 patients diagnosed during the study period and on regular follow-up. Forty five (97.8% of these were in complete remission after 28 days of induction therapy. Thirty patients (65.2% were alive and doing well at the time of study. Of these 30 patients, 26 (86.6% remained relapse free while only four (13.3% had relapsed. The remaining 16 patients (34.7% did not survive including 11 (68.7% who had a relapse. Only significant variables in terms of prognosis were age and ALL phenotype with a P value 0.04 and 0.03 respectively. Conclusion: We found that ALL is a frequent childhood hematological malignancy in our setting and is more prevalent in males and children less than ten years of age. Age and leukemia phenotype emerged as the important prognostic factors in pediatric ALL in our patients.

  8. Soviet business chaos seen lasting 5 years

    This paper reports that companies seeking work in the collapsing Soviet Union can expect political uncertainty for another 5 years. PW discussed changes in the Soviet Union and offered advice on dealing with officials of the central government and Soviet republics at a recent meeting in Houston with executives of oil field service companies. That meeting preceded reports of the Russian federation, Ukraine, and Byelorussia agreeing to form a Slavic commonwealth

  9. A retrospective review of visual outcome and complications in the treatment of retinoblastoma.

    O'Doherty, M

    2005-01-01

    The aim of this study was to look at the visual outcome and treatment complications of children diagnosed with Retinoblastoma during the years 1985-2003 inclusive. A retrospective review of all patients records was performed. Patient characteristics, treatment methods and complications were recorded. Twenty eight children presented to Temple street Hospital between 1985-2003. Six of these infants had bilateral tumours. The mean age at presentation was 23.7 months. Sixty-nine percent presented with Leucocoria, of these 33% also had a squint. The mean duration of symptoms was only known in 58% and this figure was approximately 19.8 months. Enucleation was performed in 24 eyes of 24 patients. Three patients required adjuvant chemotherapy post enucleation. Two eyes was treated with external beam radiation and one eye with plaque radiotherapy. One eye (second eye) was treated with systemic chemotherapy and radiation. Five eyes of three patients were treated with systemic chemotherapy followed by adjuvant Argon laser, cryotherapy and diode laser to each eye.The complications of each treatment group was recorded. The visual outcome in the salvaged eyes was favourable. There were no deaths recorded. Though chemotherapy with adjuvant local treatments provide adequate treatment for early tumours, enucleation still plays a major role in the treatment of Retinoblastoma. The total eye salvage rate in this study was 29% with an enucleation rate of 90% in unilateral cases and 33% in bilateral cases. Sixty-six percent of bilateral eyes affected were salvaged. Seventy-one percent of tumours were diagnosed after a parent noticed a gross abnormality of the eye. This highlights the possible need for screening for retinoblastoma in the infant population.

  10. Surgical Treatment and Recurrence of Cutaneous Nasal Malignancies: A 26-Year Retrospective Review of 1795 Patients.

    Christopoulos, George; Sergentanis, Theodoros N; Karantonis, Fotis; Karypidis, Dimitrios; Hampsas, Grigoris; Kostopoulos, Epaminondas; Kostaki, Maria; Papadopoulos, Othon

    2016-08-01

    Frequent localization of facial malignancies in the nasal area and their required complete surgical extirpation pose a significant challenge to the plastic surgeon, who is called to perform a suitable delicate reconstruction of produced nasal skin defects. The present study was aimed to examine the role of tumor characteristics in the prognosis of patients with nasal skin cancer undergoing surgical management.A retrospective review of 1795 patients operated on for nasal cutaneous neoplasms during a 26-year period is presented in our study. Descriptive statistics were appropriately calculated; multivariate Cox regression analysis was performed regarding the possible risk factors for recurrence. Only those with a complete follow-up were included in the study. The mean age of our study population was 66.7 years with a male majority (52.4%). Basal cell carcinoma appeared as the most common histological type (87.7%), followed by squamous cell carcinoma (7.9%); the latter correlated with poor prognosis.The nasal sidewalls were the most frequent lesion location (29.8%), followed by the alae (27.8%), dorsum (21.7%), and tip (19.3%). The columella was very rarely affected (0.5%) but was associated with increased recurrence [hazard ratio, 4.74; 95% confidence interval (CI), 1.12-20.00; P = 0.034]. Most patients were treated with elliptical excision and direct closure (58.7%). Local flaps (31.0%) and skin grafting (9.0%) proved very reliable surgical options, especially for larger, high-risk lesions. Recurrence transpired in 46 patients (2.6%) and 4 skin cancer-related deaths occurred.Surgical modality of choice should be individualized and carefully adjusted to patients' needs. Moreover, more elective techniques, such as Mohs micrographic surgery or cumulative therapeutic approaches, like irradiation, should be examined as a beneficial aid to confront high-risk malignancies. PMID:26207539

  11. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  12. Retrospective review of factors leading to dissatisfaction with subthalamic nucleus deep brain stimulation during long-term management

    Farris, Sierra; Giroux, Monique

    2013-01-01

    Background: Subthalamic nucleus deep brain stimulation is effective in reducing motor symptoms in appropriately selected patients with Parkinson's disease. We identified factors that contribute to poor outcomes during early, middle and late stages of stimulation management in a series of patients that were referred for troubleshooting poor outcomes. Methods: We performed a retrospective review of 50 patients with bilateral STN DBS seen in our movement disorders clinic with unsatisfactory clin...

  13. GCS as a predictor of mortality in patients with traumatic inferior vena cava injuries: a retrospective review of 16 cases

    Cudworth, Michael; Fulle, Angelo; Ramos, Juan P; Arriagada, Ivette

    2013-01-01

    Introduction Recent research has determined Glasgow Coma Scale (GCS) to be an independent predictor of mortality in patients with traumatic inferior vena cava (IVC) injuries. The aim of this study was to evaluate the use of GCS, as well as other factors previously described as determinants of mortality, in a cohort of patients presenting with traumatic IVC lesions. Methods A 7-year retrospective review was undertaken of all trauma patients presenting to a tertiary care trauma center with trau...

  14. Maternal and paternal filicides: a retrospective review of filicides in Finland.

    Kauppi, Anne; Kumpulainen, Kirsti; Karkola, Kari; Vanamo, Tuija; Merikanto, Juhani

    2010-01-01

    The purpose of this retrospective study was to illustrate the differences in maternal and paternal filicides in Finland during a 25-year period. In the sample of 200 filicides [neonaticides (n = 56), filicide-suicides (n = 75), other filicides (n = 69)], the incidence was 5.09 deaths per 100,000 live births: 59 percent of filicides were committed by mothers, 39 percent by fathers, and 2 percent by stepfathers. The mean age of the maternal victims (1.6 y) was significantly lower than that of the paternal victims (5.6 y), but no correlation between the sex of the victim and the sex of the perpetrator was found, and the number of female and male victims was equal. The sample of other filicides (n = 65) was studied more closely by forensic psychiatric examination and review of collateral files. Filicidal mothers showed mental distress and often had psychosocial stressors of marital discord and lack of support. They often killed for altruistic reasons and in association with suicide. Maternal perpetrators also dominated in filicide cases in which death was caused by a single episode or recurrent episodes of battering. Psychosis and psychotic depression were diagnosed in 51 percent of the maternal perpetrators, and 76 percent of the mothers were deemed not responsible for their actions by reason of insanity. Paternal perpetrators, on the other hand, were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent toward their mates. In 18 percent of the cases, they were not held responsible for their actions by reason of insanity. During childhood, most of the perpetrators had endured emotional abuse from their parents or guardians, some of whom also engaged in alcohol abuse and domestic violence. The purpose of this study was to examine the differences between maternal and paternal filicides in a sample of 200 cases in Finland. This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a

  15. Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review

    Watts Patrick

    2001-01-01

    Full Text Available Purpose: To compare the success rates of external dacryocystorhinostomy (EXT-DCR with 5-fluorouracil (5-FU augmented endonasal laser dacryocystorhinostomy (ENL-DCR and to record the complications associated with 5-FU augmented ENL-DCR Materials and Methods: This was a retrospective non-randomised study. Forty-one patients with primary acquired nasolacrimal duct obstruction underwent an EXT-DCR (19 patients or an ENL-DCR (22 patients over a 3-year period. A Holmium YAG laser (Ho:YAG was used in the latter group of patients. Silicone tubes intubated in all patients were removed at three months. 5-FU was applied intraoperatively at the site of the ostium in the ENL-DCR patients. The median follow-up was 12 months (range 3-24 months for the ENL-DCR group and 22 months (range 6-28 months for the EXT-DCR group. The patency of the lacrimal system and the severity of epiphora were assessed at a final-review. Results: The median age of the EXT-DCR group was 77 years (range 53-87 and that of the ENL-DCR group was 71 years (range 23 to 84. There were 12 female patients in the former group and 19 in the latter. The percentage of success in the EXT-DCR group was 94.7% (95% confidence interval (CI = 75.4-99.1 = , and 63.6% in the ENL-DCR group (95% CI= 43.0-80.3. The confidence interval for the difference of 31.1% was 5.6-52.2. There was a statistically significant difference between the two groups, p=0.024 (Fisher exact test. Conclusions: These data suggest that EXT-DCR provides better results than 5-FU augmented ENL-DCR. However, ENL-DCR is the procedure of choice in certain circumstances such as in elderly, frail or medically unfit patients. Our results of 5-FU augmented ENL-DCR compare favourably with other published series.

  16. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications.

    Slade, J F; Gillon, T

    2008-01-01

    The purpose of this paper is to retrospectively review 234 consecutive cases of scaphoid fractures and nonunions treated using arthroscopy with the dorsal percutaneous implantation of a headless compression screw for healing and complications. Solid union of fracture is determined by CT scan. We identified 126 acute injuries, including 65 proximal pole fractures; 67 grossly displaced fractures; 12 trans-scaphoid perilunate dislocations including four trans-scaphoid trans-capitate fractures; and ten combined scaphoid and distal radius fractures. 108 scaphoid nonunions were identified. 98 were correctly aligned and ten had a humpback deformity which was correctable using arthroscopic assisted reduction techniques at the time of surgery. 82 presented with a fracture gap 2mm or greater requiring percutaneous bone grafting. 12 cases of avascular necrosis (AVN) were identified by MRI. 20 nonunions had surgery performed at other institutions. The mean time to surgery for the nonunions was 20 months. 99% union rate of acute scaphoid fractures was obtained by 12 weeks, as determined by CT scan. Two complications were identified (3%). One case of delayed healing was identified. this delayed union was treated with percutaneous bone grafting and continued on to heal uneventfully. The other complication was a case of volar trans-scaphoid peri-lunate dislocation. While the fracture healed, the patient developed a traumatic dislocation requiring a capitate-lunate arthrodesis. Treatment of scaphoid nonunions resulted in ten cases of delayed healing, which were treated with repeat percutaneous bone grafting. This represented a 9% complication rate. of the ten cases of delayed unions that were re-bone grafted, four failed to heal by nine months. This resulted in a 96% union rate of our nonunion group by nine months. when acute fracture healing was compared to nonunions the average healing of acute fractures as determined by CT scanning measuring trabecular bridging was 12 weeks

  17. 76 FR 26651 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-05-09

    ... diplomacy are based on generation of trust, and the establishment of common dialogue. Most of these..., ongoing culture of retrospective analysis? The Department's leadership, beginning with Secretary Clinton... change, human rights, institution building, and international trade and finance. The complexity of...

  18. 76 FR 78183 - Preliminary Plan for Retrospective Review Under E.O. 13579

    2011-12-16

    ... burdens caused by the rule. This order highlights the importance of maintaining a culture of retrospective... economic entities and businesses. Over the last ten years, the Commission has issued 13 publications of..., headed by the former chief of staff, undertook a project to rewrite the Commission's Rules and...

  19. Epidemiology of basal cell carcinomas and squamous cell carcinomas in a Department of Dermatology: a 5 year review Epidemiologia dos carcinomas basocelulares e espinhocelulares em um Serviço de Dermatologia: revisão de 5 anos

    Pedro Andrade

    2012-04-01

    Full Text Available BACKGROUND: Non-melanoma skin cancer, a common designation for both basal cell carcinomas and squamous cell carcinomas, is the most frequent malignant skin neoplasm. OBJECTIVE: Epidemiologic characterization of the population with Non-melanoma skin cancer. METHODS: Retrospective analysis of all patients diagnosed with Non-melanoma skin cancer based on histopathologic analysis of all incisional or excisional skin biopsies performed between 2004 and 2008 in a Department of Dermatology. RESULTS: A total of 3075 Non-melanoma skin cancers were identified, representing 88% of all malignant skin neoplasms (n=3493 diagnosed in the same period. Of those, 68,3% were basal cell carcinomas. Most Non-melanoma skin cancer patients were female and over 60 years old. Of all Non-melanoma skin cancer, 81,7% (n=1443 were located in sun-exposed skin, and represented 95,1% of malignant skin neoplasms in sun-exposed skin. Non-melanoma skin cancer was the most frequent malignant skin neoplasm in most topographic locations, except for abdomen and pelvis - over 95% of all malignant skin neoplasms in the face, neck and scalp were Non-melanoma skin cancer. Basal cell carcinomas were clearly predominant in all locations, except in upper and lower limbs, lower lip and genitals, where squamous cell carcinomas represented respectively 77,7%, 77,4%, 94,7% and 95,3% of the Non-melanoma skin cancers. CONCLUSION: Being the most common skin cancer, Non-melanoma skin cancer should be under constant surveillance, in order to monitor its epidemiologic dynamics, the efficiency of preventive measures and the adaptation of the healthcare resources.FUNDAMENTOS: O cancro cutâneo não-melanoma, designação conjunta para os carcinomas basocelulares e espinhocelulares, é o tipo de neoplasia cutânea maligna mais frequente. OBJETIVOS: Caracterização epidemiológica da população diagnosticada com cancro cutâneo não-melanoma. MÉTODOS: Foi realizada uma análise retrospectiva dos

  20. Ocular manifestations of idiopathic aplastic anemia: retrospective study and literature review

    Mansour AM

    2014-04-01

    Full Text Available Ahmad M Mansour,1 Jong Wook Lee,2 Seung Ah Yahng,2 Kyu Seop Kim,3 Maha Shahin,4 Nelson Hamerschlak,5 Rubens N Belfort,6 Shree K Kurup71Department of Ophthalmology, American University of Beirut, Rafic Hariri University Hospital, Beirut, Lebanon; 2Division of Hematology, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea; 3Department of Ophthalmology, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea; 4Department of Ophthalmology, Mansoura University, Mansoura City, Egypt; 5Oncology and Hematology Program, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil; 6Vision Institute, Hospital São Paulo, Federal University of São Paulo, Brazil; 7Department of Ophthalmology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USAAbstract: Aplastic anemia (AA is a rare disease with few reports on its ophthalmic ­manifestations. The ocular findings are described in a retrospective consecutive series of 719 AA Korean patients followed at the Hematology Clinic of The Catholic University of Korea. Out of a total of 719 patients, 269 patients had eye examinations, 156 patients had retinal evaluation, and 37 (23.7% had retinal findings. These 37 patients had unilateral retinal ­hemorrhage in seven and bilateral retinal hemorrhage in 30 with mean hemoglobin of 6.6 g/dL (range 2.7–12.6 g/dL and platelet counts of 18.8×109/L (range 4–157×109/L; central retinal vein occlusion-like picture occurred in nine patients and these had similar rheology to the rest of the subjects; optic disc edema, cotton-wool spots, macular edema, and dry eyes occurred in two, three, five, and three patients, respectively. In this Korean series of 141 subjects with AA, systemic bleeding occurred in 24.8% of subjects, retinal hemorrhage in 37% of subjects, and any bleeding site (eye or elsewhere occurred in 47.5% of subjects with AA. A

  1. Peri-Abortion Contraceptive Choices of Migrant Chinese Women: A Retrospective Review of Medical Records

    Rose, Sally B; Wei, Zhang; Cooper, Annette J.; Lawton, Beverley A.

    2012-01-01

    Background Migrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees. Methods Retrospective re...

  2. MULTIPLE SCLEROSIS ASSOCIATED WITH ANAEMIC SYNDROME: A RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW

    Nadezhda S. Deleva; Kalina V. Drenska; Ara G. Kaprelyan; Alexandra J. Tzoukeva

    2012-01-01

    An association of MS with different anaemic syndromes, most often pernicious and Vit. B12 deficiency anaemia has been reported in the literature. Accordingly, the coincidence of anaemia with MS has been considered to impact seriously on clinical presentation, therapeutic strategy and patient´s quality of life. Objective: To perform a retrospective analysis of 18 cases with anaemic syndrome as a factor of comorbidity in patients with MS. Material and methods: 18 MS patients (15 women and 3 men...

  3. The American Board of Radiology Holman Research Pathway: 10-Year Retrospective Review of the Program and Participant Performance

    Introduction: In 1999, the American Board of Radiology (ABR) implemented an innovative training program track in diagnostic radiology (DR) and radiation oncology (RO) designed to stimulate development of a cadre of future academic researchers and educators in the 2 disciplines. The program was designated the Holman Research Pathway (HRP). An in-depth retrospective review of initial certification examination performance, post-training career choices, and academic productivity has not been written. This report represents a 10-year retrospective review of post-training performance of a cohort of trainees who have had sufficient time to complete their training and initial certification process and to enter practice. Methods and Materials: All pertinent proceedings of the ABR and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committees for DR and RO between 1997 and May 2011 were reviewed. Thirty-four HRP candidates who fulfilled the established evaluation criteria were identified, and their ABR data files were analyzed regarding performance on the qualifying and certifying examinations. All candidates were contacted directly to obtain a current curriculum vitae. Results: Twenty candidates in RO and 14 candidates in DR were identifiable for review. All candidates attained initial certification. At the time of analysis, 23 of 33 (66.6%) candidates were employed in full-time academic practice (1 DR candidate remained in a fellowship and was not evaluated regarding employment status). Fifteen of 20 (75%) RO candidates were in faculty positions compared with 7 of 13 (53.8%) DR trainees. Additional academic productivity metrics are reported. Conclusions: A high percentage of HRP trainees remained in academic practice and demonstrated significant academic productivity as measured by manuscript authorship and research support. Additional time and observation will be needed to determine whether these findings will be sustained by past, current

  4. The American Board of Radiology Holman Research Pathway: 10-Year Retrospective Review of the Program and Participant Performance

    Wallner, Paul E., E-mail: pwallner@theabr.org [21st Century Oncology, LLC, Fort Myers, Florida, and American Board of Radiology, Tucson, Arizona (United States); Ang, K. Kian [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zietman, Anthony L. [Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (United States); Harris, Jay R. [Harvard Medical School and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Ibbott, Geoffrey S. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mahoney, Mary C. [University of Cincinnati Medical Center, Cincinnati, Ohio (United States); Mezwa, Duane G. [Oakland University William Beaumont School of Medicine, Royal Oaks, Michigan (United States); Wilson, Lynn D. [Yale University School of Medicine, New Haven, Connecticut (United States); Becker, Gary J. [American Board of Radiology, Tucson, Arizona (United States)

    2013-01-01

    Introduction: In 1999, the American Board of Radiology (ABR) implemented an innovative training program track in diagnostic radiology (DR) and radiation oncology (RO) designed to stimulate development of a cadre of future academic researchers and educators in the 2 disciplines. The program was designated the Holman Research Pathway (HRP). An in-depth retrospective review of initial certification examination performance, post-training career choices, and academic productivity has not been written. This report represents a 10-year retrospective review of post-training performance of a cohort of trainees who have had sufficient time to complete their training and initial certification process and to enter practice. Methods and Materials: All pertinent proceedings of the ABR and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committees for DR and RO between 1997 and May 2011 were reviewed. Thirty-four HRP candidates who fulfilled the established evaluation criteria were identified, and their ABR data files were analyzed regarding performance on the qualifying and certifying examinations. All candidates were contacted directly to obtain a current curriculum vitae. Results: Twenty candidates in RO and 14 candidates in DR were identifiable for review. All candidates attained initial certification. At the time of analysis, 23 of 33 (66.6%) candidates were employed in full-time academic practice (1 DR candidate remained in a fellowship and was not evaluated regarding employment status). Fifteen of 20 (75%) RO candidates were in faculty positions compared with 7 of 13 (53.8%) DR trainees. Additional academic productivity metrics are reported. Conclusions: A high percentage of HRP trainees remained in academic practice and demonstrated significant academic productivity as measured by manuscript authorship and research support. Additional time and observation will be needed to determine whether these findings will be sustained by past, current

  5. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

    Sam, Sing-Sin; Omar, Sharifah Faridah Syed; Teoh, Boon-Teong; Abd-Jamil, Juraina; Abubakar, Sazaly

    2013-01-01

    Background Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. Methodology/Principal Findings We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if t...

  6. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

    Sing-Sin Sam; Sharifah Faridah Syed Omar; Boon-Teong Teoh; Juraina Abd-Jamil; Sazaly AbuBakar

    2013-01-01

    BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if...

  7. A retrospective study regarding the treatment of lupoid onychodystrophy in 30 dogs and literature review.

    Mueller, Ralf S; Rosychuk, Rodney A W; Jonas, Leonard D

    2003-01-01

    The treatment records of 30 dogs with lupoid onychodystrophy were evaluated retrospectively. Dogs were treated with fatty acid supplementation (n=18), doxycycline and niacinamide (n=12), tetracycline and niacinamide (n=10), pentoxifylline (n=6), prednisolone (n=5), azathioprine (n=1), clofazimine (n=1), or with combinations thereof. An excellent response was seen in almost half of the patients treated with tetra- or doxycycline in combination with niacinamide. Six of the dogs were maintained successfully on fatty acid supplementation. Spontaneous remissions and recurrences made evaluation of success rates difficult and emphasized the varied and often unclear etiology and natural course of the syndrome. PMID:12617542

  8. 76 FR 11395 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-03-02

    ... Regulatory Review,'' HUD is reviewing its existing regulations to evaluate their continued effectiveness in... burdensome. The purpose of this regulatory review is to make the Department's regulations more effective and... INFORMATION CONTACT: Camille E. Acevedo, Associate General Counsel for Legislation and Regulations, Office...

  9. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    Moorthy, I.; Joshi, N.; Cook, J.V. E-mail: jcook@epsom-sthelier.nhs.uk; Warren, M

    2003-12-01

    AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG

  10. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG

  11. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients

    Nielsen SA

    2013-04-01

    Full Text Available CorrigendumNielsen SA, McDonald MB, Majmudar PA. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients. Clinical Ophthalmology. 2013;7:149–156. The paper titled "Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients," contains an inaccurate description of the intraoperative use of medications.In the Results section it is reported that 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface. We have determined that ambiguity in the design of the electronic case report form resulted in all day-of-surgery drops provided to patients in the LASER suite being reported in the flap interface field. The authors have since clarified with each surgeon who reported intraoperative drug use that the drops were delivered either prior to the flap creation, or following replacement of the flap.The sentence at the top of page 152 stating: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface" should say: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had intraoperative drops applied."Read the original article

  12. Retrospective review of thoracic neural damage during lung ablation - what the interventional radiologist needs to know about neural thoracic anatomy

    Palussiere, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonie, Department of Interventional Radiology (France); Canella, Mathieu [Centre Hospitalier Pau, Department of Radiology (France); Cornelis, Francois; Catena, Vittorio; Descat, Edouard [Institut Bergonie, Department of Interventional Radiology (France); Brouste, Veronique [Institut Bergonie, Clinical and Epidemiological Research Unit (France); Montaudon, Michel [CHU Haut Leveque, Department of Radiology (France)

    2013-12-15

    Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications.

  13. Surgical excision of wrist ganglia; literature review and nine-year retrospective study of recurrence and patient satisfaction

    Surjit Lidder

    2009-06-01

    Full Text Available The main options for the treatment of wrist ganglia are reassurance, aspiration, arthroscopic resection and open excision. Variations within each option have been described and the literature is clouded by widespread variability in the results reported. We present the results of our own long-term retrospective study, review the literature and question the surgical risks and demands placed on healthcare resources. A retrospective review of the surgical results of dorsal and volar wrist ganglia excision between January 1998 and March 2005 was undertaken at a single institution. Of the 152 patients in this consecutive series, 117 (77% patients responded to a telephone questionnaire. The mean length of follow-up in this series of 117 patients was 4.2 years (range 1.5-8.7 years. The overall recurrence rate following excision of all wrist ganglia in this series was 41.8 %. When looking just at volar ganglia, the risk of recurrence is higher at 46.8%. Should the ganglion recur, the risk of developing a moderate to severely tender scar is 34.6% and the risk of developing an unsightly scar is 8.2%. This study questions the effectiveness of surgical excision in the treatment of wrist ganglia when performed by a mixture of surgeons in that the recurrence rates are very similar to the rates seen in studies that merely observe or aspirate wrist ganglia. We propose that for symptomatic ganglia, specialists in hand surgery may be more appropriate at treating such a pathology.

  14. Peer review comments on drug trials submitted to medical journals differ depending on sponsorship, results and acceptance: a retrospective cohort study

    Lent, M. van; Hout, J. in't; Out, H.J.

    2015-01-01

    OBJECTIVE: During peer review, submitted manuscripts are scrutinised by independent experts to assist journal editors in their decision-making and to help improve the quality of articles. In this retrospective cohort study, peer review comments for drug trials submitted to medical journals were anal

  15. PROFILE OF EYELID TUMORS AT TERTIARY CARE INSTITUTE IN KARNATAKA: A 5-YEARS SURVEY

    Hemalatha

    2014-10-01

    Full Text Available PURPOSE: The purpose of this study was to evaluate the proportion of eyelid tumors, compare the clinical diagnosis with histopathological diagnosis in all possible cases in a tertiary eye hospital over a 5-year period. MATERIALS AND METHODS: Retrospective chart review was performed for patients with eyelid tumors from June 2009 to June 2014.Data were collected and analyzed on location of tumor, types of treatment, and pathologic findings. Histopathological diagnosis of benign and malignant tumors was stratified based on age, gender and tumor location. RESULTS: Total number of 235 patients was evaluated of which, 216 (91.9% cases were benign and 19(8.1% cases were malignant neoplasms. Most common benign tumors included epidermal cyst(30.5%, nevi (17.5%, dermoid cyst (13.8% and papilloma (6.5%.Most frequent malignant tumors included Sebaceous gland carcinoma (SGC (31.6%, Basal cell carcinoma (BCC (26.3%, Squamous cell carcinoma (21%, Malignant melanoma (10.5%, Merkel cell carcinoma(5.3% and Lymphoma (5.3%.Most common site for malignancy was lower lid followed by upper lid. BCC recurred in 1case in lower lid. CONCLUSION: Epidermal cyst, nevi, dermoid cyst and papilloma are the most common benign lesions and SGC is the most common malignant lesion. Recurrence is a feature of BCC in lower lid.

  16. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  17. Evolving standards of practice for cervical spine imaging in trauma: a retrospective review

    Full text: Recently published works on radiology and emergency medicine suggest an increasing role for primary CT imaging of the cervical spine (C-spine) in trauma, rather than plain X-rays. This observational retrospective study of 406 patients was undertaken to examine current practice in a metropolitan teaching hospital setting and to define factors affecting the use of primary imaging for suspected C-spine fracture. This study supports the increasing recognition of the limited accuracy and adequacy of plain films, especially among the more severely injured patients. It is suggested that intubated patients, patients with severe trauma or patients with Glasgow Coma Scale <13 have CT as a primary screening examination for suspected C-spine fracture rather than X-ray. Patients having head CT for suspected intracranial injury may also benefit from included C-spine CT. The increasing usage of primary CT will increase overall imaging costs and resource utilization

  18. The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review.

    Fishco, W D; Goecker, R M; Schwartz, R I

    2000-02-01

    A retrospective study was conducted on the use of the instep plantar fasciotomy for the treatment of recalcitrant plantar fasciitis. A total of 83 patients (94 feet) were analyzed. The average postoperative follow-up time was 20.9 months. Surgery was deemed successful 93.6% of the time, and in 95.7% of cases, the patient would recommend the procedure to someone with the same condition. The main complications were scarring (9.6%), medial arch or heel pain (7.5%), cramping in the arch (6.4%), lateral column pain (5.3%), aching or pain across the dorsal midfoot (5.3%), and burning or tingling of the ball of the foot (5.3%). PMID:10697969

  19. 76 FR 34177 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    2011-06-13

    ... regulation and regulatory review, the Department of Labor (DOL or the Department) prepared a preliminary plan... 18, 2011, President Obama issued Executive Order 13563, ``Improving Regulation and Regulatory Review.'' The Order explains the Administration's goal of creating a regulatory system that protects...

  20. 77 FR 5193 - Retrospective Review Under E.O. 13563: Shipping-Removal of Obsolete Regulations

    2012-02-02

    ... 12866, ``Regulatory Planning and Review,'' (58 FR 51735, 10/4/1993), by requiring Federal agencies to design cost- effective, evidence-based regulations that are compatible with economic growth, job creation... outlined a plan to improve regulation and regulatory review (76 FR 3821, 1/21/11). Executive Order...

  1. 76 FR 57941 - Retrospective Review Under E.O. 13563: Cargo Preference

    2011-09-19

    ... regulatory review (76 FR 3821, 1/21/11). Executive Order 13563 reaffirms and builds upon governing principles... ] Review,'' (58 FR 51735, 10/4/1993), by requiring Federal agencies to design cost-effective, evidence... April 11, 2000 (65 FR 19476, 04/11/2011) or at http://www.dot.gov/privacy.html . Authority: 5 U.S.C....

  2. Using systematic reviews to inform NIHR HTA trial planning and design: a retrospective cohort

    Bhurke, Sheetal; Cook, Andrew; Tallant, Anna; Young, Amanda; William, Elaine; Raftery, James

    2015-01-01

    Background Chalmers and Glasziou’s paper published in 2014 recommends research funding bodies should mandate that proposals for additional primary research are built on systematic reviews of existing evidence showing what is already known. Jones et al. identified 11 (23 %) of 48 trials funded during 2006–8 by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme did not reference a systematic review. This study did not explore the reasons for trials not ...

  3. The Alcohol Warning and Adolescents: 5-Year Effects.

    MacKinnon, David P.; Nohre, Liva; Pentz, Mary Ann; Stacy, Alan W.

    2000-01-01

    Examined the effect of alcohol warning labels on adolescents during the first 5 years that the warning was required. Surveys of 10th and 12th grade students over 5 years indicated that the initial positive effects of the labels on adolescents leveled off after 3.5 years. The labels have not affected adolescents' beliefs about alcohol or…

  4. Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

    Chirag Choudhary

    2013-01-01

    Full Text Available To highlight a potentially fatal complication of broncho-vascular fistula arising from the self expanding metallic stent (SEMS placement. We retrospectively analyzed five patients with benign and malignant airway diseases, who developed tracheo/broncho-vascular fistulas following SEMS placement in our tertiary care setting. All patients received either Wallstent or Ultraflex® stent (Boston Scientific, Natick, MA between 1999 and 2007. All patients had received adjunct therapy such as balloon bronchoplasty, laser therapy or electrocautery. Most patients presented with massive hemoptysis. A total of 483 SEMS were placed during this period. SEMS placement can be complicated by Broncho-vascular fistula formation. True incidence and precise time interval between the insertion of stent and onset of this complication is unknown. Additional therapeutic modalities to maintain stent patency may enhance the risk of fistula formation. SEMS should only be used in a select sub-group of patients, after exhaustive evaluation of other treatment options. These cases provide evidence that broncho-vascular fistulas can develop at any time following SEMS placement, suggesting the need for a more cautious approach, especially while using them for a long term management. In benign airway disease, the stent should be removed as soon as healing has taken place.

  5. RETROSPECTIVE ANALYSIS OF PULMONARY SARCOMA AND BLASTOMA WITH REVIEW OF LITERATURES

    陈晋峰; 张力建; 刘静贤

    2003-01-01

    Objective: To explore the clinical characteristics, diagnosis and treatment of pulmonary sarcoma and blastoma. Methods: Seven cases of pulmonary sarcoma (including 1 case of pulmonary carcinosarcoma, 1 case of pulmonary malignant fibroneuroma, 1 case of pulmonary malignant fibrous tissue tumor and 1 case of pulmonary blastoma from August 1995 to June 2002 in our hospital) were retrospectively summarized the histological characteristics, clinical features, diagnosis and treatment. Results: Pulmonary sarcoma and blastoma both are rare malignant tumors and can be easily misdiagnosed or mistreated. The main symptoms of both diseases are cough and expectoration. X ray or CT shows node or focus in lung. They both are diagnosed by histological pathology. Because the symptoms of these diseases are not typical, it is difficult for patients to be diagnosed without pathology. Conclusion: These two kinds of diseases are often easy to be misdiagnosed. Early diagnosis and treatment are important to improve the efficiency of treatment. Surgical resection is the best method of treatment, and it is important to combine with chemotherapy and radiation treatment.

  6. Combined Effect of Opioids and Corticosteroids for Alleviating Dyspnea in Terminal Cancer Patients: A Retrospective Review.

    Maeda, Tsuyoshi; Hayakawa, Toru

    2016-06-01

    Dyspnea is a prognostic factor that affects the quality of life of terminal cancer patients, and many reports have described opioid treatment for dyspnea alleviation. Here, we retrospectively evaluated differences in the effects of various opioids administered concomitantly with corticosteroids on dyspnea in 20 terminal-stage cancer patients (13 men, 7 women; mean age [range]: 71 [49-94] years) who received opioids concomitantly with corticosteroids. Effectiveness was assessed throughout administration using the Support Team Assessment Schedule, Japanese version (STAS-J), particularly the subscale indicating how strongly a patient is affected by symptoms. The effectiveness of combined opioid and corticosteroid therapy against dyspnea and the opioid dose comprised the primary and secondary foci, respectively. Among concomitantly treated patients, STAS-J scores at initiation (mean ± SD: 3.1 ± 0.24) and lowest recorded STAS-J scores (1.4 ± 0.22) differed significantly (P = .0034) among those receiving morphine, but not among those receiving oxycodone (P = .068) or fentanyl (P = .18). Concomitant opioid and corticosteroid treatment was associated with a ≥2-point STAS-J score improvement in 14/20 patients (effectiveness: 70%). The opioid dose did not significantly affect dyspnea alleviation. We conclude that concomitant opioid and corticosteroid treatment can effectively alleviate dyspnea in terminal cancer patients. PMID:27093633

  7. A retrospective review of the adnexal outcome after detorsion in premenarchal girls

    Abdullah Yildiz

    2014-01-01

    Full Text Available Background: The aim of this study was to report our results on premenarchal girls with adnexal torsion who were treated with different approaches. Materials and Methods: Twenty-six adnexal torsions in children were analysed retrospectively. Group 1 included cases of oophorectomy for the twisted adnexa. Group 2 contained the patients with adnexal torsion who untwisted either with a laparoscopic or open approach. Postoperative restoration of ovarian function was evaluated by Doppler ultrasound at the 6 th month. All oophorectomy and biopsy specimens were also evaluated. Results: Group 1 consisted of eleven cases that underwent oophorectomy due to gangrenous change and haemorrhagic infarction. Histology was of a mature teratoma in two cases and haemorrhagic necrosis due to torsion in seven. Group 2 consisted of 15 patients. In 10 out of 15 patients, preoperative biopsy is performed in which their histology revealed haemorrhagic necrosis in eight cases, and simple cyst with a benign nature in two cases. In all of the 10 untwisted adnexas, postoperative radiological imaging showed complete recovery with normal follicular development. No malignancy or increased tumour markers were noted in both groups. Conclusion: Adnexas can be left in place regardless of the preoperative degree of necrosis. Biopsy can be added to the procedure to rule out malignancy.

  8. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT) alone or with high dose rate (HDR) brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS) compared to surgery alone (Ρ =0.044 and Ρ =0.028 resp.). Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  9. Spontaneous Pneumothorax: A retrospective study of twenty-five patients and literature review

    We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent) comprising 16 Saudis (nine males and seven females) and eight non-Saudi's (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient) and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases, precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of 25 patients, with three failures of closed thoracostomy tube drainage needing thoractomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. (author)

  10. Retrospective review of the clinical BNCT trial at Brookhaven National Laboratory

    Diaz, A.Z.; Chanana, A.D.; Coderre, J.A.; Ma, R. [Brookhaven National Laboratory, Medical Department, Upton, NY (United States)

    2000-10-01

    The primary objective of the phase I/II dose escalation studies was to evaluate the safety of the boronophenylalanine-fructose (BPA-F) mediated boron neutron capture therapy (BNCT) in subjects with glioblastoma multiforme (GBM). A secondary objective was to retrospectively assess the palliation of GBM by BNCT. Fifty-three subjects with GBM were treated under multiple dose escalation protocols at the Brookhaven Medical Research Reactor (BMRR). Twenty-six subjects were treated using one field, 17 subjects were treated using 2 fields and 10 subjects were treated using 3 fields. BPA-F related toxicity was not observed. The maximum radiation dose to a volume of approximately 1 cc of the normal brain varied from 8.9 to 15.9 gray-equivalent (Gy-Eq). The volume-weighted average radiation dose to normal brain varied from 1.9 to 9.5 Gy-Eq. Six RTOG (Radiation Therapy Oncology Group) grade 3 or 4 toxicities were attributed to BNCT. Four of the 53 subjects are still alive with 3 of them free of recurrent disease with over two years follow-up. The median times to progression and median survival time from diagnosis were 28.4 weeks and 12.8 months respectively. (author)

  11. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    Hualei Li

    2014-01-01

    Full Text Available Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT alone or with high dose rate (HDR brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS compared to surgery alone (P=0.044 and P=0.028, resp.. Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  12. Synchronous and Metachronous Breast Malignancies: A Cross-Sectional Retrospective Study and Review of the Literature

    Ambrogio P. Londero

    2014-01-01

    Full Text Available Objective. There is increasing interest in patients with metachronous (MBC and synchronous breast cancer (SBC. The objective of this study was to evaluate the occurrence and outcome of MBCs and SBCs. Methods. A retrospective study on women operated in our department for breast cancer between 2002 and 2005 was carried out. Patients were divided into three groups: women with MBC, SBC, and unilateral breast cancer (UBC. Moreover, we performed a meta-analysis of the English literature about multiple breast cancers between 2000 and 2011 taking into consideration their prevalence and overall survival (OS. Results. We identified 584 breast cancer patients: 16 women (3% presented SBC and 40 MBC (7%, second cancer after 72-month follow-up IQR 40–145. Although the meta-analysis showed significant OS differences between MBC or SBC and UBC, we did not observe any significant OS difference among the three groups of our population. Anyway, we found a significant worse disease-free survival in MBC than UBC and a significant higher prevalence of radical surgery in MBC and SBC than UBC. Conclusions. Despite the low prevalence of MBC and SBC, the presence of a long time risk of MBC confirms the crucial role of ipsi- and contralateral mammographies in the postoperative follow-up.

  13. Retrospective review of the clinical BNCT trial at Brookhaven National Laboratory

    The primary objective of the phase I/II dose escalation studies was to evaluate the safety of the boronophenylalanine-fructose (BPA-F) mediated boron neutron capture therapy (BNCT) in subjects with glioblastoma multiforme (GBM). A secondary objective was to retrospectively assess the palliation of GBM by BNCT. Fifty-three subjects with GBM were treated under multiple dose escalation protocols at the Brookhaven Medical Research Reactor (BMRR). Twenty-six subjects were treated using one field, 17 subjects were treated using 2 fields and 10 subjects were treated using 3 fields. BPA-F related toxicity was not observed. The maximum radiation dose to a volume of approximately 1 cc of the normal brain varied from 8.9 to 15.9 gray-equivalent (Gy-Eq). The volume-weighted average radiation dose to normal brain varied from 1.9 to 9.5 Gy-Eq. Six RTOG (Radiation Therapy Oncology Group) grade 3 or 4 toxicities were attributed to BNCT. Four of the 53 subjects are still alive with 3 of them free of recurrent disease with over two years follow-up. The median times to progression and median survival time from diagnosis were 28.4 weeks and 12.8 months respectively. (author)

  14. Repair and reconstruction of severe leg injuries: retrospective review of eighty-five patients

    XU Yong-qing; SHI Ji-hong; LI Chun-xiao; MA Tao; LIN Yue-qiu; LI Jun; DING Jing; ZHU Yue-liang; RUAN Mo; GUO Yuan-fa; WANG Xin-ming; X(U) Xiao-shan

    2006-01-01

    Objective: To explore a good way of the reconstruction of severe tibial shaft fractures by using different flaps and external fixators.Methods: Eighty-five patients of Type ⅢC tibial shaft fractures with average age of 42.5 years were treated in our hospital from 1990 to 2005. Injuries were caused by motorcycle accidents in 66 patients, by machine accidents in 16 patients, and by stone bruise in 3 patients. The management procedures consisted of administration of antibiotics, serial debridment, bone grafting if needed,application of different flaps, such as free thoracoumbilical flaps, fasciocutaneous flaps, saphenous neurocutaneous vascular flaps, sural neurocutaneous vascular flaps and gastrocnemius muscular flaps, and different external fixations, for instance, half-ring fixators, unilateral axial dynamic fixators, AO fixators, Weifang fixators, and Hybrid fixators. The average follow up was 6.3 years.Results: All flaps survived. Eighty-three cases had bone healed. The average bone healing time of different external fixations was 5.5 months in 47 cases with half-ring fixators, 9.2 months in 4 cases treated with unilateral axial dynamic fixators, 8.5 months in 6 cases with AO fixators,10.7 months in 16 cases with Weifang fixators, and 7.8months in 10 cases with assembly fixators. Except half-ring fixation, other fixations all needed necessary bone graft.Two cases treated with unilateral axial dynamic fixators had nonunion of bone and developed osteomyelitis. The wounds healed after the removal of the fixators and immobilization by plaster. The last follow up examination showed ankle and knee motion was normal and no pain was noted.Conclusions: The combination of half- ring external fixators with various flaps provides good results for Type ⅢC tibial shaft fractures.

  15. Retrospectives: Trouble in the Inaugural Issue of the American Economic Review: The Cross/Eaves Controversy

    Ann Mari May; Robert W. Dimand

    2009-01-01

    The papers from the first year of the American Economic Review are included in the Archives of the American Economic Association. While researching the early years of the AEA, Ann Mari May came across a folder marked "Controversies, Criticisms, etc."-which stood out in the midst of a review of AEA minutes and reports. This folder included a bulky file on what AER Editor Davis Rich Dewey would come to refer to as the "Cross/Eaves Controversy"-a controversy that, according to a letter he wrote,...

  16. Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study.

    Sing-Sin Sam

    Full Text Available BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if there have been changes in the presentation of severe to fatal dengue. Nine of ten fatal cases involved adult females with a median age of 32 years. All had secondary dengue infection. The mean duration of illness prior to hospitalization was 4.7 days and deaths occurred at an average of 2.4 days post-admission. Gastrointestinal pain, vomiting, diarrhea, intravascular leakages and bleeding occurred in the majority of cases. DSS complicated with severe bleeding, multi-organ failure and coagulopathy were the primary causes of deaths. Seven patients presented with thrombocytopenia and hypoalbuminemia, five of which had hemoconcentration and increased ALT and AST indicative of liver damage. Co-morbidities particularly diabetes mellitus was common in our cohort. Prominent unusual presentations included acute renal failure, acute respiratory distress syndrome, myocarditis with pericarditis, and hemorrhages over the brain and heart. CONCLUSIONS: In our cohort, dengue fatalities are seen primarily in adult females with secondary dengue infection. The majority of the patients presented with common clinical and laboratory warning signs of severe dengue. Underlying co-morbidities may contribute to the rapid clinical deterioration in severe dengue. The uncommon presentations of dengue are likely a reflection of the changing demographics where adults are now more likely to contract dengue in dengue endemic regions.

  17. An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System.

    Doroudgar, S; Perry, P J; Lackey, G D; Veselova, N G; Chuang, H M; Albertson, T E

    2016-07-01

    Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration-approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient's progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects. PMID:26351291

  18. Potential brain death organ donors - challenges and prospects: A single center retrospective review

    Yousef Al-Maslamani

    2014-01-01

    Full Text Available Organ donation after brain death (BD is a major source for obtaining transplantable organs for patients with end-stage organ disease (ESOD. This retrospective, descriptive study was carried out on all potential BD patients admitted in different intensive care units (ICUs of the Hamad medical Corporation (HMC, Doha, Qatar during a period from January 2011 to April 2012. Our aim was to evaluate various demographic criteria and challenges of organ donation among potential BD organ donors and plan a strategy to improve the rate of organ donation in Qatar. Various aspects of BD patients in the ICUs and their possible effects on organ donation were studied. The time intervals analyzed to determine the possible causes of delay of organ retrieval were: time of diagnosing fixed dilated pupils in the ICU, to performing the first BD test, then to the second BD test, to family approach, to organ retrieval and/or circulatory death (CD without organ retrieval. There were a total of 116 potential BD organ donors of whom 96 (82.75% were males and 20 (17.25% were females. Brain hemorrhage and head injury contributed to 37 (31.9% and 32 (27.6% BD cases, respectively. Time interval between diagnosing fixed dilated pupil and performing the first test of BD was delayed >24 h in 79% of the cases and between the first and second BD tests was >6 h in 70.8% of the cases. This delay is not compatible with the Hamad Medical Corporation (HMC policy for BD diagnosis and resulted in a low number of organs retrieved. BD organ donation, a potential source for organs to save patients with ESOD has several pitfalls and every effort should be made to increase the awareness of the public as well as medical personnel to optimize donation efficacy.

  19. Improving Outcomes in Elective Colorectal Surgery: A Single-institution Retrospective Review.

    Rumberger, Lindsay K; Vittetoe, Debra; Cathey, Lorene; Bennett, Harriet; Heidel, Robert E; Daley, Brian J

    2016-04-01

    Our hospital, a Tennessee Surgical Quality Collaborative (TSQC) member, adopted a statewide colorectal care bundle intended to reduce surgical site infections (SSI) in elective colorectal cases. The bundle includes proper antibiotics/dosing, normoglycemia, normothermia, supplemental oxygen six hours postoperatively, and early enteral nutrition. A single-institution retrospective study of our National Surgical Quality Improvement Program (NSQIP) database for the rates of SSI before and after the colorectal bundle. We compared our SSI rates to TSQC hospitals as well as NSQIP datasets. Because of low case numbers in the NSQIP data, National Healthcare Safety Network (NHSN) data collected at our institution was used to compare our colorectal SSI before and after our colorectal bundle. From January 2010 to December 2011, 188 patients underwent nonemergent colorectal surgery in the NSQIP data. Of these, 5.4 per cent (10/188) developed superficial SSIs. During this same time, the rate of the TSQC superficial SSI was 7.1 per cent and NSQIP was 7.8 per cent. From January 2013 to October 2014, after the colorectal bundle started, 76 patients in NSQIP underwent nonemergent colorectal surgery. Of these, 6.5 per cent (5/76) developed superficial SSI, compared with 5.5 per cent in TSQC and 5.5 per cent in NSQIP. NHSN data showed a prebundle rate of 11 per cent and a postbundle rate of 3.5 per cent (P SSI rates in NSQIP; however, our NHSN data demonstrated considerable improvement. Differences in data collection may affect SSI rates, and ultimately "quality" based reimbursement. Implementation of the bundle did improve outcomes in colorectal surgery. PMID:27097625

  20. Review of optically stimulated luminescence (OSL) instrumental developments for retrospective dosimetry

    Bøtter-Jensen, Lars; Thomsen, Kristina Jørkov; Jain, Mayank

    2010-01-01

    This review describes 40 years of experience gained at Risø National Laboratory in the development of facilities for irradiation, thermal/optical stimulation and luminescence signal detection. These facilities have mainly been used in luminescence dating and nuclear accident dosimetry. We focus...

  1. Electrocution-related mortality in northern India – A 5-year retrospective study

    Sachil Kumar

    2014-03-01

    Conclusion: Death rates from electrocution among all medico-legal deaths were found to be lower in this study than in previous reports, most of them were work-related and preventable. Workers and their employers should be educated to avoid such accidents with safety measures.

  2. Specialist pediatric palliative care referral practices in pediatric oncology: A large 5-year retrospective audit

    Arunangshu Ghoshal

    2016-01-01

    Conclusions: Oncologists referred patients late in the course of disease trajectory. Most of the referrals were made for counseling and communication, but many patients had high symptom burden during referral.

  3. Granulomatous reaction - a histopathological study: a retrospective and prospective study of 5 years

    Khyati Ranchhodbhai Babaria

    2015-01-01

    Conclusion: Our study confirms that the most common granulomatous reaction is tuberculosis, mainly found in skin and more common among the population of lower socioeconomic class and rural population, signifying increasing incidence of granulomation infection. The present study is a comprehensive comparative study of granulomatous reactions done in correlation with the age, sex, involved sites and clinical profile of the patients. This information is valuable in policy formation for the control and specific treatment and outcome of granulomatous infection. [Int J Res Med Sci 2015; 3(1.000: 201-206

  4. Granulomatous reaction - a histopathological study: a retrospective and prospective study of 5 years

    Khyati Ranchhodbhai Babaria; Amit H Agravat; Gauravi A Dhruva

    2015-01-01

    Background: The present study was done to investigate the prevalence of granulomatous infection among the patients. The study was conducted from the time period of July 2008 to June 2013. The study was conducted at the histopathology laboratory, pathology department, P. D. U. government medical college, Rajkot (Gujarat, India). Methods: In the present study, total 300 cases were studied. Specimens for study were received from various departments like surgery, ENT, medicine, pediatrics etc...

  5. Total Knee Arthroplasty Using a Posterior Cruciate Ligament Sacrificing Medial Pivot Knee: Minimum 5-year Follow-up Results

    Youm, Yoon-Seok; Cho, Sung-Do; Lee, Seon-Ho; Cho, Hye-Yong

    2014-01-01

    Purpose To evaluate minimum 5-year follow-up clinical and radiological results of total knee arthroplasty (TKA) using a posterior cruciate ligament sacrificing (PS), non-substituting Advance Medial Pivot Knee. Materials and Methods One hundred and twenty knees in 80 patients who could be followed up for more than 5 years after TKA using the PS Advance Medial Pivot Knee were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemor...

  6. Pediatric ovarian tumors in a tertiary care hospital of Kolkata: An experience of last 5 years with its clinicopathological correlation

    Senjuti Dasgupta; Debdas Bose; Nirmal Kumar Bhattacharyya; Arnab Chaudhuri; Kanika Gupta; Pranab Kumar Biswas

    2016-01-01

    Background: Pediatric ovarian tumors are rare with an approximate incidence of 2.6 per 100,000 girls per year. Aims and Objectives: This study was done to delineate the clinicopathological profile of pediatric ovarian masses encountered in a tertiary care hospital over 5 years. Materials and Methods: A retrospective study was conducted for a period of 5 years during which all patients whose age did not exceed 20 years and underwent surgical resection of ovarian masses, were included. History,...

  7. Review of optically stimulated luminescence (OSL) instrumental developments for retrospective dosimetry

    Botter-Jensen, L., E-mail: boetter@youmail.d [Radiation Research Division, Riso National Laboratory for Sustainable Energy, Technical University of Denmark, Frederiksborgvej 399, DK-4000 Roskilde (Denmark); Thomsen, K.J.; Jain, M. [Radiation Research Division, Riso National Laboratory for Sustainable Energy, Technical University of Denmark, Frederiksborgvej 399, DK-4000 Roskilde (Denmark)

    2010-03-15

    This review describes 40 years of experience gained at Riso National Laboratory in the development of facilities for irradiation, thermal/optical stimulation and luminescence signal detection. These facilities have mainly been used in luminescence dating and nuclear accident dosimetry. We focus especially on methods for light stimulation and irradiation, and developments of new portable TL/OSL readers for determining doses directly in the field on both Earth and the planet Mars.

  8. Gastric cancer at a university teaching hospital in northwestern Tanzania: a retrospective review of 232 cases

    Mabula Joseph B

    2012-11-01

    Full Text Available Abstract Background Despite marked decreases in its incidence, particularly in developed countries, gastric cancer is still the second most common tumor worldwide. There is a paucity of information regarding gastric cancer in northwestern Tanzania. This study was undertaken to describe our experience, in our local setting, on the management of gastric cancer, outlining the clinicopathological and treatment outcome of these patients and suggesting ways to improve the treatment outcome. Methods This was a retrospective study of histologically confirmed cases of gastric cancer seen at Bugando Medical Centre between January 2007 and December 2011. Data were retrieved from patients’ files and analyzed using SPSS computer software version 17.0. Results A total of 232 gastric cancer patients were enrolled in the study, representing 4.5% of all malignancies. The male to female ratio was 2.9:1. The median age of patients was 52 years. The majority of the patients (92.1% presented late with advanced gastric cancer (Stages III and IV. Lymph node and distant metastasis at the time of diagnosis was recorded in 31.9% and 29.3% of cases, respectively. The antrum was the most frequent anatomical site (56.5% involved and gastric adenocarcinoma (95.1% was the most common histopathological type. Out of 232 patients, 223 (96.1% patients underwent surgical procedures for gastric cancer of which gastro-jejunostomy was the most frequent performed surgical procedure, accounting for 53.8% of cases. The use of chemotherapy and radiotherapy was documented in 56 (24.1% and 12 (5.1% patients, respectively. Postoperative complication and mortality rates were 37.1% and 18.1%, respectively. According to multivariate logistic regression analysis, preoperative co-morbidity, histological grade and stage of the tumor, presence of metastases at the time of diagnosis was the main predictors of death (P P Conclusions Gastric cancer in this region shows a trend towards relative

  9. Plant maintenance management practices in automobile industries: a retrospective and literature review

    Mahesh Pophaley

    2010-12-01

    Full Text Available This paper endeavors to present a classification, review and analysis of the literature on Plant Maintenance Management Practices (PMMP employed in Automobile Industries. There is a considerable amount of published research available concerning plant maintenance during the last few decades. Similarly many research articles are available which focuses on various aspects of automobile industries. However, very few studies focus on critical examination of maintenance practices in Automobile Industries in particular. Hence considering the slump in automobile industries in the recent times, a wide-ranging and focused review is attempted here and only those researches have been examined which mainly concentrates on this core aspect. Thus one of the objectives of this literature review is to investigate the present state of Plant Maintenance Management Practices, based on studies conducted in different countries and published in a variety of journals over the past two decades. An examination of 55 pertinent research studies have shown that the publications can be grouped in two categories namely Conceptual and Empirical Research. An analysis of these research articles published between 1990 and 2008, revealed that current maintenance practices ranges from conventional to the latest techniques for optimizing maintenance function like TPM, RCM and Proactive Maintenance. These studies focused more on maintenance problem solving and the main difficulties are reported along with probable solutions. Another goal of the paper is to analyze the articles by year and type of journal they were published in, to determine the trends in maintenance management studies and recommend future direction for research.

  10. A Retrospective Review of Shale Gas Development in the United States: What Led to the Boom?

    Wang, Zhongmin; Krupnick, Alan

    2013-01-01

    This is the first academic paper that reviews the economic, policy, and technology history of shale gas development in the United States. The primary objective of the paper is to answer the question of what led to the shale gas boom in the United States to help inform stakeholders in those countries that are attempting to develop their own shale gas resources. This paper is also a case study of the incentive, process, and impact of technology innovations and the role of government in promotin...

  11. The third NPT review conference, Geneva, 27 August to 21 September 1985: a retrospective

    The success of the Third NPT Review Conference held in September 1985 is illustrated by the fact that the conference was able to reach concensus on the final report that strongly reaffirmed support of the NPT, contained useful recommendations and included three difficult issues - nuclear arms control, the 1981 Israeli attack on the Iraqi Tammuz reactor and a proposal that a non-proliferation commitment should be a condition of supply of nuclear plants and materials. The factors which enabled the consensus to be achieved are discussed. The uncertainty of the future of NPT is mentioned. (U.K.)

  12. Outcome and Prognostic Factors for Traumatic Endophthalmitis over a 5-Year Period

    Simona Delia Nicoară; Iulian Irimescu; Tudor Călinici; Cristina Cristian

    2014-01-01

    Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period. Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data. Re...

  13. Obstetric Scar Endometriosis: Retrospective Study on 19 Cases and Review of the Literature.

    Kaplanoglu, Mustafa; Kaplanoğlu, Dilek Kaya; Dincer Ata, Ceren; Buyukkurt, Selim

    2014-01-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. This disease is one of the most common gynecologic disorders in reproductive age women. It generally occurs in pelvic cavity. But extrapelvic location has been defined (such as extremities, central nervous system, lungs, pleurae, liver, umbilicus, pericardium, urinary tract, intestines, and surgical scar tissue). Scar endometriosis is a rare disease and defined as presence of endometriotic lesions on the abdominal (such as cesarean section and hysterectomy) or vaginal (episiotomy) excision line. It is difficult to diagnose due to the extreme variability in presentation. The symptoms are nonspecific, typically involving pain, swelling at the incision site at the time of menstruation. Excision and histopathologic examination are necessary for diagnosis. We present a case series of obstetric scar endometriosis and review of the literature. PMID:27379258

  14. Pollution Status of Pakistan: A Retrospective Review on Heavy Metal Contamination of Water, Soil, and Vegetables

    Amir Waseem

    2014-01-01

    Full Text Available Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water, soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health.

  15. Pollution status of Pakistan: a retrospective review on heavy metal contamination of water, soil, and vegetables.

    Waseem, Amir; Arshad, Jahanzaib; Iqbal, Farhat; Sajjad, Ashif; Mehmood, Zahid; Murtaza, Ghulam

    2014-01-01

    Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water), soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health. PMID:25276818

  16. Paediatric parotid neoplasms: a 10 year retrospective imaging and pathology review of these rare tumours

    Aim: To determine the relative incidence of benign and malignant paediatric parotid gland tumours and whether particular presenting symptoms or imaging characteristics were more likely to predict malignancy. Materials and methods: Hospital records were reviewed for all patients <18 years with histopathology-proven parotid neoplasms over the 10 year period from 2003–2013. Infantile haemangiomas and patients with neurofibromatosis type I were excluded. The presenting clinical symptoms for each patient were recorded. All available CT and MRI examinations for these patients were evaluated for tumour imaging characteristics. Results: Seventeen patients (nine boys, eight girls; age range 2–17 years) were identified with neoplastic parotid masses; 11 tumours were malignant (65%) and six were benign (35%). The malignant tumours consisted of three acinic cell carcinomas, two mucoepidermoid carcinomas, one alveolar rhabdomyosarcoma, one poorly differentiated carcinoma, one low-grade adenocarcinoma, and three metastases (two melanoma, one orbital medulloepithelioma). The benign tumours consisted of five pleomorphic adenomas and one schwannoma. Presenting clinical symptoms were similar between benign and malignant tumours. Twelve MRI and six CT examinations were available for review with five patients undergoing both techniques. MRI features commonly identified with malignant tumours included: hypointense T2 signal, restricted diffusion, ill-defined borders, and focal necrosis. Only four of the six tumours imaged at CT were visualized, and of those, the margins were indeterminate in three patients. Conclusion: Paediatric parotid masses are more likely to be malignant than benign. Presenting clinical symptoms and CT are not helpful for distinguishing benign and malignant disease. MRI features such as T2 hypointensity, restricted diffusion, ill-defined borders, and focal necrosis, although not specific, should raise concern for malignancy. - Highlights: • Pediatric parotid

  17. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

    Alexandru V. Georgescu

    2012-10-01

    Full Text Available Background : Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. Patients and methods : This article reviews 25 propeller perforator flaps (PPF which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. Results : A primary healing rate (96% was obtained in 18 (72% cases. Revisional surgery and SG for skin necrosis was performed in six (24% cases with one complete loss of the flap (4% which led to a lower extremity amputation. Conclusions : The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.

  18. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

    Georgescu, Alexandru V.; Matei, Ileana R.; Capota, Irina M.

    2012-01-01

    Background Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. Patients and methods This article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. Results A primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation. Conclusions The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds. PMID:23050066

  19. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips

    Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)], E-mail: andoni.toms@nnuh.nhs.uk; Marshall, T.J.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Darrah, C.; Nolan, J. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Donell, S.T. [Institute of Health, University of East Anglia, Norwich, Norfolk (United Kingdom); Barker, T. [Department of Pathology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Tucker, J.K. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)

    2008-01-15

    Aim: To perform a retrospective review of all the conventional radiographic and magnetic resonance imaging (MRI) studies performed in patients with early postoperative pain following cobalt-chrome metal-on-metal total hip arthroplasty. Methods: A retrospective review of the radiology, surgical findings and histology in nineteen patients who had undergone a total of 20 hip arthroplasties using a cobalt-chromium on cobalt-chromium alloy prosthesis was undertaken. Results: Measures of implant placement on the immediate postoperative radiographs were all within the normal ranges (n = 20). Where more than one postoperative radiograph was available statistical analysis revealed no evidence of progressive change before the MRI examination (14). The median postoperative time to MRI was 35 months (range 11-63 months). Abnormalities were demonstrated using MRI in all symptomatic hips (n = 20). These comprised: periprosthetic fluid collections (20), which were isointense to muscle on T1-weighted images in 19 cases and hyperintense on T2-weighted images in 18 cases, periprosthetic bone marrow oedema (n = 6), muscle oedema (n = 4), avulsion of the gluteus minimus and medius tendons (n = 5), atrophy of piriformis (n = 15) and obturator internus (n = 17), and fracture of the medial calcar (n = 1). Operative findings in patients who had undergone revision surgery (n = 15) included: fluid-filled cavities (n = 11), soft tissue necrosis (n = 8), gluteal tendon avulsion (n = 5), proximal femoral diaphyseal necrosis (n = 4), and pitting and corrosion of the femoral stems (n = 8), which were, in all cases, firmly fixed to the cement mantle. Histology revealed viable tissue in six hips with necrosis (n = 12) and fibrin deposition (n = 15) being the predominate findings. Other findings included a perivascular lymphocytic infiltrate (n = 5), features of active inflammation (n = 4), and metallosis (n = 1). Conclusion: A significant number of patients with metal-on-metal hip replacements

  20. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  1. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Kawasumi, Yusuke, E-mail: ssu@rad.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: t7402r0506@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: hosokai@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: igari@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: yoshie@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: hsaito@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: tisibasi@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: funayama@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)

    2015-04-15

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  2. A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

    Joanna Reeves

    2015-06-01

    Full Text Available Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011. The age-bands frequently injured were 10–19 (22%, 40–49 (22%, 30–39 (14% and 50–59 (13% years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39. Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

  3. Sinography in the investigation of draining tracts in small animals: retrospective review of 25 cases

    The signalment, history, clinical signs, radiographic findings, and surgical findings of 25 consecutive animals that had sinography were reviewed to assess the contribution made by sinography to diagnosing and surgically managing draining tracts in small animals. There were 23 dogs and 2 cats; a variety of breeds and both sexes were represented (18 males, 7 females). Before referral the mean duration of clinical signs was 9.8 months (range, 0.5 to 33 months) and a mean of 2.0 surgical procedures (range, 1 to 5) had been performed. Sinuses occurred in a variety of locations, most commonly the neck (10), head (6), and paws (5). The most common cause was foreign body (15). Survey radiographs showed abnormalities in 21 of 26 (78%) instances, including soft-tissue swelling (11), chronic-appearing periosteal reaction on adjacent bones (5), possible foreign body (4), and gas in soft tissues (2). Sinography (or fistulography) enabled definite diagnosis of the cause of the sinus (or fistula) in 15 of 26 (58%) instances and demonstrated 13 of 15 foreign bodies (sensitivity 87%; specificity 100%). Tracts caused by an esophageal perforation and otitis media were also correctly shown by fistulography. In 11 animals, sinography indicated that the position or extent of the lesion was different to that expected on the basis of clinical signs and survey radiographs

  4. Effects of Parvovirus B19 Infection in Renal Transplant Recipients: A Retrospective Review of Three Cases.

    Krishnan, Prathik; Ramadas, Poornima; Rajendran, Prejith P; Madhavan, Parvathy; Alex, Asha; Jayaschandran, Vivek; Humayun, Shaesta G; Ali, Nicole; Sachdeva, Mala; Flecha, Antonette; Basu, Amit; Bhaskaran, Madhu; Molmenti, Ernesto P

    2015-06-01

    Parvovirus B19 (PVB19) is a DNA virus which causes clinically relevant infection in renal transplant recipients (RTR) leading to significant morbidity. Manifestations include erythropoietin resistant anemia, proteinuria, and glomerulosclerosis in the allograft. Severe infection may require administration of intravenous immunoglobulin, reduction in immunosuppression and transfusions. The major challenge in managing and preventing the infection in RTR involves the act of balancing the decreased level of immunosuppression and the risk of rejection. The objective of this article is to understand the importance of PVB19 infection and its outcome in RTR. We reviewed the medical records of three RTR with confirmed PVB19 infection and recorded patient information including demographics, clinical and laboratory data, management, and outcome. The average time of occurrence of PVB19 infection as transplant was 8.6 weeks and they presented with symptomatic anemia. Elevated creatinine values were noted in two of them. Following treatment, anemia improved and creatinine values returned to baseline. One of them developed an early relapse and had to be treated once again similarly. We emphasize the importance of maintaining a high index of suspicion for PVB19 infection in patients with anemia in the posttransplant phase, especially in patients on higher doses of immunosuppressants. Early and proper treatment can prevent worsening clinical condition and possible effects on the allograft. PMID:26060378

  5. RECENT METHODS FOR OPTIMIZATION OF PLASTIC INJECTION MOLDING PROCESS –A RETROSPECTIVE AND LITERATURE REVIEW

    P.K. Bharti

    2010-09-01

    Full Text Available Injection molding has been a challenging process for many manufacturers and researchers to produce products meeting requirements at the lowest cost. Faced with global competition in injection molding industry, using the trialand- error approach to determine the process parameters for injection molding is no longer good enough. Factors that affect the quality of a molded part can be classified into four categories: part design, mold design, machineperformance and processing conditions. The part and mold design are assumed as established and fixed. During production, quality characteristics may deviate due to drifting or shifting of processing conditions caused by machine wear, environmental change or operator fatigue. Determining optimal process parameter settings critically influences productivity, quality, and cost of production in the plastic injection molding (PIM industry. Previously, production engineers used either trial-and-error method or Taguchi’s parameter design method to determine optimal process parameter settings for PIM. However, these methods are unsuitable in present PIM because of the increasing complexity of product design and the requirement of multi-response quality characteristics. This article aims to review the recent research in designing and determining process parameters of injection molding. A number of research works based on various approaches have been performed in the domain of the parameter setting for injection molding. These approaches, including mathematical models, Taguchi method, Artificial Neural Networks (ANN,Fuzzy logic, Case Based Reasoning (CBR, Genetic Algorithms (GA, Finite Element Method(FEM,Non Linear Modeling, Response Surface Methodology, Linear Regression Analysis ,Grey Rational Analysis and Principle Component Analysis (PCA are described in this article. The strength and theweakness of individual approaches are discussed. It is then followed by conclusions and discussions of the potential

  6. Incidence of Soft-Tissue Injuries in Patients with Posterolateral Tibial Plateau Fractures: A Retrospective Review from 2009 to 2014.

    Wang, Yanqing; Cao, Fujiang; Liu, Minghui; Wang, Jiantao; Jia, Shikong

    2016-08-01

    Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures. PMID:27183240

  7. Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review

    Myelofibrosis (MF) is a clonal hematopoietic malignancy characterized by constitutional and localized symptoms, progressive splenomegaly, bone marrow fibrosis, and cytopenias. Although MF is well studied, few studies exist regarding its symptomatic burden in routine clinical practice. This study aimed to characterize symptoms and other clinical features of MF among patients in the United States. We conducted a retrospective medical record review of adult patients with an MF diagnosis between 1 January 2005 and 31 March 2010, stratified by the presence of palpable splenomegaly. Eligible patients had 12 months or more of follow-up after diagnosis (or after detection of splenomegaly, if present) unless death occurred. Demographic and clinical characteristics, MF-related symptoms, and treatments were reported by treating physicians. We report on 180 MF patients: 102 with splenomegaly, 78 without. Median age was 66 years, 63% were male, and 82% had intermediate-2 or high-risk MF (International Prognostic Scoring System). Fatigue was reported by ∼85% of patients; weight loss, night sweats, and fever (any grade) were each reported by 50% or more of patients. Generalized abdominal pain, left subcostal pain, and early satiety occurred more frequently among patients with splenomegaly. Multiple symptoms were reported by 95% of patients. Common comorbidities were hypertension, diabetes, and chronic pulmonary disease. Symptoms are common in MF patients, regardless of the presence of palpable splenomegaly. Careful assessment of symptom burden is an important aspect of the clinical evaluation of patients with MF

  8. Osteosarcoma in Pediatric Patients and Young Adults: A Single Institution Retrospective Review of Presentation, Therapy, and Outcome

    Candace L. Haddox

    2014-01-01

    Full Text Available Background. Little is known about how cumulative chemotherapy delivery influences the poorer outcome observed in young adult (YA, 18–40 years versus pediatric (<18 years osteosarcoma patients. Here, we retrospectively examined differences in presentation, therapy, including cumulative chemotherapy dose, and outcome in YA and pediatric patients. Methods. We reviewed 111 cases of high-grade osteosarcoma at Moffitt Cancer Center between 1988 and 2012. Presentation factors, therapies, and survival were compared between YA and pediatric cohorts. Results. The cohorts were equivalent with respect to metastatic status, gender, tumor size, tumor site, and histological subtype. We found that the YA patients tended to have poorer histologic response to neoadjuvant chemotherapy measured by necrosis with 55% and 35% of pediatric versus YA patients responding favorably (P=0.06. Only 39% of YA patients achieved the typical pediatric dose of methotrexate, doxorubicin, and cisplatin. These patients had a 3-year EFS of 76% (CI 53–100% versus 47% (CI 26–69%; P=0.09 in those who received less chemotherapy. Conclusion. Age continues to be a prognostic factor in osteosarcoma. Our study suggests that presentation factors are not associated with prognosis, while poorer response to chemotherapy and lower cumulative dose of chemotherapy delivered to YA patients may contribute to poorer outcomes.

  9. Non-injected illicit drug use and infectious disease risk of donor tissue: a single institution retrospective review.

    Barton, Mark D; Qureshi, Amir; Vijapura, Anita; Temple, H Thomas

    2015-12-01

    This study assessed the relationship of non-injected illicit drug use and infectious disease seropositivity for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), hepatitis C virus (HCV), and Syphilis. In a retrospective review of 986 donor charts recovered from 2009 to 2011 at a single tissue bank, the absence of reported non-injected illicit drug use corresponded with seropositivity in 6.61 %, of recovered donors while reported illicit drug use in the medical and social history corresponded with seropositivity in 11.25 %, representing a 70 % increased risk. There was no significant difference noted for overall seropositivity rates between types on noninjected illicit drugs, although donors that used cocaine had a higher incidence of HIV, while marijuana use was associated with a higher rate of HBV, HCV, and syphilis positivity. Toxicology screening results were not an accurate predictor of seropositivity (PPV = 3.77 %; NPV = 91.56 %). Further, the degree of relationship between the donor and the next of kin had no bearing on the veracity of actual drug use when comparing the response of the medical-social history and the toxicology screen. PMID:26006785

  10. Incidence and Cause of Delirium in Hospitalized Patients between the Ages of 18 and 56: A Retrospective Chart Review

    Michelle T. Weckmann

    2014-01-01

    Full Text Available Background. Delirium is a common and devastating condition which has been well characterized in elderly cancer patients, but little is known about delirium in cancer patients under the age of 65. Aim. A pilot study to explore the incidence and potential causes of delirium in hospitalized advanced cancer patients at the age of 18–56 years. Design. A retrospective chart review using validated instruments was used to examine the charts of hematology-oncology admissions in a large academic institution. Data was collected as to the likelihood of delirium and potential precipitants. Results. Delirium incidence was 29% among advanced cancer patients. The associated precipitants of delirium were multifactorial, the most common being medications and infection. Delirium was more common in patients admitted for either acute symptom management or the presence of a lung malignancy. Patients with delirium demonstrated significantly increased total hospital cost and a borderline significant result for increased mortality compared to those without delirium. Conclusions. Delirium is common in hospitalized advanced cancer patients (age 18–56 years and the cause is typically multifactorial. Delirium results in a more complicated hospital course and likely increased mortality. Further research is needed to define strategies to prevent and treat this common and distressing condition.

  11. A Retrospective Review on Feasibility and Safety of a New Pneumatic Compression Device for Femoral Arteriotomy Hemostasis

    Kang, Min Ho [Chungbuk National University Hospital, Cheongju (Korea, Republic of); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-01-15

    To report our initial experience on the technical feasibility and safety for hemostasis of a new pneumatic compression device in patients undergoing femoral arteriotomy. This study included 40 consecutive patients in whom hemostasis after transfemoral catheterization was readered by using a pneumatic compression device consisting of an inflatable bulb-containing main body and four pieces of supplementary tape. Medical records were retrospectively reviewed for outcomes and complications of hemostasis. Technical success was defined as achieving immediate hemostasis 10 minutes after applying the device over the arteriotomy sites, and clinical success was defined as the ability to ambulate after 4 hours of bed rest without any complications. Technical and clinical success was achieved in 38 (95%) and 37 (93%) patients, respectively. In two patients, hemostasis was achieved after conversion to manual compression. One patient required sand bag placement after removal of the device to control minimal oozing of blood. No patients had late complications. The new pneumatic compression device provides effective and safe hemostasis after transfemoral catheterization in selected patient populations.

  12. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  13. Thirty-nine cases of intracranial hemangiopericytoma and anaplastic hemangiopericytoma: A retrospective review of MRI features and pathological findings

    Objective: To retrospectively review the imaging features of surgically and pathologically confirmed intracranial hemangiopericytoma and anaplastic hemangiopericytoma. Methods: Thirty-nine cases of surgically and pathologically confirmed hemangiopericytoma and anaplastic hemangiopericytoma were analyzed retrospectively. The MRI features were compared with pathological findings in all cases. Results: Of the 39 cases, 21 were anaplastic hemangiopericytoma (WHO grade III) and the remaining cases were hemangiopericytoma (WHO grade II); all lesions were solitary. MRI of anaplastic hemangiopericytoma showed that 20 cases were lobulated, and nine grew cross-leaf. The lesions showed mixed iso-high-low signal (n = 20) or iso-signal (n = 1) on plain T1WI, and mixed high-low signal (n = 20) or iso-signal (n = 1) on plain T2WI. After contrast injection, marked heterogeneous enhancement was seen in 19 cases. Significant necrosis and cystic changes were seen in 16 cases, and the “dural tail sign” was found in two cases. Ten cases had bony destruction, and 16 showed significant peritumoral edema. In 18 cases of hemangiopericytoma, nine were oval-shaped and three grew cross-leaf. The lesions showed mixed iso-low signal (n = 10) or iso-signal (n = 8) on plain T1WI, and mixed iso-high signal (n = 10) or iso-signal (n = 8) on plain T2WI. After contrast injection, significant uniform enhancement was seen in 10 cases. Significant necrosis and cystic changes were seen in seven cases, and “dural tail sign” was seen in six cases. Two cases had bony destruction. No case showed significant peritumoral edema. Pathological immunohistochemical Ki67 staining showed a concentration of ∼18.4% positive cells in anaplastic hemangiopericytoma, whereas in hemangiopericytoma it was 7.12%. Conclusion: Imaging findings of intracranial anaplastic hemangiopericytoma had more pronounced lobulation, cross-leaf growth tendency, more and easier bleeding, more necrosis, more cystic changes giving

  14. Causes of mortality and associated modifiable health care factors for children (< 5-years admitted at Onandjokwe Hospital, Namibia

    Johnface F. Mdala

    2015-02-01

    Full Text Available Introduction: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5year-old children admitted to Onandjokwe Hospital, Namibia.Method: A descriptive retrospective review of the medical records of all children under fiveyears who died in the hospital for the period of 12 months during 2013, using two differentstructured questionnaires targeting perinatal deaths and post-perinatal deaths respectively.Results: The top five causes of 125 perinatal deaths were prematurity 22 (17.6%, birth asphyxia 19 (15.2%, congenital anomalies 16 (12.8%, unknown 13 (10.4% and abruptio placenta 11 (8.8%. The top five causes of 60 post-perinatal deaths were bacterial pneumonia 21 (35%, gastroenteritis 12 (20%, severe malnutrition 6 (10%, septicaemia 6 (10%, and tuberculosis 4 (6.7%. Sixty-nine (55% perinatal deaths and 42 (70% post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a health care facility, antenatal clinics not screening for danger signs, long distance referral, district hospitals not providing emergency obstetric care, poor monitoring of labour and admitted children in the wards, lack of screening for malnutrition, failure to repeat an HIV test in pregnant women in the third trimesteror during breastfeeding, and a lack of review of the urgent results of critically ill children.Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

  15. Blunt traumatic cardiac rupture. A 5-year experience.

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  16. Surgical site infection following hernia repair in the day care setting of a developing country: a retrospective review

    Objective: To determine the incidence proportion of surgical site infection following hernia repair in a daycare setting at a tertiary care hospital of a low-income country. Methods: The retrospective audit was done at the Aga Khan University Hospital, Karachi, from June 1, 2008 to May 30, 2009. Patients with age >15 years who underwent Lichenstein's open mesh repair in daycare were included. Surgical Site Infection was labelled if the records revealed any of the following: opening of the wound by the primary surgeon; pain, tenderness and raised temperature of skin; purulent discharge from the wound; if the surgeon had documented it as a surgical site infection. SPSS 16 was used for data analysis. Results: After reviewing the retrieved files, 104 patients were found eligible. Of them, 102 (98%) were males. Overall wound-related complications were found in 13 (12.5%), whereas surgical site infection was found in 8 (7.7%) patients. The mean age of those with infections was 38.7+-18 year, while that of those with no surgical site infection was 47.8+-18 years. Smoking was found significantly associated with surgical site infection with 5.8 times higher incidence as compared to the non-smokers (OR with 95% CI: 5.6 (1.2, 25.3)). Conclusions: The incidence of surgical site infection after hernia repair with mesh in a daycare setting at a tertiary care hospital of a low-income country was higher than internationally reported incidence. Smoking was found to be a significant risk factor. (author)

  17. Retrospective Review of Watershed Characteristics and a Framework for Future Research in the Sarasota Bay Watershed, Florida

    Kish, George R.; Harrison, Arnell S.; Alderson, Mark

    2008-01-01

    The U.S. Geological Survey, in cooperation with the Sarasota Bay Estuary Program conducted a retrospective review of characteristics of the Sarasota Bay watershed in west-central Florida. This report describes watershed characteristics, surface- and ground-water processes, and the environmental setting of the Sarasota Bay watershed. Population growth during the last 50 years is transforming the Sarasota Bay watershed from rural and agriculture to urban and suburban. The transition has resulted in land-use changes that influence surface- and ground-water processes in the watershed. Increased impervious cover decreases recharge to ground water and increases overland runoff and the pollutants carried in the runoff. Soil compaction resulting from agriculture, construction, and recreation activities also decreases recharge to ground water. Conventional approaches to stormwater runoff have involved conveyances and large storage areas. Low-impact development approaches, designed to provide recharge near the precipitation point-of-contact, are being used increasingly in the watershed. Simple pollutant loading models applied to the Sarasota Bay watershed have focused on large-scale processes and pollutant loads determined from empirical values and mean event concentrations. Complex watershed models and more intensive data-collection programs can provide the level of information needed to quantify (1) the effects of lot-scale land practices on runoff, storage, and ground-water recharge, (2) dry and wet season flux of nutrients through atmospheric deposition, (3) changes in partitioning of water and contaminants as urbanization alters predevelopment rainfall-runoff relations, and (4) linkages between watershed models and lot-scale models to evaluate the effect of small-scale changes over the entire Sarasota Bay watershed. As urbanization in the Sarasota Bay watershed continues, focused research on water-resources issues can provide information needed by water

  18. a retrospective review of medical records of patients in Park-Klinik Weißensee from April 1997 to September 2003

    Gerhardt, Ulrike

    2010-01-01

    Pancreatic pseudocysts are fluid collections that frequently occur as complications of an acute or chronic pancreatitis. Acute pseudocysts in particular do have an intense tendency to involution, the necessity of a therapy only arises in symptomatic pseudocysts. The percutaneous catheter drainage has become an alternative to a surgical treatment of pancreatic pseudocysts. With the help of a retrospective review of medical records of all patients, that were medicated due to symptomatic pse...

  19. Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members

    Schildmeijer, Kristina; Nilsson, Lena; Perk, Joep; Franzén Årestedt, Kristofer; Nilsson, Gunilla

    2013-01-01

    Objectives: The aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm. Design: A qualitative, descriptive approach with focus group interviews using content analysis. Setting: 5 Swedish hospitals in 2011. Participants: 5 GTT teams, with 5 physicians and 11 registered nurses. Intervention: 5 focus group interviews were carried out with t...

  20. Retrospective review of the epidemiology of epilepsy in special schools for children with cerebral palsy, learning difficulties, and language and communication difficulties

    Peet, Danielle Samar

    2006-01-01

    Purpose of the study: To determine in children the proportion and characteristics of epilepsy associated with cerebral palsy, learning difficulties and language and communication difficulties in a specific population of two special schools. Basic procedures: Retrospective review of case notes for 142 children in two special schools (school A and school B) in Newcastle, UK Main findings: School A had more children with learning difficulties (X2 = 32.41, p < 0.01) and active epilepsy (X2 = 3.03...

  1. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Greenblatt JM; Sussman C; Jameson M; Yuan L; Hoffman DA; Iosifescu DV

    2011-01-01

    James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a refer...

  2. The assessment of weight status in children and young people attending a spina bifida outpatient clinic: a retrospective medical record review

    McPherson, Amy C.; Swift, Judy Anne; Yung, Emily; Lyons, Julia; Church, Paige

    2013-01-01

    PURPOSE: Children with disabilities are two to three times more likely to become overweight or obese than typically developing children. Children with spina bifida (SB) are at particular risk, yet obesity prevalence and weight management with this population are under-researched. This retrospective chart review explored how weight is assessed and discussed in a children's SB outpatient clinic. METHOD: Height/weight data were extracted from records of children aged 2-18 with a diagnos...

  3. Psychostimulants in the therapy of treatment-resistant depression Review of the literature and findings from a retrospective study in 65 depressed patients

    Stotz, Gabriele; Woggon, Brigitte; ANGST, JULES

    1999-01-01

    The use of psychostimulants as an adjuvant therapy in treatment-resistant depression is not very common nowadays and has been the subject of much criticism. This article gives a brief review of the literature and reports on the findings from a retrospective study carried out in 65 depressed patients treated with psychostimulants (amphetamine and methylphenidate) in addition to conventional antidepressants. Thirty-eight out of 65 patients showed significant improvement, in particular with resp...

  4. Is postoperative radiation beneficial in the management of Stage I-II squamous-cell carcinoma of the uterine cervix with negative metastatic nodes and positive parametrial involvement; A retrospective review of 70 patients

    Takamura, Akio (Asahikawa Kosei Hospital, Hokkaido (Japan)); Mizoe, Jun-etsu; Arimoto, Takuro; Kamada, Tadashi; Shirato, Hiroki; Matsuoka, Yoshisuke; Tomita, Masayoshi; Irie, Goro

    1993-06-01

    Seventy patients having squamous-cell carcinoma of the uterine cervix FIGO (Federation Internationale de Gynecologie et d'Obstetrique : International Federation of Gynecology and Obstetrics) Stage I-II with negative lymph nodes and positive parametrial involvement received postoperative radiotherapy following radical hysterectomy and pelvic lymphadenectomy. In 48 patients with microscopic parametrial involvement had a 5-year survival rate of 75%. The overall recurrence was 13% (9 of 70). The sites of failure were 3 pelvic alone, 5 distant metastases alone, and 1 combined pelvis and para-aortic lymph node. All of those with recurrence were Stage-II cases. The absolute pelvic-control rate was 94.3% (66/70). Fifty-six percent of the patients experienced mild-to-moderate lymphedema. Severe complications requiring surgical intervention were observed in 6 patients (5 bowel obstructions and 1 femoral head fracture). A review of the literature suggests that early carcinoma can be successfully treated by surgery alone. Taking into consideration the risk and benefits involved, postoperative radiotherapy is not recommended for most patients with cervical carcinoma with negative lymph nodes and positive parametrial involvement in the present form, despite excellent local control. However, no definite conclusion can be drawn from this retrospective analysis. (author).

  5. Assessment of caries prevalence among children below 5 years old

    Prabhu, Poornima; Rajajee, K. T. S. S.; Sudheer, K. A.; Jesudass, G.

    2014-01-01

    Context: In the current scenario of developing countries, dental caries has been a long-standing challenge in the oral health issue and still on the rise. Aim: The aim of the following study is to estimate the caries prevalence in the primary dentition among children below 5 years of age. Meterials and Methods: Study population included both boys and girls below 5 years old attending KGF Dental College and Hospital, Karnataka. A simple random sampling method was used. A total of 672 children ...

  6. A 5-year experience with an elective scholarly concentrations program

    Paul George

    2015-11-01

    Full Text Available Problem: Programs that encourage scholarly activities beyond the core curriculum and traditional biomedical research are now commonplace among US medical schools. Few studies have generated outcome data for these programs. The goal of the present study was to address this gap. Intervention: The Scholarly Concentration (SC Program, established in 2006 at the Warren Alpert Medical School of Brown University, is a 4-year elective program that not only encourages students to pursue scholarly work that may include traditional biomedical research but also seeks to broaden students’ focus to include less traditional areas. We compared characteristics and academic performance of SC students and non-SC students for the graduating classes of 2010–2014. Context: Approximately one-third of our students opt to complete an SC during their 4-year undergraduate medical education. Because this program is additional to the regular MD curriculum, we sought to investigate whether SC students sustained the academic achievement of non-SC students while at the same time producing scholarly work as part of the program. Outcome: Over 5 years, 35% of students elected to enter the program and approximately 81% of these students completed the program. The parameters that were similar for both SC and non-SC students were age at matriculation, admission route, proportion of undergraduate science majors, and number of undergraduate science courses. Most academic indicators, including United States Medical Licensing Examinations scores, were similar for the two groups; however, SC students achieved more honors in the six core clerkships and were more likely to be inducted into the medical school's two honor societies. Residency specialties selected by graduates in the two groups were similar. SC students published an average of 1.3 peer-reviewed manuscripts per student, higher than the 0.8 manuscripts per non-SC student (p=0.013. Conclusions: An elective, interdisciplinary

  7. Prevalence of respiratory diseases in hospitalized patients in Saudi Arabia: A 5 years study 1996-2000

    Alamoudi Omer

    2006-01-01

    Full Text Available OBJECTIVES: 1 To determine the prevalence of respiratory diseases and the length of stay among hospitalized patients with respiratory disorders 2 To detect the medical disorders commonly associated with respiratory diseases. MATERIALS AND METHODS: A retrospective review was done for 810 patients hospitalized with respiratory diseases in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, over 5 years (January 1996 to December 2000. A special form was used to collect information from patient medical records including demographic data (such as age, sex and nationality, discharge diagnosis with other associated diseases and length of stay during hospitalization. RESULTS: Fifty-five percent of patients were males and 56.3% were Saudis. The mostly affected age group was 46-65 years (41.8%. Asthma (38.6%, chronic obstructive pulmonary disease (COPD (17.2%, pneumonia (11.5%, lung cancer (8.4% and tuberculosis (TB (7.2% had the highest prevalence among hospitalized patients. Asthma was higher among females (63.3% than males (36.7%. In contrast, lung cancer, COPD and TB were higher among males (88.2, 66.9 and 74.1% than females (11.8, 33.1 and 25.9% respectively ( P P CONCLUSION: Asthma, COPD and pneumonia were the leading causes of hospitalization among patients with respiratory disorders, while diabetes and hypertension were the most commonly associated diseases.

  8. Imaging Findings in Pediatric Posterior Reversible Encephalopathy Syndrome (PRES): 5 Years of Experience From a Tertiary Care Center in India.

    Gupta, Vivek; Bhatia, Vikas; Khandelwal, Niranjan; Singh, Paramjeet; Singhi, Pratibha

    2016-08-01

    This study sought to evaluate the radiological and clinical spectrum of posterior reversible encephalopathy syndrome (PRES) in pediatric population. A retrospective evaluation of the pediatric patients with posterior reversible encephalopathy syndrome seen over the last 5 years in the authors' hospital was done. The magnetic resonance imaging (MRI) findings were analyzed, and a review of literature was performed. Out of 32 pediatric patients of posterior reversible encephalopathy syndrome, 10 (31.25%) were males and 22 (68.75%) were females, with a mean age of 10.6 years. Renal disease (62.5%) was the most common primary disease, followed by chemotherapy for hemato-oncologic malignancies (15.6%). Hypertension was present in 81.2% of cases. Atypical MRI findings were seen in 62.5% cases. Frontal involvement was common and seen in 56% of the cases. Overall, MRI findings considered atypical in adults were found to be common in the series of pediatric posterior reversible encephalopathy syndrome. The understanding of the clinical settings and familiarity with radiological findings in pediatric posterior reversible encephalopathy syndrome patients is important to adequately treat these patients and to avoid misdiagnosis. PMID:27071468

  9. Scott Shuler's "Music and Education in the Twenty-First Century: A Retrospective"--Review and Response

    McLain, Barbara Payne

    2014-01-01

    Predicting the future is a challenging task for music education, requiring both retrospection, analysis of current events, and foresight. This article examines several predictions from 2001 and challenges music educators to consider factors that may influence the future of teaching music in society.

  10. Are reviewers suggested by authors as good as those chosen by editors? Results of a rater-blinded, retrospective study

    Parkin Emma C; Wager Elizabeth; Tamber Pritpal S

    2006-01-01

    Abstract Background BioMed Central (BMC) requires authors to suggest four reviewers when making a submission. Editors searching for reviewers use these suggestions as a source. The review process of the medical journals in the BMC series is open – authors and reviewers know each other's identity – although reviewers can make confidential comments to the editor. Reviews are published alongside accepted articles so readers may see the reviewers' names and recommendations. Our objective was to c...

  11. Are reviewers suggested by authors as good as those chosen by editors? Results of a rater-blinded, retrospective study

    Parkin Emma C

    2006-05-01

    Full Text Available Abstract Background BioMed Central (BMC requires authors to suggest four reviewers when making a submission. Editors searching for reviewers use these suggestions as a source. The review process of the medical journals in the BMC series is open – authors and reviewers know each other's identity – although reviewers can make confidential comments to the editor. Reviews are published alongside accepted articles so readers may see the reviewers' names and recommendations. Our objective was to compare the performance of author-nominated reviewers (ANR with that of editor-chosen reviewers (ECR in terms of review quality and recommendations about submissions in an online-only medical journal. Methods Pairs of reviews from 100 consecutive submissions to medical journals in the BMC series (with one author-nominated and one editor-chosen reviewer and a final decision were assessed by two raters, blinded to reviewer type, using a validated review quality instrument (RQI which rates 7 items on 5-point Likert scales. The raters discussed their ratings after the first 20 pairs (keeping reviewer type masked and resolved major discrepancies in scoring and interpretation to improve inter-rater reliability. Reviewers' recommendations were also compared. Results Reviewer source had no impact on review quality (mean RQI score (± SD 2.24 ± 0.55 for ANR, 2.34 ± 0.54 for ECR or tone (mean scores on additional question 2.72 ANR vs 2.82 ECR (maximum score = 5 in both cases. However author-nominated reviewers were significantly more likely to recommend acceptance (47 vs 35 and less likely to recommend rejection (10 vs 23 than editor-chosen reviewers after initial review (p Conclusion Author-nominated reviewers produced reviews of similar quality to editor-chosen reviewers but were more likely to recommend acceptance during the initial stages of peer review.

  12. Dietary predictors of 5-year changes in waist circumference

    Halkjaer, Jytte; Tjønneland, Anne; Overvad, Kim;

    2009-01-01

    , whereas snack foods intake was positively associated. Sex differences occurred for vegetables, high-fat dairy products, and processed meat. CONCLUSIONS: The results suggest that a diet low in fruits and red meat and high in snack foods was associated with larger waist circumference gains in both sexes......, baseline diet (192 items food frequency questionnaire), body mass index, and selected potential confounders (eg, smoking status, sport activities, and intake of alcoholic beverages). Multiple linear regression analyses were performed. RESULTS: For women, 5-year difference in waist circumference was...... inversely related to intake from red meat, vegetables, fruit, butter, and high-fat dairy products, whereas intake from potatoes, processed meat, poultry, and snack foods was positively associated. For men, red meat and fruit intakes were inversely associated with 5-year difference in waist circumference...

  13. Predictive Preoperative Factors for Renal Insufficiency in Patients Followed for More Than 5 Years After Radical Nephrectomy

    Ahn, Joong Seo; Kim, Hyung Joon; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Lee, Hyun Moo; Choi, Han Yong; Jeon, Seong Soo

    2013-01-01

    Purpose We assessed the predictive factors for renal insufficiency in patients followed for more than 5 years after radical nephrectomy. Materials and Methods Age, gender, history of diabetes, history of hypertension, body mass index, preoperative estimated glomerular filtration rate (eGFR), serum uric acid, urine albumin, normal renal parenchymal volume, tumor size, and ratio of normal parenchymal volume of the removed kidney to that of the remaining kidney were evaluated retrospectively in ...

  14. Hodgkin Lymphoma at the Paediatric Oncology Unit of Gabriel Touré Teaching Hospital, Bamako, Mali: 5-Year Experience

    T. Sidibé; B. Traoré; F. Traoré-Dicko; Sylla, M.; A. A. Diakité; Diawara, M.; K. Dumke; C. B. Traoré; Togo, A. P.; F. Traoré; B Togo

    2011-01-01

    Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco—Africain d'Oncologie Pédiatrique) Hodgkin lymphoma treatment protocol. Res...

  15. Undergraduates’ opinion after 5-year experience with rotary endodontic instruments

    Flávia Sens Fagundes Tomazinho; Gisele Aihara Haragushiku; Flares Baratto Filho; Denise Piotto Leonardi; Maria da Graça Kfouri Lopes; Alexandre Moro

    2011-01-01

    Introduction: Dentistry evolution in the past few years has revolutionized daily practice in some specialties. One of these revolutions has occurred in Endodontics due to the advancement of rotary techniques for root canal preparation and its subsequent incorporation into the teaching of Dentistry undergraduates. Objective: The aim of this study was to report a 5-year experience on the undergraduate laboratorial and clinical use of rotary endodontic preparation at a private university. Materi...

  16. Facing the airway challenges in maxillofacial trauma: A retrospective review of 288 cases at a level i trauma center

    Gupta, Babita; Prasad, Arunima; Ramchandani, Sarita; Singhal, Maneesh; Mathur, Purva

    2015-01-01

    Background: Maxillofacial trauma is an apt example of a difficult airway. The anesthesiologist faces challenges in their management at every step from airway access to maintenance of anesthesia and extubation and postoperative care. Methods: A retrospective study was done of 288 patients undergoing surgery for maxillofacial trauma over a period of five years. Demographic data, detailed airway assessment and the method of airway access were noted. Trauma scores, mechanism of injury, duration o...

  17. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate 192Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy applicators and

  18. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  19. Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review

    John J. Anderson; Wallin, Kelly J.; Spencer, Loren

    2012-01-01

    We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean he...

  20. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    Osa, Etin-Osa O.; DeWyngaert, Keith [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Roses, Daniel [Department of Surgery, New York University School of Medicine, New York, New York (United States); Speyer, James [Department of Medical Oncology, New York University School of Medicine, New York, New York (United States); Guth, Amber; Axelrod, Deborah [Department of Surgery, New York University School of Medicine, New York, New York (United States); Fenton Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Goldberg, Judith D. [Department of Population Health, New York University School of Medicine, New York, New York (United States); Formenti, Silvia C., E-mail: Silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States)

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  1. STUDY OF THE CAUSES OF MORTALITY IN CHILDREN UNDER 5 YEARS OF AGE IN CHAHARMAHAL AND BAKHTIYARI PROVINCE, IRAN

    F. Majlessi

    2000-12-01

    Full Text Available In this study the causes of mortality in children less than 5 years of age has been investigated. In this retrospective cross-sectional study, results were analysed by a descriptive analytic method. The investigation was carried out among 597 children less than 5 years including 296 boys and 301 girls. The sample was selected by census method and the necessary information was collected using questionnaire and documented family records in the local health houses. The results of interviews and filed records showed that the prevalent causes of mortality in children under 5 years in this area were prematurely in order of decreasing, low birth weight, respiratory infections, accidents, non-contiguous and diarrhoeal diseases. About one-fourth of the causes of mortality still remain unknown.

  2. MYOCARDIAL BRIDGING - CLINICAL AND ANGIOGRAPHIC PROFILE IN LAST 5 YEARS; A STUDY OF 129 CASES

    Abhilash S P; Krishna Kumar B; Praveen Velappan; PrabhaniniGupta; Sunita Viswanathan; A. George Koshy

    2010-01-01

    Aims of study : To assess the clinical and angiographical profile of myocardial bridging from consecutive coronary angiograms done over last 5 years at Medical college, Thiruvananthapuram. To assess the risk of cardiovascular events and the risk of accelerated atherosclerosis in isolated myocardial bridging. Methods : Consecutive coronary angiograms done at Medical college Thiruvananthapuram from 04/02/2005 to 31/03/2010 were reviewed for myocardial bridging. A total of 10492 coronary angiogr...

  3. Energy in the USSR during the tenth 5-year plan

    The Soviet Union is the only industrial power in the world whose economic development is based on its own fuel and energy resources. The extraction and transformation of these resources are carried-out by the fuel and energy complex, which includes the petrol, refining, gas, coal and schist and peat oils industries as well as the electro-energy industry. In 1980, at the end of the tenth 5-year plan, the increase in the extraction of petrol and gas mainly came from areas in western Siberia. The programme of nuclear plants with the help of Hungary, Poland and Czechoslovakia is developed. Prospect in MHD generators and in new energies are given

  4. Retrospective review of thoracic neural damage during lung ablation – what the interventional radiologist needs to know about neural thoracic anatomy

    Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications

  5. 5-year Mortality in Hemodialysis Patients: A Single Center Study in Tripoli

    Buargub Mahdia

    2008-01-01

    Full Text Available To investigate the 5-year mortality of patients undergoing maintenance hemo-dialysis (HD at Al-Shat center Tripoli, we reviewed during June 2007 the records of all the HD patients initiated on HD from Jun 2000 and Jan 2002.There were 124 patients in the study, 77 males (63.6% and 47 (36.4% females, with a mean age of 49 ± 14 years. Diabetic nephropathy (DN was the underlying kidney disease in 34 (27.4% patients. After 5 years; 3 patients were transferred to other centers, 18 (14.9% patients underwent kidney transplan-tation. Out of the 103 patients who continued on hemodialysis, 53 (51.4% expired during the 5-year follow-up. Mortality was associated with older age (p< 0.001 and odd ratio (OR of 4.2 for age > 50 years and DN (p< 0.002 and OR of 3.9. Mortality rate in diabetics was 74.1% and significantly associated with male sex (p< 0.0067 and OR of 2.4, older age (p< 0.004, presence of hypertension (p< 0.003 and OR of 3.9, type 1 diabetes (OR 1.6, and elevated mean body weight (p< 0.046. Mortality was also relatively higher in black patients (OR of 2.0 and smokers (OR of 1.39. In conclusion, the overall 5- year mortality for dialysis patients was elevated and higher in the diabetics.

  6. Implementation of a new CT colonography service: 5 Year experience

    Aim: To describe our experience using a 5 year audit of computed tomography colonography (CTC) practice and identify factors that influence diagnostic performance to guide implementation in other centres. Material and methods: Consecutive patients referred for CTC at a single institution over a 5 year period were identified, and reporting rates and positive predictive value (PPV) calculated for small polyps, large polyps, and colorectal cancer. Diagnostic performance was compared using the Chi-squared test, and trends over time were examined with logistic regression. The effect of faecal tagging and an intravenous spasmolytic were investigated using Fisher's exact test. Results: In total, 4355 CTC examinations were performed. Overall reporting rates and PPV were 17% and 92%, respectively. Negative predictive value (NPV) for cancer was 99.9%. A significant decrease in reporting rate (p < 0.001) was accompanied by an increase in PPV for small polyps (p = 0.02) following the introduction of faecal tagging. Adequacy rates for CTC improved over time (96% to 99%), with improved adequacy rates when using a spasmolytic, 98% versus 96% without. A significant difference in reporting rates, but not PPV, was found between radiologists. Conclusion: Accurate colonic investigation using CTC can be delivered safely to a high-risk patient population at a single centre. Faecal tagging and an intravenous spasmolytic improve diagnostic performance

  7. Demographics of rabies exposure in north-west of Iran:5years experience

    Samad Shams Vahdati; Nahid Mesbahi; Milad Anvari; Paria Habibollahi; Sara Babapour

    2013-01-01

    BACKGROUND: Rabies is a neuropathogenic disease, always fatal, which involves domestic and wild animals andattracted global concern for its distribution. This research aimed to demonstrate potential rabies infected animal bitesand related risk factors in North-West of Iran in order to evaluate the area’s demographics and risk factors. METHODS: A retrospective cross-sectional review was done for patients referred to Rabies Disease Control andPrevention Center placed in Sina Hospital, Tabriz, I...

  8. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary

    Cairns, G.; Angus, K; Hastings, G; Caraher, M.

    2013-01-01

    A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003-2012. Food promotions have a direct effect on children's nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutritio...

  9. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  10. A retrospective analysis of submissions, acceptance rate, open peer review operations, and prepublication bias of the multidisciplinary open access journal Head & Face Medicine

    Cehreli Murat

    2007-06-01

    Full Text Available Abstract Background Head & Face Medicine (HFM was launched in August 2005 to provide multidisciplinary science in the field of head and face disorders with an open access and open peer review publication platform. The objective of this study is to evaluate the characteristics of submissions, the effectiveness of open peer reviewing, and factors biasing the acceptance or rejection of submitted manuscripts. Methods A 1-year period of submissions and all concomitant journal operations were retrospectively analyzed. The analysis included submission rate, reviewer rate, acceptance rate, article type, and differences in duration for peer reviewing, final decision, publishing, and PubMed inclusion. Statistical analysis included Mann-Whitney U test, Chi-square test, regression analysis, and binary logistic regression. Results HFM received 126 articles (10.5 articles/month for consideration in the first year. Submissions have been increasing, but not significantly over time. Peer reviewing was completed for 82 articles and resulted in an acceptance rate of 48.8%. In total, 431 peer reviewers were invited (5.3/manuscript, of which 40.4% agreed to review. The mean peer review time was 37.8 days. The mean time between submission and acceptance (including time for revision was 95.9 days. Accepted papers were published on average 99.3 days after submission. The mean time between manuscript submission and PubMed inclusion was 101.3 days. The main article types submitted to HFM were original research, reviews, and case reports. The article type had no influence on rejection or acceptance. The variable 'number of invited reviewers' was the only significant (p Conclusion The positive trend in submissions confirms the need for publication platforms for multidisciplinary science. HFM's peer review time comes in shorter than the 6-weeks turnaround time the Editors set themselves as the maximum. Rejection of manuscripts was associated with the number of invited

  11. Assessing Caudal Block Concentrations of Bupivacaine With and Without the Addition of Intravenous Fentanyl on Postoperative Outcomes in Pediatric Patients: A Retrospective Review.

    Karkera, Megha M; Harrison, Dale R; Aunspaugh, Jennifer P; Martin, Timothy W

    2016-01-01

    Caudal blocks are a significant and efficacious aspect of pediatric anesthesia, especially in urologic and many general surgery cases. This type of regional anesthesia is common because it has a high success rate and provides between 6 and 8 hours of postoperative pain control. The aim of this study was to determine whether the concentration of bupivacaine or the addition of intravascular (i.v.) fentanyl affected the postanesthesia care unit (PACU) discharge time. A retrospective cohort study comparing the outcomes in pediatric patients who have received varying caudal concentrations with and without the addition of i.v. fentanyl was performed. A total of 849 consecutive patients undergoing hypospadias repairs or circumcisions were reviewed and placed in one of the following 3 groups: 0.125% bupivacaine (group 1), 0.25% bupivacaine (group 2), or one of these concentrations of bupivacaine + i.v. fentanyl intraoperatively (group 3). Total PACU time for each group was 46.1 minutes (group 1), 48.9 minutes (group 2), and 49.7 minutes (group 3). Our results revealed that there is no statistically significant difference between concentrations of bupivacaine administered in a caudal block with or without i.v. fentanyl with regard to the outcome of PACU duration (P = 0.16). Overall, based on the retrospective cohort design, there is no difference in primary and secondary outcomes based on the concentration of bupivacaine, when administered at a volume of 1 mL/kg. PMID:24832387

  12. Post-laryngectomy voice rehabilitation with voice prosthesis: 15 years experience of the ENT Clinic of University of Catania. Retrospective data analysis and literature review.

    Serra, A; Di Mauro, P; Spataro, D; Maiolino, L; Cocuzza, S

    2015-12-01

    This study reports our 15-year experience, in Sicily, with the use of voice prostheses, analysing the different variables that have influenced the success or failure of speech rehabilitation. The retrospective clinical analysis was carried out by reviewing the clinical histories of 95 patients with laryngeal cancer, in whom a voice prosthesis had been placed by trachea-oesophageal puncture between 1998 and 2013. Age, type of tumour, type of surgery, use of prior radiation therapy, type of puncture, prosthesis used and its duration, number of replacements, complications and causes for prosthetic success or failure were analysed. The results showed a mean of Harrison-Robillard-Schultz (HRS) TEP rating scale of 11.8 in primary TEP and 12.6 in secondary TEP (P =0.613). PORT did not affect overall rehabilitation success. In these patients, the mean HRS rating scale was 11.2, with long-term success of 85% (P =0.582). In patients over 70 years old, long-term success was 82.5%, with 78% in primary and 86% in secondary TEP, the mean HRS was 11.2 in primary and 12 in secondary TEP (P =0.648). In total, long-term success was 87.5%, with 84% in primary and 91% in secondary TEP. The results obtained by retrospective analysis of 15 years of prosthetic rehabilitation in the Sicilian territory highlighted standard rehabilitation, in terms of intra and postoperative complications, fistula related pathology and overall success. PMID:26900247

  13. The epidemiology of fungemia in an infectious diseases hospital in Mexico city: A 10-year retrospective review.

    Gaona-Flores, Verónica Alejandra; Campos-Navarro, Luz Arcelia; Cervantes-Tovar, Rosa María; Alcalá-Martínez, Enrique

    2016-08-01

    The epidemiology of invasive fungal infections has recently changed in immunosuppressed populations as a result of HIV infection, organ transplant, chemotherapy and in elderly patients. The diagnosis of invasive fungal infections by culture is prolonged since fungi grow slowly in vitro. we wanted to estimate the frequency of fungemia diagnoses established through the Clinical Mycology Laboratory over the past 10 years; through a retrospective study; data was obtained from the laboratory patient registry in the Infectious Disease Hospital's laboratory registry of patients with a systemic fungal isolate between 2005 and 2014. One hundred and thirty two (132) systemic fungal infections were identified. They were more prevalent in males, in the age group between 20 and 59 years and in patients with a diagnosis of AIDS. The most frequently isolated agents belonged to the genus Candida and others such as Histoplasma sp., Cryptococcus sp., Aspergillus sp., and Coccidioides sp. Of all blood and bone marrow cultures received 17.9% had fungal development; of these, in 70% of cases it was through blood cultures. In general, fungal agents were not diagnostically suspected. We identified that Sixty percent (60%) of fungemias developed in AIDS patients, followed by patients with sepsis. The most common agents belonged to the genus Candida, predominantly the albicans species. They were more frequently identified by blood culture than by bone marrow culture. Invasive fungal infections have not followed a usual clinical pattern and are not easily recognizable. PMID:27118806

  14. Pronuclear morphology evaluation in in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles: a retrospective clinical review

    Nicoli Alessia

    2013-01-01

    Full Text Available Abstract Background The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles. Methods Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET. Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology. Results Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis. Conclusions Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2.

  15. A retrospective outcomes review of patients with idiopathic normal pressure hydrocephalus treated with a low flow valve system

    Phillip G. St. Louis, MD, FACS

    2015-03-01

    Full Text Available Accepted treatment of patients with Idiopathic Normal Pressure Hydrocephalus (INPH dictates the placement of a Ventriculoperitoneal (VP shunt. Selection of a valve regulated system for implantation is usually determined by the treating surgeon. Data regarding the efficacy of a Low Flow Valve (LFV are sparse. The use of this type of system may be of benefit in patients with INPH. Data from fourteen patients in the Florida Hospital NPH Program Registry with placement of a Low Flow Valve were retrospectively examined. All patients completed baselines studies to quantify gait disturbance, cognitive dysfunction, and ventriculomegaly (Evan's Ratio. Studies were repeated post three day external lumbar drain, as well as 6, 12, and 24 months post shunt placement. Significant improvement was noted in gait (Berg Balance Score at six months and one year post shunt placement. Patients improved from a "medium" fall risk to a "low" fall risk. Significant improvement in NAB was noted at 2 years of follow up, improving from "mildly impaired" to "average". Evan's ratio was stable throughout the study. There were no instances of over drainage or shunt infection. One shunt obstruction which necessitated surgical intervention was observed. Objective improvement in BERG and NAB appears to provide conclusive evidence of efficacy in this small group of patients with INPH treated with placement of an LFV and followed for two years. The absence of over-drainage as a related complication in this small group is encouraging.

  16. Comparative effectiveness of everolimus and axitinib as second targeted therapies for metastatic renal cell carcinoma in the US: a retrospective chart review.

    Vogelzang, Nicholas J; Pal, Sumanta K; Signorovitch, James E; Reichmann, William M; Li, Nanxin; Yang, Chelsey; Liu, Zhimei; Perez, Jose Ricardo; Jonasch, Eric

    2016-04-01

    Background Second targeted therapies for metastatic renal cell carcinoma (mRCC) include mammalian target of rapamycin inhibitors (mTORis) and tyrosine kinase inhibitors (TKIs). This observational study compares overall survival (OS) and progression-free survival (PFS) of patients treated with everolimus (an mTORi) and axitinib (a TKI) following first TKI, and assesses the impact of type and duration of first TKI on the relative effectiveness of these second targeted therapies. Methods Retrospective reviews of medical records were conducted by medical oncologists or hematologists/oncologists recruited from a nationwide panel. Included patients with mRCC were required to have discontinued a first TKI (sunitinib, sorafenib, or pazopanib) for medical reasons, and to have initiated everolimus or axitinib as second targeted therapy between February 2012 and January 2013. OS and PFS were compared between patients treated with everolimus vs. axitinib using multivariable Cox proportional hazards regression models. Comparative results were also stratified by type and duration of first TKI. Results Included patients (n = 325 for everolimus and n = 127 for axitinib) had a mean age of 61 years and 31% were female. Sunitinib was the most commonly used first TKI (73%). After adjusting for patient characteristics, no statistically significant differences were observed in OS or PFS between everolimus and axitinib. When stratifying by type and duration of first TKI, there was no statistically significant difference in OS between everolimus and axitinib in all subgroups except for patients with sorafenib as first TKI. No significant difference in PFS was observed in any subgroup. Limitations Important limitations include potential missing or inaccurate data in medical charts, and confounding due to unobserved factors. Conclusions In this retrospective chart review, no significant differences were detected in OS or PFS between axitinib and everolimus as second targeted

  17. Salt repository sealing materials development program: 5-year work plan

    This plan covers 5 years (fiscal years 1986 through 1990) of work in the repository sealing materials program to support design decisions and licensing activities for a salt repository. The plan covers a development activity, not a research activity. There are firm deliverables as the end points of each part of the work. The major deliverables are: development plans for code development and materials testing; seal system components models; seal system performance specifications; seal materials specifications; and seal materials properties ''handbook.'' The work described in this plan is divided into three general tasks as follows: mathematical modeling; materials studies (salt, cementitious materials, and earthen materials); and large-scale testing. Each of the sections presents an overview, status, planned activities, and summary of program milestones. This plan will be the starting point for preparing the development plans described above, but is subject to change if preparation of the work plan indicates that a different approach or sequence is preferable to achieve the ultimate goal, i.e., support of design and licensing

  18. Modifiable diarrhoea risk factors in Egyptian children aged <5 years.

    Mansour, A M; Mohammady, H El; Shabrawi, M El; Shabaan, S Y; Zekri, M Abou; Nassar, M; Salem, M E; Mostafa, M; Riddle, M S; Klena, J D; Messih, I A Abdel; Levin, S; Young, S Y N

    2013-12-01

    By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus and Cryptosporidium spp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4.9, 95% CI 2.8-8.4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1.7-5.4), and the child being cared for outside home (mOR 2.6, 95% CI 1.3-5.2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6.3, 95% CI 1.2-33.9) for children aged 7-12 months, and pacifier use (mOR 1.9, 95% CI 1.0-3.5) in children aged 0-6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years. PMID:23433452

  19. Undergraduates’ opinion after 5-year experience with rotary endodontic instruments

    Flávia Sens Fagundes Tomazinho

    2011-01-01

    Full Text Available Introduction: Dentistry evolution in the past few years has revolutionized daily practice in some specialties. One of these revolutions has occurred in Endodontics due to the advancement of rotary techniques for root canal preparation and its subsequent incorporation into the teaching of Dentistry undergraduates. Objective: The aim of this study was to report a 5-year experience on the undergraduate laboratorial and clinical use of rotary endodontic preparation at a private university. Material and methods: Data survey was performed by using a questionnaire composed of nine objective questions; the questionnaire was answered by the undergraduates. Results: The results showed a positive acceptance regarding the undergraduate teaching of the rotary technique (94.7%. The following advantages were highlighted: faster root canal preparation (91.6% and reduction of patient’s stress (80.9%. Conclusion: It can be concluded that the experience with the two undergraduate groups was excellent due to the high acceptance level of the new technique by the students.

  20. Bifocal Intracranial Germinoma: A Retrospective Analysis of Treatment Outcomes in 20 Patients and Review of the Literature

    Purpose: Bifocal germinoma (BFG) is a rare intracranial neoplasm for which the choice of radiation therapy (RT) field is controversial. Some believe that BFG represents disseminated disease requiring craniospinal irradiation (CSI), whereas others believe that BFG represents localized disease and advocate for more limited fields. Methods and Materials: We analyzed 20 BFG patients at our institutions with classic bifocal lesions (pineal gland and suprasellar region). In addition, we identified 60 BFG patients from the literature. The RT fields, use of chemotherapy and extent of disease were recorded and analyzed for each patient. Results: There were 55 patients with bifocal lesions only (Group I), and 25 with bifocal lesions plus ventricular and/or CSF positive disease (Group II). The 5-year progression-free survival was 95% for Group I and 80% for Group II. In Group I, there were no failures in patients receiving CSI (n = 11), two spinal failures in those treated with more limited RT fields without chemotherapy (n = 17), and one spinal failure with chemotherapy (n = 23). In Group II, there were no failures in patients receiving CSI (n = 11), but four spinal failures were observed in patients receiving more limited RT fields with chemotherapy (n = 13); 1 patient who received whole-brain RT without chemotherapy experienced failure in the spine and brain. Conclusions: CSI is associated with excellent PFS in BFG. In Group I BFG patients, omission of spinal irradiation appears to be a reasonable approach, especially when chemotherapy is used. Patients with Group II BFG are best treated with CSI.

  1. Bifocal Intracranial Germinoma: A Retrospective Analysis of Treatment Outcomes in 20 Patients and Review of the Literature

    Weksberg, David C. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Shibamoto, Yuta [Department of Radiology, Nagoya City University, Graduate School of Medical Sciences, Nagoya (Japan); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States)

    2012-03-15

    Purpose: Bifocal germinoma (BFG) is a rare intracranial neoplasm for which the choice of radiation therapy (RT) field is controversial. Some believe that BFG represents disseminated disease requiring craniospinal irradiation (CSI), whereas others believe that BFG represents localized disease and advocate for more limited fields. Methods and Materials: We analyzed 20 BFG patients at our institutions with classic bifocal lesions (pineal gland and suprasellar region). In addition, we identified 60 BFG patients from the literature. The RT fields, use of chemotherapy and extent of disease were recorded and analyzed for each patient. Results: There were 55 patients with bifocal lesions only (Group I), and 25 with bifocal lesions plus ventricular and/or CSF positive disease (Group II). The 5-year progression-free survival was 95% for Group I and 80% for Group II. In Group I, there were no failures in patients receiving CSI (n = 11), two spinal failures in those treated with more limited RT fields without chemotherapy (n = 17), and one spinal failure with chemotherapy (n = 23). In Group II, there were no failures in patients receiving CSI (n = 11), but four spinal failures were observed in patients receiving more limited RT fields with chemotherapy (n = 13); 1 patient who received whole-brain RT without chemotherapy experienced failure in the spine and brain. Conclusions: CSI is associated with excellent PFS in BFG. In Group I BFG patients, omission of spinal irradiation appears to be a reasonable approach, especially when chemotherapy is used. Patients with Group II BFG are best treated with CSI.

  2. Outcome and Prognostic Factors for Traumatic Endophthalmitis over a 5-Year Period.

    Nicoară, Simona Delia; Irimescu, Iulian; Călinici, Tudor; Cristian, Cristina

    2014-01-01

    Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period. Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009-2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data. Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB) was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more. Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered with IRCT2014082918966N1. PMID:25302113

  3. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: A retrospective review

    Background and purpose: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. Patients and methods: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. Results: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant-body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. Conclusion: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT

  4. Retrospective review of clozapine in the treatment of patients with autism spectrum disorder and severe disruptive behaviors.

    Beherec, Laurène; Lambrey, Simon; Quilici, Gwendoline; Rosier, Antoine; Falissard, Bruno; Guillin, Olivier

    2011-06-01

    Autism spectrum disorder (ASD) is a serious childhood-onset disorder in which social and language development are primarily affected, with associated repetitive behavior and, in some patients, behavioral symptoms including aggression and self-injury. In ASD, risperidone and aripiprazole are the only second-generation antipsychotic drugs that have shown to decrease disruptive behaviors in large-scale, controlled, double-blind studies. However, in some patients, these medications are not effective. Clozapine, a second-generation antipsychotic drug known to be effective in the treatment of aggression associated with schizophrenia, has received little attention in ASD.We conducted a retrospective analysis of the changes in disruptive behaviors for all patients with ASD treated with clozapine from 2002 to 2010. Disruptive behaviors were monitored during the 4 to 6 months before and after the initiation of clozapine. Long-term tolerance (10 months to 7 years) was also assessed. The relationship between disruptive behaviors and period of treatment (before and after clozapine) was studied with a generalized linear marginal model. Clozapine resulted in a significant 2-fold decrease in the number of the days with aggression, a decrease in the number of psychotropic drugs, and a decrease in the dose of the antipsychotic drugs. The long-term tolerance of clozapine (white blood cell count and extrapyramidal effects) was good, with the exception of significant weight gain (14.3 ± 10.9 kg), the occurrence of metabolic syndrome in 1 patient, and tachycardia in another patient.These results suggest that clozapine should be considered for the management of disruptive behaviors in patients with ASD not improved by first-line antipsychotic drugs. PMID:21508854

  5. FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases

    Charest, Mathieu [Lakeshore General Hospital, Service of Nuclear Medicine, Pointe-Claire (Canada); Hickeson, Marc; Lisbona, Robert; Novales-Diaz, Javier A.; Derbekyan, Vilma [McGill University Health Center, Department of Nuclear Medicine, Montreal (Canada); Turcotte, Robert E. [McGill University Health Center, Department of Orthopedic Surgery, Montreal (Canada)

    2009-12-15

    The aims of this study are to evaluate the sensitivity of FDG PET/CT for detection of soft tissue and osseous sarcomas on the basis of FDG avidity. We retrospectively evaluated 212 consecutive patients with known soft tissue or osseous sarcoma who had undergone a FDG PET/CT study for the initial staging or assessment of recurrence of disease. The maximum standardized uptake value (SUV{sub max}) of each primary and/or most intense metastatic lesion was measured and compared with the histological data provided in the final pathological reports. An SUV{sub max} of 2.5 or greater was considered positive for our analysis. Sufficient histopathological data were available for 160 soft tissue sarcomas and 52 osseous sarcomas. FDG PET/CT detected 93.9% of all sarcomas with a sensitivity of 93.7% for soft tissue sarcomas and 94.6% for osseous sarcomas. The sensitivities of the most common sarcoma histologies were 100% for leiomyosarcomas, 94.7% for osteosarcomas, 100% for Ewing's sarcomas, 88.9% for liposarcomas, 80.0% for synovial sarcomas, 100% for gastrointestinal stromal tumors, 87.5% for malignant peripheral nerve sheath tumors, 100% for fibroblastic and myoblastic sarcomas, and 100% for malignant fibrohistiocytic tumors. The receiver-operating characteristic curve revealed an area under the curve of 94% for the discrimination of low-grade and high-grade sarcomas imaged for initial staging by FDG PET/CT. The combined metabolic and morphological information of FDG PET/CT imaging allows high sensitivity for the detection of various sarcomas and accurate discrimination between newly diagnosed low-grade and high-grade sarcomas. (orig.)

  6. FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases

    The aims of this study are to evaluate the sensitivity of FDG PET/CT for detection of soft tissue and osseous sarcomas on the basis of FDG avidity. We retrospectively evaluated 212 consecutive patients with known soft tissue or osseous sarcoma who had undergone a FDG PET/CT study for the initial staging or assessment of recurrence of disease. The maximum standardized uptake value (SUVmax) of each primary and/or most intense metastatic lesion was measured and compared with the histological data provided in the final pathological reports. An SUVmax of 2.5 or greater was considered positive for our analysis. Sufficient histopathological data were available for 160 soft tissue sarcomas and 52 osseous sarcomas. FDG PET/CT detected 93.9% of all sarcomas with a sensitivity of 93.7% for soft tissue sarcomas and 94.6% for osseous sarcomas. The sensitivities of the most common sarcoma histologies were 100% for leiomyosarcomas, 94.7% for osteosarcomas, 100% for Ewing's sarcomas, 88.9% for liposarcomas, 80.0% for synovial sarcomas, 100% for gastrointestinal stromal tumors, 87.5% for malignant peripheral nerve sheath tumors, 100% for fibroblastic and myoblastic sarcomas, and 100% for malignant fibrohistiocytic tumors. The receiver-operating characteristic curve revealed an area under the curve of 94% for the discrimination of low-grade and high-grade sarcomas imaged for initial staging by FDG PET/CT. The combined metabolic and morphological information of FDG PET/CT imaging allows high sensitivity for the detection of various sarcomas and accurate discrimination between newly diagnosed low-grade and high-grade sarcomas. (orig.)

  7. GENDER-RELATED DIFFERENCES IN CLINICAL COURSE OF CROHN?S DISEASE IN AN ASIAN POPULATION: a retrospective cohort review

    Siu-tong LAW

    2014-04-01

    Full Text Available Context Data from Asian populations about gender-related differences in Crohn’s disease are few. Objectives This study was to analyze the clinical characteristics between women and men affected by Crohn’s disease. Methods This was a retrospective cohort study to analyze consecutive Crohn’s disease patients from Jan 2000 to Dec 2012. Clinical and phenotypic characteristics and treatment outcomes were evaluated. Results 79 patients (55 male and two of them with positive family history were diagnosed with Crohn’s disease. Ileocolonic disease and inflammatory lesion was the most dominant site of involvement and disease behavior respectively in both men and women. Apart from higher frequency of nausea (45.83 vs 23.64%, P 0.024 and lower body mass index (19.44 vs 22.03 kg/m2, P 0.003 reported in women, no significant gender-related differences in clinical characteristics were observed. Women were more associated with delay use of immunosuppressive therapy (12 vs 36 months, P = 0.028, particularly for those aged less than 40 years old (85 vs 62.6%, P = 0.023. Cox proportional hazard regression analysis revealed that active smoking (HR, 4.679; 95% CI, 1.03-21.18 and delayed use of immunosuppressive therapy (HR, 4.13; 95% CI, 1.01-16.88 were only independent risk factors associated with increased risk of complications. Conclusions There were no significant gender-specific differences in clinical and phenotypic characteristics between male and female Crohn’s disease patients. Smoking history and delay use of immunosuppressive therapy were associated with higher risk of complications.

  8. Ten-year experiences with Tracheostomy at a University teaching hospital in Northwestern Tanzania: A retrospective review of 214 cases

    Gilyoma Japhet M

    2011-11-01

    Full Text Available Abstract Background Tracheostomy remains a very important life saving surgical procedure worldwide and particularly in our environment where patients present late in upper airway obstruction. Little work has been done on this subject in our environment and therefore it was necessary to conduct this study to describe our own experiences with tracheostomy, outlining the common indications and outcome of tracheostomized patients in our setting and compare our results with those from other centers in the world. Methods This was a 10-year retrospective study which was conducted at Bugando Medical Centre from January 2001 to December 2010. Data were retrieved from patients' files kept in the Medical record department and analyzed using SPSS computer software version 15.0. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study. Results A total of 214 patients were studied. The male to female ratio was 3.1: 1. The majority of patients were in the 3rd decade of life. The most common indication for tracheostomy was upper airway obstruction secondary to traumatic causes in 55.1% of patients, followed by upper airway obstruction due to neoplastic causes in 39.3% of cases. The majority of tracheostomies (80.4% were performed as an emergency. Transverse skin crease incision was employed in all the cases. Post-tracheostomy complication rate was 21.5%. Complication rate was significantly higher in emergency tracheostomy than in electives (P Conclusion Upper airway obstruction secondary to trauma and laryngeal tumors still remains the most common indication for tracheostomy in our centre and tracheostomy is still a life saving procedure in the surgical management of airway despite complications which are seen more commonly in paediatric patients. Most of tracheostomy related complications can be avoided by meticulous attention to the details of the technique and postoperative tracheostomy care by skilled

  9. Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

    Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. The delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. The dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity. Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis. After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). In multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m2 (p < 0.01). IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m2

  10. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary.

    Cairns, Georgina; Angus, Kathryn; Hastings, Gerard; Caraher, Martin

    2013-03-01

    A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003-2012. Food promotions have a direct effect on children's nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutrition foods and beverages. Rebalancing the food marketing landscape' is a recurring policy aim of interventions aimed at constraining food and beverage promotions to children. The collective review evidence on marketing practice indicates little progress towards policy aims has been achieved during the period 2003-2012. There is a gap in the evidence base on how substantive policy implementation can be achieved. We recommend a priority for future policy relevant research is a greater emphasis on translational research. A global framework for co-ordinated intervention to constrain unhealthy food marketing which has received high level support provides valuable insight on some aspects of immediate implementation research priorities. PMID:22561190

  11. Skin cancers among Albinos at a University teaching hospital in Northwestern Tanzania: a retrospective review of 64 cases

    Mabula Joseph B

    2012-06-01

    Full Text Available Abstract Background Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. The challenges associated with the care of these patients are numerous and need to be addressed. The aim of this study was to outline the pattern and treatment outcome of skin cancers among albinos treated at our centre and to highlight challenges associated with the care of these patients and proffer solutions for improved outcome. Methods This was a retrospective study of all albinos with a histopathological diagnosis of skin cancer seen at Bugando Medical Centre from March 2001 to February 2010. Data collected were analyzed using descriptive statistics. Results A total of 64 patients were studied. The male to female ratio was 1.5:1. The median age of patients was 30 years. The median duration of illness at presentation was 24 months. The commonest reason for late presentation was financial problem. Head and the neck was the most frequent site afflicted in 46(71.8% patients. Squamous cell carcinoma was the most common histopathological type in 75% of cases. Surgical operation was the commonest modality of treatment in 60 (93.8% patients. Radiotherapy was given in 24(37.5% patients. Twenty-seven (42.2% of the patients did not complete their treatment due to lack of funds. Local recurrence following surgical treatment was recorded in 6 (30.0% patients. Only thirty-seven (61.7% patients were available for follow-up at 6–12 months and the remaining patients were lost to follow-up. Conclusions Skin cancers are the most common cancers among albinos in our environment. Albinism and exposure to ultraviolet light appears to be the most important risk factor in the development of these cancers. Late presentation and failure to complete treatment due to financial difficulties and lack of radiotherapy services at our centre are major challenges in the care of these patients. Early institution of preventive

  12. Retrospective review of bone mineral metabolism management in end-stage renal disease patients wait-listed for renal transplant

    Chavlovski A

    2012-09-01

    Full Text Available Anna Chavlovski,1 Greg A Knoll,1–3 Timothy Ramsay,4 Swapnil Hiremath,1–3 Deborah L Zimmerman1–31University of Ottawa, 2Ottawa Hospital, 3Kidney Research Centre, Ottawa Hospital Research Institute, 4Ottawa Methods Centre, Ottawa, ON, CanadaBackground: In patients with end-stage renal disease, use of vitamin D and calcium-based phosphate binders have been associated with progression of vascular calcification that might have an impact on renal transplant candidacy. Our objective was to examine management of mineral metabolism in patients wait-listed for renal transplant and to determine the impact on cardiac perfusion imaging.Methods: Data was collected retrospectively on patients wait-listed for a renal transplant (n = 105, being either active (n = 73 and on hold (n = 32. Demographic data, medications, serum concentrations of calcium, phosphate, parathyroid hormone, and cardiac perfusion imaging studies were collected from the electronic health record. Chi-square and Student’s t-tests were used to compare active and on-hold patients as appropriate. Logistic regression was used to examine variables associated with worsening cardiac imaging studies.Results: The wait-listed patients were of mean age 56 ± 14 years and had been on dialysis for 1329 ± 867 days. On-hold patients had received a significantly greater total dose of calcium (2.35 ± .94 kg versus 1.49 ± 1.52 kg; P = 0.02 and were more likely to have developed worsening cardiovascular imaging studies (P = 0.03. Total doses of calcium and calcitriol were associated with worsening cardiovascular imaging studies (P = 0.05.Conclusion: Patients on hold on the renal transplant waiting list received higher total doses of calcium. A higher total dose of calcium and calcitriol was also associated with worsening cardiovascular imaging. Time on dialysis before transplant has been associated with worse post-transplant outcomes, and it is possible that the total calcium and calcitriol dose

  13. A 5-year retrospective study of rampant dental caries among adult patients in a Nigerian Teaching Hospital

    M Ajayi Deborah; M F Abiodun-Solanke Iyabode; O Gbadebo Shakeerah

    2015-01-01

    Background: Rampant caries in adults has not been a focus of many researches unlike the childhood form of the disease. The disease is an interesting finding in an adult patient. When the condition occurs in children, it has been described as nursing bottle caries, baby bottle tooth decay, and the most recently adopted term, "early childhood caries". Aim: The aim was to determine the prevalence of rampant caries among adult patients. Materials and Methods: Cases of rampant caries were id...

  14. Retrospective 5-Year Analysis of Revision Rate and Functional Outcome of TKA With and Without Patella Implant.

    Albrecht, Dominique C; Ottersbach, Andreas

    2016-05-01

    The aim of this study was to compare a patient cohort after total knee arthroplasty (TKA) in terms of the revision rate and the functional outcome, with and without patella resurfacing. Sixty-six patients (71 TKAs) were implanted with the mobile-bearing knee prosthesis system e.motion UC (Aesculap AG, Tuttlingen, Germany). These patients were divided into 2 groups, 1 of which received primary patella resurfacing (PPR; 51 TKAs) and 1 of which did not (non-PPR; 20 TKAs), with an average follow-up of 65.6 months (±6.9). The cohort was recorded consecutively. The evaluation was performed using the Knee Society Score and selected questions relating to the Knee Injury and Osteoarthritis Outcome Score, as well as with radiographs. Results showed that PPR was no better than non-PPR in terms of functional outcome. Two knees (10%) were revised in the non-PPR group, and 1 knee (1.96%) in the PPR group (not significant). In this cohort, 100% of implants, including the 5 TKAs of patients who did not attend the follow-up examination, had neither explanted nor loosened at the time of follow-up examination. The authors concluded that the revision rate for PPR is slightly lower, and this avoids the need for secondary patella resurfacing. The risk for complications is low, and the functional outcome is comparable. [Orthopedics. 2016; 39(3):S31-S35.]. PMID:27219724

  15. Disability in young adults following major trauma: 5 year follow up of survivors

    Connelly James B

    2003-01-01

    Full Text Available Abstract Background Injuries are a major cause of mortality and morbidity in young people. Despite this, the long-term consequences for young survivors of severe injury are relatively unexplored. Methods Population based cohort study involving 5 year post injury structured interview of all cases of major trauma (Injury Severity Score > 15 identified retrospectively for 12 month period (1988 to 1989 within former Yorkshire Health Authority area of the United Kingdom. Results 125 individuals aged 11–24 years at time of injury were identified. Of these, 109 (87% were interviewed. Only 20% (95% CI 14–29% of those interviewed reported no disability. Mean Office of Population Census and Surveys (OPCS disability score of the remainder was 7.5 (median 5.8, range 0.5 to 19.4. The most commonly encountered areas of disability were behaviour (54%, 95% CI 45–63%, intellectual functioning (39%, 95% CI 31–49% and locomotion (29%, 95% CI 22–39%. Many respondents reported that their daily lives were adversely affected by their health problems for example, causing problems with work, 54% (95% CI 45–63%, or looking after the home, 28% (95% CI 21–38%. Higher OPCS scores were usually but not always associated with greater impact on daily activities. The burden of caring responsibilities fell largely on informal carers. 51% (95% CI 42–61% of those interviewed would have liked additional help to cope with their injury and disability. Conclusion The study has revealed significant disability amongst a cohort of young people 5 years post severe injury. Whilst many of these young people were coping well with the consequences of their injuries, others reported continuing problems with the activities of daily life. The factors underpinning the young people's differing experiences and social outcome should be explored.

  16. Injuries suffered by dogs from riding in the back of open pickup trucks: a retrospective review of seventy cases.

    Houston, D M; Fries, C L; Alcorn, M J; Thomas, S S

    1995-08-01

    Case records of 70 dogs injured while riding in the back of open pickup trucks during the period January 1, 1982, to May 1, 1993, were reviewed. Most dogs were young (mean age 2.4 y) and of medium to large size (average weight 22.6 kg). Sixty-five dogs (93%) were injured during the months of April through October. Forty-nine dogs (70%) had single injuries and 21 dogs (30%) sustained multiple injuries. Fractures were the most frequent injury incurred, with fractures of the femur the most common. Surgical repair was recommended in all but 2 cases. PMID:7585438

  17. Primary pancreatic lymphoma – pancreatic tumours that are potentially curable without resection, a retrospective review of four cases

    Primary pancreatic lymphomas (PPL) are rare tumours of the pancreas. Symptoms, imaging and tumour markers can mimic pancreatic adenocarcinoma, but they are much more amenable to treatment. Treatment for PPL remains controversial, particularly the role of surgical resection. Four cases of primary pancreatic lymphoma were identified at Prince of Wales Hospital, Sydney, Australia. A literature review of cases of PPL reported between 1985 and 2005 was conducted, and outcomes were contrasted. All four patients presented with upper abdominal symptoms associated with weight loss. One case was diagnosed without surgery. No patients underwent pancreatectomy. All patients were treated with chemotherapy and radiotherapy, and two of four patients received rituximab. One patient died at 32 months. Three patients are disease free at 15, 25 and 64 months, one after successful retreatment. Literature review identified a further 103 patients in 11 case series. Outcomes in our series and other series of chemotherapy and radiotherapy compared favourably to surgical series. Biopsy of all pancreatic masses is essential, to exclude potentially curable conditions such as PPL, and can be performed without laparotomy. Combined multimodality treatment, utilising chemotherapy and radiotherapy, without surgical resection is advocated but a cooperative prospective study would lead to further improvement in treatment outcomes

  18. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period-The Da Qing Children Cohort Study.

    Yan Yan Chen

    Full Text Available The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance.To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood.424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later.Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight. Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001 in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001 in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR and triglycerides at 10 years of age.Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin.

  19. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  20. Robotic assisted Laparoscopic partial Nephrectomy for suspected Renal Cell Carcinoma: Retrospective review of surgical outcomes of 35 Cases

    Das Nitin

    2008-09-01

    Full Text Available Abstract Background A standard of care for the treatment of small renal masses is partial nephrectomy. The open and laparoscopic approaches have been well described in the literature. Robotic assistance may augment partial nephrectomy by aiding in dissection and renal reconstruction. In this communication we describe the surgical outcomes of 35 patients undergoing robotic partial nephrectomy. Methods Patient records and databases were reviewed for 35 consecutive patients undergoing RPN. Clinical, pathological, and radiographic data were obtained. The data was deidentified. Results Thirty five patients successfully underwent RPN. An additional 2 patients were converted to other nephron sparing procedures. Mean tumor size was 2.8 cm, and mean OR time was 142 minutes. Mean warm ischemia time was 20 minutes. All margins were negative. There were 4 complications, and no patients required reoperation. Conclusion Robotic partial nephrectomy can produce excellent initial results. Further studies should be performed to compare the outcomes to laparoscopic and open operations.

  1. The magnetosphere, ionosphere, and atmosphere as a system - Dynamics Explorer 5 years later

    Hoffman, R. A.

    1988-01-01

    The Dynamics Explorer (DE) program summarizes its accomplishments during the first 5 years since the launch of the two DE satellites. This introduction to six review articles provides background information and a brief history of the program, especially citing the contributions of many people to its development. The principal investigators who had primary responsibility to implement the program are listed, together with the instruments they provided. Orbital information and approaches and constraints to data acquisition are explained. The brief description of the ground data processing and analysis system provides information on access to data catalogs and data sets. Each review article is then placed in the context of the categories of scientific objectives of the program.

  2. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies Pólipos gástricos: análise retrospectiva de 26 000 endoscopias digestivas

    Drausio Jefferson Morais; Ademar Yamanaka; José Murilo Robilotta Zeitune; Nelson Adami Andreollo

    2007-01-01

    BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one exami...

  3. PERSIST: Physician's Evaluation of Restasis® Satisfaction in Second Trial of topical cyclosporine ophthalmic emulsion 0.05% for dry eye: a retrospective review

    Mah F

    2012-11-01

    Full Text Available Francis Mah,1 Mark Milner,2 Samuel Yiu,3 Eric Donnenfeld,4 Taryn M Conway,5 David A Hollander51University of Pittsburgh, Pittsburgh, PA, 2The Eye Center, Hamden, CT, 3University of Southern California, Los Angeles, CA, 4Ophthalmic Consultants of Long Island and Connecticut, Rockville Centre, New York, NY, 5Allergan Inc, Irvine, CA, USABackground: Chronic dry eye disease often requires long-term therapy. Tear film alterations in the setting of dry eye may include reduced tear volume as well as an increase in inflammatory cytokines and osmolarity. Topical cyclosporine ophthalmic emulsion 0.05% (Restasis®; Allergan Inc, Irvine, CA is indicated to increase tear production in patients with dry eye and reduced tear production presumed to be due to ocular inflammation. This study was designed to evaluate the efficacy of a second trial of topical cyclosporine in patients with dry eye who were previously considered treatment failures.Materials and methods: This multicenter (three cornea practices retrospective chart review evaluated clinical outcomes in patients with dry eye who received a second trial of cyclosporine after a prior treatment failure, defined as prior discontinuation of topical cyclosporine after less than 12 weeks.Results: Thirty-five patients, most of whom were female (71.4% and Caucasian (62.9%, were identified. Prior discontinuation was most commonly due to burning/stinging (60%. The median duration of second treatment was 10 months (range 1 week to 45 months. Physician education was provided in the second trial in 97.1% of cases. At initiation of the second trial of cyclosporine, 10 (28.6% patients received courses of topical corticosteroids. Physicians reported on a questionnaire that 80% of patients achieved clinical benefit with a second trial of cyclosporine.Conclusion: A repeat trial with topical cyclosporine can achieve clinical success. Direct patient education via the physician and staff may be key to success. Proper patient

  4. Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study

    Hassan Al-Thani

    2014-01-01

    Full Text Available Foot ulceration (FU remains a serious concern for patients worldwide. We analyzed the incidence, risk factors, and outcome of FU in hemodialysis (HD patients. A retrospective cohort study was conducted for 252 HD patients who were followed up for 5 years. Patients were categorized according to whether they developed FU or not. The FU group (17% was older and had significantly higher incidence of nephropathy, retinopathy, peripheral (PAD, coronary artery disease (CAD, and diabetes mellitus (DM as compared to no-FU group. FU group had higher frequency of major amputation (P=0.001 and HD vascular access (P=0.01. Patients with combined DM and PAD had a 10-fold increased risk of FU in comparison to those who had DM alone. Presence of PAD was the main independent predictor for development of FU in HD with an adjusted odd ratio (aOR of 16.0 (95% CI: 4.41–62.18; P=0.001. After adjusting for age, sex, and CAD, predictors for mortality were PAD (aOR 4.3, FU (aOR 3.6, and DM (aOR 2.6. FU is common in HD patients regardless of DM. However, the presence of PAD is significantly associated with more FU and mortality in HD. HD patients need intensive foot care and warrant progressive modification of vascular risk factors.

  5. Atomoxetine response in the inattentive and combined subtypes of attention deficit hyperactivity disorder: a retrospective chart review.

    Ercan, Eyup Sabri; Akyol Ardic, Ulku; Kabukcu Basay, Burge; Ercan, Elif; Basay, Omer

    2013-12-01

    The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 1994, American Psychiatric Association) describes attention deficit hyperactivity disorder (ADHD) as a heterogeneous disorder; providing diagnostic criteria for three subtypes: hyperactive/impulsive (ADHD/HI), inattentive (ADHD/I), and combined type (ADHD/C). Differences among the subtypes are well defined, but there may be also differences in terms of treatment responses. The aim of this study is to assess the responses of ADHD/I and ADHD/C to atomoxetine treatment. The medical records of the January-June 2012 term, first time referrals to outpatient clinic, were reviewed, and 37 ADHD diagnosed primary school age children (18 ADHD/I, 19 ADHD/C) that were treated with atomoxetine were determined. Thirty-five of them who completed 8 weeks of treatment duration were recruited for the study. The children with an ADHD medication use history in 2 months time prior to onset of treatment and/or the children receiving additional psychopharmacologic treatment to atomoxetine were excluded. Baseline and eighth week assessment, records were evaluated. Efficacy assessments included Turgay DSM-IV ADHD Screening and Rating Scale parent and teacher forms (T-DSM-IV) and Clinical Global Impression Scale-Severity and Improvement subscales. Safety assessments included laboratory and body weight assessments, ECG, heart rate, and blood pressure evaluations (baseline and eighth week) along a scale filled by the parents at the eighth week to review side effects. Atomoxetine was found to be effective in both ADHD/I and ADHD/C groups. Atomoxetine also decreased the opposition defiance subscale scores of T-DSM-IV (both parent and teacher forms), whereas it was not found to make statistically significant difference in the conduct disorder subscale scores. Mean difference in 8-week time in T-DSM-IV hyperactivity subscale and total scores of parent and teacher forms; inattention subscale scores of only parent forms and the

  6. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  7. [Glaucoma in dogs and cats. Review and retrospective evaluation of 421 patients. I. Pathobiological background, classification and breed predisposition].

    Boevé, M H; Stades, F C

    1985-03-15

    Glaucoma is diagnosed frequently in dogs and cats. A review of case records at the University of Utrecht Small Animal Clinic revealed that during a 4-year period glaucoma accounted for 8.6% of all ophthalmological diagnoses. Glaucoma is defined as an increased intraocular pressure, which sooner or later leads to loss of function of the eye. Primary and secondary types can be distinguished. In primary glaucoma an increased intraocular pressure exists in the absence of other primary eye disorders. By gonioscopy a discrimination can be made between open and narrow or closed anterior chamber angle forms of primary glaucoma. This requires a clear distinction between the definitions of chamber angle and filtration angle. In the Netherlands primary glaucoma is seen especially in the American Cocker Spaniel, Bouvier and Basset breeds. In secondary glaucoma an increased intraocular pressure occurs as a consequence of another primary eye disorder. Dislocation of the lens is the main cause for secondary glaucoma. Several-mainly small-terrier breeds are predisposed to this entity. PMID:3873120

  8. The liver is a common non-exocrine target in primary Sjögren's syndrome: A retrospective review

    Ike Robert W

    2002-09-01

    Full Text Available Abstract Background The autoimmune destruction of exocrine glands that defines primary Sjögren's syndrome (1°SS often extends to non-exocrine organs including the liver. We aimed to determine the prevalence of liver disease in patients with 1°SS and to evaluate the association of this complication with other non-exocrine features and serologic markers of autoimmunity and systemic inflammation. Methods We reviewed 115 charts of patients with 1°SS and further analyzed the 73 cases that fulfilled the European Epidemiology Center Criteria, seeking evidence for clinical and subclinical liver disease. Results Liver function tests had been determined in 59 of the 73 patients. Of those, 29 patients (49.1% had abnormal liver function tests including 20.3% with clinically overt hepatic disease. Liver disease was the most common non-exocrine feature in this cohort. Risk factors for abnormal liver function tests were distributed similarly between the patients with and without liver disease. In 60% of patients with abnormal liver function tests no explanation for this complication was found except for 1°SS. Liver involvement was significantly more common in 1°SS patients who also had evidence of lung, kidney and hematological abnormalities. Patients with abnormal liver function tests were also more likely to have an elevated sedimentation rate and a positive anti-ENA during the course of their disease. Conclusion Liver involvement is a common complication in 1°SS. Its presence correlates with systemic disease. We consider that this complication should be routinely sought in patients with 1°SS, especially when a positive anti-ENA or evidence of systemic inflammation is found.

  9. Technology transfer in human vaccinology: a retrospective review on public sector contributions in a privatizing science field.

    Hendriks, Jan

    2012-09-28

    As health intervention, vaccination has had a tremendous impact on reducing mortality and morbidity caused by infectious diseases. Traditionally vaccines were developed and made in the western, industrialised world and from there on gradually and with considerable delay became available for developing countries. Today that is beginning to change. Most vaccine doses are now produced in emerging economies, although industrialised countries still have a lead in vaccine development and in manufacturing innovative vaccines. Technology transfer has been an important mechanism for this increase in production capacity in emerging economies. This review looks back on various technology transfer initiatives and outlines the role of WHO and other public and private partners. It goes into a more detailed description of the role of the National Institute of Public Health and the Environment (RIVM) in Bilthoven, the Netherlands. For many decades RIVM has been providing access to vaccine technology by capacity building and technology transfer initiatives not only through multilateral frameworks, but also on a bilateral basis including a major project in China in the 90 s of the previous century. Looking forward it is expected that, in a globalizing world, the ambition of BRICS countries to play a role in global health will lead to an increase of south-south technology transfers. Further, it is argued that push approaches including technology transfer from the public domain, connecting innovative enabling platforms with competent developing country vaccine manufacturers (DCVM), will be critical to ensure a sustainable supply of affordable and quality vaccines to national immunization programmes in developing countries. PMID:22902679

  10. Observational clinical study of 22 adult-onset Pompe disease patients undergoing enzyme replacement therapy over 5years.

    Stepien, Karolina M; Hendriksz, Christian J; Roberts, Mark; Sharma, Reena

    2016-04-01

    Pompe disease is an autosomal recessive disease resulting from deficiency of the acid alpha-glucosidase (GAA). The late-onset Pompe Disease (LOPD) patients develop muscular and respiratory complications later in life. We describe a retrospective observational cohort study including 22 patients with LOPD. The cohort was assessed at baseline before Enzyme Replacement Therapy (ERT) with alglucosidase alpha (20mg/kg biweekly) was commenced and subsequently relevant information was collected at 2, 4 and 5years later. The median age of the patients at study entry was 44years (16-64years), with median disease duration of 11.5years (4-31years). At baseline, 10 patients (45%) could walk without support, 12 (55%) could walk with unilateral or bilateral support including 3/12 were wheelchair bound. Mean predicted FVC % was 55.7 (95% CI 45-66) of predicted normal at baseline and showed no significant change after 5years (54.6 (95% CI 43-66)), (all p=0.9815). Mean FVC % supine was 41.8 (95% CI 33.8-49) of predicted normal at baseline and remained significantly unchanged at 5years (48.4 (95% CI 37-59.6)), (all p=0.8680). The overnight non-invasive ventilator dependence increased by 18.2% as compared with baseline and requirement of mobility aids increased during this period by 5.2% as compared with the baseline. Mean walking distance at 6min walk test was 411.5 (95% CI 338-485) at baseline, 266.5 (95% CI 187-346) m at 2years, 238.6 (95% CI 162-315) m at 4years and 286.8 (95% CI 203-370) m at 5years (p=0.1981; ANOVA was completed only for 14 patients). A gradual decline in FVC% predicted was noted only in four cases and a decline in FVC% supine in two other. Only one patient showed a decline in both pulmonary function tests. In all remaining cases (17/22) respiratory function remains stable. In conclusion overall pulmonary function tests and mobility remained stable for 5years in majority of patients on ERT. However, in some patients they continued to decline in spite of ERT

  11. Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients

    Liberato Manuel José

    2012-08-01

    Full Text Available Abstract Background Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS and plastic stents (PS.We also compared unilateral and bilateral stent placement according to the Bismuth classification. Methods Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS, functional success (FS, early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type > III. Results The initial stent insertion was successful in 450 (93.8% patients. TS was achieved in 204 (88.3% patients treated with PS and in 246 (98.8% patients palliated with SEMS (p P P  Conclusions SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients.

  12. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

    Kachelmeyer Andrea

    2011-09-01

    Full Text Available Abstract Objective The AAP recommends that a follow-up skeletal survey be obtained for all children Methods A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were Results Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7; the mean number of days between skeletal surveys was 18.7 (SD 10.1 Four children (8.5% had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75% had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

  13. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Greenblatt JM

    2011-09-01

    Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

  14. A 5-year prospective observational study of the outcomes of international treatment guidelines for Crohn's disease.

    Cullen, Garret

    2012-02-01

    BACKGROUND & AIMS: Therapeutic strategies for patients with Crohn\\'s disease are based on American and European guidelines. High rates of corticosteroid dependency and low remission rates are identified as weaknesses of this therapy and as justification for early introduction of biologic agents (top-down treatment) in moderate\\/severe Crohn\\'s disease. We reviewed outcomes and corticosteroid-dependency rates of patients with moderate-to-severe disease who were treated according to the international guidelines. METHODS: Consecutive patients (102) newly diagnosed with Crohn\\'s disease in 2000-2002 were identified from a prospectively maintained database. Severity of disease was scored using the Harvey-Bradshaw Index (HBI). Disease was classified by Montreal classification. Five-year follow-up data were recorded. RESULTS: Seventy-two patients had moderate\\/severe disease at diagnosis (HBI >8). Fifty-four (75%) had nonstricturing, nonpenetrating disease (B1). Sixty-four (89%) received corticosteroids, and 44 (61%) received immunomodulators. Twenty-one patients (29%) received infliximab. Thirty-nine patients (54%) required resection surgery. At a median of 5 years, 66 of 72 (92%) patients with moderate\\/severe disease were in remission (median HBI, 1). Twenty-five patients (35%) required neither surgery nor biologic therapy. CONCLUSIONS: When international treatment guidelines are strictly followed, Crohn\\'s disease patients can achieve high rates of remission and low rates of morbidity at 5 years. Indiscriminate use of biologic agents therefore is not appropriate for all patients with moderate-to-severe disease.

  15. The thermoregulatory theory of yawning: what we know from over 5 years of research.

    Gallup, Andrew C; Eldakar, Omar T

    2012-01-01

    Over the past 5 years numerous reports have confirmed and replicated the specific brain cooling and thermal window predictions derived from the thermoregulatory theory of yawning, and no study has found evidence contrary to these findings. Here we review the comparative research supporting this model of yawning among homeotherms, while highlighting a recent report showing how the expression of contagious yawning in humans is altered by seasonal climate variation. The fact that yawning is constrained to a thermal window of ambient temperature provides unique and compelling support in favor of this theory. Heretofore, no existing alternative hypothesis of yawning can explain these results, which have important implications for understanding the potential functional role of this behavior, both physiologically and socially, in humans and other animals. In discussion we stress the broader applications of this work in clinical settings, and counter the various criticisms of this theory. PMID:23293583

  16. Highlights from the Fermi Large Area Telescope after 5 years of operations

    The Fermi Large Area Telescope (LAT) has been exploring the high-energy γ-ray sky since its launch on June 11, 2008. After 5 years of essentially flawless operations, the LAT collected more than 800 million γ rays from 20 MeV to more than 300 GeV. With its uniform coverage of the sky, the LAT allowed the first high statistics observations of γ-ray sources of known classes as well as the discovery of new emitters. The LAT also allowed a detailed study of the diffuse γ-ray emission, which constitutes roughly 90% of the LAT photons, and constrains cosmic-ray production and propagation in our own Galaxy. In this talk I will review the status and the performance of the LAT and describe some of the most important scientific results

  17. Intraoperative radiation therapy with the photon radiosurgery system in locally advanced and recurrent rectal cancer: retrospective review of the Cleveland clinic experience

    Patients with locally advanced or recurrent rectal cancer often require multimodality treatment. Intraoperative radiation therapy (IORT) is a focal approach which aims to improve local control. We retrospectively reviewed 42 patients treated with IORT following definitive resection of a locally advanced or recurrent rectal cancer from 2000–2009. All patients were treated with the Intrabeam® Photon Radiosurgery System (PRS). A dose of 5 Gy was prescribed to a depth of 1 cm (surface dose range: 13.4-23.1, median: 14.4 Gy). Median survival times were calculated using Kaplan-Meier analysis. Of 42 patients, 32 had recurrent disease (76%) while 10 had locally advanced disease (24%). Eighteen patients (43%) had tumors fixed to the sidewall. Margins were positive in 19 patients (45%). Median follow-up after IORT was 22 months (range 0.2-101). Median survival time after IORT was 34 months. The 3-year overall survival rate was 49% (43% for recurrent and 65% for locally advanced patients). Local recurrence was evaluable in 34 patients, of whom 32% failed. The 1-year local recurrence rate was 16%. Distant metastasis was evaluable in 30 patients, of whom 60% failed. The 1-year distant metastasis rate was 32%. No intraoperative complications were attributed to IORT. Median duration of IORT was 35 minutes (range: 14–39). Median discharge time after surgery was 7 days (range: 2–59). Hydronephrosis after IORT occurred in 10 patients (24%), 7 of whom had documented concomitant disease recurrence. The Intrabeam® PRS appears to be a safe technique for delivering IORT in rectal cancer patients. IORT with PRS marginally increased operative time, and did not appear to prolong hospitalization. Our rates of long-term toxicity, local recurrence, and survival rates compare favorably with published reports of IORT delivery with other methods

  18. Review of the Current Status of Intra-Arterial Thrombolysis for Treating Acute Cerebral Infarction: a Retrospective Analysis of the Data from Multiple Centers in Korea

    Lee, Deok Hee [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Na, Dong Gyu [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ihn, Yon Kwon [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)] (and others)

    2007-04-15

    The purpose of the study was to review the current status of intraarterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers. The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis. We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale {<=}2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (p = 0.01), initially severe neurological symptoms (p < 0.0001), MR findings of a wide distribution of lesions (p = 0.001), involvement of the basal ganglia (p = 0.01), performance of procedures after working hours (p 0.01), failure of recanalization (p 0.003), contrast extravasation after the procedure (p = 0.007) and significant hemorrhagic transformation (p = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable. There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical

  19. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services.

    Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L

    2015-06-01

    Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. PMID:24674302

  20. Mortality and morbidity patterns in under-five children with severe acute malnutrition (SAM) in Zambia: a five-year retrospective review of hospital-based records (2009–2013)

    Munthali, Tendai; Jacobs, Choolwe; Sitali, Lungowe; Dambe, Rosalia; Michelo, Charles

    2015-01-01

    Background Severe acute malnutrition has continued to be growing problem in Sub Saharan Africa. We investigated the factors associated with morbidity and mortality of under-five children admitted and managed in hospital for severe acute malnutrition. Methods It was a retrospective quantitative review of hospital based records using patient files, ward death and discharge registers. It was conducted focussing on demographic, clinical and mortality data which was extracted on all children aged ...

  1. [A retrospective study about 11 cases of Esthesioneuroblastomas treated in Hospital Santa Creu i Sant Pau between 2000 and 2008 and literature review].

    Muñoz, F; Tresserras, P; Montserrat, J R; Sancho, F J; Bartumeus, F

    2011-10-01

    INTRODUCTION. Esthesioneuroblastoma (ENB) is a very uncommon malignant tumor with a neuroectodermal origin that usually involves the anterior cranial fossa and nasal cavity. OBJECTIVES. To review our experience in the management of ENB and assess the validity of the histopathological diagnosis, modality of treatment and prognostic factors of the disease comparing our findings with the literature. METHODS. A retrospective study of 11 cases with the diagnosis of esthesioneuroblastoma treated in our hospital between 2000 and 2008. Statistical analysis was performed in search for prognostic factors. The bibliography about ENB published between 1990 and 2009 was reviewed RESULTS. There were 3 women and 8 men, with a mean age of 42 years old (range 20-71y). Their symptoms upon admission were nasal obstruction (81%), epistaxis (27%), visual loss (18%), headache and others. According to the Kadish Stage, 2 were stage B and 9 were stage C. Dulguerov and Calcaterra Classification was also used: 2 were T2, 3 were T3 and 6 were T4. The hystopathological result according to the Hyams classification was: 2 cases in stage I, 4 in stage II, 3 in stage III and 2 in stage IV. The two cases classified in stage IV changed the diagnosis to undifferenciate tumor in the second biopsy. A subcranial approach was performed in 8 cases combined with endonasal endoscopy to confirm the total removal, followed by radiotherapy in all and chemotherapy in one case, resulting on 62% (5 patients) being alive without disease, 12,5% (1 p) alive with disease, and 25% (2 p) dead of disease. Another patient was operated by a single endonasal endoscopic approach and a subtotal removal was achieved. This patient is alive without disease. The other 2 patients were treated by biopsy plus radiotherapy and chemotherapy, because they were considered unresectable, and one of them is alive with disease and the other one is dead of disease. Radiotherapy was performed in all cases and chemotherapy in 5 cases. The

  2. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P < 0.0001), lower time to positivity (P < 0.0001), immunosuppression (P = 0.03), and recommendation made by an infectious disease consultant (P = 0.0005). On multivariable analysis, infectious diseases consultation (P = 0.03), higher number of positive blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs

  3. Use of 3.0-T MRI for Stereotactic Radiosurgery Planning for Treatment of Brain Metastases: A Single-Institution Retrospective Review

    Purpose: To investigate the efficacy of 3.0-T magnetic resonance imaging (MRI) for detecting brain metastases for stereotactic radiosurgery (SRS) planning. Methods and Materials: All adult patients scheduled for SRS treatment for brain metastases at our institution between October 2005 and January 2008 were eligible for analysis. All patients underwent radiosurgery treatment planning 3.0-T MRI on the day of scheduled radiosurgery and a diagnostic 1.5-T MRI in the days or weeks prior to radiosurgery for comparison. Both scans were interpreted by neuroradiologists who reported their findings in the radiology reports. We performed a retrospective review of the radiology reports to determine the number of brain metastases identified using each MRI system. Results: Of 254 patients scheduled for treatment from October 2005 to January 2008, 138 patients had radiology reports that explicitly described the number of metastases identified on both scans. With a median interval of 17 days (range, 1-82) between scans, the number of metastases detected using 1.5-T MRI system ranged from 1 to 5 and from 1 to 8 using the 3.0 T-MRI system. Twenty-two percent of patients were found to have a greater number of metastases with the 3.0 T-MRI system. The difference in number of metastases detected between the two scans for the entire cohort ranged from 0 to 6. Neither histology (p = 0.52 by chi-sq test) nor time between scans (p = 0.62 by linear regression) were significantly associated with the difference in number of metastases between scans. Conclusions: The 3.0-T MRI system appears to be superior to a 1.5-T MRI system for detecting brain metastases, which may have significant implications in determining the appropriate treatment modality. Our findings suggest the need for a prospectively designed study to further evaluate the use of a 3.0 T-MRI system for stereotactic radiosurgery planning in the treatment of brain metastases.

  4. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records.

    Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk

    2016-05-01

    We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted. PMID:27149503

  5. Evaluation of costs accrued through inadvertent continuation of hospital-initiated proton pump inhibitor therapy for stress ulcer prophylaxis beyond hospital discharge: a retrospective chart review

    Shin S

    2015-04-01

    Full Text Available Sooyoung Shin Ajou University College of Pharmacy, Yeongtong-gu, Suwon-si, Gyeonggi-do, South Korea Background: Stress ulcers and related upper gastrointestinal bleeding are well-known complications in intensive care unit (ICU patients. Proton pump inhibitor (PPI-based stress ulcer prophylaxis (SUP has been widely prescribed in noncritically ill patients who are at low risk for clinically significant bleeding, which is then injudiciously continued after hospital discharge. This study aimed to evaluate the incidence of inappropriate prescribing of PPI-based preventative therapy in ICU versus non-ICU patients that subsequently continued postdischarge, and to estimate the costs incurred by the unwarranted outpatient continuation of PPI therapy.Methods: A retrospective review of patient data at a major teaching hospital in Korea was performed. During the 4-year study period, adult patients who were newly initiated on PPI-based SUP during hospital admission and subsequently discharged on a PPI without a medical indication for such therapy were captured for data analysis. The incidence rates of inappropriate prescribing of PPIs were compared between ICU and non-ICU patients, and the costs associated with such therapy were also examined.Results: A total of 4,410 patients, more than half of the inpatient-initiated PPI users, were deemed to have been inadvertently prescribed a PPI at discharge in the absence of a medical need for acid suppression. The incidence of inappropriate outpatient continuation of the prophylaxis was higher among ICU patients compared with non-ICU patients (57.7% versus 52.2%, respectively; P=0.001. The total expenditure accrued through the continuation of nonindicated PPI therapy was approximately US$40,175.Conclusion: This study confirmed that excess usage of PPIs for SUP has spread to low-risk, non-ICU patients. The overuse of unwarranted PPI therapy can incur large health care expenditure, as well as clinical complications

  6. TP53 mutational status and cetuximab benefit in rectal cancer: 5-year results of the EXPERT-C trial.

    Sclafani, Francesco; Gonzalez, David; Cunningham, David; Hulkki Wilson, Sanna; Peckitt, Clare; Tabernero, Josep; Glimelius, Bengt; Cervantes, Andrés; Dewdney, Alice; Wotherspoon, Andrew; Brown, Gina; Tait, Diana; Oates, Jacqueline; Chau, Ian

    2014-07-01

    In this updated analysis of the EXPERT-C trial we show that, in magnetic resonance imaging-defined, high-risk, locally advanced rectal cancer, adding cetuximab to a treatment strategy with neoadjuvant CAPOX followed by chemoradiotherapy, surgery, and adjuvant CAPOX is not associated with a statistically significant improvement in progression-free survival (PFS) and overall survival (OS) in both KRAS/BRAF wild-type and unselected patients. In a retrospective biomarker analysis, TP53 was not prognostic but emerged as an independent predictive biomarker for cetuximab benefit. After a median follow-up of 65.0 months, TP53 wild-type patients (n = 69) who received cetuximab had a statistically significant better PFS (89.3% vs 65.0% at 5 years; hazard ratio [HR] = 0.23; 95% confidence interval [CI] = 0.07 to 0.78; two-sided P = .02 by Cox regression) and OS (92.7% vs 67.5% at 5 years; HR = 0.16; 95% CI = 0.04 to 0.70; two-sided P = .02 by Cox regression) than TP53 wild-type patients who were treated in the control arm. An interaction between TP53 status and cetuximab effect was found (P < .05) and remained statistically significant after adjusting for statistically significant prognostic factors and KRAS. PMID:24957073

  7. Pediatric ovarian tumors in a tertiary care hospital of Kolkata: An experience of last 5 years with its clinicopathological correlation

    Senjuti Dasgupta

    2016-01-01

    Full Text Available Background: Pediatric ovarian tumors are rare with an approximate incidence of 2.6 per 100,000 girls per year. Aims and Objectives: This study was done to delineate the clinicopathological profile of pediatric ovarian masses encountered in a tertiary care hospital over 5 years. Materials and Methods: A retrospective study was conducted for a period of 5 years during which all patients whose age did not exceed 20 years and underwent surgical resection of ovarian masses, were included. History, operative notes, gross findings, and microscopic features of each case were noted. Results: A total of 76 cases were included in the study. The age of patients ranged between 2 and 20 years with a mean of 17 ± 2.5 years. Of the 76 cases, 53 (69.7% were benign and 23 (30.3% malignant tumors. The benign tumors included 16 cases each of teratoma (21.1% and serous cystadenoma (21.1%, and 21 cases of mucinous cystadenoma (27.6%. Germ cell tumors were the commonest malignant tumors in patients up to 15 years of age and they included four cases of dysgerminoma (5.3% and one case of immature teratoma (1.3%. Between 16 and 20 years, 8 cases of serous cystadenocarcinoma were found (10.5%, in addition to seven malignant germ cell tumors (9.2%. One case (1.3% each of granulosa cell tumor and sertoli leydig cell tumor was also found in the same age group. Conclusion: Pediatric ovarian tumors require early attention and institution of appropriate treatment since they bear important implications on the future lives of young females.

  8. Long-term complications of JJ stent and its management: A 5 years review

    Ray, Rajendra Prasad; Mahapatra, Rajkumar Singha; Mondal, Partha Pratim; Pal, Dilip Kumar

    2015-01-01

    Objectives: To assess the long term complications of JJ stent, the management of complications and the role of endoscopic approach to manage these complications. Materials and Methods: Nineteen patients with indwelling JJ stent for a duration of more than 6 months were included in this study. Patients were assessed with X-ray KUB, USG KUB, blood urea, creatinine and DTPA renogram. Data were analyzed by Microsoft excel 2007. Results: Out of 19 patients 12 (63.16%) were male and 7 (36.84%) were...

  9. Long-term complications of JJ stent and its management: A 5 years review

    Rajendra Prasad Ray

    2015-01-01

    Conclusions: JJ stent related long-term complications are not uncommon and are usually seen after 6 months of indwelling time. Endourological procedure should be the initial approach with a high success rate. Coordinated use multimodality and technology helps in management of difficult cases. Open surgery is rarely required. Prevention of the complication by judicious use and early removal is the cornerstone.

  10. Long-term complications of JJ stent and its management: A 5 years review

    Rajendra Prasad Ray; Rajkumar Singha Mahapatra; Partha Pratim Mondal; Dilip Kumar Pal

    2015-01-01

    Objectives: To assess the long term complications of JJ stent, the management of complications and the role of endoscopic approach to manage these complications. Materials and Methods: Nineteen patients with indwelling JJ stent for a duration of more than 6 months were included in this study. Patients were assessed with X-ray KUB, USG KUB, blood urea, creatinine and DTPA renogram. Data were analyzed by Microsoft excel 2007 . Results: Out of 19 patients 12 (63.16%) were male and 7 (36.8...

  11. Cancer incidence in the Republic of Mauritius- 5 Years Review 1997 to 2001

    Mr. P Burhoo

    2006-01-01

    Full Text Available 6484 new cases of cancer have been registered in Mauritius during 1997-2001 corresponding to Age-Standardized Incidence Rates (ASR world of 99.9 per 100,000 in men and 121.1 per 100,000 in women. The commonest sites of cancer in men were colo-rectal cancer (9.5% followed closely by oral cavity & pharynx (9.4% and prostate (8.8%. In women breast cancer was, by far, the main site (28%, ASR 31.7 ahead of cervical cancer (11.7% and colorectal (5.7% and leukaemias (4.7%. Comparisons with figures from neighboring countries show much lower rates in Mauritius for both sexes.

  12. Hypomineralized second primary molars: Prevalence data in Dutch 5-year-olds

    Elfrink, M.E.C.; Schuller, A.A.; Weerheijm, K.L.; Veerkamp, J.S.J.

    2008-01-01

    The aim of this cross-sectional observational study was to report on the prevalence of hypomineralizations in second primary molars in 5-year-old Dutch children. In the study 386 (45% girls) 5-year-old Dutch children, all insured by a Health Insurance Fund, participated. Scoring criteria for molar i

  13. Early Number and Arithmetic Performance of Ecuadorian 4-5-Year-Olds

    Bojorque, Gina; Torbeyns, Joke; Moscoso, Jheni; Van Nijlen, Daniël; Verschaffel, Lieven

    2015-01-01

    This study aimed at (a) constructing a reliable and valid test to assess Ecuadorian 4-5-year olds' number and arithmetic skills; (b) providing empirical data on Ecuadorian 4-5-year olds' number and arithmetic skills; and (c) confronting these children's actual performances with the performances expected by national experts in this domain. We…

  14. A 5-year longitudinal study of fatigue in patients with late-onset sequelae of poliomyelitis.

    Tersteeg, I.M.; Koopman, F.S.; Stolwijk-Swuste, J.M.; Beelen, A.; Nollet, F.

    2011-01-01

    Objectives: To study the severity and 5-year course of fatigue in patients with late-onset sequelae of poliomyelitis (LOSP) and to identify physical and psychosocial determinants of fatigue. Design: Prospective cohort study with 5 measurements over 5 years. Setting: University hospital.Participants:

  15. A 5-Year Longitudinal Study of Fatigue in Patients With Late-Onset Sequelae of Poliomyelitis

    I.M. Tersteeg; F.S. Koopman; J.M. Stolwijk-Swüste; A. Beelen; F. Nollet

    2011-01-01

    Tersteeg IM, Koopman FS, Stolwijk-Swuste JM, Beelen A, Nollet F, on behalf of the CARPA Study Group. A 5-year longitudinal study of fatigue in patients with late-onset sequelae of poliomyelitis. Arch Phys Med Rehabil 2011; 92:899-904. Objectives: To study the severity and 5-year course of fatigue in

  16. Malpractice and radiologists, update 1986: an 11.5-year perspective

    All medical malpractice lawsuits filed in Cook County, IL, from January 1, 1980, through June 30, 1986, were reviewed and compared with similar data for the period of January 1, 1975, through December 30, 1979. A total of 11,203 suits were filed during the 11.5-year period; of these, 1391 (12%) were radiology related. The latter were categorized into six groups. The largest was missed radiologic diagnoses, which accounted for 40% of the total. The remaining groups included complications, 19%; failure to order, 17%; radiation therapy, 11%; slip and fall, 5%; and miscellaneous, 8%. Over the 1975-1986 period, the rise in the number of suits alleging radiologic misses outpaced all other groups. Although the most common type of miss continues to involve fractures, the frequency of missed carcinomas has grown at a disproportionately faster rate. Misses specifically involving CT, nuclear medicine, and sonography also are becoming more prevalent. Radiographic misses continue to occur at an average rate of 30%, with little hope of improvement. Methods to combat the rising number of malpractice suits are discussed. It is concluded that although programs to educate radiologists on risk management should continue, the ultimate solution may be a more enlightened public attitude as to what actually constitutes malpractice, and institution of tort reform measures by federal and state legislatures

  17. Necrotizing soft tissue infection: analysis of the factors related to mortality in 30 cases of a single institution for 5 years

    Park, Sung Jin; Choi, Chang In; Yun, Sung Pil; Kim, Jae Hun; Seo, Hyung Il; Jo, Hong Jae; Jun, Tae Yong

    2016-01-01

    Purpose Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years. Methods From January 2009 to December 2013, 30 patients diagnosed with necrotizing fasciitis or Fournier's gangrene in Pusan National University Hospital were enrolled for this study. The following parameters were analyzed retrospectively: demographics, infection site, initial laboratory finding, initial antibiotics, isolated microorganisms, number of surgeries, time to first operation, length of intensive care unit, and total hospital stays. Results The overall mortality rate was 23.3%. Mean body mass index (BMI) of the survival group (24.7 ± 5.0 kg/m2) was significantly higher than the nonsurvival group (22.0 ± 1.4 kg/m2, P = 0.029). When BMI was less than 23 kg/m2, the mortality rate was significantly higher (P = 0.025). Two patients (6.7%) with chronic kidney disease requiring hemodialysis died (P = 0.048). Initial WBC count (>13×103/µL), CRP (>26.5 mg/dL), and platelet (PLT) count (27.6 mg/dL), serum creatinine (>1.2 mg/dL) that reflected kidney function were significant mortality factors. Conclusion Patients with low BMI or abnormal values of WBC count, CRP, and PLT count reflecting the degree of infection or abnormal renal function will need more intensive care. PMID:27433464

  18. MYOCARDIAL BRIDGING - CLINICAL AND ANGIOGRAPHIC PROFILE IN LAST 5 YEARS; A STUDY OF 129 CASES

    Abhilash S P

    2010-11-01

    Full Text Available Aims of study : To assess the clinical and angiographical profile of myocardial bridging from consecutive coronary angiograms done over last 5 years at Medical college, Thiruvananthapuram. To assess the risk of cardiovascular events and the risk of accelerated atherosclerosis in isolated myocardial bridging. Methods : Consecutive coronary angiograms done at Medical college Thiruvananthapuram from 04/02/2005 to 31/03/2010 were reviewed for myocardial bridging. A total of 10492 coronary angiograms were reviewed. Myocardial bridges with systolic lumen reduction of more than 50% were considered for analysis. Quantitative coronary angiography (QCA was used for analysis. Clinical presentation as well as correlation with structural heart disease and coronary heart disease was assessed. Results: Incidence of myocardial bridges was 1.23%. Of the 129 patients with myocardial bridges 63 ( 48.8% had associated significant coronary artery disease. Remaining 66 (51.2% patients presented with isolated bridges. Out of these 66 patients with isolated myocardial bridges, 7 (10.6% patients presented with acute myocardial infarction and 3 (4.5% presented with cardiac arrhythmias. Of the 63 patients with significant coronary disease 11 (17.5% patients had single vessel disease and they had the culprit lesion and myocardial bridge seen in the same vessel. Most common location of myocardial bridge was mid LAD (64.9% followed by distal LAD (23.8%. Length of bridge was 20 mm in 35.7%. Mean percentage of systolic obliteration by the bridge was 74.5%. 100% systolic obliteration was seen in 7.79% of isolated bridges and in 9.79% of bridges with CAD. Among 120 rhuematic heart disease patients who underwent coronary angiogram, 10 (8.3% patients had myocardial bridging. 12.1% of all HCM patients who underwent coronary angiograms had myocardial bridging. Conclusion: Myocardial bridging can be lethal- can accelerate atherosclerosis, can precipitate acute MIs and life

  19. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

    Sadosky A

    2013-02-01

    Full Text Available Alesia Sadosky,1 Caroline Schaefer,2 Rachael Mann,3 Felicia Bergstrom,2 Rebecca Baik,2 Bruce Parsons,1 Srinivas Nalamachu,4 Edward Nieshoff,5 Brett R Stacey,6 Alan Anschel,7 Michael Tuchman81Pfizer Inc, New York, NY, 2Covance Market Access Services Inc, Gaithersburg, MD, 3Covance Market Access Services Inc, San Diego, CA, 4International Clinical Research Institute, Overland Park, KS, 5Rehabilitation Institute of Michigan/Wayne State University, Detroit, MI, 6Oregon Health and Science University, Portland, OR, 7Rehabilitation Institute of Chicago, Chicago, IL, 8Palm Beach Neurological Center, Palm Beach Gardens, FL, USABackground: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN seeking treatment in the US.Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%, depressive symptoms (41.1%, and anxiety (35.7%. The mean pain severity score was 5.2 (0–10 scale, and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale overall, with 2.0 among mild, 5.1 among moderate, and 7

  20. Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

    Hüseyin Cengiz

    2012-01-01

    Full Text Available Background: The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied. Materials and Methods: This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records. Results: In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27-39 years. The mean gestational age was 38.3±1.3 weeks (range 37-41 weeks. Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50-130 minutes and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy. Conclusions: In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity.

  1. Severe idiosyncratic drug reactions with epidermal necrolysis: A 5-year study

    I O Fadeyibi

    2011-01-01

    Full Text Available Introduction: Idiosyncratic drug reactions (IDRs are unexpected responses to a drug. The spectrums of severe cutaneous reactions include Stevens-Johnson Syndrome (SJS, SJS/Lyell Syndrome and Toxic Epidermal Necrolysis (TEN. The conditions are associated with high mortality. This study was designed to determine the causal agents, patterns of presentations, review the management and make recommendations to reduce the incidence and mortality of this class of drug reactions. Materials and Methods: A retrospective study was made of patients seen with IDR in the Lagos State University Teaching Hospital, LASUTH, between January, 2004 and December, 2008. They were cases admitted with bullous skin eruptions with associated systemic symptoms. Results: Sixty-seven patients were seen, with 45 (67.2% satisfying the inclusion criteria. Fifteen males and 30 females were involved, giving a male to female (M:F ratio of 1:2. Their ages ranged from 7 to 79 years (mean, 40.02 ± 17.89 years. Peak incidences occurred among the 20-24 and 30-34 year age groups. The causal agents were antibiotics (48.89%, sulphonamides (24.44%, herbal preparations (17.78% and artemisinin drugs (8.89%. Conclusions: The age groups with the peak incidence are the most likely to indulge more in drug abuse in environments with poor drug control. Diagnosis of SJS, SJS/TEN and TEN were missed in many patients at first contact due to the progressive nature of the conditions. Patients needed reviews at regular intervals when IDR was suspected. Health education to prevent drug abuse is important and herbal preparations should be scientifically studied to determine the efficacy and side-effects.

  2. Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

    Edward McPherson

    2014-06-01

    Full Text Available This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA procedures utilizing a technique to optimize knee flexion. The main features include: (1the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2 patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4incorporation of a rapid recovery protocol with features to promote knee flexion. Results were categorized into three groups: low pre-op flexion (90 degrees and below, regular pre-op flexion (91-125 degrees, and high pre-op flexion (126 degrees and above. Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years. In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years. Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years. In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.

  3. Causes of Mortality in Newborns and Children Under 5 Years of Age in Northern Iran

    FS Sharifi

    2002-01-01

    1- A survey of the causes of mortality in newborns and children under 5 years of age during 10 years (1988-1997) in northern Iran (Regions eastern and western bandpey, gatab and kolagarmahalleh in province babol) revealed following results: Average incidence of mortality in newborns and children under 5 years of age was 10.5 and 4 per thousand respectively. The most frequently encountered causes of death in children under 5 years of age were congenital anomalies (20.2%), infections (16.8%), p...

  4. Care for overweight children attending the 5-year preventive child health examination in general practice

    Andersen, Merethe Kousgaard; Christensen, Bo; Søndergaard, Jens

    2013-01-01

    -assessed overweight at the 5-year preventive child health examination (PCHE).Results. Out of 1135 children attending the 5-year PCHE, 171 were assessed overweight by the GP. According to the Danish body mass index (kg/m(2)) growth charts, 147 children were overweight. The GPs addressed their concern about the child...... cases.Conclusion. Various care activities were carried out for most children with GP-assessed overweight at the 5-year PCHE. However, the GP did not raise concern about the child's weight with the parents in almost one third of the children. It seems that there is a potential for improving the...

  5. HIV Decline Falls Short of U.S. 5-Year Goal

    ... nlm.nih.gov/medlineplus/news/fullstory_158705.html HIV Decline Falls Short of U.S. 5-Year Goal ... 2016 FRIDAY, May 6, 2016 (HealthDay News) -- Although HIV infection and transmission rates in the United States ...

  6. Abdominal computed tomography during pregnancy for suspected appendicitis: a 5-year experience at a maternity hospital.

    Shetty, Mahesh K; Garrett, Nan M; Carpenter, Wendy S; Shah, Yogesh P; Roberts, Candace

    2010-02-01

    The objective of this article is to evaluate the role of computed tomography (CT) in a pregnant patient with right lower quadrant pain in whom there was a clinical suspicion of acute appendicitis. During a 5-year period the clinical records of all pregnant women who underwent imaging examination for clinically suspected appendicitis were reviewed. The imaging findings were correlated with patient management and final outcome. Thirty-nine pregnant patients were referred for imaging, of which 35 underwent initial evaluation with sonography, 23 of these women underwent a computed tomographic examination, and an additional 4 patients were directly imaged with CT without earlier sonographic assessment. Surgery confirmed appendicitis in all 5 patients who were operated on on the basis of findings of appendicitis on a CT scan. Two patients underwent surgery based on an alternate diagnosis suggested preoperatively (tubal torsion = 1, ovarian torsion = 1). All patients with negative findings at CT had an uneventful clinical course. In those patients who were evaluated only with ultrasound, a diagnosis of appendicitis was missed in 5 patients. The sensitivity of CT in the diagnosis of appendicitis in our study group was 100%, compared with a sensitivity of 46.1% for ultrasound. CT provides an accurate diagnosis in patients suspected to have acute appendicitis and is of value in avoiding false negative exploratory laparatomy with its consequent risk of maternal and fetal mortality and morbidity. Although sonography is the preferred initial imaging modality as its lack of ionizing radiation, CT is more accurate in providing a timely diagnosis and its use is justified to reduce maternal mortality and mortality in patients with appendicitis. PMID:20102691

  7. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    Johnson Shanthi

    2012-09-01

    Full Text Available Abstract Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131 were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE were employed to assess predictors of outcome. Results We could follow up 95 (72.5% patients. Sixty-five of these patients (68.4% achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context

  8. Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet-Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy

    Jones, Michael E.; Hardy, Cherrell; Ridgway, Julie

    2016-01-01

    ABSTRACT OBJECTIVE: The objective of this retrospective study was to evaluate the efficacy of the authors’ combination therapy protocol for keloid treatment. DESIGN: Retrospective. SETTING: Plastic surgery office-based outpatient setting in New York City. PATIENTS: Forty patients with 44 keloid scars requiring surgical excision. INTERVENTIONS: Keloid scars were treated using surgical excision, platelet-rich plasma, and postoperative in-office superficial photon X-ray radiation therapy. Intralesional triamcinolone injections were administered once to 4 patients with poor results on scar scale assessment. Patient follow-up visits ranged from 3 to 11 months to assess for evidence of recurrence and adverse effects. MAIN OUTCOME MEASURE(S): For the purpose of this study, recurrence was defined as any sign of extraordinary erythema, induration, and hypertrophy beyond the site of excision. MAIN RESULTS: In the 16 keloids treated with 2 fractions, there was no evidence of recurrence. One of 25 keloids treated with 3 fractions demonstrated evidence of recurrence. One of 3 keloids treated with a single fraction displayed signs of recurrence. Postirradiation hyperpigmentation was noted in all patients. CONCLUSIONS: Surgical excision combined with platelet-rich plasma and postoperative in-office superficial radiation therapy achieved a 95.5% nonrecurrence rate at 1- to 3-month follow-up. This protocol appears to be a safe and viable option in the management of keloids and merits further randomized controlled study of its comparative efficacy. PMID:27300360

  9. Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age

    Patel, Niraj C.; Gallagher, Joel L.; Ochs, Hans D.; Prescott Atkinson, Thomas; Wahlstrom, Justin; Dorsey, Morna; Bonilla, Francisco A.; Heimall, Jennifer; Kobrynski, Lisa; Morris, David; Haddad, Elie

    2015-01-01

    Background Hizentra® (IGSC 20 %) is a 20 % liquid IgG product approved for subcutaneous administration in adults and children 2 years of age and older who have primary immunodeficiency disease (PIDD). There is limited information about the use of IGSC 20 % in very young children including those less than 5 years of age. Methods A retrospective chart review involved 88 PIDD infants and children less than 5 years of age who received Hizentra®. Results The mean age at the start of Hizentra® was ...

  10. Demographics of rabies exposure in north-west of Iran:5years experience

    Samad Shams Vahdati

    2013-08-01

    Full Text Available BACKGROUND: Rabies is a neuropathogenic disease, always fatal, which involves domestic and wild animals andattracted global concern for its distribution. This research aimed to demonstrate potential rabies infected animal bitesand related risk factors in North-West of Iran in order to evaluate the area’s demographics and risk factors. METHODS: A retrospective cross-sectional review was done for patients referred to Rabies Disease Control andPrevention Center placed in Sina Hospital, Tabriz, Iran. RESULTS: A total of 1084 patients, 918 men and 166 women (777 city and 307 rural residential were enrolled in thisstudy. Median age ranged from 20 to 30 years. Accidents were the highest in January and May. Dogs accounted for72.4%, cats 20.6%, rats 4.1% and others 3%. 45.8% of the attacks occurred at homes, 41.8% outdoors, and 12.4% at work. 80.4% of them were pet animals, 15.6% were outdoors and 4.1% were wild. 80.4% were under observation, 17.5% escaped, and 2.1% were killed. Superficial bites accounted for 78.7% of all bites, and 21.3% were deeply bitten.Bites conflicted to upper limbs (50.6%, lower limb (43.5%, head (2.4%, neck (0.6%, chest (1.8%, abdomen (0.7%,and genitalia (0.3%. 54.3% of all the bite exposures occurred in covered sites whereas 45.7% affected naked sites.Surprisingly, 98.6% of the animal, mostly pets, had no history of vaccination. CONCLUSIONS: This research admitted lacked attention in vaccination when it would have been appropriate, led torabies disease which is always fatal. Bite rates were higher among adult males, in cities by dogs. Upper limbs, mostlycovered, were bitten commonly superficial.

  11. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients ...

  12. Efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with colorectal cancer: a retrospective chart review and telephone patient questionnaire.

    Pan Li

    Full Text Available BACKGROUND: Numerous clinical trials have demonstrated that elderly patients with colorectal cancer (CRC can benefit from chemotherapy, yet compliance in real-world practice is low. The purpose of this study is to investigate the efficacy, compliance and reasons for refusal of postoperative chemotherapy for elderly patients with CRC and to provide corresponding strategies. PATIENTS AND METHODS: The clinico-pathological and biochemical data of the chemotherapy group and chemo-refusing group were compared among 386 elderly patients (>70 years old with CRC who underwent surgery. 226 patients received chemotherapy and 160 patients refused. Follow-up of the subjective reasons for refusal was investigated using the elderly caner patients' chemo-refusal reason questionnaire (ECPCRRQ prepared by the authors and a group of psychologists. The questionnaire is administrated by telephone. A predictive model for 5-year disease-free survival (DFS and 5-year overall survival (OS was constructed by using Kaplan-Meier analysis, logistic and Cox regression. RESULTS: Among stage III patients, receiving chemotherapy was associated with a significantly higher OS (68% compared to those who refused ( OS 50% (HR: 2.05, 95%CI: 1.12-3.77, P = 0.02. The Chemo-refusal group had more female and elderly patients, significantly higher rate of severe complications, and lower body mass index (BMI. Follow-up phone questionnaire analysis showed the doctors' uncertainty of chemotherapy benefit, economic difficulties, uncomfortable feeling, superstition of Traditional Chinese Medicine, concealing information and lack of social support were the main factors for elderly CRC patients to decline chemotherapy. CONCLUSION: The receipt of post-operative chemotherapy in elderly patients with resected stage III CRC was associated with a more favorable survival. The low compliance rate (160/386 of postoperative chemotherapy was influenced by various subjective and objective factors.

  13. Optically stimulated luminescence in retrospective dosimetry

    Bøtter-Jensen, L.; Murray, A.S.

    2002-01-01

    Since the beginning of the 1990s the exploration of optically stimulated luminescence (OSL) in retrospective accident dosimetry has driven an intensive investigation and development programme at Riso into measurement facilities and techniques. This paper reviews some of the outcomes of this progr......Since the beginning of the 1990s the exploration of optically stimulated luminescence (OSL) in retrospective accident dosimetry has driven an intensive investigation and development programme at Riso into measurement facilities and techniques. This paper reviews some of the outcomes...

  14. Hodgkin Lymphoma at the Paediatric Oncology Unit of Gabriel Touré Teaching Hospital, Bamako, Mali: 5-Year Experience

    B. Togo

    2011-01-01

    Full Text Available Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco—Africain d'Oncologie Pédiatrique Hodgkin lymphoma treatment protocol. Results. During the study period, 217 cancer cases were diagnosed in our centre. Of these cases, 7 were Hodgkin Lymphoma (LH (0.04%. The mean age was 11.7 years. The sex-ratio was 6/1. 4% (5/7 of patients were stage IIB and 28.6% (2/7 stage IIIB of Ann-Arbor classification. There were 3 cases (42.8% of sclero-nodular subtype, 2 cases (28.6% of lymphocyte-rich classical HL subtype, 1 case (14.3% of mixed cellularity and 1 case (14.3% of lymphocyte depleted subtype. With a median followup of 37 months, 5 patients (71.4% are alive, and 2 patients (28.6% died. Conclusion. Broader multicentric studies are needed for more accurate data on this malignancy.

  15. Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age--Uganda, 2009.

    Menon, Manoj P; Yoon, Steven S

    2015-09-01

    Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

  16. BISPHOSPHONATES IN LANGERHANS CELL HISTIOCYTOSIS: AN INTERNATIONAL RETROSPECTIVE CASE SERIES

    Deepak Chellapandian

    2016-07-01

    Full Text Available Background: Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH, which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method: We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results: Ten patients (77% had a single system bone disease, and 3 (23% had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years. Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve  (92% achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years. One patient did not respond. No major adverse effects were reported in this series.  Conclusion: Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted.

  17. The effect of standard lumbar discectomy on segmental motion: 5-year follow-up using radiostereometry

    Halldin, K.; Zoëga, B.; Nyberg, P.; Kärrholm, J.; Lind, B. I.

    2005-01-01

    We measured the effects of lumbar discectomy on segmental motion over a period of 5 years. Twenty-four patients with lumbar disc herniation were treated by standard lumbar discectomy at the L4–L5 or L5–S1 level. Peroperatively, tantalum markers were inserted into L4, L5, and the sacrum. Radiostereometric analysis was performed at discharge from hospital and 5 years postoperatively. The treated level was compared with the corresponding untreated level. Thus, patients who had discectomy at the ...

  18. Analysis of 5-year survivors of esophageal cancer treated with radiation and chemotherapy

    From 1967 to 1980, 240 cases of esophageal cancer, consisting of 153 curative and 87 palliative cases, were treated with a combination of radiation and chemotherapy. The five-year survival rate in 124 curative cases given a dose of more than 50 Gy was 12.9 %, and 17 cases survived more than 5 years. In the 5-year survivors, T1 in the advancement of tumors, less than 7 cm in length, and cancer of both the serrated and tumorous types were characteristic factors, indicating a good prognosis. These cases were irradiated with a dose of 60 - 70 Gy and the tumors showed a high response to irradiation. (author)

  19. A 5 year prospective study of patient-relevant outcomes after total knee replacement

    Nilsdotter, A-K; Toksvig-Larsen, S; Roos, E M

    2008-01-01

    men, mean age 71 (51-86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years......OBJECTIVE: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). METHODS: 102 consecutive patients with knee OA, 63 women and 39...

  20. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  1. Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report

    Intramural hematoma of the jejunum is rare and can be classified as trauma-related or occurring spontaneously. Spontaneous intramural hematoma commonly occurs in patients treated with warfarin. We report a case of intramural hematoma of the jejunum with intestinal obstruction in a 5-year-old boy who had neither a definite history of trauma nor the tendency to bleed

  2. Effects of A 2.5-Year Campus-Wide Intervention to Reduce College Drinking

    Seo, Dong-Chul; Owens, Dee; Gassman, Ruth; Kingori, Caroline

    2013-01-01

    Objective: The present study reports on the results of a 2.5-year college-wide, coordinated intervention that was implemented from June 2007 to December 2009 to reduce the amount and frequency of students' alcohol consumption. Design: Quasi-experimental study using a one-group (freshmen living on campus) pretest/posttest design ("N"…

  3. Haematoma-like primary intracranial malignant fibrous histiocytoma in a 5-year-old girl

    We present CT and MRI of an intracranial malignant fibrous histiocytoma in a 5-year-old girl with headache and vomiting. This case is unusual particular by virtue of its radiological appearances and the young age of the patient. (orig.)

  4. Hands as Companions of the Mind: Essential Practical Life for the 5-Year-Old

    Gilder, Sharon Allen

    2012-01-01

    Numerous observations in Montessori classrooms led veteran Montessorians Pamela W. Trumble and Eleni Bokas to the conclusion that a universal need exists to bring integrity back to Practical Life, especially for 5-year-olds. Maria Montessori's observations over a century ago revealed the importance of Practical Life and its relationship to the…

  5. A Multidimensional Scaling Study of Visual Memory of 5-Year Olds and Adults

    Arabie, Phipps; And Others

    1975-01-01

    An investigation of memory development using nonmetric multidimensional scaling. Judgments of similarities between complex objects were obtained from 5-year-olds and adults under two conditions: (1) when objects were simultaneously present at the time of comparison, and (2) when the objects were not simultaneously present and had to be compared on…

  6. Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study

    Bakke, Merete; Holm, Betty; Gotfredsen, Klaus

    2002-01-01

    PURPOSE: The aim of this study was to assess the outcome of treatment with implant-supported mandibular overdentures in terms of biting and chewing, in entirely satisfied and not fully satisfied patients. MATERIALS AND METHODS: Twelve edentulous patients who had worn dentures for at least 5 years...

  7. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants

    Feldman, Ruth

    2009-01-01

    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  8. Nutrition and mental development of 4-5-year old children on macrobiotic diets.

    Herens, M.C.; Dagnelie, P.C.; Kleber, R.J.; Mol, M.C.; Staveren, van W.A.

    1992-01-01

    Mental development of 4–5-year old children on macrobiotic diets (almost devoid of animal foods and fat) with long-term growth deficits, was studied using the Snijders-Oomen Non-verbal Intelligence (SON) scale. In addition, food consumption and behavioural style of the children, and family and paren

  9. The introduction of the 5-year impact factor : does it benefit statistics journals?

    van Nierop, Erjen

    2010-01-01

    In this paper, we investigate the effects of the introduction of 5-year impact factors. We collect impact factor data for all disciplines available in the Journal Citation Reports. For all these categories, we give insights into the relationship between the traditional 2-year impact factor and the n

  10. Influence of Emotional Facial Expressions on 3-5-Year-Olds' Face Recognition

    Freitag, Claudia; Schwarzer, Gudrun

    2011-01-01

    Three experiments examined 3- and 5-year-olds' recognition of faces in constant and varied emotional expressions. Children were asked to identify repeatedly presented target faces, distinguishing them from distractor faces, during an immediate recognition test and during delayed assessments after 10 min and one week. Emotional facial expression…

  11. The effects of oil pollution on Antarctic benthic diatom communities over 5 years

    Highlights: • We examine the impact of hydrocarbon pollution on Antarctic benthic diatoms. • The effect of standard synthetic lubricant oil and a biodegradable oil were examined. • There were significant effects from both treatments for over 5 years. • There was little difference between the different types of oil. - Abstract: Although considered pristine, Antarctica has not been impervious to hydrocarbon pollution. Antarctica’s history is peppered with oil spills and numerous abandoned waste disposal sites. Both spill events and constant leakages contribute to previous and current sources of pollution into marine sediments. Here we compare the response of the benthic diatom communities over 5 years to exposure to a commonly used standard synthetic lubricant oil, an alternative lubricant marketed as more biodegradable, in comparison to a control treatment. Community composition varied significantly over time and between treatments with some high variability within contaminated treatments suggesting community stress. Both lubricants showed evidence of significant effects on community composition after 5 years even though total petroleum hydrocarbon reduction reached approximately 80% over this time period. It appears that even after 5 years toxicity remains high for both the standard and biodegradable lubricants revealing the temporal scale at which pollutants persist in Antarctica

  12. Intranasal LH-RH treatment of cryptorchidism. A clinical trial and 5 years follow-up

    Thorup, Jørgen Mogens; Mauritzen, K; Skakkebaek, N E

    1987-01-01

    The effect of intranasal LH-RH on cryptorchidism was investigated in 45 prepubertal boys with 68 undescended testes. A daily dose of 1.2 mg LH-RH was given for 4 weeks. A total of 16 testes (24%) descended. Follow-up examination 5 years later showed that relapse had occurred in two cases. Fifty-t...

  13. Efficacy and safety of raltegravir for treatment of HIV for 5 years in the BENCHMRK studies

    Eron, Joseph J; Cooper, David A; Steigbigel, Roy T; Clotet, Bonaventura; Gatell, Jose M; Kumar, Princy N; Rockstroh, Jurgen K; Schechter, Mauro; Markowitz, Martin; Yeni, Patrick; Loutfy, Mona R; Lazzarin, Adriano; Lennox, Jeffrey L; Strohmaier, Kim M; Wan, Hong; Barnard, Richard Jo; Nguyen, Bach-Yen T; Teppler, Hedy; Pedersen, Court

    2013-01-01

    Two randomised, placebo-controlled trials-BENCHMRK-1 and BENCHMRK-2-investigated the efficacy and safety of raltegravir, an HIV-1 integrase strand-transfer inhibitor. We report final results of BENCHMRK-1 and BENCHMRK-2 combined at 3 years (the end of the double-blind phase) and 5 years (the end ...

  14. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  15. How Do 5-Year-Olds Understand Questions? Differences in Languages across Europe

    Sauerland, Uli; Grohmann, Kleanthes K.; Guasti, Maria Teresa; Andelkovic, Darinka; Argus, Reili; Armon-Lotem, Sharon; Arosio, Fabrizio; Avram, Larisa; Costa, João; Dabašinskiene, Ineta; de López, Kristine; Gatt, Daniela; Grech, Helen; Haman, Ewa; van Hout, Angeliek; Hrzica, Gordana; Kainhofer, Judith; Kamandulyte-Merfeldiene, Laura; Kunnari, Sari; Kovacevic, Melita; Kuvac Kraljevic, Jelena; Lipowska, Katarzyna; Mejias, Sandrine; Popovic, Maša; Ruzaite, Jurate; Savic, Maja; Sevcenco, Anca; Varlokosta, Spyridoula; Varnava, Marina; Yatsushiro, Kazuko

    2016-01-01

    The comprehension of constituent questions is an important topic for language acquisition research and for applications in the diagnosis of language impairment. This article presents the results of a study investigating the comprehension of different types of questions by 5-year-old, typically developing children across 19 European countries, 18…

  16. Sexual function in multiple sclerosis. A 5-year follow-up study

    Stenager, E; Stenager, E N; Jensen, K

    1996-01-01

    Sexual dysfunction is known to occur in multiple sclerosis (MS). The purpose of the study is to describe the change in sexual function and symptoms in a longitudinal study. Forty-nine patients (27 females, 22 males) with definite MS were interviewed and examined with 5 years interval. The number of...

  17. Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

    Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

    2014-01-01

    This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants…

  18. Secondary Science Teachers' Use of Technology in the Classroom during Their First 5 Years

    Bang, EunJin; Luft, Julie A.

    2013-01-01

    This study examined the technology use of beginning secondary science teachers and explored factors facilitating or inhibiting their use of technology. The researchers collected and analyzed interviews and observational data from 95 teachers over a 5-year period. The results show that teachers used PowerPoint the most and other software the least…

  19. Morphologic characteristics of hepatocellular carcinoma in patients with more than 5 year-survival

    To determine which morphologic and radiologic characteristics and common features of HCC in patients with a survival time of more than five years are useful for prognosis and appropriate therapeutic modality. Among 178 patients in whom HCC was diagnosed at our hospital and who underwent dynamic CT and angiography, we retrospectively reviewed the cases of 12 who survived more than five years. Initially, the gross finding, size, number, vascularity of HCC, and extent of portal vein invasion were analyzed. The presence lymph node enlargement was investigated during follow-up study and in cases confirmed surgically, the results were compared with the histopathologic findings. The therapeutic modalities of the 12 patients were as follows; only surgical resection, 3 cases (1 case: re-operation); surgical resection with transarterial chemoembolization (TAE), 5 cases (1 case: re-operation); only TAE, 4 cases (1 case: combined with holmium injection); and at present, expiry after survival for more than five years, 3 cases; survival with disease, 3 cases and survival without disease, 6 cases (2 cases: re-operation after recurrence). In 12 patients who survived more than five years, initial gross classification was single nodular type in 11 cases and massive type in one case; all showed typical hypervascularity on dynamic CT and hepatic angiography. With regard to extent of portal vein invasion, two cases showed involvement of the lobar branch and in one case invasion of the segmental branch was noted. In the other nine cases there was either invasion of the distal small branch or no definite portal vein invasion. HCCs size ranged from 2 to 10 (mean, 5) cm. In eight cases involving surgical resection (re-operation : two cases), the histopathologic findings indicated, predominantly, the trabecular type and Edmondson grade II-III. The exception was one case of grade III-IV. In eight cases of single HCC at the time of diagnosis, multiple recurrent HCCs were present. In four

  20. Distant comparison (more than 5 years) of external beam radiation and radical prostatectomy for localized prostate cancer

    Objective: Comparison of patients with clinically localized prostate cancer treated with radical prostatectomy (RP) or external beam radiotherapy (RT) more than 5 years of the treatment. Material and Methods: We review charts of patients treated with PR or RT between 4/92 and 12/98 with clinically localized prostate cancer. Dose RT was 65 Gy. We reported digital rectal examination (DRE), PSA pretreatment, biopsies and evolution: progression, morbidity. Results: We evaluated 84 patients; 35 treated with RT, DRE+ 21, PSA range 5.6-38.2 ng/ml and Score Gleason (SG) 3-7; 49 patients treated with RP, DRE+ 17, PSA range 4.2-43, SG 3-9. We found capsular disruption in 20 (40.8%), 8 of them with seminal vesicles invaded; 4 had lymph node metastasis. PSA > 10 in 18 of 20 patients classified pT3. Of 29 pT1-2 patients, 18 had PSA 20. Two patients needed artificial urinary sphincter and 4 suffer light incontinence. After 5 years, 77% of irradiated patients had progression; 24 treated with RP had progression (48.9%), 5 were pT2. Conclusions: PR was better than RT to treat clinically localized prostate cancer, but more morbidity. Dose 65 Gy RT seems to be not enough to cure this neoplasm. PR was successful more than 80% of clinically stage T1c and PSA 20. (author)

  1. Primary and secondary malignant involvement of gynaecological organs at radical cystectomy for bladder cancer: review of literature and retrospective analysis of 360 cases.

    Salem, H; El-Mazny, A

    2012-08-01

    The pathological analysis of cystectomy specimens from 360 female patients who underwent radical cystectomy for bladder cancer was retrospectively reported. The uterus was not available in 29 specimens, while one ovary was absent in 18 specimens and the two ovaries were absent in 20 specimens. Uterine involvement was observed in one case of transitional cell carcinoma, and benign uterine pathology was detected in 37 cases. All patients had normal ovaries, while the vagina was involved in 13 cases. A total of 12% of the patients had urethral involvement. None of the 29 patients, in whom the internal genitalia were totally or partially preserved, had late ovarian, vaginal or uterine recurrence at the last follow-up. Thus, the preservation of female internal genitalia in young patients undergoing radical cystectomy should be considered under strict criteria (low-grade, low-stage tumours away from the bladder neck). This will improve the quality-of-life (QoL) and the functional outcome without compromising cancer control. PMID:22779969

  2. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014.

    Nusrat Homaira

    Full Text Available We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh.Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals.We estimated that the annual incidence per 1000 children (95% CI of all cause associated respiratory hospitalization was 11.5 (10-12. The incidences per 1000 children (95% CI per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2-3, 0.5(0.4-0.8, 0.4 (0.3-0.6, 0.4 (0.3-0.6, and 0.4 (0.3-0.6 respectively. The incidences per 1000 children (95%CI of rhinovirus-associated infections among hospitalized children were 5 (3-7, 2 (1-3, 1 (0.6-2, and 3 (2-4 in 2010, 2011, 2012 and 2013, respectively.Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh.

  3. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014

    Homaira, Nusrat; Luby, Stephen P.; Hossain, Kamal; Islam, Kariul; Ahmed, Makhdum; Rahman, Mustafizur; Rahman, Ziaur; Paul, Repon C.; Bhuiyan, Mejbah Uddin; Brooks, W. Abdullah; Sohel, Badrul Munir; Banik, Kajal Chandra; Widdowson, Marc-Alain; Willby, Melisa; Rahman, Mahmudur; Bresee, Joseph; Ramirez, Katharine-Sturm; Azziz-Baumgartner, Eduardo

    2016-01-01

    Background We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. Methods Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. Results We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10–12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2–3), 0.5(0.4–0.8), 0.4 (0.3–0.6), 0.4 (0.3–0.6), and 0.4 (0.3–0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3–7), 2 (1–3), 1 (0.6–2), and 3 (2–4) in 2010, 2011, 2012 and 2013, respectively. Conclusion Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh. PMID:26840782

  4. Under-5 Year Mortality: Result of In-Hospital Study, Tehran, Iran

    Nojomi Marzieh

    2009-10-01

    Full Text Available In July 2003, the Bellagio Study Group on Child Survival estimated that the lives of 6 million children could be saved each year if 23 proven interventions were universally available in the 42 countries re-sponsible for 90% of child deaths in 2000. The aim of this study was to determine frequency of important causes of mortality among under-5 year old children in hospitals, Tehran, Iran. Information about Mortality data of under-5 year old children from 16 hospitals in the West of Tehran was collected. The study period was conducted from 1 October 2005 to 30 March 2006. Educated health personnel in each hospital interviewed parents of children who died in hospital and filled out a checklist. 142 under-5 year old children died over the course of study, of whom, 118 (83% were neonates (under 28 days-old, 53.5% had low birth weights (< 2500 Kg, 62 (43% were girls and 80 (57% boys. The most common cause of under-5 year death was due to certain conditions originating in the perinatal period (ICD-10: P00-P96 (68%. Congenital abnormalities (12% and pneumonia (5% were the second and third most common causes respectively. Among 28-day to one-year old children, the leading cause of death was pneumonia (27.3%, while for children being 1 to 5 years of age, this included pneumonia and chronic hepatitis (about 30%. Overall, the most common causes of death were disorders related to short gestation and low birth weight. Therefore, achievement of the millennium development goal of reducing child mortality by two-thirds from 1990 rate will depend on renewed efforts to prevent and control low birth weight, preterm delivery, pneumonia, and infectious diseases in our setting.

  5. Optically stimulated luminescence in retrospective dosimetry

    Bøtter-Jensen, L.; Murray, A.S.

    Since the beginning of the 1990s the exploration of optically stimulated luminescence (OSL) in retrospective accident dosimetry has driven an intensive investigation and development programme at Riso into measurement facilities and techniques. This paper reviews some of the outcomes of this...

  6. Long-term clinical outcome in patients with stage-i nonseminomatous germ cell cancer: a critical review of own treatment modalities in a retrospective study

    Sandra Seseke

    2008-12-01

    Full Text Available PURPOSE: The optimal management of patients with clinical stage I non-seminomatous germ cell testicular cancer (NSGCT I was considered controversial until the European Germ Cell Cancer Consensus Group determined unambiguous treatment strategies. In order to assess the long-term outcome we evaluated the data of patients with NSGCT I. MATERIALS AND METHODS: In a retrospective evaluation, we included 52 patients with a mean age of 26 years (range 15-58 who were treated with different modalities at our department between 1989 and 2003. Mean follow-up was 5.9 years (range 2-14 years. After orchiectomy, 39 patients were treated with chemotherapy, 7 patients underwent retroperitoneal lymph node dissection and 6 men were managed using a surveillance strategy. Survival, recurrence rate and time of recurrence were evaluated. The histological staging and treatment modality was related to the relapse. RESULTS: Tumor specific overall mortality was 3.8%. The mortality and relapse rate of the surveillance strategy, retroperitoneal lymph node dissection and chemotherapy was 16.7% / 50%, 14.3% / 14.3% and 0% / 2.5% respectively. All relapsed patients in the surveillance group as well as in the RPLND group had at least one risk factor for developing metastatic disease. CONCLUSIONS: Following the European consensus on diagnosis and treatment of germ cell cancer in patients with NSGCT Stage I any treatment decision must be individually related to the patient according to prognostic factors and care capacity of the treating centre. In case of doubt, adjuvant chemotherapy should be the treatment of choice, as it provides the lowest risk of relapse or tumor related death.

  7. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  8. Short communication. Growth and nodulation of cowpea after 5 years of consecutive composted tannery sludge amendment

    Ana R. L. Miranda

    2014-10-01

    Full Text Available Tannery industry releases high amounts of tannery sludge which are currently composted and used in agricultural soils. The consecutive amendment of such composted tannery sludge (CTS may affect soil microrganisms, such as rhizobia. In this study, we evaluated the effects of 5-year repeated CTS amendment on growth, nodulation, and yield of cowpea (Vigna unguiculata L. CTS was applied in different amounts (0, 2.5, 5, 10 and 20 Mg/ha to a sandy soil. Amendment of CTS increased soil pH, electrical conductivity (EC, sodium and chromium content. Plant growth, nodulation, N accumulation, and cowpea yield increased up to 10 Mg/ha; however, above this rate, these variables decreased. After 5 years of CTS amendment, the increase in soil chemical properties, particularly EC and Na content, exerted negative effects on the growth, nodulation, and yield of cowpea.

  9. Separable sustained and selective attention factors are apparent in 5-year-old children

    Underbjerg, Mette; George, Melanie S; Thorsen, Poul;

    2013-01-01

    In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy...... population. A new test battery (TEA-Ch(J)) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual and...... auditory stimuli were good. In a factor analysis, the two TEA-Ch(J) selective attention tasks (one visual, one auditory) loaded onto a common factor and diverged from the two sustained attention tasks (one auditory, one motor), which shared a common loading on the second factor. This pattern, which...

  10. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life. PMID:25909527

  11. Synovial Sarcoma in the Foot of a 5-Year-Old ChildA Case Report.

    Lepow, Gary M; Grimmer, Daniel L; Lemar, Onya V; Bridges, Evan A

    2016-07-01

    The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised. PMID:27489968

  12. Developmental potential in the first 5 years for children in developing countries.

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data--the prevalence of early childhood stunting and the number of people living in absolute poverty--to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  13. Measles Antibody Titres In 0-5 Years Children At Aligarh

    Kandpal S D

    1999-01-01

    Full Text Available Research Question: What is the level of measles antibodies in 0-5 year children? Objectives: 1.To assess the pattern of decline of maternal antibodies in 0-9 months infants. 2. To estimate the seropositivity for measles antibodies in vaccinated 9 months infants. Study design: Cross- sectional. Setting: Rural areas of District Aligarh, U.P. Participants: 456 children in the age group of 0-5 years. Statistical analysis: Percentages, correlation coefficient. Results: 1. In all the study subjects below 9 months of age, the transplacentally acquired maternal measles antibodies showed a linear decline with increase in age. Out of 202 study subjects who had been immunized against measles 195(96.50% were seropositive and 7(3.5% were seronegative for measles antibodies.

  14. Bone marrow cytology in Hiroshima atomic bomb survivors 5 years following exposure

    Bone marrow aspiration smears obtained from 35 individuals, 5 years following exposure to the Hiroshima atomic bomb, were intensively evaluated for radiation related cytologic abnormalities. No definite radiation related changes were observed, but some findings were very suggestive. The most interesting of these was the occurrence of internuclear bridges joining erythroid precursors in the marrow smears of seven (20%) of the heavily exposed survivors. Although not specific it is likely that this lesion is indicative of residual stem cell damage and some degree of ineffectual erythropoiesis. The bone marrow morphologic lesions may be good markers of residual radiation damage but they are too infrequent in their occurrence to be of value as a biologic dosimeter. The findings in this study also suggest that a gradual disappearance of radiation induced late bone marrow changes continues for periods of 3 to 5 years or more following high dose acute radiation exposure. (author)

  15. Surveillance of lymphatic filariasis 5 years after stopping mass drug administration in Menoufiya Governorate, Egypt.

    Moustafa, M A; Thabet, H S; Saad, G A; El-Setouhy, M; Mehrez, M; Hamdy, D M

    2014-05-01

    The World Health Organization recommends that before lymphatic filariasis elimination in an area can be confirmed, an additional survey should be performed at least 5 years after stopping mass drug administration. The current study aimed to determine the status of lymphatic filariasis 5 years after cessation ofthe mass drug administration in 3 sentinel Egyptian villages in Menoufiya Governorate. The rapid immunochromatographic card test (ICT) and a new commercial antibody detection kit (CELISA®) were used. All 1321 primary-school children aged 6-7 years old were ICT negative but 27 children were antibody positive. All households surveyed in one village with the highest antibody prevalence were ICT negative, indicating an absence of lymphatic filariasis. The CELISA antibody kit needs more standardization and development to be useful under field conditions. We conclude that lymphatic filariasis is no longer a public health problem in these villages and other villages with similar epidemiological conditions. PMID:24952286

  16. MEAD retrospective analysis report

    Hasager, Charlotte Bay; Carstensen, J.; Frohn, L.M.;

    2003-01-01

    The retrospective analysis investigates links between atmospheric nitrogen deposition and algal bloom development in the Kattegat Sea from April to September 1989-1999. The analysis is based on atmospheric deposition model results from the ACDEP model,hydrodynamic deep-water flux results, phytopl...

  17. Henry's Law: A Retrospective

    Rosenberg, Robert M.; Peticolas, Warner L.

    2004-01-01

    A retrospective view of Henry's law and its applicability in any specific system at a finite concentration is tested. It can be concluded that Henry's law is only a limiting law and is adequate at low mole fractions but is useful for practical purposes where high precision is not required.

  18. New spontaneous breast seroma 5 years after augmentation: a case report

    Chourmouzi, Danai; Vryzas, Trantafillos; Drevelegas, Antonios

    2009-01-01

    The case of a 36 year old woman who experienced a late, spontaneous breast seroma 5 years after augmentation in the absence of any known precipitating factors is reported. Although seroma is not an uncommon complication in the immediate postoperative period, it is extremely rare as a late complication of breast implantation. Magnetic resonance imaging is a reliable method to confirm the diagnosis of late seroma formation. Surgery is the preferred treatment.

  19. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor

    Carmichael, Samuel P.; Pulliam, Joseph F.; D'Orazio, John A.

    2012-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her ini...

  20. 26 CFR 1.410(a)-5 - Year of service; break in service.

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Year of service; break in service. 1.410(a)-5 Section 1.410(a)-5 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.410(a)-5 Year of service; break in service. (a) Year...

  1. CORRELATION BETWEEN PENIS LENGTH AND ANTHOPOMETRY OF 5 YEAR OLD CHILDREN

    Doddy Kurnia Indrawan; Bikin Suryawan; Lanang Sidiartha; Arimbawa *

    2013-01-01

    Short penis still a problem for parents. Penis lenght is associated with  weight and considered abnormal in obese children. The purpose of this study was to find out the correlation between penis length and the anthropometry children aged 5 years. A cross sectional study was conducted, at the Division of Endocrinology, Department of Child Health, Medical Faculty of Udayana University, Sanglah Hospital Denpasar, during October 2010, at TK Sayang Ibu Sanglah Hospital. The calculation of the sam...

  2. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    Kim, Jung Ryul; Song, Ji Hun; Lee, Ju Hong [Chonbuk National University, Medical School, Department of Orthopaedic Surgery, Jeonju (Korea); Lee, Sang Yong [Chonbuk National University, Medical School, Department of Diagnostic Radiology, Jeonju (Korea); Yoo, Wan Hee [Chonbuk National University, Medical School, Department of Rheumatology, Jeonju (Korea)

    2008-04-15

    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  3. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  4. Renal Stone Associated with the Ketogenic Diet in a 5-Year Old Girl with Intractable Epilepsy

    Choi, Ji Na; Song, Ji Eun; Shin, Jae Il; Kim, Heung Dong; Kim, Myung Joon; Lee, Jae Seung

    2010-01-01

    In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal s...

  5. Born Near the Limit of Viability – Developmental Outcomes 2.5 Years Later

    Månsson, Johanna

    2015-01-01

    Although advances in neonatal care have resulted in increased survival rates among extremely preterm infants (born < 28 gestational weeks), they still face substantial morbidity risks during the neonatal period. The question of possible later outcomes is a key issue faced by health care professionals working with these infants. Objectives The objective of the present thesis was to explore developmental outcomes of extremely preterm birth at corrected age 2.5 years. The included ...

  6. Social competence of 3 to 5-year-old children born with low birth weight

    Nurul Komariah

    2015-05-01

    Full Text Available Background Low birth weight (LBW has long been used as an indicator of public health. Low birth weight is not a proxy for any dimension of other maternal or perinatal health outcomes. Low birth weight infants require special care, and have more chronic conditions, learning delays, and attention deficit hyperactivity disorders compared to infants of normal birth weight (NBW. Social competence is viewed as a primary component of healthy function and development and is an important predictor of academic and financial success. Objective To examine social competence of children aged 3-5 years born with low birth weight. Methods This cross-sectional study was undertaken in Palembang in 2012. Subjects consisted of children aged 3-5 years attended a preschool in the Seberang Ulu I District, Palembang, and were divided into two groups: low birth weight (LBW and normal birth weight (NBW. Social competence was assessed by observation and Interaction Rating Scale (IRS and Parenting Style questionnaire (PSQ. Chi-square analysis was used to compare social competence between the two groups. Multivariate regression logistic analysis was used to assess for the dominant factors that may affect a child’s social competence. Results Low birth weight children aged 3 to 5 years had a 1.435 times higher risk of low social competence compared to normal birth weight children of similar age. (RP 1.435; 95%CI 1.372 to 13.507; P=0.019. Multivariate regression logistic analysis revealed that parenting style was a dominant factor affecting social competence. Conclusion Social competence in 3 to 5-year-old children born with low birth weight is lower compared to those with normal birth weight. [Paediatr Indones. 2015;55:158-63.].

  7. Central Venous Catheters for Chemotherapy of Solid Tumors – Our Results in the Last 5 Years

    Žganjer, Mirko; Čizmić, Ante; Butković, Diana; MATOLIĆ, MARTINA; Karaman-Ilić, Maja; Stepan, Jasminka

    2008-01-01

    Central venous catheters provide an easy access for intravenous medications. Having a central line in place will relieve a child from the discomfort and danger of multiple regular intravenous lines for chemotherapy. The use of indwelling central venous catheters has become commonplace in the management of children undergoing oncological treatment. There are two types of central lines commonly used. There are Broviac catheters and Port-A-Cath (PAC) catheters. In the last 5 years we...

  8. Posttraumatic stress disorder among Danish soldiers 2.5 years after military deployment in Afghanistan

    Hellerup, Janne; Andersen, Søren Bo; Høgh (Hogh), Annie

    2015-01-01

    Understanding the development of posttraumatic stress disorder (PTSD) implicates research regarding factors besides the preceding traumatic event. This study investigated the influence of predisposing personality traits on development of PTSD in a group of Danish Soldiers deployed to Afghanistan ...... Spearman¡'s rho significant relationships were identified between pre-existing personality traits of neuroticism and agreeableness with development of PTSD symptoms 2.5 years after homecoming, however, a number of additional cofounders were identified....

  9. GLOBAL STRATEGY FOR THE DIAGNOSIS AND MANAGEMENT OF ASTHMA IN CHILDREN 5 YEARS AND YOUNGER

    Pedersen, Soren; Hurd, Suzanne; Lemanske, Robert; Becker, Allan; Zar, Heather; Sly, Peter; Soto-Quiroz, Manuel; Wong, Gary; Bateman, Eric

    2010-01-01

    Abstract Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalizations1. Many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non-specific. Furthermore, neither airflow limitation nor...

  10. Development of Speech Intelligibility Measurement Test for 3 to 5 Years Old Normal Children

    Fatemeh Hoseyni; Zahra Agha Rasouli; Farhad Torabi Nezhad; Sara Heydari

    2011-01-01

    Background and Aim: Speech intelligibility is defined as a measure of effectiveness of understanding speech. It has many applications such as nomination of speech disorder intensity. Different methods and speech tasks have been designed for assessment of speech intelligibility amongst which word identification tasks have high validity. This study aimed to provide a test to measure speech intelligibility among children aged 3 to 5 years old.Methods: Many words were collected and content validi...

  11. Childhood leukaemia incidence below the age of 5 years near French nuclear power plants

    Laurier, D [Institute for Radiation Protection and Nuclear Safety, IRSN/DRPH/SRBE, BP 17, 92262 Fontenay aux Roses cedex (France); Hemon, D; Clavel, J [INSERM Unit 754, Villejuif (France)], E-mail: Dominique.laurier@irsn.fr

    2008-09-01

    A recent study indicated an excess risk of leukaemia among children under the age of 5 years living in the vicinity of nuclear power plants in Germany. We present results relating to the incidence of childhood leukaemia in the vicinity of nuclear power plants in France for the same age range. These results do not indicate an excess risk of leukaemia in young children living near French nuclear power plants. (note)

  12. Intraindividual variation in plasma 25-hydroxyvitamin D measures 5 years apart among postmenopausal women

    Meng, Jennifer E.; Hovey, Kathleen M.; Wactawski-Wende, Jean; Andrews, Christopher A; LaMonte, Michael J.; Horst, Ronald L.; Genco, Robert J.; Millen, Amy E.

    2012-01-01

    Background Current literature examining associations between vitamin D and chronic disease generally use a single assessment of 25-hydroxyvitamin D (25(OH)D), assuming an individual’s 25(OH)D concentration is consistent over time. Methods We investigated the intraindividual variability between two measures of plasma 25(OH)D concentrations collected ~5 years apart (1997-2000 to 2002-2005) in 672 postmenopausal women participating in the Women’s Health Initiative. Plasma 25(OH)D was assessed using the DiaSorin LIAISON® chemiluminescence immunoassay. The within-pair coefficient of variation (CV) was 4.9% using blinded quality control samples. Mean and standard deviations (SD) of 25(OH)D at the two time points were compared using a paired t-test. An intraindividual CV and intra-class correlation coefficient (ICC) were used to assess intraindividual variability. A Spearman correlation coefficient (r) assessed the strength of the association between the two measures and concordance in vitamin D status at two time points Results Mean 25(OH)D concentrations (nmol/L) significantly increased over time from 60.0 (SD=22.2) to 67.8 (SD=22.2) (p<0.05). The CV was 24.6%, the ICC (95% Confidence Interval (CI)) was 0.59 (0.54-0.64), and the Spearman r was 0.61 (95% CI=0.56-0.66). Greater concordance over 5 years was observed in participants with sufficient compared to deficient or inadequate baseline 25(OH)D concentrations (weighted kappa=0.39). Reliability measures were moderately influenced by season of blood draw and vitamin D supplement use. Conclusion There is moderate intraindividual variation in 25(OH)D concentrations over approximately 5 years. Impact These data support the use of a one-time measure of blood 25(OH)D in prospective studies with ≤ 5 years of follow-up. PMID:22523182

  13. Fertility issues in Simmental cows in Central Croatia: a 5-year study

    Zobel, Robert; TKALCIC, Suzana; COLE, Wendell

    2013-01-01

    The purpose of this study was to establish the fertility trends in dairy cows in Central Croatia and compare the trends and causes of infertility and subfertility during a 5-year period. A total of 12,060 Simmental cows and heifers were included in the study. The animals were examined by vaginoscopy, transrectal palpation, and ultrasonography on a regular basis. Fertility problems that included infertility and subfertility were diagnosed in 56.61% of all observed animals. The total number of ...

  14. Predictors of Emotional Distress and Wellbeing 2–5 Years After Stroke

    Bergersen, H.; A.-K. Schanke; K. S. Sunnerhagen

    2013-01-01

    Objectives. To identify predictors of emotional distress and psychological wellbeing in stroke survivors 2–5 years after discharge from comprehensive rehabilitation. Material and Methods. The Hospital Anxiety and Depression Scale (HADS), the General Health Questionnaire (GHQ-30), and questions regarding life situations were mailed to former patients. Multiple regression analyses were performed. Results. The responses from 68 participants (37% women), of an average age of 58 years old, were us...

  15. EPIDEMIOLOGY OF UNDER - NUTRITION IN CHILDREN BETWEEN 0-5 YEARS FROM RURAL AREAS OF DEHRADUN

    Megha Luthra; Surekha Kishore; Kajal Jain

    2010-01-01

    Background: Under nutrition is a major problem in India. This is a study conducted in rural catchment areas of Department of Community Medicine, SGRRMC, Dehradun to asses the same. Objectives: To find out prevalence of under nutrition in children in the age group of 0-5 years and also to study its epidemiological correlates. Methods :All registered children of RHTC Mothrowala during October to December2009 were studied. Detailed histories were taken & growth chartingwas done using growth ...

  16. Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report

    K. G. Snoek

    2012-01-01

    Full Text Available We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar spinal cord injury without radiographic abnormalities (SCIWORAs. The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2.

  17. Long-term (5 year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial.

    Thomson, NC; Rubin, AS; Niven, RM; Corris, PA; Siersted, HC; Olivenstein, R.; Pavord, ID; McCormack, D.; Laviolette, M.; Shargill, NS; Cox, G.

    2011-01-01

    BACKGROUND: Bronchial thermoplasty (BT) is a bronchoscopic procedure that improves asthma control by reducing excess airway smooth muscle. Treated patients have been followed out to 5 years to evaluate long-term safety of this procedure. METHODS: Patients enrolled in the Asthma Intervention Research Trial were on inhaled corticosteroids ≥200 μg beclomethasone or equivalent + long-acting-beta2-agonists and demonstrated worsening of asthma on long-acting-β2-agonist withdrawal. Following initial...

  18. Long term (5 Year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial

    Thomson, N C; Rubin, A.S.; Niven, R. M.; Corris, P A; Siersted, H. C.; Olivenstein, R.; Pavord, I.D.; McCormick, D.; Laviolette, M.; Shargill, N.S.; Cox, G.

    2011-01-01

    Background: Bronchial thermoplasty (BT) is a bronchoscopic procedure that improves asthma control by reducing excess airway smooth muscle. Treated patients have been followed out to 5 years to evaluate long-term safety of this procedure. Methods: Patients enrolled in the Asthma Intervention Research Trial were on inhaled corticosteroids ≥200 μg beclomethasone or equivalent + long-acting-beta2-agonists and demonstrated worsening of asthma on long-acting-β2-agonist withdrawal. ...

  19. Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review

    Abebe Eyowas F

    2016-07-01

    Full Text Available Fantu Abebe Eyowas,1 Ashebir Kidane Negasi,1 Gizachew Eyassu Aynalem,1 Abebaw Gebeyehu Worku2 1International NGO, Strengthening Human Resource for Health, Bahir Dar, 2Institute of Public Health, University of Gondar, Gondar, Ethiopia Introduction: Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery, while others emphasize that the quality of care during labor, birth, and immediate postpartum period plays a great role than the route of delivery. However, little information is locally available regarding the incidences of adverse birth outcome with respect to the route of delivery. Methods: This study was a retrospective analysis of eligible patient records that included 3,003 pregnant women who had undergone either cesarean or vaginal delivery from July 1, 2012, to June 31, 2013. Pretested questionnaire was used to collect the data. The completeness and consistency of the data were checked, cleaned, and double entered to EPI-INFO 3.5.2 and analyzed with SPSS V20. Independent sample t-test and chi-square test were conducted to compare the outcome of vaginal delivery and cesarean section (CS using index variables. Significance was taken at P<0.05. Results: Among the enrolled women, 760 mothers had CS delivery and the remaining 2,243 mothers delivered vaginally. Children born through CS (mean =6.83, standard deviation =1.31 had a significantly lower first-minute Apgar score than those in the vaginal delivery group (mean =7.19, standard deviation =1.18, P=0.001. Similarly, the observed respiratory distress syndrome (c2=0.09, P=0.793 and neonatal transfer rate to neonatal intensive care unit (c2=0.086, P=0.766 were more in neonates delivered by CS than those in the vaginally delivered group. Besides, the observed neonatal death (c2=0.675, P=0.411 and maternal death (c2= 8.878, P=0.003 were higher among CS deliveries compared with vaginal deliveries. Conclusion: Neonatal and maternal morbidity and mortality appear

  20. Upgrade of ductal carcinoma in situ on core biopsies to invasive disease at final surgery: a retrospective review across the Scottish Breast Screening Programme

    Aim: To identify factors affecting upgrade rates from B5a (non-invasive) preoperative core biopsies to invasive disease at surgery and ways to improve screening performance. Material and methods: This was a retrospective analysis of 1252 cases of B5a biopsies across all six Scottish Breast Screening Programmes (BSPs), ranging between 2004 and 2012. Final surgical histopathology was correlated with radiological and biopsy factors. Data were analysed using basic Microsoft Excel and standard Chi-squared test used for evaluating statistical significance. Results: B5a upgrade rates for the units ranged from 19.2% to 29.2%, with an average of 23.6%. Mean sizes of invasive tumours were small (3–11 mm). The upgrade rate was significantly higher for cases where the main mammographic abnormality was mass, distortion, or asymmetry, compared with micro-calcification alone (33.2% versus 21.7%, p = 0.0004). The upgrade rate was significantly lower with the use of large-volume vacuum-assisted biopsy (VAB) devices than 14 G core needles (19.9% versus 26%, p = 0.013); in stereotactic than ultrasound-guided biopsies (21.2% versus 36.1%, p < 0.001). Heterogeneity of data from different centres limited evaluation of other potential factors. Conclusion: Upgrade rates are lower for cases with micro-calcification as the sole mammographic feature with the use of VAB devices. Nevertheless, there is variation in practice across Scottish BSPs, including first-line biopsy technique and/or device; and it is of interest that a few centres maintain low upgrade rates despite not using VAB routinely for biopsy of micro-calcification. - Highlights: • Average B5a upgrade rate of 23.6% in our screening programme is comparable to published series. • Upgrade rate was lower in microcalcifications than non-calcific findings on mammography. • Upgrade rate was lower with use of vacuum-assisted biopsy devices than 14-gauge core needles

  1. Lumbar paraspinal muscle morphometry and its correlations with demographic and radiological factors in adult isthmic spondylolisthesis: a retrospective review of 120 surgically managed cases.

    Thakar, Sumit; Sivaraju, Laxminadh; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

    2016-05-01

    OBJECTIVE The objective of this study was to assess the cross-sectional areas (CSAs) of lumbar paraspinal muscles in adults with isthmic spondylolisthesis (IS), to compare them with those in the normative population, and to evaluate their correlations with demographic factors and MRI changes in various spinal elements. METHODS The authors conducted a retrospective study of patients who had undergone posterior lumbar interbody fusion for IS, and 2 of the authors acting as independent observers calculated the CSAs of various lumbar paraspinal muscles (psoas, erector spinae [ES], multifidus [MF]) on preoperative axial T2-weighted MR images from the L-3 to L-5 vertebral levels and computed the CSAs as ratios with respect to the corresponding vertebral body areas. These values were then compared with those in an age- and sex-matched normative population and were analyzed with respect to age, sex, duration of symptoms, grade of listhesis, and various MRI changes at the level of the listhesis (pedicle signal change, disc degeneration, and facetal arthropathy). RESULTS Compared with values in normative controls, the mean CSA value for the ES muscle was significantly higher in the study cohort of 120 patients (p = 0.002), whereas that for the MF muscle was significantly lower (p = 0.009), and more so in the patients with PSC (p = 0.002). Magnetic resonance imaging signal change in the pedicle was seen in half of the patients, all of whom demonstrated a Type 2 change. Of the variables tested in a multivariate analysis, age independently predicted lower area values for all 3 muscles (p ≤ 0.001), whereas female sex predicted a lower mean psoas area value (p muscle area values. A decrease in the mean MF muscle area value alone was associated with a significantly increased likelihood of a PSC (p = 0.039). CONCLUSIONS Compared with normative controls, patients with IS suffer selective atrophy of their MF muscle, whereas their ES muscle undergoes a compensatory hypertrophy

  2. Comparison of Undernutrition Prevalence of Children under 5 Years in China between 2002 and 2013

    YU Dong Mei; ZHAO Li Yun; YANG Zhen Yu; CHANG Su Ying; YU Wen Tao; FANG Hong Yun; WANG Xun

    2016-01-01

    Objective To describe the undernutrition status of children under 5-year in China, and study the trend between 2002 and 2013. Methods The study was based on two national surveys. Undernutrition wasdetermined against WHOs 2006 growth standards.The prevalence in 2013 and 2002 was weighted by China sixth National Population Census (2010). The relationship between undernutrition and gender/age groups/different areas use weighted logistic regression. Results The results indicated the overall prevalence of stunting, underweight, and wasting of Chinese children under 5-year was 8.1%, 2.4%, and 1.9% in 2013, respectively. The prevalence of stunting was higher for children aged 12-47 month, while underweight was higher for children aged 48-59 month. The prevalence of undernutrition was higher in rural areas than in urban areas, especially in poor rural areas. There was a decline of stunting, underweight, and wastingbetween 2002 and 2013 among the children, with greater reduction in rural areas than in urban areas. Conclusion The prevalence of undernutrition of children under 5-year remains high in rural areas especially in poor rural areas in China. It is urgent totake action to control undernutrition in the vulnerable areas and subgroups.

  3. Development of Speech Intelligibility Measurement Test for 3 to 5 Years Old Normal Children

    Fatemeh Hoseyni

    2011-06-01

    Full Text Available Background and Aim: Speech intelligibility is defined as a measure of effectiveness of understanding speech. It has many applications such as nomination of speech disorder intensity. Different methods and speech tasks have been designed for assessment of speech intelligibility amongst which word identification tasks have high validity. This study aimed to provide a test to measure speech intelligibility among children aged 3 to 5 years old.Methods: Many words were collected and content validity was assessed by 9 speech-language pathologists and 1 linguist. Thirty four words with a content validity above 70% were chosen as the test words and the speech-language pathologists collected suitable pictures for the words. One hundred boys and girls aged 3 to 5 years participated in the study. Inter-rater reliability was administered to assess the test reliability.Results: An interclass correlation coefficient of 0.85 and spearman correlation coefficient of 0.81 was obtained for the speech intelligibility test.Conclusion: Speech intelligibility test has appropriate validity and reliability and is suitable for assessment of intelligibility in 3 to 5 years old children.

  4. Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study

    Rinkens Paula ELM

    2006-10-01

    Full Text Available Abstract Background Many risk factors for fractures have been documented, including low bone-mineral density (BMD and a history of fractures. However, little is known about the short-term absolute risk (AR of fractures and the timing of clinical fractures. Therefore, we assessed the risk and timing of incident clinical fractures, expressed as 5-year AR, in postmenopausal women. Methods In total, 10 general practice centres participated in this population-based prospective study. Five years after a baseline assessment, which included clinical risk factor evaluation and BMD measurement, 759 postmenopausal women aged between 50 and 80 years, were re-examined, including undergoing an evaluation of clinical fractures after menopause. Risk factors for incident fractures at baseline that were significant in univariate analyses were included in a multivariate Cox survival regression analysis. The significant determinants were used to construct algorithms. Results In the total group, 12.5% (95% confidence interval (CI 10.1–14.9 of the women experienced a new clinical fracture. A previous clinical fracture after menopause and a low BMD (T-score Conclusion In postmenopausal women, clinical fractures cluster in time. One in two women with a recent clinical fracture had a new clinical fracture within 5 years, regardless of BMD. The 5-year AR for a first clinical fracture was much lower and depended on BMD.

  5. The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

    Gopinath, Vellore Kannan

    2016-01-01

    Objective: The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. Materials and Methods: A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. Results: In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P dental erosion compared to children who drink water (P dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion. PMID:27095899

  6. Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages.

    Zhou, Huanfen; Zhao, Shuo; Yin, Dongfang; Chen, Xiaofei; Xu, Quangang; Chen, Tingjun; Li, Xiaoyan; Wang, Junqing; Li, Hongyang; Peng, Chunxia; Lin, Dahe; Wei, Shihui

    2016-07-01

    Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female. The median age at onset was 36.8 years (range 18-73). Serum AQP4-Ab was positive in 45 (35.2 %) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6 %, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients (p = 0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group (p transverse myelitis (TM) episode were ocular pain and recurrence within 1 year. The older patients had worse visual outcome after the first episode of ON than the younger patients (p = 0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS. PMID:27159992

  7. Ectopic pregnancy in a tertiary care center: a retrospective study

    Chaitra Shivananjaiah; Ashwini Nayak U.; Kamya Ramesh Swaminathan; Asha Swarup; Suneha Pocha; Davis Sabu Pathadan

    2016-01-01

    Background: Ectopic pregnancy is an obstetric emergency which if not diagnosed in time can cost the life of the patient. This emphasizes the importance of diagnosing this perilous condition and hence this study was undertaken to study symptoms with which the patients with ectopic pregnancy present. Methods: Retrospective study of 5 years was done in the department of Obstetrics and Gynecology, M. S. Ramaiah medical college and teaching hospital, Bangalore, India between January 2011 to Ja...

  8. Clinical analysis of 38 cases of unresectable primary hepatic carcinoma survived for more than 5 years after interventional therapy

    Objective: T investigate the affecting factors on long-term effect of interventional therapy for unresectable primary hepatic carcinoma (PHC). Methods: From May 1988 to April 1996, 660 cases of unresectable PHC were treated with lipiodol transcatheter hepatic artery chemoembolization (LP-TACE), 63 cases of them also received percutaneous ethanol injection (PEI). Of the 660 cases, 96 cases were proved by pathology. The clinical stage included stage II (543 cases) and stage III (117 cases). The tumor pattern included mononodular type (171 cases), multinodular type (67 cases), large lesion type (388 cases), and diffuse type (34 cases). The angiographic findings included hypervascular type (538 cases) and hypovascular type (122 cases). 473 cases had AFP20 μg/L. According to the liver function (Child's system), 430 cases belonged to grade A, 164 cases grade B, and 66 cases grade C. 660 cases underwent LP-TACE for 1765 times (mean 2.7 times) and 63 cases received PEI for 165 times (mean 2.6 times). Of the 38 cases survived more than 5 years after interventional therapy, 8 cases were demonstrated by pathology. All the 660 cases were followed up for more than 5 years and 38 cases were analyzed retrospectively and concentratively. Results: 38 cases of unresectable PHC survived more than 5 years after interventional therapy. Among them, 14 cases survived for more than 7 years and 6 cases survived for more than 10 years. The survival rate of 5, 7 and 10 years was 5.8% (38/660), 2.1% (14/660), and 0.9%(6/660), respectively. 2 cases had survived for more than 13 years up to now. All the 38 cases were in clinical stage II, and the tumor pattern included mononodular type (20 cases), multinodular type (8 cases), large lesion type (10 cases), and diffuse type (0 cases). All these 38 cases were hypervascular type angiographically. AFP20 μg/L in 20 cases. The liver function included grade A in 29 cases, grade B in 9 cases, and grade C in 0 cases. 38 cases underwent LP-TACE for 175

  9. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  10. Clinical Experience with Octagam® 10 %, a solvent detergent virus inactivated intravenous immunoglobulin: a Canadian retrospective review of utilization.

    Betschel, Stephen D; Warrington, Richard J; Schellenberg, Robert

    2016-01-01

    In Canada, intravenous immune globulin (IVIg) products are licensed for six disease indications, however it has been demonstrated that patients with a number of other conditions also benefit from IVIg. Here we report the routine clinical use of Octagam(®) 10 % across three Canadian institutions. A total of 135 patients were treated with Octagam(®), for conditions represented by five distinct indication groups. The results of this review indicate that Octagam(®) has been well adopted and is prescribed to Canadian patients similar to other IVIg products. In alignment with current practices, 85 % of Octagam's utilization was classified as appropriate based on Canadian IVIg guidelines. PMID:27468299

  11. A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis

    Tony Yuqi Tang

    2012-01-01

    Mono- or combine immunosuppressants are commonly used for psoriasis; however the side effect caused by potent systemic immunosuppressants frequently incurred; moreover the inflammation flares up shortly after immunosuppressants are discontinued. An alternative nonimmunosuppressive therapy was introduced to psoriasis subjects. A retrospective observational study consisted of 1583 psoriasis patients who were treated with Herose Psoria capsule 1440 mg three times daily at two clinical centres, o...

  12. SPECTRUM OF CERVICAL LESIONS IN CIMS, BILASPUR: A 5 YEAR RETROSPECTIVE STUDY OF 215 CASES IN A TERTIARY HOSPITAL OF CENTRAL INDIA

    Sadhna

    2015-10-01

    Full Text Available BACKGROUND AND OBJEC TIVE: Cancer of the cervix is a leading cause of morbidity and mortality among women W orld W ide. Therefore to curb the disease there is need of awareness of this disease. This study is aimed to categorize the premalignant and malignant lesions at the earliest, to reduce the mortality and morbidity. It also aimed to know the incidence of malignancies at our set up and to calculate distribution of patient in relation to parity and symptoms. DESIGN AND SETTING: Study included 215 patients with complain of white dis charge per vagina, per vaginal bleeding and backache attending the gynecology OPD over a period of 05 years. PATIENT AND METHODS: Patients were subjected to cervical biopsy and biopsies were sent to pathology department. Detailed clinical history, age, age at marriage, parity and socio - economic status was obtained. RESULT: Result were classified histopathological l y as inflammatory lesions 70 cases, polypoidal lesion were 30, LSIL accounted for 32 cases and HSIL were 20 cases and 30 were malignant lesions. U nder malignant category moderately differentiated squamous cell carcinoma was the commonest. Maximum numbers of patients were subjected to cervical biopsies in 3 rd decade of life. Malignancies were common in 3 rd & 4 th decade of life. Most of the cases were of parity 4. CONCLUSION : Tissue biopsy is a valuable diagnostic procedure on which surgeons and radiologists still rely.

  13. Roll of the adjuvant radiotherapy. Kidney cancer. Stage III. Results to 5 years. Observational, descriptive, retrospective, quantitative and comparative study with data numerical description

    Kidney cancer represents 3 % of the tumors in adults. In the United States, the 45% is diagnosed in early stages. Its natural history is characterized for being absolutely unpredictable and probably related to hormonal, immunologic and unknown factors. There are patients in advanced stage with prolonged or low average survival and even with metastasis declination. These particularities along with the lack of prospective random studies make difficult to establish which is the roll of the adjuvant radiotherapy, being considered not standard since 1997

  14. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: Retrospective physician surveys including chart reviews at numerous centers

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient's sex; patient's age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient's medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards

  15. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: Retrospective physician surveys including chart reviews at numerous centers

    Gossman, Michael S., E-mail: MGossman@TSRCC.com [Regulation Directive Medical Physics, Russell, KY (United States); Wilkinson, Jeffrey D. [Medtronic, Inc., Mounds View, MN (United States); Mallick, Avishek [Department of Mathematics, Marshall University, Huntington, WV (United States)

    2014-01-01

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient's sex; patient's age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient's medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards.

  16. MEAD retrospective analysis report

    Hasager, Charlotte Bay; CARSTENSEN J.; Frohn, L. M.; Gustafson, B.; Brandt, J.; Conley, D.; Geernaert, G.; Henriksen, P.; C. A. Skjøth; Johnsson, M.

    2003-01-01

    The retrospective analysis investigates links between atmospheric nitrogen deposition and algal bloom development in the Kattegat Sea from April to September 1989-1999. The analysis is based on atmospheric deposition model results from the ACDEP model,hydrodynamic deep-water flux results, phytoplankton abundance observations from Danish and Swedish marine monitoring stations and optical satellite data. Approximately 70 % of the atmospheric deposition consists of wet depostion of highly episod...

  17. Assessment of Iron Overload in Homozygous and Heterozygous Beta Thalassemic Children below 5 Years of Age

    Dhiraj J. Trivedi

    2014-07-01

    Full Text Available Background: Thalassemia is a genetic disease having 3-7% carrier rate in Indians. It is transfusion dependent anemia having high risk of iron overloading. A clinical symptom of iron overload becomes detectable in second decade causing progressive liver, heart and endocrine glands damage. There is a need to assess iron overload in thalassemics below 5 years of age to protect them from complications at later age of life. Aims and objectives: Present study was undertaken to estimate serum iron status and evaluate serum transferrin saturation in both homozygous & heterozygous form of thalassemia as an index of iron overload among children of one to five years of age. Materials and Methods: Clinically diagnosed thirty cases of β thalassemia major & thirty cases of β thalassemia minor having severe anemia, hepatospleenomegaly and between 1 year to 5 years of age were included in study group and same age matched healthy controls were included in the study. RBC indices and HbA, HbA2 and HbF were estimated along with serum iron & serum Total Iron Binding Capacity (TIBC and serum transferrin levels. Results: Significant difference was observed in hemoglobin levels between control and both beta thalassemia groups. Mean Corpuscular Volume (MCV and Mean Corpuscular Hemoglobin (MCH values were reduced. Hemoglobin electrophoresis showed the elevated levels of HbF and HbA2 in both beta thalassemia groups. Among serum iron parameters, serum iron, TIBC and transferrin saturation were elevated whereas serum transferrin levels were low in thalassemia major in children below 5 years of age. Conclusion: Although clinical symptoms of iron overload have been absent in thalassemic children below five years of age, biochemical iron overloading has started at much lower age which is of great concern.

  18. Calcineurin activity in tacrolimus-treated renal transplant patients early after and 5 years after transplantation.

    Mortensen, D M; Koefoed-Nielsen, P B; Jørgensen, K A

    2006-10-01

    The pharmacodynamic (PD) action of tacrolimus (FK) within the T-cell is inhibition of calcineurin phosphatase (CaN). Determination of CaN activity provides us with an important PD marker. Eleven renal transplant patients treated with FK were investigated on day 14 following transplantation and 5 years later. Blood samples drawn before as well as 1, 2, 3, and 4 hours after oral intake of FK were analyzed for CaN activity and blood FK concentrations. Twenty healthy subjects had one blood sample drawn for CaN activity, which was measured as the release of (32)P from a phosphorylated peptide. Radioactivity of (32)P was quantitated by liquid scintillation counting with the results converted to units of CaN utilizing a calibration curve. On day 14, we observed significant inhibition of CaN activity at T:1, 2, and 3 compared with the predose level (P = .002; P = .015; P = .015). Furthermore, all measured CaN activities were significantly different from those observed in healthy nonmedicated subjects. In contrast, at 5 years posttransplant only the CaN activity at T:2 was significantly inhibited compared with the predose level (P = .02). Additionally, all CaN activities at this time were not significantly different from CaN activities in the healthy subjects. We were not able to demonstrate individual CaN activity profiles in the patients. The lack of CaN inhibition at 5 years after transplantation despite relevant drug concentrations, probably reflected the lower drug dose used long after transplantation. This result raises the question of whether CaN inhibition is necessary to hold graft function and whether FK possess CaN-independent mechanisms of action. PMID:17098028

  19. Annual Papanicolaou screening for 5 years among human papillomavirus-negative women

    Primary human papilloma virus (HPV) screening is more effective than cytology in reducing the risk of cervical cancer, but screening intervals should be extended in HPV-negative women. However, some Markov models predicted that long intervals are associated with an excess risk of cervical cancer. The aim of this analysis was to estimate the real-life risks and benefits of annual Papanicolaou (Pap) screening in HPV-negative women with normal cytology. Women with negative Hybrid Capture 2 (HC2) results and normal cytology at the time of inclusion in the Hannover HPV screening trial underwent annual Pap smears for 5 years. A subgroup was randomly selected for retesting with cytology, HC2, and colposcopy 60–68 months after recruitment. Of 4236 women included, 3406 had at least one Pap smear, but only 1185 attended all five annual screening visits. The proportion of women with at least one abnormal smear was 14.4% in 60 months. The probability of abnormal smears increased continuously over time. No case of ≥ CIN2+ was observed during 5 years. Of 605 women selected for subgroup analysis, 292 agreed to be retested (48.3%). The rate of high-risk HPV at 60–68 months was 3.0% (9/296). The long-term risk of high-grade neoplasia after an initial negative HC2 test and normal cytology result was low, while the rate of false-positive abnormal Pap smears was significant and increased constantly over time. Pap smear screening of HPV-negative women more frequently than every 5 years could be potentially harmful and seems to be of little clinical value

  20. CLINICAL PROFILE OF ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN BETWEEN 2MONTHS TO 5 YEARS

    Amitoj Singh Chhina

    2015-08-01

    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  1. Diffuse, retroperitoneal mesenteric and intrahepatic periportal plexiform neurofibroma in a 5-year-old boy

    We present a case of plexiform neurofibroma involving the retroperitoneum, mesentery, and liver in a 5-year-old boy who underwent evaluation for extent of a palpable left neck mass. The mass had intrathoracic extension with great vessel encasement and extension into the abdomen. Abdominal CT revealed a diffuse low-attenuation non-enhancing mass encasing the retroperitoneal vessels with serpiginous extension into the liver along the portal vein. This spread pattern of plexiform neurofibroma is an unusual manifestation of neurofibromatosis in a young child. (orig.)

  2. A case of spontaneous gastric rupture in a 5 years girl

    D. Salerno

    2014-06-01

    Full Text Available We describe a case of spontaneous gastric rupture in a child of 5 years old. The patient reached us in a serious condition; the anamnesis was negative for traumatic events or gastrointestinal disorders. An abdominal X-ray and CT scan revealed free air and fluid in the abdominal cavity, leading to the diagnosis of gastro-intestinal perforation. Submitted to urgent surgery, a rupture of the posterior wall of the stomach was found that was treated with gastrectomy “à la demande”. The surgery follow-up was regular. Morphological and immunohistochemical study showed some muscular abnormalities of the muscular gastric wall.

  3. Short communication. Growth and nodulation of cowpea after 5 years of consecutive composted tannery sludge amendment

    Ana R. L. Miranda; Luis A. P. L. Nunes; Mara L. J. Oliveira; Wanderley J. Melo; Ademir S. F. Araujo

    2014-01-01

    Tannery industry releases high amounts of tannery sludge which are currently composted and used in agricultural soils. The consecutive amendment of such composted tannery sludge (CTS) may affect soil microrganisms, such as rhizobia. In this study, we evaluated the effects of 5-year repeated CTS amendment on growth, nodulation, and yield of cowpea (Vigna unguiculata L.) CTS was applied in different amounts (0, 2.5, 5, 10 and 20 Mg/ha) to a sandy soil. Amendment of CTS increased soil pH, electr...

  4. 5 year Survey of Carcinoma Breast at No.(2) Military Hospital (1987 to 1991)

    Over 250 cases of carcinoma of Breast in different stages, treated by Joint Cancer Clinic (JCC) of No (2) Military Hospital over 5 years (1987 to 1991) were analysed. Different combination of drugs CMF, CMF(P),CMFVP and COFA regimes were given either alone on in combination with local radiation therapy after surgery- lumpectomy or extended simple mastectomy. Hormonal therapy was also added to the standard method of treatment in most of the cases. Results were evaluated in different arms of treatment. The value of immunotherapy and neochemotherapy were also studied

  5. Conservative management of chronic gastric volvulus:44 cases over 5 years

    Yao-Chun; Hsu; Chin-Lin; Perng; Jai-Jen; Tsai; Hwai-Jeng; Lin

    2010-01-01

    AIM:To investigate clinical outcomes of patients with chronic gastric volvulus(GV)who were managed conservatively over a 5-year period.METHODS:A total of 44 consecutive patients with chronic GV,as diagnosed by barium study between October 2002 and July 2008 were investigated.All of these patients received conservative management initially without anatomical correction.Their clinical manifestations,diagnostic work-ups,and clinical outcomes were analyzed.We sought to identify independent risk factors for poor...

  6. Study visit carbon sinks Peugeot. Evaluation after 5 years and perspectives

    In the framework of its project of the climatic change control, PSA Peugeot Citroen, decided to involve in the decrease of the carbon dioxide emissions. In parallel to the vehicles consumption decrease and the biofuels utilization, the group developed since 5 years a pilot project of carbon sink. This project aims to study the impact of a trees plantation, at a big scale, on the atmospheric carbon dioxide fixation. This document is a first evaluation after the phase of trees plantation. (A.L.B.)

  7. Prevalence of obesity among 2- 5 years old children of Amritsar: A comparison of three criteria

    Navdeep Kaur; Sharda Sidhu

    2013-01-01

    This was a cross-sectional study of 1879 subjects (949 boys and 930 girls) to define the prevalence of overweight and obesity using three reference standards. The study involved affluent preschool children (2-5 years of age) from six crèches, fifteen play-pen and three public schools of Amritsar city. Weight and height was obtained for each child and body mass index was calculated according to the formula weight (kg)/ height (m)². The prevalence of overweight and obesity was then determined u...

  8. Urinary phthalates from 168 girls and boys measured twice a year during a 5-year period

    Mouritsen, A; Frederiksen, H; Sørensen, K;

    2013-01-01

    . Methods: This was a longitudinal study of 168 healthy children (84 girls) examined every 6 months for 5 years. Serum levels of dehydroepiandrostenedione sulfate (DHEAS), Δ4-androstenedione, testosterone, and urinary morning excretion of 14 phthalate metabolites, corresponding to 7 different phthalate......Background: Little is known about the possible deleterious effects of phthalate exposure on endogenous sex steroid levels in children. Objective: Our objective was to investigate whether urinary phthalate metabolite levels are associated with circulating adrenal androgen levels and age at puberty...

  9. Diffuse, retroperitoneal mesenteric and intrahepatic periportal plexiform neurofibroma in a 5-year-old boy

    Fenton, L.Z. [Dept. of Radiology, The Children' s Hospital, Denver, CO (United States); Foreman, N. [Dept. of Oncology, The Children' s Hospital, Denver, CO (United States); Wyatt-Ashmead, J. [Dept. of Pathology, The Children' s Hospital, Denver, CO (United States)

    2001-09-01

    We present a case of plexiform neurofibroma involving the retroperitoneum, mesentery, and liver in a 5-year-old boy who underwent evaluation for extent of a palpable left neck mass. The mass had intrathoracic extension with great vessel encasement and extension into the abdomen. Abdominal CT revealed a diffuse low-attenuation non-enhancing mass encasing the retroperitoneal vessels with serpiginous extension into the liver along the portal vein. This spread pattern of plexiform neurofibroma is an unusual manifestation of neurofibromatosis in a young child. (orig.)

  10. Diarrhea Caused by Rotavirus in Children Less than 5 Years of Age in Hanoi, Vietnam

    Nguyen, Trung Vu; Le Van, Phung; Le Huy, Chinh; Weintraub, Andrej

    2004-01-01

    Group A rotaviruses are the major cause of diarrhea in young children worldwide. From March 2001 to April 2002, 836 children less than 5 years of age were investigated in Hanoi, Vietnam. This included 587 children with diarrhea and 249 age-matched controls. Group A rotavirus was identified in 46.7% of the children with diarrhea and 3.6% of the controls, which was a significant difference. Within the diarrhea group, the highest prevalence was seen in children from 13 to 24 months of age, and t...

  11. Giant parietal lobe infantile gliosarcoma in a 5-year-old child

    Hemant V Savant

    2015-01-01

    Full Text Available The relative frequency of pediatric gliosarcoma (GSM is 1.9% among glioblastomas and 0.5% among pediatric central nervous system tumors. A 5-year-old female child came to us with history of fever and loss of appetite since 2 weeks and right sided weakness since 4 days. Magnetic resonance imaging showed a large heterogeneously enhancing space occupying lesion in the left parieto-occipital region. A parieto-occipital craniotomy with radical excision of tumor was performed. The patient was given adjuvant therapy following surgery and survived until 9 months following surgery. The etiopathogenesis, treatment modalities and prognosis of GSM is discussed.

  12. Sudden Onset Monoparesis and Dysarthria in a 5-Year-Old boy: A Case Report

    Okhovat

    2015-10-01

    Full Text Available Introduction Moyamoya disease (MD is a disorder caused by blocked arteries at the base of the brain. As the normal blood vessels narrow and become blocked, a person may suffer a stroke. The MD mainly affects children, although adults may have the condition. This is a rare condition, with a marked prevalence gradient between Asian countries. Case Presentation We report a 5-year-old boy, who was presented with sudden right hand monoparesis and dysarthria. Conclusions The patient was investigated with magnetic resonance angiography and diagnosed as MD.

  13. Analysis of the 5-year final dataset of the Supernova Legacy Survey project

    The Supernova Legacy Survey (SNLS) is a program that aims at discovering and photometrically following hundreds of Type Ia supernovae (SNe Ia). Its goal is to measure the expansion history of the Universe in order to constrain the nature of the dark energy, namely its equation of state wDE. The survey completed its data taking during summer 2008 after 5 years of program. This thesis work consists in the analysis of these 5 years of SNLS data and the photometry of the 419 Type Ia supernovae discovered and spectroscopically identified. For each supernova, the light-curves are produced in the gMrMiMzM bands, calibrated and fitted with a spectrophotometric model. A new photometric method which does not make use of any pixel re-sampling has also been implemented and tested. This method preserves the pixels statistical properties, and produces this way more accurate flux measurement statistical uncertainties, that can be propagated to cosmological measurements. Both photometry results were checked and compared using calibration stars and supernovae, proving that the accuracy of the new method flux measurement uncertainty is indeed better, and that the photometric accuracy and stability of both techniques are similar. A sample of supernovae with unprecedented statistics and quality is now available for cosmological analysis. With the complement of an external nearby supernovae sample, a measurement within 5% of the dark energy equation of state of dark energy is thus for the first time within reach. (author)

  14. Electroencephalographic (EEG) Photoparoxysmal Responses Under 5 Years of Age: Diagnostic Implications and Peculiarities.

    Binelli, Simona; Ragona, Francesca; Canafoglia, Laura; Freri, Elena; Saletti, Veronica; Casazza, Marina; Gilioli, Isabella; D'Arrigo, Stefano; Visani, Elisa; Panzica, Ferruccio; Granata, Tiziana; Riva, Daria; Franceschetti, Silvana

    2015-11-01

    Electroencephalographic (EEG) photoparoxysmal response has been little investigated in very young patients. We studied 5055 patients aged less than 5 years with no acquired brain damage, who underwent EEG recording. We determined the prevalence and significance of photoparoxysmal response induced by 1 to 20 Hz photic stimulation. Fifty-three showed photoparoxysmal response and were diagnosed as having Dravet syndrome (11), epileptic encephalopathy with myoclonic seizures (8), neurodegenerative disorders (8), benign idiopathic epilepsies (9), and static disorders with a known or suspected genetic origin (17). Photoparoxysmal response occurred in response to 1 to 5 Hz trains in 41.5% subjects. In most patients with epileptic encephalopathies, photoparoxysmal response was a transient finding: in 53.2%, it failed to be replicated in the recordings performed more than 6 months after initial evaluation. Photoparoxysmal response is rare in patients aged less than 5 years and has some peculiarities such as occurrence with low-frequency stimuli. Its distribution in specific conditions indicates that photoparoxysmal response may be useful in diagnostic workup. PMID:25944474

  15. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (−.04 points) did not correlate with annual change in VABS (−.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  16. Neutron star crustal cooling in KS 1731-260 14.5 years into quiescence

    Merritt, Rachael L; Brown, Edward F; Page, Dany; Cumming, Andrew; Degenaar, Nathalie; Deibel, Alex; Homan, Jeroen; Miller, Jon M; Wijnands, Rudy

    2016-01-01

    Crustal cooling of accretion-heated neutron stars provides insight into the stellar interior of neutron stars. The neutron star X-ray transient, KS 1731-260, was in outburst for 12.5 years before returning to quiescence in 2001. We have monitored the cooling of this source since then through Chandra and XMM-Newton observations. Here, we present a 150 ks Chandra observation of KS 1731-260 taken in August 2015, about 14.5 years into quiescence, and 6 years after the previous observation. We find that the neutron star surface temperature is consistent with the previous observation, suggesting that crustal cooling has likely stopped and the crust has reached thermal equilibrium with the core. Using a theoretical crust thermal evolution code, we fit the observed cooling curves and constrain the core temperature (T$_c = 9.35\\pm0.25\\times10^7$ K), composition (Q$_{imp} = 4.4^{+2.2}_{-0.5}$) and level of extra shallow heating required (Q$_{sh} = 1.36\\pm0.18$ MeV/nucleon). We find that the presence of a low thermal co...

  17. Factors associated with vaccination coverage in children < 5 years in Angola

    Manuel Falcão Saturnino de Oliveira

    2014-12-01

    Full Text Available OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0% and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups.

  18. Bayesian analysis of white noise levels in the 5-year WMAP data

    Groeneboom, N E; Gorski, K; Huey, G; Jewell, J; Wandelt, B

    2009-01-01

    We develop a new Bayesian method for estimating white noise levels in CMB sky maps, and apply this algorithm to the 5-year WMAP data. We assume that the amplitude of the noise RMS is scaled by a constant value, alpha, relative to a pre-specified noise level. We then derive the corresponding conditional density, P(alpha | s, C_l, d), which is subsequently integrated into a general CMB Gibbs sampler. We first verify our code by analyzing simulated data sets, and then apply the framework to the WMAP data. For the foreground-reduced 5-year WMAP sky maps, we find that the posterior means typically range between alpha=1.005 +- 0.001 and alpha=1.010 +- 0.001 depending on differencing assembly, indicating that the noise level of these maps are underestimated by 0.5-1.0%. The same problem is not observed for the uncorrected WMAP sky maps. The only difference between these two cases is that the nominal white noise level for the foreground-reduced map is specified to be lower than that of the raw maps. This is likely in...

  19. The relation of hearing loss degrees and oral stereognosis in 5-year-old children

    Seyede Zohre Mousavi

    2012-12-01

    Full Text Available Background and Aim: Oral stereognosis is the ability to recognize the objects placed in the mouth; this plays a significant role in speech sounds production. Since the children with hearing loss have articulation disorders, this study aimed to clear the relation of hearing loss degrees and oral stereognosis in 5-year-old children.Methods: In this cross-sectional non-invasive study, 40 children of 5-year-old (30 children with different degrees of hearing loss and 10 normal children were involved. Oral steriognostic test was done for all of them and the Mann-Whitney U was used for statistical analysis.Results: There were significant differences between the mean of oral stereognostic ability between the normal children and the children with severe (p<0.01 or profound hearing loss (p=0.05. There was no significant difference between the mean of oral stereognostic ability among the children with moderate, severe and profound hearing loss compared with together. Besides, there was no significant difference between the mean of the time of diagnosis among all of hearing loss and normal children.Conclusion: The study shows that the children with moderate, severe and profound hearing loss have inefficient oral stereognosis in comparison with the normal children.

  20. CLINICO – EPIDEMIOLOGY OF U TI IN UNDER 5 YEARS OF AGE IN CHILDREN

    Sonali

    2015-06-01

    Full Text Available Urinary tract infections (UTIs are a common , potentially serious , and often occult bacterial infections of childhood . UTI is more frequent in females than males at all ages with the exception of the neonatal period . Urinary tract infections imply invasion of urinary tract by pathogens which may involve the upper or lower urinary tract depending on the infection in kidney , bladder and urethra . OBJECTIVES: To determine the incidence of UTI in febrile children be low 5years of age and to know the aetiological profile of UTI among the same group of children with fever . METHODS: This cross sectional observational study included all febrile children from one month to 5years of age , admitted in Pediatric ward in MGM Me dical College , Kishanganj , Bihar . RESULTS: Overall incidence rate of UTI in the present study was 6% with maximum incidence in children <2years of age . Among culture positive cases majority (50% grew E . coli . DMSA revealed renal cortical scarring in 42 . 8 5% cases following UTI . CONCLUSION: From the present study it can be concluded that UTI is a common bacterial infection in infant and children . Rapid evaluation and treatment of UTI is important to prevent renal parenchymal damage and renal scarring or ren al failure .

  1. Spanish Network on Effects of Wildfires on Soils. The view after 5 years of networking

    Jordán, Antonio; Mataix-Solera, Jorge; Cerdà, Artemi

    2013-04-01

    1. WHAT IS FUEGORED? The Spanish Thematic Network "Effects of Wildfires on Soils" (FUEGORED, http://grupo.us.es/fuegored) has been working for over 5 years at becoming a point of reference for the study of fire-affected soils and restoration strategies. FUEGORED started in 2007, originally scheduled to run three years, as a result of the interest of Spanish researchers for developing better strategies and scientific interchange of ideas, people and collaboration between research groups. The first steps towards the establishment of a working group were a series of fieldtrips through Spain (2003), USA (2004) and Portugal (2005), where discussions about problems and research strategies arised. In its early years the network was supported by the former Ministry of Science and Innovation. This is a project to review scientific knowledge developed to date and discuss and propose future developments in scientific research about the effects of wildfires on soils. The objectives of the network are to promote and disseminate scientific research findings, provide technical and management information, and facilitate transference of knowledge between scientists, forest managers, students and society. 2. WHO IS IN THE NETWORK? The research group consists of the leading names of Spanish science in the topic and young talents, which are currently developing the most innovative research lines. Currently, the network is formed by 245 members, researchers from over 30 Spanish universities and research centers to provide the experience of decades of scientific and technical work in areas affected by forest fires and outstanding foreign researchers from Europe, Australia and America, including countries such as Australia, Italy, Lithuania, Portugal, UK, USA and others. Forest managers and technicians from various institutions are also present. 3. MAIN ACHIEVEMENTS Four international congresses have been promoted by the network in Valencia, 2008, Seville, 2009, Santiago de Compostela

  2. A Retrospective Review of Outcomes of Dental Treatment Performed for Special Needs Patients under General Anaesthesia: 2-Year Follow-Up

    Sreekanth Kumar Mallineni

    2014-01-01

    Full Text Available Objective. The purpose of the study was to evaluate the follow-up pattern of special needs patients (SNP treated under general anaesthesia (GA and the failure rates of different treatment procedures and restorative materials. Study Design. The treatment records of the patients who received dental treatment under GA during 2005 to 2009 were reviewed. The duration of follow-up periods, the outcomes of different treatment procedures, and the quality of different restorative materials were recorded and evaluated. Statistics were used for the comparison (SPSS 20.0. Pearson’s chi-square test and post hoc analysis were used to evaluate the attendance of postoperative appointments and the associations of failure rates of different treatment procedures and restorative materials. Cohen kappa statistics was used for intraexaminer reliability. Results. A total of 177 patients were included in the study. The attendance of postoperative appointments showed a gradual decrease from 96% to 36% within 24 months (P<0.05. Restorative procedures had the highest failure rates among all treatment procedures (P<0.05. Stainless steel crowns showed higher survival rates among different restorative materials (P<0.05. Pulp treatment in primary molars has higher success rate than primary incisors and canines. Composite restorations placed in primary canines have low survival rates. The intraexaminer reliability was good (k=0.94. Conclusion. The attendance for postoperative follow-up appointments declined within two years. Restorative treatment was less successful when compared to preventive and pulp treatments. Stainless steel crowns were more reliable restorations with higher survival rates and composite restorations were less durable.

  3. The reverse sural fasciocutaneous flap for the treatment of traumatic, infectious or diabetic foot and ankle wounds: A retrospective review of 16 patients

    Ioannis A. Ignatiadis

    2011-01-01

    Full Text Available The authors present their experience with the use of sural fasciocutaneous flaps for the treatment of various soft tissue defects in the lower limb. This paper is a review of these flaps carried out between 2003 and 2008. The series consists of 16 patients, 11 men and 5 women with an average age of 41 years (17-81 and with a follow-up period between 2 and 7 years. The etiology was major velocity accident in six cases, diabetes mellitus with osteomyelitis after ORIF for fractures (2, work accident in five, and another two cases with complications of lower limb injuries. The defect areas were located on calcaneus, malleolar area, tarsal area and lower tibia. Associated risk factors in the patients for the flap performance were diabetes (five patients and cigarette smoking (ten patients.The technique is based on the use of a reverse-flow island sural flap combined with other flaps in three cases (cross-leg, peroneal, gastrocnemius. The anatomical structures which constituted the pedicle were the superficial and deep fascia, the sural nerve, the lesser saphenous vein and skin.The flap was viable in all 15 patients. On 8 cases was achieved direct closure, on three cases occurred a superficial necrosis and was skin grafted, on one case was observed partial necrosis which was treated with a second flap (posterior tibial perforator flap and another one occurred delayed skin healing.The sural fasciocutaneous flap is useful for the treatment of severe and complex injuries and their complications in diabetic and non diabetic lower limbs. Its technical advantages are easy dissection, preservation of more important vascular structures in the limb and complete coverage of the soft tissue defects in just one operation without the need of microsurgical anastomosis. Thus this flap offers excellent donor sites for repairing soft tissue defects in foot and ankle.

  4. Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases

    Al-Koudmani Ibrahim

    2012-04-01

    Full Text Available Abstract Background Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this study, we present our 11-year experience in the management and clinical outcome of 888 chest trauma cases as a result of blunt and penetrating injuries in our university hospital in Damascus, Syria. Methods We reviewed files of 888 consequent cases of chest trauma between January 2000 and January 2011. The mean age of our patients was 31 ± 17 years mostly males with blunt injuries. Patients were evaluated and compared according to age, gender, etiology of trauma, thoracic and extra-thoracic injuries, complications, and mortality. Results The leading cause of the trauma was violence (41% followed by traffic accidents (33%. Pneumothorax (51%, Hemothorax (38%, rib fractures (34%, and lung contusion (15% were the most common types of injury. Associated injuries were documented in 36% of patients (extremities 19%, abdomen 13%, head 8%. A minority of the patients required thoracotomy (5.7%, and tube thoracostomy (56% was sufficient to manage the majority of cases. Mean hospital LOS was 4.5 ± 4.6 days. The overall mortoality rate was 1.8%, and morbidity (n = 78, 8.7%. Conclusions New traffic laws (including seat belt enforcement reduced incidence and severity of chest trauma in Syria. Violence was the most common cause of chest trauma rather than road traffic accidents in this series, this necessitates epidemiologic or multi-institutional studies to know to which degree violence contributes to chest trauma in Syria. The number of fractured ribs can be used as simple indicator of the severity of trauma. And we believe that significant neurotrauma, traffic accidents, hemodynamic status and GCS upon arrival, ICU admission, ventilator use, and complication of therapy are predictors of dismal prognosis.

  5. Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire

    Yu Ching-Hsiao

    2012-02-01

    Full Text Available Abstract Background In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS. Methods Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years. The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop, postoperative (PO and final follow-up (FFU period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed. Results The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p p = 0.12 FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%. The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25. Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p Conclusion Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.

  6. Evaluation of 5-Year Trends in Knee Society Scores Stratified by Comorbidities: A Prospective, Longitudinal Study.

    Jauregui, Julio J; Issa, Kimona; Cherian, Jeffrey J; Harwin, Steven F; Given, Kristin; Mont, Michael A

    2016-01-01

    Total knee arthroplasties (TKAs) are reliable procedures for treating end-stage knee osteoarthritis with excellent long-term outcomes. The purpose of this study was to longitudinally evaluate temporal trends of Knee Society Scores (KSS) after TKA and to identify potential demographic and comorbid factors that affect these outcomes. This prospective study evaluated 281 patients (108 men and 173 women) with a mean age of 66 years (range, 39-80 years) who underwent primary TKA (minimum follow-up 5 years). During each follow-up visit, KS objective, function, and total scores were evaluated. The effects of different demographics and comorbidities on outcomes were further analyzed using multivariate regression analysis. Following TKA, peak mean KSS were observed at 1-year follow-up (mean, 92 points), after which there was no significant difference in scores at 5 years compared with 1-year follow-up (mean, 92 points). KS function scores were observed to be unchanged from preoperative levels (mean, 53 points) and at 6 weeks (mean, 56 points). These were significantly higher at 3 months (mean, 78 points) and reached a maximum mean peak at 1 year (mean, 85 points). KS objective scores increased earlier than function scores. The demographic variables and comorbidities that demonstrated a significantly negative impact in KS function scores were increased age, female gender, higher body mass index, and several medical comorbidities including immunological and neurological disease, and neoplasm. Race was the only variable that significantly decreased the KS objective scores. KSS after TKA follow temporal trends with scores initially unchanged from preoperative levels for the objective component, but the scores increased for the functional component. All components demonstrated higher levels compared with preoperative scores by 3 months and peaked at 1-year follow-up. At 5-year follow-up, all mean KSS were unchanged relative to peak scores seen at 1 year. Various patient

  7. Prognosis for Emergency Physician with Substance Abuse Recovery: 5-year Outcome Study

    John S. Rose

    2014-02-01

    Full Text Available Introduction: Emergency physicians (EPs are reported to have a higher rate of substance use disorder (SUD than most specialties, although little is known about their prognosis. We examined the outcomes of emergency physician compared to other physicians in the treatment of substance use disorders in Physician Health Programs (PHP. Methods: This study used the dataset from a 5-year, longitudinal, cohort study involving 904 physicians with diagnoses of SUD consecutively admitted to one of 16 state PHPs between 1995 and 2001. We compared 56 EPs to 724 other physicians. Main outcome variables were rates of relapse, successful completion of monitoring, and return to clinical practice. Results: EPs had a higher than expected rate of SUD (odds ratio [OR] 2.7 confidence interval [CI]: 2.1–3.5, p,0.001. Half of each group (49% of EPs and 50% of the others enrolled in a PHP due to alcohol-related problems. Over a third of each group (38% of EPs and 34% of the others enrolled due to opioid use. During monitoring by the PHPs, 13% of EPs had at least one positive drug test compared to 22% of the other physicians; however, this difference was not significant (p¼0.13. At the end of the 5-year follow-up period, 71% of EPs and 64% of other physicians had completed their contracts and were no longer required to be monitored (OR 1.4 [CI: 0.8-2.6], p ¼ 0.31. The study found that the proportion of EPs (84% continuing their medical practice was generally as high as that of other physicians (72% (OR 2.0 [CI: 1.0–4.1], p ¼ 0.06. Conclusion: In the study EPs did very well in the PHPs with an 84% success rate in completion and return to clinical practice at 5 years. Of the 3 outcome variables measured, rates of relapse, successful completion of monitoring, and return to clinical practice, EPs had a high rate of success on all variables compared to the other physician cohort. These data support the conclusion that EM physicians do well following treatment of SUD

  8. Hipparcos: a Retrospective

    Perryman, Michael

    2011-01-01

    The Hipparcos satellite was launched in 1989. It was the first, and remains to date the only, attempt at performing large-scale astrometric measurements from space. Hipparcos marked a fundamentally new approach to the field of astrometry, revolutionising our knowledge of the positions, distances, and space motions of the stars in the solar neighbourhood. In this retrospective, I look back at the processes which led to the mission's acceptance, provide a short summary of the underlying measurement principles and the experiment's scientific achievements, and a conclude with a brief summary of its principal legacy - the Gaia mission.

  9. [Deep neck infections: a retrospective study].

    Bagnati, Tania; Olina, Massimo; Guglielmetti, Chiara; Borello, Giovanni; Valletti, Paolo Aluffi; Pia, Francesco; Garavelli, Pietro Luigi

    2007-09-01

    A retrospective study was carried out on 79 patients with deep neck infections (DNI) admitted to our Department between 1990 and 2005 in order to review our experience with DNI and verify if diabetic and immunocompromised patients have more aggressive infections and poorer prognosis. Demographics, clinical presentation, etiology, site of infection, associated systemic diseases (26.6%-21/79), microbiology, treatment and complications were considered. PMID:17902568

  10. Long-term efficacy of risedronate: a 5-year placebo-controlled clinical experience

    Sorensen, O H; Crawford, G M; Mulder, H; Hosking, D J; Gennari, C; Mellstrom, D; Pack, S; Wenderoth, D; Cooper, C; Reginster, J-Y

    2003-01-01

    Limited placebo-controlled data are available to assess the long-term fracture efficacy of bisphosphonates. In order to determine the effects of 5 years of risedronate treatment, we extended a 3-year, placebo-controlled vertebral fracture study in osteoporotic women for an additional 2 years; women...... who entered the extension study continued to receive 5 mg risedronate or placebo according to the original randomization, with maintenance of blinding. End points included vertebral and nonvertebral fracture assessments, bone mineral density measurements, and changes in biochemical markers of bone...... turnover. A total of 265 women (placebo, 130; 5 mg risedronate, 135) entered the study extension and 220 (83%) completed the additional 2 years. Fracture results observed in the study extension were consistent with those observed in the first 3 years. The risk of new vertebral fractures was significantly...

  11. Thrombolysis of the basilar artery: 5-year results from the Saarland stroke registry

    Acute thrombosis of the basilar artery has a fatal outcome if left untreated. The relatively good prognosis with intra-arterial thrombolysis makes it the therapy of choice for acute basilar thrombosis. In the Saarland stroke registry, we analyzed 47 patients with angiographically proven basilar artery thrombosis within the last 5 years. We observed a better outcome in patients with good income, with recanalization, and a short time between onset of symptoms and start of thrombolysis. The complications, such as intracerebral bleedings, occurred only in the group treated with rt-PA. Intra-arterial thrombolysis with urokinase or rt-PA is a relatively safe therapy, but should be performed in neuroradiological centers. With progressing symptoms the therapeutic window can be stretched up to 12 h, but coma lasting for more than 4 h is related to a bad outcome. (orig.)

  12. Torpedo maculopathy with an anisometropic amblyopia in a 5-year-old Caucasian girl: case report

    Marco Dutra-Medeiros

    2013-08-01

    Full Text Available The aim of this study is to report a clinical case of asymptomatic female Caucasian children with torpedo maculopathy. A 5-year-old girl was referred to our clinic for routine evaluation. The ophthalmic examination revealed best-corrected visual acuity of 20/20 in both eyes, without any changes in the biomicroscopy. Fundus examination showed normal findings in one eye, whereas in the contralateral eye it disclosed, in the temporal sector of the macular region, a whitish, atrophic, oval chorioretinal lesion with clearly defined margins. Posterior evaluations documented the stability of the lesion. Torpedo maculopathy diagnosis is based on its characteristic shape and peculiar location. The differential diagnosis has to be estabilished versus choroidal lesions (melanoma and nevus, congenital or iatrogenic hyperplasia of the retinal pigment epithelium (RPE and particularly versus the congenital pigmented lesions associated with Gardner's syndrome.

  13. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor.

    Carmichael, Samuel P; Pulliam, Joseph F; D'Orazio, John A

    2013-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her initial chemotherapeutic course was complicated by tumor lysis syndrome manifested by elevated serum uric acid and was treated effectively with hyperhydration and alkalization of intravenous fluids. The patient's disease responded well to chemotherapy, and she underwent successful tumor excision after 12 weeks of chemotherapy. The resected tumor was identified as anaplastic Wilms tumor, illustrating that pathologic identification of Wilms tumor is possible even after multiple cycles of neoadjuvant chemotherapy and marked tumor shrinkage. PMID:24964423

  14. Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study

    Mathiesen, E R; Feldt-Rasmussen, B; Hommel, E; Deckert, T; Parving, H H

    1997-01-01

    patients with persistent microalbuminuria (mean urinary albumin excretion [UAE] 84 mg/24 h [range 30-300]) were followed prospectively for 5 years of clinical examinations that included the measurement of GFR (51Cr-labeled EDTA clearance) at least once a year. The mean GFR at baseline was 120 +/- 18 ml x...... min-1.1 x 73 m-2. RESULTS: Using multiple regression analysis, the rate of decline in GFR was independently correlated to onset of diabetic nephropathy (P < 0.001) and systolic blood pressure (sBP) at baseline (P < 0.05). Increase in UAE was correlated to the mean HbA1c during the observation period...

  15. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study.

    Rösler, H; Triller, J; Baer, H U; Geiger, L; Beer, H F; Becker, C; Blumgart, L H

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. PMID:7997379

  16. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study

    Roesler, H. (Dept. of Nuclear Medicine, Paul Scherrer-Inst., Villigen (Switzerland)); Triller, J. (Dept. of Diagnostic Radiology, Paul Scherrer-Inst., Villigen (Switzerland)); Baer, H.U. (Clinic of Visceral Surgery, Paul Scherrer-Inst., Villigen (Switzerland)); Geiger, L. (Dept. of Nuclear Medicine, Paul Scherrer-Inst., Villigen (Switzerland)); Beer, H.F. (Paul Scherrer-Inst., Villigen (Switzerland)); Becker, C. (Dept. of Diagnostic Radiology, Paul Scherrer-Inst., Villigen (Switzerland)); Blumgart, L.H. (Clinic of Visceral Surgery, Paul Scherrer-Inst., Villigen (Switzerland))

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with [sup 90]Y-resin particles. Diagnostic radioembolizations of [sup 99m]Tc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumor occurred even after [>=]300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. (orig.)

  17. Montelukast reduces asthma exacerbations in 2- to 5-year-old children with intermittent asthma

    Bisgaard, Hans; Zielen, Stefen; Garcia-Garcia, María Luz;

    2005-01-01

    The PREVIA study was designed to investigate the role of montelukast, a leukotriene receptor antagonist, in the prevention of viral-induced asthma exacerbations in children aged 2 to 5 years with a history of intermittent asthma symptoms. The study was a 12-month multicenter, double-blind, parallel......-group study of patients with asthma exacerbations associated with respiratory infections and minimal symptoms between episodes. Patients were randomized to receive oral montelukast 4 or 5 mg (depending on age) (n = 278) or placebo (n = 271) once per day for 12 months. Caregivers recorded children's symptoms......, beta-agonist use, and health care resource use in a diary card. Over 12 months of therapy, montelukast significantly reduced the rate of asthma exacerbations by 31.9% compared with placebo. The average rate of exacerbation episodes per patient was 1.60 episodes per year on montelukast compared with 2...

  18. Central venous catheters for chemotherapy of solid tumors--our results in the last 5 years.

    Zganjer, Mirko; Cizmić, Ante; Butković, Diana; Matolić, Martina; Karaman-Ilić, Maja; Stepan, Jasminka

    2008-09-01

    Central venous catheters provide an easy access for intravenous medications. Having a central line in place will relieve a child from the discomfort and danger of multiple regular intravenous lines for chemotherapy. The use of indwelling central venous catheters has become commonplace in the management of children undergoing oncological treatment. There are two types of central lines commonly used. There are Broviac catheters and Port-A-Cath (PAC) catheters. In the last 5 years we inserted 194 catheters in 175 children. We inserted 121 Broviac catheters and 73 PAC catheters. During the follow up of 39382 catheter days 44 complications were observed. In Broviac group the median follow up was 155 days and in PAC group was 230 days. We observed differences in the incidence between two devices. In Broviac group infections were more frequent and in PAC group other complications were more frequent than infections. PMID:18982750

  19. Transgenic plants: a 5-year update on oral antipathogen vaccine development.

    Hernández, Marisela; Rosas, Gabriela; Cervantes, Jacquelynne; Fragoso, Gladis; Rosales-Mendoza, Sergio; Sciutto, Edda

    2014-12-01

    The progressive interest in transgenic plants as advantageous platforms for the production and oral delivery of vaccines has led to extensive research and improvements in this technology over recent years. In this paper, the authors examine the most significant advances in this area, including novel approaches for higher yields and better containment, and the continued evaluation of new vaccine prototypes against several infectious diseases. The use of plants to deliver vaccine candidates against viruses, bacteria, and eukaryotic parasites within the last 5 years is discussed, focusing on innovative expression strategies and the immunogenic potential of new vaccines. A brief section on the state of the art in mucosal immunity is also included. PMID:25158836

  20. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-01-01

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications. PMID:24832710