Ulcerativecolitis (UC) is a chronic inflammatory disease of the colon with a high incidence of colon cancer. Dysplasia is a precursor to carcinoma and a predictor of malignant potential; epithelia...Full Text Available
The sequential events and the inflammatory mediators that characterize disease onset and progression of ulcerativecolitis (UC) are not well known. In this study, we evaluated the early pathologic events...Full Text Available
We examined the physiology of continence in 12 patients at least four months after colectomy, mucosal proctectomy, and endorectal ileo-anal anastomosis for ulcerativecolitis and familial polyposis....Full Text Available
AbstractBackground: The dinitrofluorobenzene/dinitrosulfonic acid (DNFB/DNS) model was originally described as an experimental model of intestinal inflammation resembling human ulcerativecolitis (UC). Due to the absence of acceptable UC experimental models for pharmacological preclinical assays, here we examine the immune response induced in this model. Methods: Balb/c mice were sensitized by skin application of DNFB on day 1, followed by an intrarectal challenge with DNS on day 5. We further expanded this model by administering a second DNS challenge on day 15. The features of colonic inflammation and immune response were evaluated. Results: The changes observed in colonic tissue corresponded, in comparison to the trinitrobenzene sulfonic acid (TNBS) colitis model, to a mild mucosal effe...
Many foods have been implicated in theories about the etiology of inflammatory bowel disease. While evidence has accumulated that nutritional factors as part of overall lifestyle changes may play a role in the growing incidence, no specific dietary recommendations except the promotion of breastfeeding can currently be given to decrease the risk of developing Crohn's disease or ulcerativecolitis. For the treatment of Crohn's disease in children and adolescents, however, enteral feeding with a semi-elemental diet seems to be as effective as corticosteroids in inducing and maintaining remission. In the meta-analyses, advantages of one formula over the other are evened out, and more research is warranted into the anti-inflammatory properties of different nutrients, such as polyunsaturated fat...
AbstractBackground: A defective innate immune response may contribute to the pathogenesis of Crohn's disease (CD) and ulcerativecolitis (UC). Employing a global gene expression analysis, this study was aimed at identifying specifically regulated genes within the epithelial compartment in inflammatory bowel disease (IBD). Methods: The epithelial fraction of human ileal mucosa samples from surgical specimens was obtained by laser microdissection. Gene expression was examined by global expression profiling (n = 18, Affymetrix), quantitative reverse-transcription polymerase chain reaction (RT-PCR) (n = 35), immunoblot analysis (n = 9), and immunohistochemistry (n = 25). Results: Global expression profiling revealed a pronounced downregulation of the retinoic acid-inducible gene I (RIG-I) with...
Clostridium difficile (C. difficile) is a common causative agent of pseudomembranous colitis (PMC). C. difficile-associated diarrhea (CDAD) ranges...Full Text Available
Exposure of a group of horses to tetracycline-contaminated feed resulted in acute colitis and subsequent death in one horse and milder diarrhea in 3 others. The most severely affected animal demonstrated...Full Text Available
Giant duodenal ulcers (GDUs) are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently, few cases had been successfully treated...Full Text Available
AimsTo assess whether frequency of placebo administration is associated with duodenal ulcer healing.MethodsA systematic literature...Full Text Available
The ability to directly compare gastric ulcerated and healthy tissue would aid in the understanding of the physiological differences between these tissue types. Presently, these comparisons...Full Text Available
Peptic ulcer bleeding is a common disease and recurrent bleeding is an independent risk factor of mortality. Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful...Full Text Available
Giant lipomas are benign soft tissue tumours. They are found relatively rarely on the posterior part of the neck. Bleeding pressure ulcer in this giant tumour is a rare presentation. Surgical interventions...Full Text Available
Cimetidine 1 g daily is often continued for a fixed period beyond the time of healing of duodenal ulcer on the assumption that it might reduce the subsequent relapse rate. To test this, 194 patients...Full Text Available
BACKGROUND: Epinephrine injection is the most common endoscopic therapy for peptic ulcer bleeding. Controversy exists concerning the optimal dose of proton pump inhibitors (PPI) for patients with bleeding peptic ulcers after successful endoscopic therapy. The objective of this study was to determine the optimal dose of PPI after successful endoscopic epinephrine injection in patients with bleeding peptic ulcers. METHODS: A total of 200 peptic ulcer patients with active bleeding or nonbleeding visible vessels (NBVV) who had obtained initial hemostasis with endoscopic injection of epinephrine were randomized to receive omeprazole 40 mg infusion every 6 h, omeprazole 40 mg infusion every 12 h or cimetidine (CIM) 400 mg infusion every 12 h. Outcomes were checked at 14 days after enrollment. RE...
A sensitive radio-assay for ferritin was developed and used to examine serum ferritin levels in 105 patients with recurrent oral ulceration (ROU), 41 patients with Behcet's syndrome (BS), 42 with other ulcerative oral lesions, 35 patients with non-ulcerative oral lesions and in 78 controls. Ferritin levels increased with age and were significantly higher in males than females. The mean ferritin concentrations in male patients with ROU, BS or with other oral ulcers were significantly reduced in comparison with controls, and in female patients were significantly reduced in those with major aphthous ulcers. The prevalence of low serum ferritin levels was about 8% in patients with ROU, 15% in BS and 9.5% in patients with other ulcerative oral lesions, compared with less than 3% in patients with non-ulcerative oral disorders and in ...
Recurrence of microbial keratitis in the presence of protozoal infection is very rare and infrequently reported unless predisposing factors are present. The association of recurrent microbial keratitis...Full Text Available
Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical...Full Text Available
Opinion statementCritical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced...Full Text Available
An animated test is made for mice with malignant tumors irradiated by a self-made millimetre wave radiator for medical purpose. It is observed that S-180 sarcomas in mice after irradiation has been distinctly suppressed. And remarkable effects are shown through a lot of clinical practices on peptic ulcer, skin-deep ulcer, acute and chromic soft tissue injuries etc.
Background:The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed...Full Text Available
This article examines social stratification in individual health trajectories for multiple cohorts in the context of China’s dramatically changing macro-social environment. Using data...Full Text Available
This study assesses the contribution of smoking to all-cause mortality among a primarily minority cohort of urban transit operators. Survey and medical exam data, obtained from 1,785 workers (61% African...Full Text Available
Individuals from families recruited for the Long Life Family Study (LLFS) (n= 4559) were examined and compared to individuals from other cohorts to determine whether the recruitment targeting longevity...Full Text Available
The authors studied noncancer mortality among phenoxyacid herbicide and chlorophenol production workers and sprayers included in an international study comprising 36 cohorts from 12 countries followed...Full Text Available
BackgroundThe aim of this cohort study was to quantify the effect of alcohol in the risk of oral cancer in different strata of folate intake, controlling for known...Full Text Available
OBJECTIVES--This case cohort study examines whether there is an association between exposure to electric and magnetic fields and suicide in a population of 21,744 male electrical utility workers from...Full Text Available
Five standard, non-invasive tests of cardiovascular, autonomic function were performed in each of four groups of 30 subjects: controls, group 1, diabetics without clinical evidence of neuropathy; group...Full Text Available
BackgroundBuruli ulcer, the third mycobacterial disease after tuberculosis and leprosy, is caused by the environmental mycobacterium M. ulcerans. Various modes of...Full Text Available
We report the first case of human infection by Phaeoisaria clematidis. This fungus caused a corneal ulcer in a Brazilian man who had previously suffered an eye injury. Diagnosis was...Full Text Available
Organisms in the genus Mycobacterium cause a variety of human diseases. One member of the genus, M. ulcerans, causes a necrotizing skin disease called Buruli ulcer....Full Text Available
It is generally accepted that hypoxia and recovery from oxygen deprivation contribute to the breakdown and ulceration of human skin. The effects of these stresses on proliferation, differentiation...Full Text Available
BackgroundThe study aimed at (i) characterizing the mode of transmission of blaCTX-M and blaTEM-1 among extended-spectrum-β-lactamase...Full Text Available
Chronic colonization of the human stomach by Helicobacter pylori, a Gram-negative bacterium, is the major cause of chronic gastritis, peptic ulcers and gastric cancer. Recent...Full Text Available
Mycobacterium ulcerans is the causative agent of Buruli ulcer, the third most common mycobacterial disease after tuberculosis and leprosy. It is an emerging infectious disease that...Full Text Available
Cutaneous leishmaniasis (CL) is a parasitic disease characterized by single or multiple ulcerations. Secondary bacterial infections are one of the complications that can increase the tissue destruction...Full Text Available
Background:The present study was undertaken to evaluate the anti-ulcer and antioxidant activities of the ethanol extract of Lagenaria breviflora (EELB)...Full Text Available
... The study cohort consisted of 2,123 military working dogs that were ... maintained at the Department of Defense Military Working Dog Training Center ...
ObjectiveTo determine whether accounting for the time dynamics of diabetes exposure will change the risk estimates for colorectal cancer.Full Text Available
Two cases of tetracycline ulcers of the oesophagus are reported and compared with thirteen other cases from the literature. In most cases, the patients had taken their capsules with little or no fluid just before going to bed. Some hours later they developed retrosternal pain that was intensified by swallowing. Endoscopy showed sharply demarcated greyish-white areas of mucosal damage which represented layers of stratified squamous cells, separated by oedema, and a dense neutrophilic infiltration of the lamina propria and the muscularis mucosa. Roentgenology was unsuitable to detect the lesions. They healed without complications within one to six weeks. Prolonged retention of the capsules in the oesophagus is thought to cause the mucosal damage. Patients on oral tetracycline or doxycycline treatment should therefore be instructed to take their capsules with a meal or with copious water and not just before going to bed.
Extraskeletal Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are widely regarded as clinically and histologically identical tumors which consist of small blue round cells. Extraskeletal ESs/PNETs usually occur in the deep soft tissues of the paraspinal region, chest wall, or lower extremities. However, superficially located cases, so-called cutaneous ESs/PNETs, are exceedingly rare, and the vast majority of the reported cases present as a single small mass. We present magnetic resonance imaging (MRI) findings and clinical course of a unique case of primary cutaneous ES/PNET presenting as numerous huge masses with severe ulceration on them. (orig.)
Kundur [Benincasa hispida (Thunb.) Cogn.], a member of the family Cucurbitaceae, is one of the famous crops that are grown primarily for its fruits and usually recognized with its nutritional and medicinal properties especially in Asian countries. Kundur fruit has been valued as a nutritious vegetable as it provides a good source for natural sugars, amino acids, organic acids, mineral elements and vitamins. A number of medicinal properties such as anti-diarrheal, anti-obesity, anti-ulcer, and antioxidant and diuretic have been ascribed to this fruit of high economic value. As a rich source of functionally important bioactives and therapeutics such as triterpenes, phenolics, sterols, and glycosides, the fruit has been widely used for the treatment of epilepsy, ulcer, and other nervous disor...
The aim of this study was to observe both the clinical signs and symptoms of wounds at risk of infection, that is critically colonised (biofilm infected) and antimicrobial-performance of an ionic silver alginate/carboxymethylcellulose (SACMC) dressing, in comparison with a non silver calcium alginate fibre (AF) dressing, on chronic venous leg and pressure ulcers. Thirty-six patients with venous or pressure ulcers, considered clinically to be critically colonised (biofilm infected), were randomly chosen to receive either an SACMC dressing or a non silver calcium AF dressing. The efficacy of each wound dressing was evaluated over a 4-week period. The primary study endpoints were prevention of infection and progression to wound healing. The SACMC group showed a statistically significant (P = ...
Abstract Iodine concentrates in gastric tissue and may act as an antioxidant for the stomach. We previously showed that self-reported goiter was associated with significantly increased risk of gastric noncardia adenocarcinoma (GNCA) and nonsignificantly increased risks of gastric cardia adenocarcinoma (GCA) and esophageal squamous cell carcinoma (ESCC) in a prospective case-cohort study in a high-risk population in China. Negatively correlated with iodine levels, serum thyroglobulin (Tg) is a more sensitive biomarker of iodine deficiency than goiter. Our study aimed to determine whether baseline serum Tg was also associated with development of GNCA, GCA and ESCC in the same cohort, the Linxian General Population Nutrition Intervention Trial. Sera from -200 subjects of each case type and 40...
Current genome-wide association studies (GWAS) are moving towards the use of large cohorts of primary cell lines to study a disease of interest and to assign biological relevance to the genetic signals...Full Text Available
AbstractThis cohort study of 1302 persons aged ≥65 years, conducted in the Yoruba-speaking regions of Nigeria, determines the prevalence and correlates of hearing impairment (HI)...Full Text Available
BackgroundInflammatory markers may be associated with recurrent vascular events after stroke. We aimed to: (1) determine the association between interleukin-6, C-reactive...Full Text Available
BackgroundIn France, it is estimated that 24% of HIV-infected patients are also infected with HCV. Longitudinal studies addressing clinical and public health questions related to...Full Text Available
BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes...Full Text Available
BackgroundThere have been dramatic changes in the approach to screening for aneuploidy over the last 20 years. However, the approach to screening for other complications of pregnancy...Full Text Available
Little is known about how sociodemographic factors relate to children’s chronic pain. This paper describes the pain, health, and sociodemographic characteristics of a cohort of children...Full Text Available
Objective:This article examines relationships between reproductive onset and lifetime history of smoking, regular smoking, and nicotine dependence, and cannabis and other illicit...Full Text Available
IntroductionMale sexual dysfunction is a common complication of diabetes (DM), but the relative impact of erectile dysfunction (ED), orgasmic dysfunction (OD), and/or...Full Text Available
Background and objectives: The relationship between serum potassium (SK) and mortality in chronic kidney disease (CKD) has not been systematically investigated.Design, setting, participants,...Full Text Available
Objectives To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental,...Full Text Available
The cumulative rate of childhood eczema during the first three years was studied in a birth cohort of 1265 New Zealand infants. A parental history of eczema was the strongest predictor of rates of childhood...Full Text Available
ObjectivesMild Cognitive Impairment (MCI) case-finding criteria have low specificity in general population studies. The present study retrospectively identifies cases...Full Text Available
BackgroundAn abdominal aortic aneurysm (AAA) that is identified when the abdomen is imaged for some other reason is known as an incidental AAA. No population-based studies have...Full Text Available
ObjectiveTo compare objective polysomnographic parameters between three cohorts: children with autism, with typical development, and with developmental delay without...Full Text Available
A prospective cohort study was undertaken in two commercial California dairies. The treatment group, 246 cows, received three doses of a whole cell bacterin of J5 Escherichia coli (mutant of E. coli...Full Text Available
Background and objectives: The objective of this study was to describe the prevalence of ocular fundus pathology in the Chronic Renal Insufficiency Cohort (CRIC) study, a multicenter, longitudinal study...Full Text Available
BackgroundSeasonal influenza A infection affects a significant cohort of the global population annually, resulting in considerable morbidity and mortality. Therapeutic strategies...Full Text Available
A historical prospective mortality study was conducted on a cohort of 34 156 male members of a heavy construction equipment operators union with potential exposure to diesel exhaust emissions. This...Full Text Available
The purpose of this prospective cohort study was to identify factors that place a dairy cow with uncomplicated milk fever (MF) at significant risk of becoming an alert downer cow (ADC) and to verify...Full Text Available
BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available
IntroductionThe presence of erectile or ejaculatory dysfunction may indicate physical problems; however, individual perceptions (e.g., sexual satisfaction) may reflect...Full Text Available
Study objectiveThe study aim was to improve our understanding of the relationships between contextual socioeconomic characteristics and coronary heart disease (CHD)...Full Text Available
PurposeIn situ fixation for mild to moderate slipped capital femoral epiphysis (SCFE) remains an acceptable treatment methodology in most centers. Satisfactory fixation results have...Full Text Available
BackgroundDepressive mood is associated with mortality. Because personality has been found to be associated with depression and mortality as well, we aimed to test...Full Text Available
BackgroundEarly exposure to ovarian hormones is considered to increase breast cancer incidence. The age at which the ovaries become functional is thus important.Full Text Available
The risk of lung cancer associated with diesel exhaust has been calculated from 14 case-control or cohort studies. We evaluated the findings from these studies to determine whether there is sufficient...Full Text Available
BackgroundLoss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified...Full Text Available
ObjectiveThe purpose of the study was to assess the risk of CHD associated with excess weight measured by BMI and waist circumference (WC) in two large cohorts of...Full Text Available
BackgroundThe occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived...Full Text Available
BackgroundLymph node metastasis in endometrial cancer significantly decreases survival rate. Few data on the influence of intratumoral lymphatic microvessel density (LMVD) on survival...Full Text Available
ObjectivesTo assess whether bacterial vaginosis or chlamydial infection before 10 weeks' gestation is associated with miscarriage before 16 weeks.DesignProspective...Full Text Available
Despite numerous investigations, the correlation between alcohol consumption and prostate cancer risk remains uncertain. This report investigated the association between alcohol use and prostate cancer...Full Text Available
BackgroundAdhesive Capsulitis (AC) affects patient of all ages, and stretching protocols are commonly prescribed for this condition. Dynamic splinting has been shown effective in...Full Text Available
OBJECTIVE: The efficacy of Toto ointment and soap on common skin disorders was tested. METHODOLOGY: A cohort of Nigerians with common skin conditions such as fungal and bacterial skin infections, scabies,...Full Text Available
OBJECTIVESTo examine the association between α-blocker use and sexual dysfunction among men participating in a population-based cohort of...Full Text Available
From 1946 - 1990, i.e. from shortly after the end of World War II and the rise of the cold war until the German reunification, there had been extensive uranium mining both in Saxony and Thuringia, which formed the southern parts of the former German Democratic Republic. Mining activities started in Saxony in the Ore Mountains (German: Erzgebirge). Mining was conducted by a Soviet, since 1954 by a Soviet- German Incorporated Company named Wismut. It is estimated that about 400,000 persons may have worked in this time period with the company, most of them underground or in uranium ore processing facilities. In the early years, exposure to radiation and dust was particularly high for underground workers. After introduction of several ventilation measures and wet drilling from 1955 onwards, the levels of exposures to the various agents steadily decreased. After German reunification, it was decided by the German Federal Ministry for the Environment to save health data that were stored in ...
Thirty-six patients with acquired immunodeficiency syndrome (AIDS), who were febrile but without localizing signs, underwent indium-111 leukocyte scintigraphy 24 hours after injection of labeled white blood cells (WBCs) and were restudied 48 hours after injection of gallium-67 citrate. Fifty-six abnormalities were identified as possible sources of the fever; 27 were confirmed with biopsy. Of these 27, 15 were identified only on In-111 WBC scans (including colitis, sinusitis, and focal bacterial pneumonia); six, only on Ga-67 scans (predominantly Pneumocystis carinii pneumonia and lymphadenopathy); and six, on both studies (predominantly pulmonary lesions). In-111 WBC scanning revealed 21 of 27 abnormalities (78%) and gallium scanning, 12 of 27 (44%). If only one scintigraphic study has been performed, particularly with Ga-67, a significant number of lesions would not have been detected. The authors believe radionuclide evaluation of the febrile AIDS patient without ...
Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm pulsed dye laser should be considered in the ...
Recently, various types of allogeneic skin substitutes including cultured epidermal substitute (CES), cultured dermal substitute (CDS), and cultured skin substitute (CSS), which are composed of keratinocytes and/or fibroblasts as the cellular component(s), have been used as biological wound dressings. In our study, the allogeneic CDS was prepared by plating fibroblasts on a spongy collagen. The clinical evaluation was conducted using fresh or cryopreserved allogeneic CDS. In 145 of our clinical cases, 95% (138/145) of various wounds were evaluated as achieving good or excellent results, including 96% (22/23) of deep dermal burns (DDB) and dermal burns (DB), 100% (53/53) of partial-thickness donor wounds, 91% (21/23) of traumatic skin defects, 100% (5/5) of pressure ulcers, 82% (9/11) of chronic skin ulcers, 100% (6/6) of coverage for debrided DB, and 92% (22/24) of coverage for autologous meshed graft. The results obtained in our study suggest ...
Purpose: To report outcomes of a single institution study of stereotactic body radiotherapy (SBRT) for unresectable cholangiocarcinoma. The dose-volume dependency of the observed gastrointestinal toxicity is explored. Methods and materials: Twenty-seven patients with unresectable cholangiocarcinoma (n = 26 Klatskin tumours and one intrahepatic cholangiocarcinoma (IHCC)) were treated by linac-based SBRT. The dose schedule was 45 Gy in three fractions prescribed to the isocenter. Results: The median progression-free survival and overall survival were 6.7 and 10.6 months, respectively. With a median follow-up of 5.4 years, 6 patients had severe duodenal/pyloric ulceration and 3 patients developed duodenal stenosis. Duodenal radiation exposure was higher in patients developing moderate to high-grade gastrointestinal toxicity with the difference in mean maximum dose to 1 cm"3 of duodenum reaching statistical significance. A statistically significant association between ...
The aim of this study was to observe both the clinical signs and symptoms of wounds at risk of infection, that is critically colonised (biofilm infected) and antimicrobial-performance of an ionic silver alginate/carboxymethylcellulose (SACMC) dressing, in comparison with a non silver calcium alginate fibre (AF) dressing, on chronic venous leg and pressure ulcers. Thirty-six patients with venous or pressure ulcers, considered clinically to be critically colonised (biofilm infected), were randomly chosen to receive either an SACMC dressing or a non silver calcium AF dressing. The efficacy of each wound dressing was evaluated over a 4-week period. The primary study endpoints were prevention of infection and progression to wound healing. The SACMC group showed a statistically significant (P = 0.017) improvement to healing as indicated by a reduction in the surface area of the wound, over the 4-week study period, compared with AF controls. In ...
The first Brazilian historical mortality cohort study on miners was conducted. The cohort consisted of 3224 workers in the underground coal mining industry in southern Brazil. This industry has been operating since 1942 without compliance with any regulatory standards, since there were no relevant national regulations. Over almost 60 years, about 5000 workers were exposed to high levels of radiation. However, later radiation exposure was significantly reduced, particularly that due to radon exposure. Recent radon concentration measurements indicated an average annual exposure to radon progeny of 2.1 WLM, ranging from 0.2 to 7.2 WLM. As radon exposure in the past was unknown, it can be suggested that mine workers have not been working safely as regards the health hazard related to radon and radon progeny exposure. The cohort inclusion criteria are as follows: (a) all male employees who had worked for at least one year at the ...
We verified and corrected inaccuracies in descriptive profile information on military working dogs (MWDs) that died from 1965 to 1980 and were reported in the Armed Forces Institute of Pathology Registry of Veterinary Pathology. Using other available military records, we determined which dogs served in Vietnam. Identified were 3,895 MWDs with a unique identity tattoo that served in Vietnam, of which 2,389 served exclusively with U.S. military forces and died in Vietnam. Another 479 Vietnam veteran MWDs completed their service elsewhere. This overall effort resulted in signalment corrections, generally age at death, in 21% of the Registry MWD accessions during the study period. The improved definition and characterization of the Vietnam cohort will lead to greater precision in epidemiologic investigations of the health effects from the Vietnam experience in U.S. military working dogs. PMID:7885593
Abstract Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results...
Meningococcal disease is an infection caused by Neisseria meningitidis. Genetic factors contribute to host susceptibility and progression to disease, but the genes responsible for disease development are largely unknown. We report here a genome-wide association study for host susceptibility to meningococcal disease using 475 individuals with meningococcal disease (cases) and 4,703 population controls from the UK. We performed, in Western European and South European cohorts (consisting of 968 cases and 1,376 controls), two replication studies for the most significant SNPs. A cluster of complement factor SNPs replicated independently in both cohorts, including SNPs within complement factor H (CFH) (rs1065489 (p.936D
AbstractBACKGROUND: The authors chose to examine the association between body mass index (BMI) and incident colorectal cancer across the spectrum of BMI, including underweight persons, because detailed prospective cohort data on this topic in Asians is scarce, as is data on underweight persons (BMI, <18.5 kg/m2) in any population. METHODS: Analysis of the Singapore Chinese Health Study included 51,251 men and women aged 45-74 years enrolled in 1993-1998 and followed through 2007. Incident cancer cases and deaths among cohort members were identified through record linkage, and 980 cases were identified. Cox regression models were used to investigate the association of baseline BMI with risk of incident colorectal cancer during a mean of 11.5 years of follow-up. RESULTS: A significant, U-sha...
Epidemiological studies of psychopathology in the first years of life are few, and the association between mental health problems in infancy and psychiatric disturbances later in life has not been systematically investigated. The aim of the present project was to study mental health problems and possibilities of intervention from infancy and onward.
A population-based, cohort study was conducted to determine the importance of Gulf War deployment to Southwest Asia, from 1 August 1990 to 31 December 1991, in explaining neurologic mortality and peripheral nerve disease among United States military worki...
New ELISA assays were developed to measure immunoreactivity for XMRV. Antibody titers were measured in a cohort of prostate cancer cases and cancer free controls from the central United States. No statistically significant differences were observed in immunoreactivity between cases and controls for either the XMRV-env or the XMRV-gag antigen.
BackgroundSeventy percent of urban populations in sub-Saharan Africa live in slums. Sustaining HIV patients in these high-risk and highly mobile settings is a major future challenge....Full Text Available
AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available
BackgroundMore optimistic perceptions of cardiovascular disease risk are associated with substantively lower rates of cardiovascular death among men. It remains unknown whether this...Full Text Available
Background:Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified...Full Text Available
Between 1983 and 1986, 35 of 90 patients with acquired immunodeficiency syndrome (AIDS) had double-contrast esophagograms to rule out opportunistic esophagitis. The radiographs were reviewed without knowledge of the clinical or endoscopic findings. Candida esophagitis was diagnosed radiographically in 17 patients who had varying degrees of plaque formation and viral esophagitis in three who had discrete ulcers without plaques. All three patients with viral esophagitis (herpes in 2 and cytomegalo virus in one) and 15 of 17 with Candida esophagitis had endoscopic and/or clinical corroboration of the radiographic diagnosis. Thus, the authors' experience suggests that fungal and viral esophagitis can often be differentiated on double-contrast esophagography, so that appropriate antifungal or antiviral therapy can be instituted without need for endoscopic intervention.
Abstract Objectives: This investigation reviewed experimental studies of laser irradiation of wound healing in mice and rats published from 2003 to August 2008, respectively, to assess putative stimulatory effects of this treatment. Background: Animal models, including rodents, attempt to reflect human wound healing and associated problems such as dehiscence, ischemia, ulceration, infection, and scarring. They have played a key role in furthering understanding of underlying mechanisms involved in impaired wound healing, and in testing new therapeutic strategies including laser irradiation. Method: Original research papers investigating effects of laser or monochromatic light therapy on wound healing in mice and rats and published from January 2003 to August 2008 were retrieved from library...
BACKGROUND: Controversy exists as to whether patients with thick (Breslow depth >4 mm), clinically lymph node-negative melanoma require sentinel lymph node (SLN) biopsy. The authors examined the impact of SLN biopsy on prognosis and outcome in this patient population. METHODS: A review of the authors institutional review board-approved melanoma database identified 293 patients with T4 melanoma who underwent surgical excision between 1998 and 2007. Patient demographics, histologic features, and outcome were recorded and analyzed. RESULTS: Of 227 T4 patients who had an SLN biopsy, 107 (47%) were positive. The strongest predictors of a positive SLN included angiolymphatic invasion, satellitosis, or ulceration of the primary tumor. Patients with a T4 melanoma and a negative SLN had a significa...
A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29?cm from the incisors with a circumferential ulcer. Dilatation up to 17?mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3?months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone ...
Clostridium difficile (C. difficile) causes 25-30% of cases of antibiotic associated diarrhea and most cases of pseudomembranous colitis. Patients presenting with diarrhea after hospitalization for 3 or more days should be tested for C. difficile. There are many options available for testing, each of which has inherent advantages and disadvantages. Most laboratories perform toxin testing using an enzyme immunoassay method. In general these tests have sensitivities ranging from 60 to 70% and specificities of 98%. When using these methods, symptomatic patients with negative tests should be tested by another more sensitive method. Until recently, cell culture cytotoxicity neutralization assays (CCNAs) were considered the gold standard in the U.S. A two-step algorithm using an EIA for glutamate dehydrogenase detection followed by testing positives using CCNA, offered an improved alternative until the availability of molecular assays. Although early studies that ...
Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiation therapy for carcinoma of the oral tongue, especially about its faculty of local control and complications. Thirty-nine patients with squamous cell carcinoma of the oral tongue were treated with IOC radiation therapy alone or in combination with external irradiation. IOC radiation therapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiation therapy. The 2 year local control rates, including surgical salvage, for T1, T2, T3 and T4 were 100%, 73.3%, 40% and 0%, respectively. The 5 year actuarial survival rates for Stage I, II, III and IV were 100%, 65.3%, 35.4% and 0%, respectively. The incidences of radiation complications, i.e. soft tissue ulceration and osteoradionecrosis, were 42.9% and 2.9%, respectively. It is suggested that relatively high rate of soft tissue ulceration was due to ...
Recent advances in cell culture technology permit the generation of large stratified epithelial sheets appropriate for wound coverage. Autografts (sheets prepared from the patient's own skin) have proven life-saving in the treatment of large third-degree burns and have been successfully employed in the management of chronic ulcers. Allografts (sheets prepared from the skin of an unrelated donor) have also been used. In our experience, cultured allografts derived from neonatal foreskin provide a potent stimulus to healing in a variety of partial thickness wounds. Their application is a simple outpatient procedure which involves no discomfort for the patient. In contrast to autografting, no biopsy is necessary and use of cultured allogenic cells permits immediate grafts availability and possibility of stockpiling and preserving grafts for future use. Preparation of epithelial sheets suitable for grafting is also faster and easier with newborn than with adult donor ...
Background The relationships between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk remain unresolved. Methods We investigated prospectively the association between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk in a pooled analysis of primary data from 13 cohort studies. Among 731 441 participants followed for up to 6-20 years, 5604 incident colon cancer case patients were identified. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and then pooled using a random-effects model. All statistical tests were two-sided. Results Compared with nonconsumers, the pooled multivariable relative risks were 1.07 (95% CI = 0.89 to 1.30, Ptrend = ...
Although hearing loss has been the focus of national surveys in the civilian population, these surveys typically do not include occupational exposure information. Furthermore, very few studies have addressed this problem in the military, particularly in industrial settings. Audiometric data, including hearing loss information, recorded and stored in the prototype application of the Navy's Occupational Health Information Management System (NOHIMS) has not been systematically evaluated to identify military and civilian populations that are at high risk for hearing loss. The objective of this study was to determine the prevalence of hearing loss in a cohort of Navy civilian workers employed at an industrialized facility. It is both appropriate and timely to look at hearing loss among civilian workers, as well as among the military, especially in relation to the recent Presidential initiative that established a government-wide five year goal of reducing ...
Objective. So far, few data are available to characterize the flare history of patients with gout. The objective of this study was to describe the frequency and risk factors of gout flares with special consideration of the comorbidity. Methods. A cohort study was conducted in a UK general practice database (The Health Improvement Network) including all patients aged 20-89 years diagnosed with incident gout between the years 2000 and 2007. Results. In this study, 23 857 incident gout patients (mean age 61.9 years) were included, overall incidence rate was 2.68 (95% CI 2.65, 2.72) per 1000 person-years. The proportion of patients with at least one flare during the follow-up period (mean 3.8 years) was 36.9% (n = 8806). A history of ischaemic heart disease [hazard ratio (HR) 1.12 (95% CI 1.06...
The risk of lung cancer associated with diesel exhaust has been calculated from 14 case-control or cohort studies. We evaluated the findings from these studies to determine whether there is sufficient evidence to implicate diesel exhaust as a human lung carcinogen. Four studies found increased risks associated with long-term exposure, although two of the four studies were based on the same cohort of railroad workers. Six studies were inconclusive due to missing information on smoking habits, internal inconsistencies, or inadequate characterization of diesel exposure. Four studies found no statistically significant association. It can be concluded that short-term exposure to diesel engine exhaust (20 years) increases the risk of lung cancer for locomotive engineers, brakemen, and diesel engine mechanics. There is inconsistent evidence on the effects of long-term exposure to diesel exhaust in the trucking industry. There is no evidence for a ...
Summary Purpose BMS-275183 is an oral C-4 methyl carbonate analogue of paclitaxel that has the same mechanism of action, stabilization of tubulin polymerization. The present study was designed to: (i) assess the safety and tolerability of BMS-275183, and (ii) determine a suitable Phase II dose of BMS-275183 when given on a continuous daily schedule to patients with advanced solid tumor(s). Methods This was a multi-institutional, open-label, Phase I, single-arm dose escalation study in which cohorts of eligible patients with advanced malignancies were treated with BMS-275183 orally on a continuous daily schedule. The starting dose level was 6?mg/m2/day administered once daily. Cohorts of 3 patients were treated at each dose level provided no dose-limiting toxicities (DLTs) were observed. Ea...
The objectives of the research in the field of epidemiology , performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study. For radiobiology, the main objectives are: (1) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phase of its development, (2) to assess the genetic risks of maternal exposure to ionizing radiation, (3) to elucidate the mechanisms by which damage to the brain and mental retardation are caused in man after prenatal irradiation. The main achievements in these domains for 1997 are presented.
The focus of the Chernobyl Studies Project has now turned to the issue of health effects from the Chernobyl accident. Currently, we are involved in and making progress on the case-control and co-hort studies of thyroid diseases among Belarussian children. Dosimetric aspects are a fundamental part of these studies. We are working to implement similar studies in Ukraine. A major part of the effort of these projects is supporting these studies, both by providing methods and applications of dose reconstruction and by providing support and equipment for the medical teams.
We evaluated 190 children with very high-risk leukemia, who underwent allogeneic hematopoietic cell transplantation in 2 sequential treatment eras, to determine whether those treated with contemporary protocols had a high risk of relapse or toxic death, and whether non-HLA-identical transplantations yielded poor outcomes. For the recent cohorts, the 5-year overall survival rates were 65% for the 37 patients with acute lymphoblastic leukemia and 74% for the 46 with acute myeloid leukemia; these rates compared favorably with those of earlier cohorts (28%, n = 57; and 34%, n = 50, respectively). Improvement in the recent cohorts was observed regardless of donor type (sibling, 70% vs 24%; unrelated, 61% vs 37%; and haploidentical, 88% vs 19%), attributable to less infection (hazard ratio [HR] = 0.12; P = .005), regimen-related toxicity (HR = 0.25; P = .002), and leukemia-related death (HR = 0.40; P = .01). Survival probability ...
OBJECTIVE: To evaluate the association between fatty acid (alpha-linolenic acid (ALA), EPA, DHA, palmitic, stearic, oleic, linoleic and arachidonic acids) intake and prospective weight change in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition. DESIGN: Prospective cohort study with mean follow-up time of 6.5 years. In a total of 9182 men and 10867 women aged 35 to 64 years, from body weight measurement at recruitment and calibrated body weight during follow-up, weight change was expressed as mean annual weight change relative to baseline weight (%/year) and categorised into four groups (weight loss, or =2.5 to or =7.5%/5 years). Energy-adjusted dietary fatty acid intake data were estimated from the FFQ completed at baseline. Multivariate linear regression models as well as multinomial logistic regression analyses (carbohydrate replacement models) were conducted. RESULTS: Stearic acid intake was linearly ...
The interest for medicinal plants has raised again in the last decades, after overcoming a declination period caused by the advances in the researches and development of the synthetic drugs industries. This growing interest has been stimulated mainly by searching cheap and accessible alternative therapies. However, in order to have natural products based treatment in an efficient and safety way, it is necessary to guarantee the plant authenticity, finding adulterations and to assure a low level of microbiological contaminations to avoid damages to consumer's health. The decontamination method should be chosen for eliminating or reduce the microorganisms level without loss of the plant active constituents that would destroy its therapeutic action. At the present work, the possibility of using #gamma# and X electromagnetic radiations to sterilize a Brazilian medicinal plant (Maytenus aquifolium Martius, Celastraceae), which shows anti-ulcer activity, was studied by ...
Between 1970 and 1981, 348 patients underwent definitive irradiation. Of these patients 6 (1.7 per cent) sustained severe rectal injury as manifest by major rectal bleeding, rectal stricture, rectal mucosal slough and rectal ulceration. Severe rectal injury was observed in 0 of 13 patients (0 per cent) treated with 125iodine, 3 of 329 (1 per cent) treated with 6,400 to 6,800 rad external irradiation, 2 of 39 (5 per cent) treated with 7,000 to 7,300 rad external irradiation, and 1 of 7 (14 per cent) treated with 198gold and external irradiation. The impact of radiation dose, radiation therapy technique and surgical trauma was assessed. Rectal injury was managed by supportive measures in 2 patients and by diverting colostomy in 3 with benefit. One patient underwent abdominoperineal resection. A small bowel fistula and an intra-abdominal abscess developed, and the patient died.
Maytenus ilicifolia Mart. ex Reissek is traditionally used in Brazil for treatment of gastric ulcers. Here we report the phytochemical investigation of an ethanol extract of M. ilicifolia leaves (EEMIL) aiming at the isolation of constituents which were used as chemical markers to monitor an activity-guided fractionation of a lyophilized aqueous extract of M. ilicifolia leaves (LAEMIL). From EEMIL, four flavonoids were isolated, namely the tri-flavonoid glycosides mauritianin (1), trifolin, (2) hyperin (4), and epi-catechin (5). Fractionation of LAEMIL led to 5 fractions which afforded the tetra-glycoside kaempferol derivative (3), and galactitol (6). LAEMIL and its fractions were evaluated in rats for their effects on gastric secretion volume and pH. HPLC (High Performance Liquid Chromatography) analysis revealed that only fractions containing the tri- and tetra-flavonoid glycosides 1 and 3 caused significant increase of gastric volume and pH, thus indicating that ...
Aim: To evaluate the usefulness of routine laboratory parameters in the decision to treat refractory cardiac arrest patients with extracorporeal life support (ECLS). Methods: Sixty-six adults with witnessed cardiac arrest of cardiac origin unrelated to poisoning or hypothermia undergoing cardiopulmonary resuscitation without return of spontaneous circulation (duration: 155min [120-180], median, [25-75%-percentiles]) were included in a prospective cohort-study. ECLS was implemented under cardiac massage, using a centrifugal pump connected to a hollow-fiber membrane-oxygenator, aiming to maintain ECLS flow >=2.5l/min and mean arterial pressure >=60mmHg. Results: Forty-seven of 66 patients died within 24h from multiorgan failure and massive capillary leak. Of 19/66 patients who survived >=24h...
Abstract Toll-like receptor 2 (TLR2) is an immune sensor for gram-positive bacterial cell wall components. Single-nucleotide polymorphisms (SNPs) in the TLR2 gene that impair its function may, therefore, influence the risk and outcomes of gram-positive bacterial infections. In a cohort of 694 liver transplant recipients, we assessed the TLR2 SNP that is translated into an amino acid substitution of arginine for glutamine at position 753 (R753Q), and we found that its presence was associated with the clinical characteristics and outcomes of gram-positive bacterial infections. The proportions of patients with the TLR2 R753Q SNP did not significantly differ between those with gram-positive bacterial infections and those without gram-positive bacterial infections (9.6% versus 9.6%, P = 0.999)....
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectatio...
Objectives: Evaluate the effect of diet, physical exercise, and a daily oral intake of a soy isoflavones extract (Fisiogen) contained 200mg of Glycine max, which corresponded to 80mg of isoflavone (60.8mg of genistein, 16mg of daidzein and 3.2mg of glicitein) on leptin and other adipokines plasma levels in healthy obese postmenopausal women. Methods: A multicentric randomized longitudinal prospective cohort study was conducted in a sample of 87 healthy obese postmenopausal women. Patients were randomly assigned to a 1200kcal diet and exercise group (control group) or a group of 1200kcal diet, exercise, and daily oral intake of daily oral intake of a soy isoflavones extract (Fisiogen) contained 200mg of Glycine max, which corresponded to 80mg of isoflavone (60.8mg of genistein, 16mg of daid...
The relationship of lead exposure to blood pressure has been examined in a longitudinal study of a cohort of 89 Boston, Massachusetts, policemen. At the baseline examination, subjects had a blood lead determination and three consecutive blood pressure measurements. Triplicate blood pressure measurements were also taken at years 3, 4, and 5. Multivariate analysis revealed that, after correction for previous systolic blood pressure, body mass index, age, and smoking, a high level of blood lead was a significant predictor of subsequent elevation of systolic pressure. Bootstrap simulations of these models provided supporting evidence for the observed associations. These data suggest that lead exposure can significantly affect systolic pressure.
Objective Comorbidities predisposing cardiac surgical patients toward deep sternal wound infection, such as diabetes and obesity, are rising in the United States. Longitudinal analysis of risk factors, morbidity, and mortality was performed to assessed effects of these health trends on deep sternal wound infection rates. Methods In this retrospective analysis of all median sternotomies performed at a single institution from 1991 through 2006, demographic and surgical characteristics were identified from a prospective database. The cohort was separated into periods from 1992 through 2001 and 2002 through 2006 to identify longitudinal trends in risk factors for deep sternal wound infection. Univariate and matched multivariable analyses were performed. Results Overall, study population had in...
Background and aimModification of low-density lipoprotein due to oxidative stress is essential in the development of coronary atherosclerosis. Data of specific carotenoids except b-carotene on cardioprotective effects in humans are limited. Methods and resultsThis study examined the associations between plasma concentrations of specific carotenoids and incidence of acute myocardial infarction. The study included 280 incident cases of acute myocardial infarction and 560 matched controls nested within the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women aged 45-74 years old enrolled in 1993-1998 in Singapore. Retinol and carotenoids in prediagnostic plasma were quantified using high-performance liquid chromatography. High levels of plasma b-cryptoxanthin a...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml...
SummaryPurposeWomen with epilepsy have increased frequency of reproductive health problems compared to women without epilepsy. In puberty, reproductive hormonal changes during sexual maturation may affect epilepsy and induce the debut of seizures as indicated in some studies. On the other hand, epileptic activity affects sex hormone function, which may induce alterations in pubertal endocrine maturation and thereby menarche age. We wanted to investigate the relation between epilepsy and menarche age in a larger population of female epilepsy patients.MethodsA retrospective, questionnaire study of a cohort of 265 female outpatients from three Norwegian hospitals and 142 controls, aged 18-45 years was conducted. Parameters regarding epilepsy and reproductive health issues were registered. Per...
Objectives To delineate the safety and tolerability profile of methylphenidate and atomoxetine in children and adolescents with attention deficit hyperactivity disorder (ADHD) monitored for more than 1?year. Design A cohort study analyzing data from the national ADHD register on patients from the Lombardy Region treated with MPH or atomoxetine. Participants A total of 229 children (median age 11?years, range 6?17), enrolled in 15 regional centers between June 2007 and May 2010. Results The prevalence rate of pharmacological treatment for ADHD was 0.23%, whereas the estimated ADHD prevalence in the population was 0.95%. In total, 73.8% of patients had been treated with atomoxetine (10?90?mg daily) or MPH (10?75?mg daily); 22% of patients also received an additional psychotropic drug. Of the...
We investigated the presence of XMRV in a cohort of Quebec patients with chronic fatigue syndrome (CFS). DNA was purified from activated peripheral blood mononuclear cells (PBMCs) and PCR was used to detect XMRV gag and env in 72 patients. Anti-XMRV antibodies were searched in sera of 62 patients by Western blot analysis. Attempts to detect XMRV antigens was made, using immunofluorescence with Gag anti-p30 antiserum on activated PBMC from 50 patients. Plasma viremia was measured by RT-PCR on 9 subjects. Finally, detection of infectious virus in 113 CFS subjects was made by co-culture of PHA+IL-2 activated PBMC with human LNCaP carcinoma cells, and by infecting the same susceptible cells with plasma, using a reverse transcriptase (RT) assay as a readout in both experiments. No detection of ...
Aims and objectives.- To investigate infant well-being as measured by feeding and sleeping and parental support following discharge from the NICU in infants following major cardiac surgery. Background.- Infant feeding and sleeping have been identified as two of the most important concerns reported by parents. These concerns have been reported anecdotally for infants who have undergone cardiac surgery in the neonatal period. Design.- A prospective study using questionnaires and phone interviews followed a cohort of parents of neonates who underwent surgery in the neonatal period for congenital heart disease. Methods.- The study was conducted using validated questionnaires and phone interviews with a semi-structured questionnaire. The questionnaires were administered prior to discharge from ...
The main objectives of research in the field of health effects at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study; (4) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phases of its development; (5) to assess the genetic risks of material exposure to ionizing radiation; (6) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (7) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas for 1997 are reported.
PurposeAlthough the safety and feasibility of partial adrenalectomy in patients with von Hippel-Lindau syndrome have been established, long-term outcomes have not been examined. In this study we evaluate the recurrence and functional outcomes in a von Hippel-Lindau syndrome cohort treated for pheochromocytoma with partial adrenalectomy with a followup of at least 5 years. Materials and MethodsWe reviewed the records of patients with von Hippel-Lindau syndrome treated with partial adrenalectomy for pheochromocytoma at the National Cancer Institute. Demographic, germline mutation status, surgical indication, oncologic and functional outcome data were collected. Local recurrence was defined as radiographic evidence of recurrent tumor on the ipsilateral side of partial adrenalectomy. Patients ...
Clin. Otolaryngol. 2009, 34, 438-446. Objective: To determine whether economic costs associated with a conservative management strategy for unilateral acoustic neuroma offer an economic advantage over active management options. Design: Cost and sensitivity analysis on a prospective cohort. Setting: Single centre study within a tertiary referral centre in Toronto, Canada. Participants: 72 patients (32 males, 40 females) aged 36 to 78 years with unilateral acoustic neuroma were assigned initially to a conservative management strategy. Entry criteria were small tumour size (less than 15mm in the cerebellopontine angle), patient preference and/or significant co-morbidity. Interventions: MRI scanning was performed every 6 months for the first year, annually subsequently and then every 2-3 years...
BACKGROUND.The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) covers the direct clinical costs of breast and cervical cancer screening and diagnostic follow-up for medically underserved, low-income women. Personal costs are not covered. In this report, the authors estimated personal costs per woman participating in NBCCEDP mammography screening by race/ethnicity and also estimated lifetime personal costs (ages 50-74 years).METHODS.A decision analysis model was constructed and parameterized by using empiric data from a retrospective cohort survey of mammography rescreening among women ages 50 years to 64 years who participated in the NBCCEDP. Data from 1870 women were collected from 1999 to 2000. The model simulated the flow of resources incurred by a woman participat...
Purpose In literature, few papers compare different hemostatic devices in laparoscopic adrenalectomy. This sequential cohort study analyzes the outcomes of laparoscopic adrenalectomy performed by different hemostatic instruments, to evaluate if any of them has any advantage over the other and as secondary endpoints, the impact of body mass index (BMI) and tumor size on the indication, and the outcome of laparoscopic adrenalectomy. Methods Forty-six patients, aged 54.6???46?years, underwent laparoscopic adrenalectomy over 5?years. Mean BMI was 27???4.8?kg/m2. Twenty-four patients had a left tumor, and 22 had a right one. Patients were divided into two groups according to the hemostatic device: Ultracision was used in 26 patients, and Ligasure was used in 20. Groups were well matched for his...
AbstractBackground: Certolizumab pegol (Cimzia, CZP) was approved for the treatment of Crohn's disease (CD) patients in 2007 in Switzerland as the first country worldwide. This prospective phase IV study aimed to evaluate the efficacy and safety of CZP over 26 weeks in a multicenter cohort of practice-based patients. Methods: Evaluation questionnaires at baseline, week 6, and week 26 were completed by gastroenterologists in hospitals and private practices. Adverse events were evaluated according to World Health Organization (WHO) guidelines. Results: Sixty patients (38F/22M) were included; 53% had complicated disease (stricturing or penetrating), 45% had undergone prior CD-related surgery. All patients had prior exposure to systemic steroids, 96% to immunomodulators, 73% to infliximab, and...
Background Despite potentially relevant chemical differences between filtered and boiled coffee, this study is the first to investigate consumption in relation to the risk of incident cancer. Methods Subjects were from the V?sterbotten Intervention Project (64,603 participants, including 3,034 cases), with up to 15?years of follow-up. Hazard ratios (HR) were calculated by multivariate Cox regression. Results No associations were found for all cancer sites combined, or for prostate or colorectal cancer. For breast cancer, boiled coffee ?4 versus <1 occasions/day was associated with a reduced risk (HR?=?0.52, CI?=?0.30?0.88, p trend?=?0.247). An increased risk of premenopausal and a reduced risk of postmenopausal breast cancer were found for both total (HRpremenopausal?=?1.69, CI?=?0.96?2.98...
Atrial fibrillation (AF) is common after coronary artery bypass grafting (CABG) and increases the morbidity and cost. Amiodarone reduces AF after CABG. Ranolazine, an antianginal agent, also prolongs atrial refractoriness and inhibits after depolarizations and triggered activity; effects that could decrease AF after CABG. The present study compared amiodarone versus ranolazine for the prevention of AF after CABG. A retrospective cohort study of patients undergoing CABG at Aspirus Hospital from June 2008 to April 2010. The patients received either amiodarone (400 mg preoperatively followed by 200 mg twice daily for 10 to 14 days) or ranolazine (1,500 mg preoperatively followed by 1,000 mg twice daily for 10 to 14 days). The primary end point was any identified AF after CABG. A total of 393 ...
Objective To demonstrate clinical features of a patient subgroup presenting with polycystic ovary syndrome (PCOS) without polycystic ovary morphology. Design Retrospective study. Setting Hospital-based IVF center. Patient(s) In the present study, 876 PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital, Shandong University, between September 2004 and October 2006. Women with PCOS were divided into two groups based on ultrasound image: group A, PCOS patients with classic polycystic ovary (n = 800); group B, PCOS patients without polycystic ovary morphology (n = 76). The following available data were analyzed in the large cohort of women: body height, weight, waistline, hip circumference, hirsutism scores, family history, serum s...
Abstract This study explored the demographic and diagnostic features of children who were currently receiving antipsychotics compared to children who were receiving other psychotropics in a cohort of children with and without elevated symptoms of mania (ESM). Participants were recruited from 10 child outpatient mental health clinics associated with four universities. Guardians with children between 6?12 years who presented for new clinical evaluations completed the Parent General Behavior Inventory-10 Item Mania Scale (PGBI-10M). All children who scored ?12 on the PGBI-10M and a select demographically matched comparison group of patients who scored ?11 were invited to participate. Children were divided into two groups: those receiving at least one antipsychotic medication and those receivi...
Excessive physical activity plays an important role in the progression of anorexia nervosa (AN) by accelerating weight loss during dietary restriction. To search for mechanisms underlying this trait, a panel of mouse chromosome substitution strains derived from C57BL/6J and A/J strains was exposed to a scheduled feeding paradigm and to voluntary running wheel (RW) access. Here, we showed that A/J chromosomes 4, 12 and 13 contribute to the development of a disrupted RW activity in response to daily restricted feeding. This pattern is characterized by intense RW activity during the habitual rest phase and leads to accelerated body weight loss. Regions on mouse chromosomes 4, 12 and 13 display homology with regions on human chromosomes linked with anxiety and obsessionality in AN cohorts. The...
AbstractBackground Few published data are available on the benefits of aspirin use in patients with unstable angina (UA). Hypothesis Aspirin use carries a mortality benefit in a population-based cohort of patients presenting with UA. Methods All residents of Olmsted County, Minnesota presenting to local emergency departments with acute chest pain from January 1985 through December 1992 having symptoms consistent with UA were identified through medical records. A total of 1628 patients were identified with UA and were stratified by aspirin use in-hospital and at discharge. Cardiovascular mortality and nonfatal myocardial infarction and stroke were assessed over a median of 7.5 years follow-up and all-cause mortality data over a median of 16.7 years. The mean age of patients with UA was 65 y...
An observational cohort study was conducted to compare the performance of the RIFLE (risk, injury, failure, loss and end-stage kidney disease), AKIN (acute kidney injury network) and conventional graded criteria to identify acute kidney injury (AKI) following SCT and to predict long-term mortality in 141 myeloablative allogeneic SCT (m-allo), 60 non-myeloablative allogeneic SCT (nm-allo) and 48 autologous SCT (auto) cases. The AKIN criteria had less ability to identify patients as having the lowest category, stage 1 (analogous to RIFLE risk): 33% (37%) in m-allo, 23% (32%) in nm-allo and 8.3% (16.7%) in auto. Cox regression showed that categories higher than the intermediate stage were independent predictors of mortality in all three definitions. The areas under receiver operating characte...
The survival of acetabular components depends on several factors: wear, osteolysis and septic or aseptic loosening. Osteolysis seems to be the main cause for concern in cementless arthroplasties. Acetabular osteolysis results from particle debris and segmental unloading of acetabular bone by rigid sockets. We investigated a cementless elastic monoblock socket with regard to acetabular osteolysis and aseptic loosening in a cohort of young patients. We evaluated 158 hip arthroplasties with a minimum follow-up of ten?years (ten to 18) and a mean age of 42?years (18?50). The overall revision rate at 14?years was 80% with a 98% survival rate for aseptic loosening. The mean polyethylene wear rate was 0.11?mm/year. Progressive acetabular osteolysis was seen in 3% of patients evaluated. In conclus...
B vitamins and polymorphisms in genes coding for enzymes involved in one-carbon metabolism may affect DNA synthesis and methylation and thereby be implicated in carcinogenesis. Previous data on vitamins B2 and B6 and genetic polymorphisms other than those involving MTHFR as risk factors for gastric cancer (GC) are sparse and inconsistent. In this case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort, cases (n = 235) and controls (n = 601) were matched for study center, age, sex, and time of blood sampling. B2 and B6 species were measured in plasma, and the sum of riboflavin and flavin mononucleotide was used as the main exposure variable for vitamin B2 status, whereas the sum of pyridoxal 5'-phosphate, pyridoxal, and 4-pyridoxic acid was used to define vitamin B6 status. In addition, we determined eight polymorphisms related to one-carbon metabolism. Relative risks for GC risk were calculated with conditional ...
We have developed refined statistical and modeling techniques to assess low-level uptake and urinary excretion of plutonium from different population group in the northern Marshall Islands. Urinary excretion rates of plutonium from the resident population on Enewetak Atoll and from resettlement workers living on Rongelap Atoll range from <1 to 8 {micro}Bq per day and are well below action levels established under the latest Department regulation 10 CFR 835 in the United States for in vitro bioassay monitoring of {sup 239}Pu. However, our statistical analyses show that urinary excretion of plutonium-239 ({sup 239}Pu) from both cohort groups is significantly positively associated with volunteer age, especially for the resident population living on Enewetak Atoll. Urinary excretion of {sup 239}Pu from the Enewetak cohort was also found to be positively associated with estimates of cumulative exposure to worldwide fallout. Consequently, the ...
Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age ...
BACKGROUND: The aetiologies of glioma and meningioma tumors are largely unknown. Although reproductive hormones are thought to influence the risk of these tumors, epidemiologic data are not supportive of this hypothesis; however, few cohort studies have published on this topic. We examined the relation between reproductive factors and risk of glioma and meningioma among women in the European Prospective Investigation into Cancer and Nutrition (EPIC).METHODS: After a mean of 8.4 years of follow-up, 193 glioma and 194 meningioma were identified among 276,212 women. Information on reproductive factors and hormone use was collected at baseline. Cox proportional hazard regression was used to determine hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: No associations were observed between glioma or meningioma risk and reproductive factors, including age at menarche, parity, age at first birth, menopausal status, and age at menopause. A higher risk of ...
We conducted a retrospective review of the North American Renal Transplant Cooperative Study (NAPRTCS) Registry transplant and dialysis arms to assess anemia and growth patterns in children who returned to dialysis after a failed renal transplant from January 1, 1992 to February 3, 2004. Of the 1807 potential study subjects, 1451 had transplant removal data (TxIn vs. TxOut) available for analysis. Four hundred and twenty-one of 1451 patients (29%) had a transplant nephrectomy at the time of entry into the NAPRTCS Registry Dialysis arm. Anemia rates steadily decreased from 72.2% at 30 days after dialysis initiation to 59.5% at 12 months after dialysis initiation. Factors associated with anemia at 30 days after dialysis initiation included hemodialysis, lack of Epo use, and patients who comprised earlier study era cohorts. At one yr after return to dialysis, earlier study cohort era was the only factor associated with anemia status. Patients did ...
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was diagnosed in eight patients, and multifocal ...
Full text: Many factors including drug efficacy, compliance and antibiotic resistance may influence HP eradication rates. The "1"4C urea breath test is a sensitive method of confirming HP colonisation and eradication. The aim was to study the relationships between the peak "1"4CO_2 counts on the breath test prior to treatment, smoking and HP eradication, and to assess if persistent or recurrent symptoms implied failure of eradication. 117 patients with DU and HP colonisation proved on biopsy or rapid urease test who underwent "1"4C urea breath tests at least one month after eradication treatment was ceased were studied (69 male, 48 female, mean age 41, range 26-87 y). Questionnaire assessment of treatment regimen, smoking history and dyspeptic symptoms was made at the time of the breath test. A sub-group of 43 patients who had pre- and post-treatment breath tests was studied to assess if high peak "1"4CO_2 counts on the pre-treatment breath test related to treatment success. The mean ...
Purpose: Patients with mycosis fungoides [cutaneous T-cell lymphoma (CTCL)] may benefit from adjuvant therapy after completing total skin electron beam therapy (TSEBT). We report the results for (T1(T2)) CTCL patients treated with adjuvant oral psoralen plus ultraviolet light (PUVA) with respect to overall survival (OS), disease-free survival (DFS), salvage of recurrence, and toxicity. Methods and Materials: Between 1974 and 1993, TSEBT was administered to a total of 213 patients with CTCL. Records were reviewed retrospectively, and a total of 114 patients were identified as having T1 or T2 disease. Radiotherapy was provided via a 6-MeV linac to a total of 36 Gy, 1 Gy/day, 4 days/week, for 9 weeks. Beginning in 1988, patients were offered adjuvant PUVA within 2 months of completing TSEBT. This was started at 0.5-2 J/m"2, 1-2 treatments/week, with a taper over 3-6 months. Therapy then continued once per month. There were 39 T1 and 75 T2 patients. Six T1 (15%) and eight T2 (11%) patients ...
The role of nurse practitioner has been established because of a shortage of doctors. In May 2007, the first cohort of 582 nurse practitioners were licensed in Taiwan. The post of nurse practitioner in Taiwan is formally moving towards systematization and the most urgent matters in that regard are the sorting out of contentious issues and the establishment of clear job descriptions. Competence in critical thinking and problem-based learning is important and has to be improved with practice. The application of teaching assessment tools such as direct observation procedural skills (DOPS), objective structured clinical examination (OSCE), miniclinical evaluation exercises (Mini-CEX), and 360 degree assessments may contribute to the improvement of nurse practitioners' skills in conducting research, appraising evidence-based nursing literature, and developing teaching strategies and advanced systems by making policy clear, evaluating, auditing and monitoring the ...
Primary adenocarcinomas of the urinary bladder are uncommon, and the molecular pathways are currently not well defined. In this study, we assessed the association between biologic markers and clinicopathologic characteristics in a cohort of 21 patients with primary urinary bladder adenocarcinoma. Immunohistochemical staining for cell cycle-specific markers, including p53, p21, p27, Ki-67, and cyclin E, were performed on sections of a tissue microarray construct. The tumors were high grade in 12 (57%) and pT2 or higher in 18 (86%); lymph nodes were involved in 6 cases (29%); and there was pathologic evidence of schistosomiasis in 14 (67%). The best prognostic combination of markers was combined alterations in p27 and Ki-67 and was associated with stage (P = .012), grade (P = .005), DNA ploidy (P = .005), and lymph node involvement (P = .04). Stage, lymph node involvement, combined alterations of p27 and Ki-67, and combined alterations of all 5 biomarkers were ...
To maintain operational readiness, military personnel engage in vigorous physical and training activities that carry risk for injury. A 1-year prospective cohort study, starting April 1996, was conducted at Fort Bragg, North Carolina among 1,965 members of the 82nd Airborne Division to quantify musculoskeletal injuries. Information collected included type of injury, site, circumstances, and resultant limited duty days. These soldiers suffered 508 overuse injuries (including 38 stress fractures), 1,415 traumatic injuries (including 100 fractures), and 101 unclassified injuries. Injury rates were 6.8% per soldier per month for traumatic injury and 2.4% for overuse injury (totaling 1.2 injuries per soldier per year). Injuries resulted in 22,041 limited duty days, averaging 11 days per injury and 13 days per soldier (4.5% of total workdays). Fractures and stress fractures/reactions produced the most days lost per case. Most of these injuries resulted from ...
Central Nervous System (CNS) involvement, whether primary by the Human Immunodeficiency Virus - HIV - itself, or secondary (toxoplasmosis or lymphoma) is remarkably frequent in AIDS, in 40 to 70% of cases, depending upon the author. In order to study the natural history of this illness, a cohort of 25 asymptomatic seropositive patients have been established. Every 6 months these patients undergo biological and clinical examinations, as well as Magnetic Resonance brain scans. After two examinations at a 6 month's interval, the first results are reported. Out of these 25 cases, 9 present anomalies: One patient with diffuse cerebral atrophy and 8 others with high signal intensity areas on T2 weighted sequences, like those of the Multiple Sclerosis. No relationship could be demonstrated between the existence of these lesions and various criteria such as age, sex, risk factors and T4 cells count. The nature of these lesions is not lear. They certainly indicate early ...
A cohort of singleton black human females exposed to diagnostic x-ray in utero and controls matched by parity, hospital of birth and birthdate have been followed to ages 25 to 30 years in Baltimore, Maryland. The search for possible effects of prenatal irradiation has focused on health, growth, development, and reproductive experience of exposed and control women. This paper reports findings related to reproductive experience. From an original data set of 1458 matched exposed-control pairs of women, questionnaire responses were received from 1109 exposed and 1124 control women including 852 each from pairs in which both the exposed and control woman responded. After careful search for alternative explanations of the findings, the authors concluded that females exposed in utero to low doses of x-ray (probably 1 to 5 rads) had significant increases in their rates of early onset of menses, births at age 15 years or less, numbers of living children, stillbirths, and ...
ObjectivesThe main objective of this study is to address the following specific questions: 1. Are the delayed effects of poor early diet on whole organism performance and senescence contingent on, or exacerbated by, the subsequent occurrence of compensatory growth? 2. Does the rate of growth influence levels of resting metabolism and/or oxidative stress, and if so, for how long does this persist? 3. How are the levels of early nutrition, growth, resting metabolism and oxidative stress linked to the lev [continued...]DescriptionIt is now widely appreciated that, while animals may appear to recover from periods of poor food quality or quantity experienced in early development, adverse effects may occur later in adult life. Such effects can influence the performance of complete cohorts of animals, and have important consequences for population dynamics. The reasons why such delayed effects occur across the animals' lifetimes are poorly understood. Following a period ...
Ionizing radiation dose levels due to home radon can rise to levels that would be illegal for workers in the nuclear industry. It is well known that radon levels within homes and from home to home, and also from month to month, vary considerably. To define an Isle of Man radon seasonal correction factor, readings were taken in eight homes over a 12 month period. An average island indoor exposure of 48 Bq m{sup -3} (range 4-518 Bq m{sup -3}) was determined from 285 homes selected from a cohort of 1300 families participating in the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) in the Isle of Man. This compares with a UK home average of 20 Bq m{sup -3} and a European Union average (excluding UK) of 68 Bq m{sup -3}. Ten homes of those measured were found to have radon levels above the National Radiological Protection Board 200 Bq m{sup -3} action level. There are 29 377 homes on the Isle of Man, suggesting that there could be some 900 or more homes ...
Abstract Aims: This study performed a systematic review and meta-analysis on glycemic control and pregnancy outcomes in women with type 1 diabetes mellitus (T1DM) treated with lispro (LP) versus regular insulin (RI) since before pregnancy. Methods: We performed a MEDLINE and EMBASE search. Abstracts (and full articles when appropriate) were reviewed by two independent researchers. Inclusion criteria were patients with T1DM, data on women treated with RI and LP since before pregnancy until delivery in the same article, at least five pregnancies in each group, and information on at least one pregnancy outcome. Quality assessment was performed using the Newcastle?Ottawa Quality Assessment Scale for cohort studies. Results: Outcome data were summarized with Revman version 5.0 (ims.cochrane.org...
These summary descriptive data of ethnically similar cohorts of indigenous and migrant Japanese males have shown similarities or slight differences in characteristics wholly or largely genetically determined, such as blood groups, stature, and skeletal size. Differences have been noted in characteristics largely environmental or behavioral, such as diet and cigarette smoking habit, as well as in characteristics determined by a varying mixture of genetic and environmental influences, such as weight, blood pressure, glucose tolerance, and serum lipid and uric acid levels. Detailed analyses of the distributions of laboratory variables, of dietary data obtained by different methods, and of correlations among laboratory, dietary, physical, and demographic variables are currently in progress. Also part of the study plan are determinations of disease prevalence from evaluation of examination, laboratory, and electrocardiographic findings, of disease incidence from repeat ...
Objective To compare the levels of interleukin (IL)-1?, IL-6, and matrix metalloproteinase (MMP)-8 in the vaginal secretions of pregnant women with a positive fetal fibronectin (fFN) test result with or without asymptomatic bacterial vaginosis (BV) before and after treatment with oral clindamycin. Methods A prospective cohort study was conducted among 43 pregnant women with a positive fFN test result. All patients were treated with clindamycin, and the pre- and post-treatment levels of IL-1?, IL-6, and MMP-8 were compared. Results Before treatment, levels of IL-1? and MMP-8 were significantly higher in women with BV compared with women without BV (P<0.05). Vaginal levels of IL-1? and IL-6, but not MMP-8, decreased after treatment in pregnant women with BV. Conclusions The inability of clin...
Mammography has emerged as a reliable non-invasive technique for the early detection of breast cancer--the second leading cause of cancer-related mortality among American women. The radiographic appearance of the female breast consists of radiolucent (dark) regions due to fat and radiodense (light) regions due to connective and epithelial tissue. The amount of radiodense tissue can be used as a marker for predicting breast cancer risk. This paper presents the development of an algorithm for estimating the percentage of radiodense tissue in a digitized mammogram. The technique involves determining a dynamic threshold for segmenting radiodense indications in mammograms. Both the mammographic image and the threshold are modeled as Gaussian random variables. This work is intended to support a concurrent study at the Fox Chase Cancer Center (FCCC) exploring the association between dietary patterns and breast cancer risk. Mammograms have been obtained from an existing ...
Abstract Aims To determine the long-term health economic benefits associated with lispro vs. regular human insulin (RHI) in UK Type 1 diabetic (T1DM) patients using the previously published and validated CORE Diabetes Model. Methods A literature review designed to capture clinical benefits associated with lispro and T1DM cohort characteristics specific to UK was undertaken. Clinical benefits were derived from a Cochrane meta-analysis. The estimated difference (weighted mean) in glycated haemoglobin (HbA1c) was -0.1% (95% confidence interval -0.2 to 0.0%) for lispro vs. RHI. Severe hypoglycaemia rates for lispro and RHI were 21.8 and 46.1 events per 100 patient years, respectively. Costs and disutilities were accounted for severe hypoglycaemia rates. All costs were accounted in 2007 UK from...
Childhood anxiety is impairing and associated with later emotional disorders. Studying risk factors for child anxiety may allow earlier identification of at-risk children for prevention efforts. This study applied an ecological risk model to address how early childhood anxiety symptoms, child temperament, maternal anxiety and depression symptoms, violence exposure, and sociodemographic risk factors predict school-aged anxiety symptoms. This longitudinal, prospective study was conducted in a representative birth cohort (n = 1109). Structural equation modeling was used to examine hypothesized associations between risk factors measured in toddlerhood/preschool (age = 3.0 years) and anxiety symptoms measured in kindergarten (age = 6.0 years) and second grade (age = 8.0 years). Early child risk factors (anxiety symptoms and temperament) emerged as the most robust predictor for both parent-and child-reported anxiety outcomes and mediated the effects of maternal and ...
Population residing in the northern part of the Chelyabinsk oblast and the south eastern part of the Sverdlovsk oblast of Russia affected to accidental exposure since 1957. The territory (East Ural Radioactive Trace - EURT) was contaminated after explosion of container with highly radioactive wastes at the Mayak Production Association. Studies of health effects of exposure in the southern, head part of EURT are conducted in the Ural Research and Practical Center of Radiation Medicine (U.R.P.R.M.). In the 1990's U.R.P.C.R.M. formed a cohort of EURT within Chelyabinsk oblast (14,500 cases and 19,400 external controls). The cohort was followed in 1957-1987 and the results of the study are discussed by Crestinina et al. First results of study on exposure late health effects among rural population in the northern part of the EURT are presented in this paper. Firstly, or the period 1958-2000 a statistically significant increase in cancer ...
The aim of this study was to document vascular complications that occurred following cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allograft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein thrombosis (n = 7; 0.5%). ...
The incidence of anogenital malignancies is greatly increased in patients who have received a renal transplant, but this has not been well studied in patients receiving maintenance dialysis. Our aim was to assess the incidence of these malignancies in patients on dialysis and compare these to transplanted patients. The age standardized incidence ratio (SIR) for anogenital malignancies was calculated by comparing the observed number of malignancies to the expected number. The expected number was calculated by multiplying the age specific incidence rates for each malignancy by the person years at risk in 5-year age cohorts. Of 15,820 patients in the Australia and New Zealand data base, 8,215 had received a renal transplant. A total of 39,750 person years at risk were contributed by patients who had received a renal transplant, while 29,276 person years at risk were contributed by dialysis patients who had not received a renal transplant. For dialysis patients, vulval ...
BACKGROUND: Immune suppressant medications such as thiopurines and anti-tumor necrosis factor agents are important for maintaining disease control in most patients with inflammatory bowel diseases (IBDs); however, their use has been associated with the development of malignant lymphoma. The purpose of this Dutch nationwide study was to estimate the relative risk of malignant lymphoma in IBD patients. METHODS: IBD patients who developed a lymphoma between 1997 and 2004 were identified using the Dutch National Database of PALGA. Data from confirmed cases were collected from individual hospitals, including data on Epstein-Barr virus (EBV). The age-adjusted 8-year incidence of malignant lymphoma in the Netherlands was retrieved from the Central Bureau of Statistics. RESULTS: Forty-two hospitals were visited and 285 matches evaluated in the total cohort of 17,834 IBD patients. Forty-four lymphomas were observed, resulting in a relative risk of 1.27 (95% confidence ...
Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS (p = 0.703). On multivariate analyses, improved OS was associated with the absence of ...
Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located (72%): spine (n = 18), ...
Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 regular patients who adhered best to our selection criteria. Main Outcome Measures: ...
Background: Anxiety disorders are known to be common in the general population. Previous studies with adults with intellectual disabilities (IDs) report a prevalence of general anxiety disorder ranging from less than 2% to 17.4%. Little is known about associated factors in this population. This study investigates point prevalence of anxiety disorders and determines the factors independently associated with them. Methods: Information was collected with 1023 adults with IDs who participated in a large-scale, population-based study. All had a comprehensive physical and mental health assessment. The point prevalence of anxiety disorders according to different diagnostic criteria was determined, as were independently associated factors by using logistic regression analysis. Results: Three point eight per cent (95% CI = 2.7-5.2%) of the cohort had an anxiety disorder at the time of assessment. Generalised anxiety disorder was the most common (1.7%), then agoraphobia ...
Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 patients; and type IV, 6 patients. One patient diagnosed as type IIIa with MDCT was ...
Retroviruses are well known pathogens of mammals, birds and fish. Their potential to induce cancer in chickens was already described almost 100 years ago and murine retroviruses have been a subject of study for 50 years. The first human retroviruses, HTLV and HIV, were discovered more than 30 years ago, surprising researchers and physicians by the profound differences in the diseases they cause. HTLV-1 is able to induce, after decades of infection, lymphomas/leukemia or neuroimmune disorders whereas untreated HIV infection leads almost inevitably to AIDS. The recently described XMRV (xenotropic murine leukemia virus-related virus) appeared to possess many of the features known for HTLV and was regarded by some to be the third human retrovirus. However, recent publications by Knox et al. [1] and Paprotka et al. [2] have shed new light on this gammaretrovirus. Knox and colleagues clearly demonstrate that XMRV is absent in patients belonging to a chronic fatigue syndrome ...
Purpose: Hormonal activity causes breast volume to change during the menstrual cycle. One possible cause of this volume change is thought to be due to water retention or oedema within the tissues. We used magnetic resonance imaging (MRI) to study the variation in breast volume and {sup 1}H Magnetic Resonance Spectroscopy (MRS) to measure T{sub 2} relaxation times which are known to increase with increasing tissue water content. We hypothesised that an increase in breast volume will elevate T{sub 2} relaxation due to the presence of an increased water content within the breast. T{sub 2} Relaxation time and volume were studied in fifteen control subjects and in a cohort of eight patients with cyclical mastalgia in order to determine whether changes in breast volume and T{sub 2} relaxation times differed in controls and patients during menses, ovulation and premenses. Method: Breast volume was determined by the Cavalieri method in combination with point counting ...
According to ICRP 60 and European-Directive 96/29, Naturally Occurring Radioactive Materials (NORM) and Technical Enriched Naturally Occurring Radioactive Materials (TENORM) have to take the radiation protection of the general population as well as of workers into account. The German radiation protection regulations stress that particularly. In connection with these regulations, various measurement programs have been and still are performed to investigate the relevant exposure paths. One of these programs is the determination of the intake of natural occurring radionuclides of the uranium decay series in individuals of the public, in exposed regions and houses and also at NORM workplaces by excretion analysis. Excretion analysis surveillance is one of the common tools for internal dosimetry. Sources of primordial radionuclides could be the ingestion of foodstuff and water and the incorporation of (mostly airborne) pollution on work places. The main focus in this report is set upon the ...
Objective: To survey the data for the state of health in the ambient residents of Daya Bay Nuclear Power Plant, and provide the background data to evaluate the state of health affected by fallout of nuclear power plant. Methods: The datas were collected by a radiation epidemiology. The investigation was carried out in the area within 20 km of radius from Daya Bay Nuclear' Power Plant, and the subjects who had lived there for three years or longer before January. 1,1993 and covered by the Household Registry were recruited to a cohort. Results: The mortality rate of overall cancer (per 100 000 PYr) was 88.57 (the standard mortality rate was 79.77 ), the mortality rate of leukemia (per 100 000 PYr) was 3.24 (the standard mortality rate was 2.94), the palpation rate of the goiter in 7-14 years old was 8.34%(9.69% in B ultrasonic), the morbidity rate of newborn's defect (per 100 00 P) was 82.33. The mortality of all cancers or leukemia was similar to the result from ...
Background and purpose: To compare 6 MV and 18 MV photon intensity modulated radiotherapy (IMRT) for non-small cell lung cancer. Materials and methods: Doses for a cohort of 10 patients, typical for our department, were computed with a commercially available convolution/superposition (CS) algorithm. Final dose computation was also performed with a dedicated IMRT Monte Carlo dose engine (MCDE). Results: CS plans showed higher D _9_5_% (Gy) for the GTV (68.13 vs 67.36, p = 0.004) and CTV (67.23 vs 66.87, p = 0.028) with 18 than with 6 MV photons. MCDE computations demonstrated higher doses with 6 MV than 18 MV in D _9_5_% for the PTV (64.62 vs 63.64, p = 0.009), PTV_o_p_t_i_m (65.48 vs 64.83, p = 0.014) and CTV (66.22 vs 65.64, p = 0.027). Dose inhomogeneity was lower with 18 than with 6 MV photons for GTV (0.08 vs 0.09, p = 0.007) and CTV (0.10 vs 0.11, p = 0.045) in CS but not MCDE plans. 6 MV photons significantly (D _3_3_%; p = 0.045) spared the esophagus in MCDE ...
Mutations in the FGD1 gene have been shown to cause Aarskog-Scott syndrome (AAS), or facio-digito-genital dysplasia (OMIM#305400), an X-linked disorder characterized by distinctive genital and skeletal developmental abnormalities with a broad spectrum of clinical phenotypes. To date, 20 distinct mutations have been reported, but little phenotypic data are available on patients with molecularly confirmed AAS. In the present study, we report on our experience of screening for mutations in the FGD1 gene in a cohort of 60 European patients with a clinically suspected diagnosis of AAS. We identified nine novel mutations in 11 patients (detection rate of 18.33%), including three missense mutations (p.R402Q; p.S558W; p.K748E), four truncating mutations (p.Y530X; p.R656X; c.806delC; c.1620delC), one in-frame deletion (c.2020_2022delGAG) and the first reported splice site mutation (c.1935+3A>C). A recurrent mutation (p.R656X) was detected in three independent families. ...
The population of U.S. Department of Defense military working dogs provides an opportunity to study the lifetime occurrence of neoplasia in 2 breeds of dogs--the German Shepherd Dog and the Belgian Malinois. Medical records were reviewed for all dogs that died or were euthanized in 1992 (135 German Shepherd Dogs and 106 Belgian Malinois). Histologically confirmed neoplasms were recorded. More than 30% of both breeds (41 German Shepherd Dogs and 33 Belgian Malinois) developed at least 1 primary neoplasm during their lives, with 10% developing more than 1 neoplasm. Nearly 57% of the neoplasms were benign, and approximately 43% were malignant. German Shepherd Dogs lived 9.7 years, on average, and Belgian Malinois lived 7.9 years, on average. Of the dogs that developed any neoplasm, Belgian Malinois had a mean age at 1st diagnosis that was 1.1 years younger and a mean age at 1st diagnosis of malignancy that was 1.7 years younger than those in German Shepherd Dogs. The risk of a malignancy ...
Using histopathologic diagnoses made on necropsy material from 3,024 military working dogs (MWDs) who died from 1968 to 1973, we analyzed the effect of military service in the Republic of Vietnam on testicular pathology. Among 1,048 MWDs that died in Vietnam and had no reported developmental risk factors for testicular disease, significant excesses of testicular hemorrhage, epididymitis/orchitis, sperm granuloma, testicular degeneration, and seminoma were evident. Among 126 MWDs with prior Vietnam service who died at other duty stations outside Vietnam from 1968 to 1973, significant excesses of testicular degeneration and seminoma were likewise evident. Among 136 MWDs with prior Vietnam service that later died from 1974 to 1980, seminoma continued to be diagnosed in significant excess. In each instance, the odds ratio for the association between Vietnam service and seminoma was 2.0 or greater. Analysis of ever service by Corps Tactical Zones showed significant excesses of seminoma with ...
Identification of factors that determine individual patient risk for recurrence and progression in superficial papillary carcinoma of the bladder is a subject of extensive research as it would be a major outcome in patient management. It has been well recognized that traditional prognostic markers as tumor grade and stage are not accurate enough in predicting biological behavior. A large number of markers have been investigated as potential prognostic factors and relatively few can help in predicting outcome. Material and Methods: Forty-nine cases undergoing complete transurethral resection for primary superficial papillary transitional cell carcinoma were subjected to clinicopathologic evaluation as well as immunohistochemical staining for p53, bcl-2, cytokeratin 20 and Ki-67. The CAS-200 image analyzer was used to estimate the Ki-67 labeling index. Results: Recurrence was observed in 19 cases (38.8%) and progression in 7 cases (14.3%) with a median followup of 49 months (range 24-84 ...
Purpose: Patients with ataxia-telangiectasia (A-T) show greatly increased radiation sensitivity and cancer predisposition. Family studies imply that the otherwise clinically silent heterozygotes of this autosomal recessive disease run a 3.5 to 3.8 higher risk of developing cancer. In vitro studies suggest moderately increased cellular radiation sensitivity of A-T carriers. They may also show elevated clinical radiosensitivity. We retrospectively examined patients who presented with severe adverse reactions during or after standard radiation treatment for mutations in the gene responsible for A-T, ATM, considering a potential means of future identification of radiosensitive individuals prospectively to adjust dosage schedules. Material and Methods: We selected 20 cancer patients (breast, 11; rectum, 2; ENT, 2; bladder, 1; prostate, 1; anus, 1; astrocytoma, 1; Hodgkins lymphoma, 1) with Grade 3 to 4 (RTOG) acute and/or late tissue radiation side effects by reaction severity. DNA from the ...
Purpose: Various published reports involving intensity-modulated radiotherapy (IMRT) plans developed using automated optimization (inverse planning) have demonstrated highly conformal plans. These reported conformal IMRT plans involve significant target dose inhomogeneity, including both overdosage and underdosage within the target volume. In this study, we demonstrate the development of optimized beamlet IMRT plans that satisfy rigorous dose homogeneity requirements for all target volumes (e.g., #+-#5%), while also sparing the parotids and other normal structures. Methods and Materials: The treatment plans of 15 patients with oropharyngeal cancer who were previously treated with forward-planned multisegmental IMRT were planned again using an automated optimization system developed in-house. The optimization system allows for variable sized beamlets computed using a three-dimensional convolution/superposition dose calculation and flexible cost functions derived from combinations of ...
BackgroundPolicies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England.MethodsA total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10) and nitrogen dioxide (NO2). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants.ResultsAbout 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in ...