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Sample records for 15-year single center

  1. Imaging button battery ingestions and insertions in children: a 15-year single-center review

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    Pugmire, Brian S.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Lin, Tom K.; Pentiuk, Scott [Cincinnati Children' s Hospital Medical Center, Division of Gastroenterology Hepatology and Nutrition, Cincinnati, OH (United States); De Alarcon, Alessandro; Hart, Catherine K. [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Otolaryngology, Cincinnati, OH (United States); University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States)

    2017-02-15

    Recent studies have shown an increase in morbidity associated with button battery ingestions in children. To perform a comprehensive, imaging-focused review of all patients with confirmed button battery ingestions/insertions imaged at our institution in the last 15 years. Radiology reports from Jan. 1, 2000, to July 12, 2015, were searched for the terms ''battery'' and ''batteries.'' Confirmed cases of battery ingestion/insertion for which images were available were reviewed. Cases were reviewed for imaging studies performed, imaging findings, patient demographics, clinical history and management. Two pediatric gastroenterologists reviewed endoscopic images and graded mucosal injuries in selected cases. Two hundred seventy-six cases were reviewed. All patients were imaged with radiography, 19 with fluoroscopy (6.8%), and 4 with CT (1.4%). Batteries retained in the esophagus (n = 27, 9.8%) were larger in diameter on average than those that had passed distally (22.1 ± 3.3 mm vs. 13.7 ± 1.6 mm, P<0.0001). Battery diameter ≥20 mm was associated with esophageal impaction (P<0.0001) and higher grade esophageal injury (P<0.0001). Mean battery diameter was greater for patients with grade 1 or higher mucosal injury than for patients with no mucosal injury (22.1 ± 2.1 mm vs. 14.7 ± 4.5 mm, P<0.0001). Sixteen percent (4/25) of patients with grade ≥1 esophageal injury had batteries in the stomach on initial imaging. Five patients (1.8%) had serious clinical complications (e.g., esophageal perforation, tracheoesophageal fistula). Button batteries >20mm in diameter warrant increased clinical scrutiny due to higher likelihood and severity of injury. Implementation of recent pediatric gastroenterology societal guidelines will likely lead to a substantial increase in the number of CT and MRI examinations. (orig.)

  2. Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center.

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    Kim, Yi-Seul; Kim, Kyung-Ran; Kang, Ji-Man; Kim, Jong-Min; Kim, Yae-Jean

    2017-03-01

    Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ≥38.0℃ for longer than ≥14 days and failure to reach a diagnosis after one week of investigations were included. Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

  3. Peritoneal dialysis-related peritonitis due to Staphylococcus aureus: a single-center experience over 15 years.

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    Pasqual Barretti

    Full Text Available Peritonitis caused by Staphylococcus aureus is a serious complication of peritoneal dialysis (PD, which is associated with poor outcome and high PD failure rates. We reviewed the records of 62 S. aureus peritonitis episodes that occurred between 1996 and 2010 in the dialysis unit of a single university hospital and evaluated the host and bacterial factors influencing peritonitis outcome. Peritonitis incidence was calculated for three subsequent 5-year periods and compared using a Poisson regression model. The production of biofilm, enzymes, and toxins was evaluated. Oxacillin resistance was evaluated based on minimum inhibitory concentration and presence of the mecA gene. Logistic regression was used for the analysis of demographic, clinical, and microbiological factors influencing peritonitis outcome. Resolution and death rates were compared with 117 contemporary coagulase-negative staphylococcus (CoNS episodes. The incidence of S. aureus peritonitis declined significantly over time from 0.13 in 1996-2000 to 0.04 episodes/patient/year in 2006-2010 (p = 0.03. The oxacillin resistance rate was 11.3%. Toxin and enzyme production was expressive, except for enterotoxin D. Biofilm production was positive in 88.7% of strains. The presence of the mecA gene was associated with a higher frequency of fever and abdominal pain. The logistic regression model showed that diabetes mellitus (p = 0.009 and β-hemolysin production (p = 0.006 were independent predictors of non-resolution of infection. The probability of resolution was higher among patients aged 41 to 60 years than among those >60 years (p = 0.02. A trend to higher death rate was observed for S. aureus episodes (9.7% compared to CoNS episodes (2.5%, (p = 0.08, whereas resolution rates were similar. Despite the decline in incidence, S. aureus peritonitis remains a serious complication of PD that is associated with a high death rate. The outcome of this infection is negatively

  4. [Balloon pulmonary valvuloplasty, 15-year experience at the Siglo XXI IMSS National Medical Center].

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    Juárez Rodríguez, Mariano; Alva Espinosa, Carlos; Ledesma Velasco, Mariano; Lázala Rodríguez, Gustavo; Jiménez Arteaga, Santiago; Sánchez Soberanes, Agustín; Ortegón Cardeña, José; David Gómez, Felipe; Hernández González, Martha; Magaña Serrano, José

    2003-01-01

    To evaluate 15 years of experience with balloon pulmonary valvuloplasty in a single third level health care center. Hundred-fifty patients underwent the procedure, 73 (48%) men and 77 (52%) women, mean age 10.5 +/- 11.3 years. The initial systolic gradient decreased from 86 +/- 35 to 21.67 +/- 12.20 mm Hg, p < 0.001, whereas the initial right ventricular systolic pressure decreased from 106 +/- 34.8 to 53 +/- 27 mm Hg, p < 0.0001. At the end of the follow-up, 48 +/- 44 months, the systolic gradient was 13.43 +/- 8.73 mm Hg, p < 0.001. Major complications occurred in 9 (6.4%) patients. Immediate technical success was achieved in 111 (74%) patients and failure in 39 (26%). At the end of the follow-up period, successful outcomes were achieved in 104 (89.6%); in contrast, failures were present in 12 (10.4%) patients, p < 0.001. Death occurred in 2 (1.33%) patients. The predictors for failure were age < 1.5 +/- 1-33 years (p < 0.004), dysplastic valve (p < 0.001), high initial systolic gradient (p < 0.002), and high initial systolic right ventricular pressure (p < 0.0001). Balloon pulmonary valvuloplasty is an effective, safe, and first choice treatment for congenital pulmonary valve stenosis.

  5. Contraception in adolescents over the last 15 years: perspective of a youth service center

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    Teresa Teixeira da Silva

    2015-09-01

    Full Text Available Introduction: Contraceptive counselling is essential in the prevention of pregnancy and sexually transmitted infections in adolescents. Objectives: Evaluate the behaviour of adolescents who recurred to our Youth Assistence Center (YAC in the past 15 years, regarding their sexual and reproductive health and contraceptive choice. Material and Methods: Retrospective study of female adolescents under 18 years, who recurred for the first time to YAC in 1997, 2002, 2007 and 2012 (group 1,2,3 and 4, respectively. Data were analysed using SPSS 21.0 and Microsoft Excel 2007. Results: Most adolescents were sexually active (61.5% in 1997 vs 76.5% in 2012, p = 0.01 and there was an increase, over the years, of adolescents who had already started regular hormonal contraception (8.4% in 1997 vs 21.4% in 2012, p <0.001. In adolescents who did not use Hormonal Contraception (HC and recurred to YAC for its beginning, we found the following results: 1997 - 98.6% started a Combined Oral Contraceptive (COC, 2002 - 100% initiated HC [99, 1% - COC, 0.9% subcutaneous implant], 2007 - 90.9% initiated HC [83% - COC, 16.4% - subcutaneous implant, 0.6% - patch] and 2012 - 97% initiated HC [85.9% - COC, 14.1% - subcutaneous implant]. Conclusion: Over the studied period, there was an increased number of adolescents who were using a hormonal contraceptive at first appointment. The COC remains the contraceptive method of choice in adolescents, although there is a growing adherence to the subcutaneous implant.

  6. A Look into the National Drought Mitigation Center: Providing 15 Years of Drought Services (Invited)

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    Svoboda, M. D.; Hayes, M. J.; Knutson, C. L.; Wardlow, B. D.

    2009-12-01

    The National Drought Mitigation Center (NDMC) was formed in 1995 at the University of Nebraska-Lincoln. Over the past 15 years, the NDMC has made it a priority to work with various local, state, tribal and federal entities to provide a suite of drought/climate services, with a goal of bringing research to fruition through applications and operations. Through our research and outreach projects, the NDMC has worked to reduce risk to drought by developing several mitigation strategies, monitoring and decision making tools and other services aimed at enhancing our nation’s capacity to cope with drought. Two of the earliest NDMC activities were the creation of a website and assessing drought conditions around the United States. An electronic drought clearinghouse was built in 1995 at drought.unl.edu. The site was designed, and still concentrates, on the concepts of drought monitoring, planning, and mitigation and also serves as a repository of information from around the world. The NDMC’s electronic quarterly newsletter, DroughtScape, disseminates information about all things drought to people across the country. In addition, the NDMC has developed and is home to websites for the U.S. Drought Monitor (USDM), Drought Impact Reporter (DIR), and the Vegetation Drought Response Index (VegDRI). In an effort to inform decision makers, the NDMC continually pursues ways to raise the awareness and visibility of drought as one of the most costly hazards we face. This began in the mid-1990s with the creation of a state-based drought impact assessment map that would help lead to the formation of the USDM in 1999 and the DIR in 2005. The NDMC plays a key role in producing the weekly USDM and the monthly North American Drought Monitor (NADM). The USDM was created out of collaborations between the NDMC, United States Department of Agriculture (USDA) and National Oceanic and Atmospheric Administration (NOAA) and has quickly become one of the most widely used products in assessing

  7. ERIC--The First 15 Years. A History of the Educational Resources Information Center.

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    Trester, Delmer J.

    This account of the Educational Resources Information Center (ERIC) provides information on its background and origin, and traces the development of the system from initial planning in 1962 through mid-1979. Although this is essentially an overview of the growth of the system, some of the more complex aspects of the ERIC story are included in the…

  8. Pancreatic Heterotopia: Masquerading as Malignancy - A 15-Year Single Institutional Surgicalpathology Review

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    Rani Kanthan

    2015-07-01

    Full Text Available Context Pancreatic heterotopia, the presence of pancreatic tissue anywhere outside of the anatomical pancreas, is rare and typically an incidental finding. This manuscript reports two index cases of unusual presentations of pancreatic heterotopia masquerading as malignant lesions. Case reports Case #1: Fifty-five year-old female with right upper quadrant pain was found to have a retroperitoneal tumor between the right kidney and liver. Case #2: Thirty-eight-year-old female with a 20-year history of right upper quadrant pain and pancreatitis was found to have an incidental jejunal mass. An intraoperative frozen section was ordered on these two patients for suspected malignancy. Frozen section analysis in both cases showed the presence of benign glandular tissue admixed with ducts in a typical lobular fashion consistent with benign pancreatic tissue, confirming pancreatic heterotopia. The two index cases were investigated and analyzed in detail with relevant review of the literature as available in PubMed and Medline. A 15-year retrospective computer-based histopathological surgical review was conducted in our laboratory and the results were analyzed in the context of evidence-based literature of pancreatic heterotopias. 153 pancreatic pathologies were identified of which the commonest lesion was adenocarcinoma (58.8% followed by pancreatic heterotopia (10.5%, pancreatic neuroendocrine tumors (7.2% and pancreatitis (7.2%. Conclusions Pancreatic heterotopia is rare and most often an incidental finding; however, occasionally patients may present with a mass suggestive of malignancy, leading to clinical diagnostic dilemmas. Awareness of this uncommon lesion is of particular importance at intraoperative frozen section analysis for lesions in atypical locations.

  9. Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

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    Baine, Michael J.; Chi Lin

    2014-01-01

    Objectives. We examined the role of radiation therapy (RT) in pancreatic adenocarcinoma (PA) treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC) as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS) were age, gender, race, stag...

  10. Gliosarcoma: An audit from a single institution in India of 24 post-irradiated cases over 15 years

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    Kumar Piyush

    2008-01-01

    Full Text Available Background: Gliosarcomas (GS are biphasic brain tumors composed of glioblastoma multiforme (GBM and sarcomatous component. Therapeutic approaches include maximum surgical decompression with postoperative radiotherapy. Outcomes in gliosarcoma are poor despite multimodality management. Aims: To analyze the outcome in patients of GS treated in our institute over a period of 15 years and compare it with GBM treated during the same period. Settings and Design: Clinical records of the post-irradiated GS patients and GBM patients seen between 1990 and 2004 were retrieved. Materials and Methods: Demographic and treatment variables were evaluated for their influence on overall survival (OS. The survival outcomes of GBM and GS treated during the same period were also compared. Statistical Analysis: Univariate analysis was carried out using the Kaplan-Meier method and tested using log-rank test for significance. Results: During these 15 years, 24 evaluable GS patients were treated as compared to 251 evaluable patients of GBM. There was a slight male preponderance in GS (14 males vs.10 females with a median age of 50 years. All patients underwent surgery followed by post-operative radiotherapy (median dose of 60 Gy. None of the patient or treatment related factors were found to be significantly influencing their OS. Median OS in GS was 7.3 months compared to 7.5 months in GBM patients (P = 0.790. Conclusions: The OS appears to be similar for GS and GBM. None of the demographic variables appeared to prognosticate the survivals of GS.

  11. 5. Mitral valve replacement for mitral stenosis: 15 years single center experience

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    A. Arifi

    2016-07-01

    Full Text Available Mitral valve replacement (MVR with either a bioprosthetic or a mechanical valve is the treatment of choice for severe mitral stenosis. This study aimed to evaluate and compare the early and late outcome of mitral valve replacement (mechanical versus bioprosthetic for severe mitral stenosis. A retrospective cohort study was performed on prospectively collected data involving mitral stenosis patients who have undergone MVR with either bioprosthetic (BMV (n = 50 or mechanical (MMV (n = 145 valves in our institute from 1999 to 2012. Data were analyzed for early and late mortality, NYHA functional classes, stroke, early and late valve-related complications, and survival. Chi Square test, logistic regression, Kaplan Meier curve, and dependent proportions tests were performed. A total of 195 patients were included in the study with a follow-up of 190 patients (97.5%. One patient died early post-operatively; twelve patients died late in the post-operative period, BMV group (6 and the MMV (6. The Late mortality had significantly associated with post-op stroke (p < 0.001 and post-op NYHA classes III and IV (p = 0.002. Post-op NYHA class was significantly associated with age (p = 0.003, pulmonary disease (p = 0.02, mitral valve implant type (p = 0.01, and post-op stroke (p = 0.02; 14 patients had strokes in the MMV (9 and in the BMV (5 groups. NYHA classes were significantly better after the replacement surgeries (p < 0.001. Bioprosthetic valves were significantly associated with worse survival (p = 0.03, worse NYHA post-op (p = 0.01, and more re-operations (p = 0.006. Survival was significantly better with mechanical valves (p = 0.03. When the two groups were matched for age and mitral regurgitation, the analysis revealed that bioprosthetic valves were significantly associated with re-operations (p = 0.02 but not significantly associated with worse survival (p = 0.4 or worse NYHA (p = 0.4. Mechanical mitral valve replacement in mitral stenosis patients is associated with lower re-operation rate, but no difference in survival as compared to bioprosthetic mitral valve replacement. Furthermore, post-operative stroke occurrence (14% is associated with late mortality and worse NYHA classes.

  12. Imaging button battery ingestions and insertions in children: a 15-year single-center review.

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    Pugmire, Brian S; Lin, Tom K; Pentiuk, Scott; de Alarcon, Alessandro; Hart, Catherine K; Trout, Andrew T

    2017-02-01

    Recent studies have shown an increase in morbidity associated with button battery ingestions in children. To perform a comprehensive, imaging-focused review of all patients with confirmed button battery ingestions/insertions imaged at our institution in the last 15 years. Radiology reports from Jan. 1, 2000, to July 12, 2015, were searched for the terms "battery" and "batteries." Confirmed cases of battery ingestion/insertion for which images were available were reviewed. Cases were reviewed for imaging studies performed, imaging findings, patient demographics, clinical history and management. Two pediatric gastroenterologists reviewed endoscopic images and graded mucosal injuries in selected cases. Two hundred seventy-six cases were reviewed. All patients were imaged with radiography, 19 with fluoroscopy (6.8%), and 4 with CT (1.4%). Batteries retained in the esophagus (n = 27, 9.8%) were larger in diameter on average than those that had passed distally (22.1 ± 3.3 mm vs. 13.7 ± 1.6 mm, PBattery diameter ≥20 mm was associated with esophageal impaction (Pbattery diameter was greater for patients with grade 1 or higher mucosal injury than for patients with no mucosal injury (22.1 ± 2.1 mm vs. 14.7 ± 4.5 mm, Pbatteries in the stomach on initial imaging. Five patients (1.8%) had serious clinical complications (e.g., esophageal perforation, tracheoesophageal fistula). Button batteries >20mm in diameter warrant increased clinical scrutiny due to higher likelihood and severity of injury. Implementation of recent pediatric gastroenterology societal guidelines will likely lead to a substantial increase in the number of CT and MRI examinations.

  13. Treatment of choledochal cyst in a pediatric population. A single institution experience of 15-years. Case series

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    Silva-Baez, Hector; Coello-Ramírez, Pedro; Ixtabalán-Escalante, Eddy Mizraím; Sotelo-Anaya, Eduardo; Gallo-Morales, Mariana; Cordero-Estrada, Eduardo; Sainz-Escarrega, Victor Hugo; Ploneda-Valencia, César Felipe

    2015-01-01

    Background Choledochal cyst (CC) is a rare congenital anomaly of the bile duct that approximately 75% of the patients are diagnosed in childhood. Without a standardized surgical procedure for the biliary reconstruction, we present our experience over the last 15 years and show the differences between the biliary reconstructions techniques in our population. Methods We did a retrospective hospital archive search for patients admitted to the pediatric surgery department with the diagnosis of a choledochal cyst from January 2000 to June 2015. Results We found 15 patients, of which, 1 was excluded because of missing data from the hospital record. Of the remaining 14, eight had hepaticojejunal (HY) anastomosis in Roux-en-Y, with a 25% rate of complications; six had hepatoduodenal (HD) anastomosis with a rate of complications of 16.6%. The average hospital length of stay in the group of HD vs. HY was 14 ± 1.6-days vs. 19 ± 8.2-days respectively. Discussion There are no standardized surgical reconstruction techniques of the biliary tract after the CC excision, there is literature that supports the biliary reconstruction with an HY and an HD without a distinct advantage over one or the other. Conclusion: In our series HD anastomosis represents a safe procedure with fewer complications than HY. PMID:26900456

  14. Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

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    Michael J. Baine

    2014-01-01

    Full Text Available Objectives. We examined the role of radiation therapy (RT in pancreatic adenocarcinoma (PA treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS were age, gender, race, stage, year of diagnosis, and treatment with surgery, chemotherapy (CT, or RT. Time to death was plotted by Kaplan-Meier method. A Cox proportional hazards model was used to evaluate prognostic factors for OS. Results. The median OS was 7.3 and 5 months for patients from UNMC and the SEER database, respectively. A Cox model of patients from UNMC showed that RT was associated with improved OS (HR 0.77, P=0.018 after adjusting for factors including age, race, gender, stage, year of diagnosis, having surgery, or having CT. Cox analysis of patients from the SEER showed similar results (HR 0.65, P<0.0001. Conclusions. RT confers an independent survival advantage in patients being treated for PA which is apparent both at UNMC and through SEER data.

  15. Pregnancy and patients with preexisting lupus nephritis: 15 years of experience at a single center in Korea.

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    Koh, J H; Ko, H S; Lee, J; Jung, S M; Kwok, S-K; Ju, J H; Park, S-H

    2015-06-01

    We investigated obstetric outcomes and comorbidities during pregnancy in females with preexisting lupus nephritis (LN) and identified predictors for renal flare. In cases of renal flare during pregnancy, we assessed the long-term post-delivery renal outcome. We performed a retrospective analysis of 183 systemic lupus erythematosus (SLE) pregnancies including blood chemistry, urinalysis, urinary protein, and disease activity recorded at prepregnancy, during pregnancy, and at one month, six months, and one year post-delivery. Pregnancies with preexisting LN had a greater frequency of adverse obstetric outcomes and maternal comorbidity. Renal flares occurred in 50.7% of pregnancies with preexisting LN, 89.2% of which were reactivations. Renal flare among pregnancies with SLE was predicted based on preexisting lupus nephritis (OR 17.73; 95% CI, 5.770-54.484), an active disease prior to pregnancy (OR 2.743; 95% CI, 1.074-7.004), and prepregnancy eGFR pregnancies. The median follow-up time after delivery was 5.9 (3.1-9.7) years and chronic kidney disease (CKD) occurred in 21.4% of pregnancies with renal flare. In patients with renal flare, failing to achieve a ≥ 50% reduction in urine protein levels within six months, longer total duration of renal flare, and acute kidney injury at renal flare was associated with CKD development. Females with preexisting LN should achieve remission before pregnancy. When patients experience renal flares during pregnancy, it is important to reduce the proteinuria level by >50% within six months and to achieve early remission for excellent long-term renal outcomes.

  16. Ectopic pregnancy following in vitro fertilization with embryo transfer: A single-center experience during 15 years.

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    Cheng, Ling-Yun; Lin, Pin-Yao; Huang, Fu-Jen; Kung, Fu-Tsai; Chiang, Hsin-Ju; Lin, Yu-Ju; Lan, Kuo-Chung

    2015-10-01

    Ectopic pregnancy is an obstetrical disease that is potentially associated with maternal death in the first trimester. It is one of the well-known complications following in vitro fertilization (IVF) with embryo transfer (ET). The incidence of ectopic pregnancy is estimated to be 2.1-8.6% of clinical pregnancy after IVF-ET, which is higher than natural conceptions (incidence rate 2%). This study aimed to re-evaluate the ectopic pregnancy rate in patients undergoing IVF-ET and to investigate the effects of embryo stage and frozen-thawed blastocyst transfer and ET during full bladder distention on ectopic pregnancy rate. This retrospective study reviewed women who achieved a clinical pregnancy after IVF-ET at the Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital between 1999 and 2013. We compared ectopic pregnancy rate following Day 3 ET with Day 5 ET, and after fresh ET with thawed ET. Besides, multivariate analysis was used to clarify the factors affecting ectopic pregnancy after IVF-ET. Of the total 1213 clinical pregnancies after fresh ET, 18 (1.5%) were verified as ectopic, which is similar to the rate following natural conception. The ectopic pregnancy rates were similar for Day 3 (1.2%) and Day 5 (1.7%) ETs. The incidence of ectopic pregnancy in thawed ET cycles (0.6%) was not significantly reduced than fresh ET cycles (1.5%). Tubal ET (TET) and ET under full bladder distention had a significant effect on ectopic pregnancy. Thawed ET was not associated with a lower incidence of ectopic pregnancy than fresh ET, and embryo stage did not affect the rate of ectopic pregnancy. In addition, TET and ET under conditions of full bladder distention may increase the ectopic pregnancy rate. Copyright © 2015. Published by Elsevier B.V.

  17. Hubble 15 years of discovery

    CERN Document Server

    Lindberg Christensen, Lars; Kornmesser, M

    2006-01-01

    Hubble: 15 Years of Discovery was a key element of the European Space Agency's 15th anniversary celebration activities for the 1990 launch of the NASA/ESA Hubble Space Telescope. As an observatory in space, Hubble is one of the most successful scientific projects of all time, both in terms of scientific output and its immediate public appeal.

  18. Neonatal Duodenal Obstruction: A 15-Year Experience

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    Kamal Nain Rattan

    2016-04-01

    Full Text Available Background: Congenital duodenal obstruction is one of the commonest causes of neonatal intestinal obstruction. We are presenting our 15-year experience by analyzing clinical spectrum and outcome in neonates with duodenal obstruction admitted at our center. Material and Methods: The hospital records of all neonates admitted with duodenal obstruction from June 2000 to June 2015 were reviewed. The patient records were analyzed for antenatal diagnosis, age, sex, clinical presentation, diagnosis, associated anomalies, surgical procedures performed; postoperative morbidity and mortality. We excluded from our study malrotation of gut associated with congenital diaphragmatic hernia and abdominal wall defects. Results: A total of 81 patients were admitted, out of which 56 were males and 25 were females. Polyhydramnios was detected in 24 (30% pregnancies. Average birth weight was 2.1±1.0Kg and average gestational age was 38 (SD±1 weeks with 17 (21% preterm neonates. Presenting features were vomiting in 81(100% which was bilious in 81% and non bilious in 19%, epigastric fullness in 56 (69% and dehydration in 18 (22% and failure to thrive in 16 (19%. Most common cause of obstruction was duodenal atresia in 38 (46.9%, followed by malrotation of gut in 33 (40.7%, and annular pancreas in 4 cases. Depending upon site of location, infra-ampullary obstruction was the most common in 64 (79%, supra-ampullary in 9 (7.4% and ampullary 8 neonates. Both duodenal atresia and malrotation of gut was present in 4 cases. X-ray abdomen was most commonly used investigation to confirm the diagnosis. All cases were managed surgically by open laparotomy. Eleven (13.5% patients died due to sepsis and associated congenital anomalies. Conclusion: Congenital duodenal obstruction most commonly presents in early neonatal period with features of upper GIT obstruction like vomiting and epigastrium fullness as in our series. Early antenatal diagnosis and surgical interventions hold the

  19. Transplant nephrectomy - A single-center experience

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    Arun Ariyarathenam

    2015-01-01

    Full Text Available Transplant nephrectomy (TN is associated with significant morbidity and mortality and influences the outcome of subsequent renal transplantation. The aim of this study was to identify the reasons for TN in a single transplant center in the United Kingdom and to determine the complication rate, effect on relisting and re-transplantation. We studied all the TNs in our center from January 2000 to December 2011. Detailed information including cause of allograft failure and reason for TN were analyzed. Of 602 renal transplants performed at our center during the period of the study, 42 TNs were performed on 38 (6% patients (24 men and 14 women. The median age of the patients at the time of transplantation who subsequently underwent TN was 56 years (range: 28-73 years and 71% of the allografts were donated after circulatory death. The mean human leucocyte antigen mismatch for these patients was 2.3. The most commonly used immunosuppression was a combination of prednisolone, mycophenolate and tacrolimus, which was used in 50% of the patients. Twenty-five (60% of the TNs in this series were for allografts failing during the first month of transplantation. The most common indication for the TN was graft thrombosis (50%, with an overall in-hospital mortality rate of 9.5% and a morbidity rate of 31%. Seven of 19 patients listed underwent successful re-transplantation. Although TN is associated with a risk of significant morbidity and mortality, it does not preclude from listing for re-transplantation. The difficulty of access to complete information about transplant failures and TN highlights the need for a national registry.

  20. Calibrating 15 years of GOLF data

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    Davies, Guy R

    2011-01-01

    The GOLF resonant scattering spectrophotometer aboard SoHO has now provided 15 years of continuous high precision Sun-as-a-star radial-velocity measurements. This length of time series provides very high resolution in the frequency domain and is combined with very good long-term instrumental stability. These are the requirements for measuring the low-l low-frequency global oscillations of the Sun that will unlock the secrets of the solar core. However, before the scientifically interesting gravity and mixed modes of oscillation fully reveal themselves, a correction and calibration of the whole data set is required. Here we present work towards producing a 15 year GOLF data set corrected for instrumental ageing and thermal variation.

  1. Pectus excavatum: a 15-year perspective.

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    Golladay, E S; Wagner, C W

    1991-09-01

    Pectus excavatum is relatively uncommon. Our experience with 177 children during a 15-year period produced changes in our surgical technique, which now includes a small transverse incision, minimal subcutaneous flap elevation, a muscle-relaxing incision over the fifth costal cartilage, complete resection of involved cartilage, use of Adkins' strut, suspension of sternum to strut, taut reefing of intercostal muscle, no tubes or drains, epidural analgesia, a patient-controlled analgesia device postoperatively, and eventual strut removal. Use of the evolved technique gives excellent cosmetic results, good functional results with minimal discomfort, and a shorter convalescent period.

  2. Childhood Candida Infections: Single-center Experience

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    Eren Cagan

    2015-06-01

    Results: Twenty-nine patients were diagnosed with Candida infection. Of these patients 17 were male (59% and 12 were female (41%. Eleven patients were less than a year old (38%, 9 were between 1-5 years (31% and 9 were above the age of five (31%. The most important underlying disease malignancies were congenital heart disease and neurological diseases. Candida growth was determined in the blood cultures of 17 patients, the urine cultures of 10 patients and in the cerebrospinal fluid of one patient. While the most commonly used anti-fungal agent was fluconazole (51.7%, others used were caspofungin (41.3% and amfoterisin B (13.7%. No isolated Candida strain showed resistance to anti-fungal agents. Treatment was clinically and microbiologically 96.5% successful. Conclusions: Fluconazole still appears to be an effective treatment choice we believe there is a necessity to review the Minimal Inhibitory Concentration (MIC values for anti-fungal agents. [Cukurova Med J 2015; 40(2.000: 245-251

  3. Pediatric renal transplantation: a single center experience

    Directory of Open Access Journals (Sweden)

    João Nascimento

    2015-12-01

    Full Text Available Introduction: End-stage renal disease in children is associated with numerous comorbidities and with age-specific mortality rates approximately 30 times higher than in healthy children. The first kidney transplantation in children was performed successfully in 1954. Surgical advances and new immunosuppressive medications have greatly improved patient’s and graft’s survival in the last years. Aim: Report Centro Hospitalar do Porto experience in pediatric renal transplantation in the last 30 years. Methods: Epidemiological and clinical data of all patients younger than 18 years, transplanted between January 1984 and August 2013, were collected from our database. In order to analyze the transplantation outcome in our center we compare graft survival between decades (1984-89 / 1990-99 / 2000-09 / 2010-13. We also compare graft survival between two age groups of patients (0-10 years ; 11-17 years at the time of surgery. Results: One hundred thirty-nine patients (58.3% male underwent 147 renal transplants (6.8% live donors. Congenital anomalies of the kidney and urinary tract (56.5% and glomerulonephritis (18.4% were the major causes of renal disease. Uncensored graft survivals rates at 5, 10, 15 and 20 years were 84.7%, 71.1%, 60.0% and 51.0%, while patient survivals were 97.9%, 95.9%, 94.7% and 94.7% respectively. Graft survival improved over time and the difference between the decades was statistically significant (p=0.004. Despite the better survival in the group of patients older than 11 years, graft’s survival difference between the two age groups was not statistically significant (p=0.697. Conclusion: The results of our hospital are comparable to other international centers. Significant improvement in survival was observed over the time. It seems that an accurate follow-up of our patients helps to minimize the negative impact of adolescence on graft survival rates.

  4. Pregnancy during Hemodialysis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Bahadi Abdelali

    2010-01-01

    Full Text Available Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialysis treatment. We reviewed the course and outcome of 9 pregnancies occurred in women on chronic hemodialysis in our center from 1999-2007; 5 of them ended with delivery of alive newborns, 2 with fetal deaths in-utero, and 2 with abortions. The average age of patients was 34 years. The etiology of the original kidney disease was unknown in 44.4% of the cases, and only 22.2% of the patients maintained diuresis. Dialysis started in 8 cases before the diagnosis of pregnancy. The average gestational age at diagnosis was 14 weeks. We modified the prescription of dialysis in 4 patients by increasing the frequency of the dialysis sessions to 6 per week and in 3 by increasing the duration of each session to 6 hours. Anemia was present in all the cases; 3 patients received erythropoietin and 4 patients required transfusion. The pregnancy was com-plicated in 44% of the cases by a polyhydramnios. The average time at delivery was 33 weeks and it was achieved in 80% of pregnancies through vaginal route. The average weight of newborns was to 2380 g. We conclude that pregnancy in women on hemodialysis is possible. The success of pregnancy may be influenced by the residual diuresis and early diagnosis to improve the quality of dialysis by increasing the dialysis dose.

  5. Ambulatory laparoscopic cholecystectomy: A single center experience

    Directory of Open Access Journals (Sweden)

    Cagri Tiryaki

    2016-01-01

    Full Text Available Aim: To evaluate the demographic and clinical parameters affecting the outcomes of ambulatory laparoscopic cholecystectomy (ALC in terms of pain, nausea, anxiety level, and satisfaction of patients in a tertiary health center. Materials and Methods: ALC was offered to 60 patients who met the inclusion criteria. Follow-up (questioning for postoperative pain or discomfort, nausea or vomiting, overall satisfaction was done by telephone contact on the same day at 22:00 p.m. and the first day after surgery at 8: 00 a.m. and by clinical examination one week after operation. STAI I and II data were used for proceeding to the level of anxiety of patients before and/or after the operation. Results: Sixty consecutive patients, with a mean age of 40.6 ± 8.1 years underwent ALC. Fifty-five (92% patients could be sent to their homes on the same day but five patients could not be sent due to anxiety, pain, or social indications. Nausea was reported in four (6.7% cases and not associated with any demographic or clinical features of patients. On the other hand, pain has been reported in 28 (46.7% cases, and obesity and shorter duration of gallbladder disease were associated with the increased pain perception (P = 0.009 and 0.004, respectively. Preopereative anxiety level was significantly higher among patients who could not complete the ALC procedure (P = 0.018. Conclusion: Correct management of these possible adverse effects results in the increased satisfaction of patients and may encourage this more cost-effective and safe method of laparoscopic cholecystectomy.

  6. Single Center Experience With Hyperthermic Intraperitoneal Chemotherapy

    Science.gov (United States)

    Kim, Woo Ram; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young

    2017-01-01

    Purpose Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proposed for controlling peritoneal seeding metastasis in some kinds of cancers, including those of colorectal origin, but their safety and oncological benefits are subjects of debate. We present our early experience with those procedures. Methods Data were retrospectively collected from all patients with peritoneal carcinomatosis (PC) and pseudomyxoma peritonei (PMP) treated using CRS and HIPEC at Yonsei Cancer Center between July 2014 and July 2015. Short-term outcomes and risk factors for postoperative complications were analyzed. Results Twenty-three patients with PC (n = 18) and PMP (n = 5) underwent CRS and HIPEC. Median follow-up and age were 2 months and 54 years, respectively. The median peritoneal carcinomatosis index score was 15, and CC0-1 was achieved in 78.3% of all patients. The median operation time and bleeding loss were 590 minutes and 570 mL, respectively. Grade-IIIa/grade-IIIb complications occurred in 4.3% (n = 1)/26.1% (n = 6) of the patients within 30 days postoperatively, and no 30-day mortalities were reported. Factors related to postoperative complications with CRS and HIPEC were number of organ resection (P = 0.013), longer operation time (P patients treated with cetuximab for recurred colorectal cancer had grade-III postoperative complication. Conclusion Our initial experience with CRS and HIPEC presented about 30% grade-III postoperative complications. Therefore, expert surgeons need to perform those procedures with great caution in selected patients who might benefit from it.

  7. Bunching and antibunching from single NV color centers in diamond

    CERN Document Server

    Beveratos, A; Poizat, J P; Grangier, P

    2000-01-01

    We investigate correlations between fluorescence photons emitted by single N-V centers in diamond with respect to the optical excitation power. The autocorrelation function shows clear photon antibunching at short times, proving the uniqueness of the emitting center. We also report on a photon bunching effect, which involves a trapping level. An analysis using rate-equations for the populations of the N-V center levels shows the intensity dependence of the rate equation coefficients.

  8. Scalable Quantum Photonics with Single Color Centers in Silicon Carbide.

    Science.gov (United States)

    Radulaski, Marina; Widmann, Matthias; Niethammer, Matthias; Zhang, Jingyuan Linda; Lee, Sang-Yun; Rendler, Torsten; Lagoudakis, Konstantinos G; Son, Nguyen Tien; Janzén, Erik; Ohshima, Takeshi; Wrachtrup, Jörg; Vučković, Jelena

    2017-02-24

    Silicon carbide is a promising platform for single photon sources, quantum bits (qubits), and nanoscale sensors based on individual color centers. Toward this goal, we develop a scalable array of nanopillars incorporating single silicon vacancy centers in 4H-SiC, readily available for efficient interfacing with free-space objective and lensed-fibers. A commercially obtained substrate is irradiated with 2 MeV electron beams to create vacancies. Subsequent lithographic process forms 800 nm tall nanopillars with 400-1400 nm diameters. We obtain high collection efficiency of up to 22 kcounts/s optical saturation rates from a single silicon vacancy center while preserving the single photon emission and the optically induced electron-spin polarization properties. Our study demonstrates silicon carbide as a readily available platform for scalable quantum photonics architecture relying on single photon sources and qubits.

  9. Nanoscale fluorescence lifetime imaging with a single diamond NV center

    CERN Document Server

    Beams, Ryan; Johnson, Timothy W; Oh, Sang-Hyun; Novotny, Lukas; Vamivakas, Nick

    2013-01-01

    Solid-state quantum emitters, such as artificially engineered quantum dots or naturally occurring defects in solids, are being investigated for applications ranging from quantum information science and optoelectronics to biomedical imaging. Recently, these same systems have also been studied from the perspective of nanoscale metrology. In this letter we study the near-field optical properties of a diamond nanocrystal hosting a single nitrogen vacancy center. We find that the nitrogen vacancy center is a sensitive probe of the surrounding electromagnetic mode structure. We exploit this sensitivity to demonstrate nanoscale fluorescence lifetime imaging microscopy (FLIM) with a single nitrogen vacancy center by imaging the local density of states of an optical antenna.

  10. 15 Years of Chandra Observations of Capella

    Science.gov (United States)

    Kashyap, Vinay

    2014-11-01

    Capella is the strongest coronal line source accessible to Chandra. It has been cumulatively observed with gratings for over 1.2 Ms. The accumulated spectrum represents astrophysical ground truth for atomic physics calculations that is unprecedented in quality. We analyze co-added spectra to generate a comprehensive list of detectable lines and their locations, spanning two orders of magnitude in photon energy. We compare the locations of identifiable lines with locations from atomic databases ATOMDB and Chianti and characterize the uncertainties in the databases. The full line lists and comparisons will be made available at the Dataverse at http://dx.doi.org/10.7910/DVN/27084 This work is supported by Chandra grant AR0-11001X and NASA Contract NAS8-03060 to the Chandra X-Ray Center.

  11. Leprosy among children under 15 years of age: literature review.

    Science.gov (United States)

    Oliveira, Marcela Bahia Barretto de; Diniz, Lucia Martins

    2016-04-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age.

  12. Leprosy among children under 15 years of age: literature review*

    Science.gov (United States)

    de Oliveira, Marcela Bahia Barretto; Diniz, Lucia Martins

    2016-01-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age. PMID:27192519

  13. Coffee to Go: Woman "Thinks" First Cup in 15 Years

    Science.gov (United States)

    ... turn Javascript on. Feature: NIBIB Robotics Coffee to Go: Woman "Thinks" First Cup in 15 Years Past ... Athlete Stands Again…On His Own! / Coffee to Go: Woman "Thinks" First Cup in 15 Years Spring ...

  14. Generalized quiver mutations and single-centered indices

    Energy Technology Data Exchange (ETDEWEB)

    Manschot, Jan [Institut Camille Jordan, Université Claude Bernard Lyon 1,43 boulevard du 11 novembre 1918, 69622 Villeurbanne cedex (France); Pioline, Boris [CERN PH-TH,Case C01600, CERN, CH-1211 Geneva 23 (Switzerland); Laboratoire de Physique Théorique et Hautes Energies, CNRS UMR 7589,Université Pierre et Marie Curie,4 place Jussieu, 75252 Paris cedex 05 (France); Sen, Ashoke [Harish-Chandra Research Institute,Chhatnag Road, Jhusi, Allahabad 211019 (India)

    2014-01-13

    Quiver quantum mechanics is invariant under Seiberg duality. A mathematical consequence is that the cohomology of the Higgs branch moduli space is invariant under mutations of the quiver. The Coulomb branch formula, on the other hand, conjecturally expresses the Poincaré/Dolbeault polynomial of the Higgs branch moduli space in terms of certain quantities known as single-centered indices. In this work we determine the transformations of these single-centered indices under mutations. Moreover, we generalize these mutations to quivers whose nodes carry single-centered indices different from unity. Although the Higgs branch description of these generalized quivers is currently unknown, the Coulomb branch formula is conjectured to be invariant under generalized mutations.

  15. Generalized quiver mutations and single-centered indices

    CERN Document Server

    Manschot, Jan; Sen, Ashoke

    2014-01-01

    Quiver quantum mechanics is invariant under Seiberg duality. A mathematical consequence is that the cohomology of the Higgs branch moduli space is invariant under mutations of the quiver. The Coulomb branch formula, on the other hand, conjecturally expresses the Poincar\\'e / Dolbeault polynomial of the Higgs branch moduli space in terms of certain quantities known as single-centered indices. In this work we determine the transformations of these single-centered indices under mutations. Moreover, we generalize these mutations to quivers whose nodes carry single-centered indices different from unity. Although the Higgs branch description of these generalized quivers is currently unknown, the Coulomb branch formula is conjectured to be invariant under generalized mutations.

  16. Plasmonic resonators for enhanced diamond NV- center single photon sources

    OpenAIRE

    Bulu, Irfan; Babinec, Thomas; Hausmann, Birgit; Choy, Jennifer T.; Loncar, Marko

    2011-01-01

    We propose a novel source of non-classical light consisting of plasmonic aperture with single-crystal diamond containing a single Nitrogen-Vacancy (NV) color center. Theoretical calculations of optimal structures show that these devices can simultaneously enhance optical pumping by a factor of 7, spontaneous emission rates by Fp ~ 50 (Purcell factor), and offer collection efficiencies up to 40%. These excitation and collection enhancements occur over a broad range of wavelengths (~30nm), and ...

  17. Single-color centers implanted in diamond nanostructures

    Science.gov (United States)

    Hausmann, Birgit J. M.; Babinec, Thomas M.; Choy, Jennifer T.; Hodges, Jonathan S.; Hong, Sungkun; Bulu, Irfan; Yacoby, Amir; Lukin, Mikhail D.; Lončar, Marko

    2011-04-01

    The development of material-processing techniques that can be used to generate optical diamond nanostructures containing a single-color center is an important problem in quantum science and technology. In this work, we present the combination of ion implantation and top-down diamond nanofabrication in two scenarios: diamond nanopillars and diamond nanowires. The first device consists of a 'shallow' implant (~20 nm) to generate nitrogen-vacancy (NV) color centers near the top surface of the diamond crystal prior to device fabrication. Individual NV centers are then mechanically isolated by etching a regular array of nanopillars in the diamond surface. Photon anti-bunching measurements indicate that a high yield (>10%) of the devices contain a single NV center. The second device demonstrates 'deep' (~1 μm) implantation of individual NV centers into diamond nanowires as a post-processing step. The high single-photon flux of the nanowire geometry, combined with the low background fluorescence of the ultrapure diamond, allowed us to observe sustained photon anti-bunching even at high pump powers.

  18. Coupling of single NV Center to adiabatically tapered optical single mode fiber

    CERN Document Server

    Vorobyov, Vadim V; Bolshedvorskii, Stepan V; Javadzade, Javid; Lebedev, Nikolay; Smolyaninov, Andrey N; Sorokin, Vadim N; Akimov, Alexey V

    2016-01-01

    We demonstrated a simple and reliable technique of coupling diamond nanocrystal containing NV center to tapered optical fiber. We carefully studied fluorescence of the fiber itself and were able to suppress it to the level lower than single photon emission from the NV center. Single photon statistics was demonstrated at the fiber end as well as up to 3 times improvement in collection efficiency with respect to our confocal microscope

  19. Liver transplantation in Greek children: 15 years experience

    Directory of Open Access Journals (Sweden)

    Dimitrios Takoudas

    2010-09-01

    Full Text Available Liver transplantation (LT is the only available live-saving procedure for children with irreversible liver failure. This paper reports our experience from the follow-up of 16 Greek children with end-stage liver failure who underwent a LT. Over a period of 15 years, 16 pediatric liver recipients received follow up after being subjected to OLT (orthotopic liver transplantation due to end-stage liver failure. Nine children initially presented with extrahepatic biliary atresia, 2 with acute liver failure after toxic mushroom ingestion, 2 with intrahepatic cholestasis, 2 with metabolic diseases and one with hepatoblastoma. Ten children received a liver transplant in the Organ Transplantation Unit of Aristotle University of Thessaloniki and the rest in other transplant centers. Three transplants came from a living-related donor and 13 from a deceased donor. Six children underwent immunosuppressive treatment with cyclo­sporine, mycophenolate mofetil and corticosteroids, and 7 with tacrolimus, mycophenolate mofetil and corticosteroids. Three out of 16 children died within the first month after the transplantation due to post-transplant complications. Three children presented with acute rejection and one with chronic organ rejection which was successfully managed. Five children presented with cytomegalovirus infection, 5 with Epstein-Barr virus, 2 with HSV1,2, 2 with ParvoB19 virus, 2 with varicella-zoster virus and one with C. Albicans infection. One child presented with upper gastrointestinal hemorrhage and one with small biliary paucity. A satisfying outcome was achieved in most cases, with good graft function, except for the patient with small biliary paucity who required re-transplantation. The long-term clinical course of liver transplanted children is good under the condition that they are attended in specialized centers.

  20. Annual Death Toll from Alzheimer's Nearly Doubles in 15 Years

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163957.html Annual Death Toll From Alzheimer's Nearly Doubles in 15 Years ... to success in treating other leading causes of death, and partly due to increasing awareness that AD [ ...

  1. Laparoscopic myomectomy in Kenya : A 15 year retrospective review

    African Journals Online (AJOL)

    Laparoscopic myomectomy in Kenya : A 15 year retrospective review. ... offers all the advantages of laparoscopic surgery including less haemorrhage, quicker recovery ... The fertility outcomes are comparable to open myomectomy with better ...

  2. Cardiogenetic counseling : An overview of results and daily practice after 15 years experience

    NARCIS (Netherlands)

    Hofman, Nynke; Kolder, Iris; Alders, Marielle; Mannens, Marcel; Tan, Hanno; Van Langen, Irene; Wilde, Arthur

    2012-01-01

    Introduction: We evaluated the results of 15 years of cardiogenetic counseling in the Academic Medical Center (AMC). Methods: We retrospectively analyzed all families who were counseled between 1996 and 2011 with a suspected inherited arrhythmia syndrome including primary electrical diseases, cardio

  3. Epidemiologia de 118 casos de esclerose múltipla com seguimento de 15 anos no centro de referência do Hospital da Restauração de Pernambuco Epidemiology of 118 cases of multiple sclerosis after 15 years of follow-up on the reference center of Hospital da Restauração, Recife, Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Brito Ferreira

    2004-12-01

    : according to a descriptive, prospective, longitudinal, prevalence study, we analyzed data of 118 patients, who attended at the Reference Center for Attention to Patients with Demielinizating Diseases of Hospital da Restauração (CRAPPDD-HR - Recife - Pernambuco, Brazil, from January 1987 to March 2002, to have MS diagnosed according to Poser criteria. RESULTS: The patients were followed up by 1 to 15 years. Ninety five (80.5% patients were in treatment with immune-modulators. The prevalence was 1,36:100000 habitants. We have identified: predominance of mulattoes (110,93.2%, 82 (82.2% cases clinically defined, 15 (12.7% cases laboratorial defined and 6 (5.1% cases clinically probable; a number of maximum bouts equal to 46; more frequent mild EDSS for patients with 1 to 10 years of MS of remittent-recurrent (RR form. Gender rate of 83 cases of RR form was equivalent to the general one, however on RR with secondary progressive form form, the rate was 2.5 times greater for females than for males, and on primary progressive form, 5.5 times greater for males. CONCLUSION: Although some results of this research had been similar to that of eight studies used as standards for comparison, the differences will require new approaches.

  4. Impact of aprotinin and renal function on mortality: a retrospective single center analysis

    Directory of Open Access Journals (Sweden)

    Von Visger Jon

    2011-08-01

    Full Text Available Abstract Background An estimated up to 7% of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the U.S. Food and Drug Administration after a large prospective, randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However, only patients with normal kidney function have been studied. Methods In this study, we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question: Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction? Results Based on our model, aprotinin use was associated with a 3.8-fold increase in odds of death one year later compared to no aprotinin use with p-value = 0.0018, regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Conclusions Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding, but for overall safety to the whole organism using long-term clinical outcome studies, including those with varying degree of baseline kidney function.

  5. Impact of aprotinin and renal function on mortality: a retrospective single center analysis.

    Science.gov (United States)

    Schloss, Brian; Gulati, Parul; Yu, Lianbo; Abdel-Rasoul, Mahmoud; O'Brien, William; Von Visger, Jon; Awad, Hamdy

    2011-08-30

    An estimated up to 7% of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the U.S. Food and Drug Administration after a large prospective, randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However, only patients with normal kidney function have been studied. In this study, we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question: Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction? Based on our model, aprotinin use was associated with a 3.8-fold increase in odds of death one year later compared to no aprotinin use with p-value = 0.0018, regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding, but for overall safety to the whole organism using long-term clinical outcome studies, including those with varying degree of baseline kidney function.

  6. Acute Invasive Fungal Rhinosinusitis: A 15-Year Experience with 41 Patients.

    Science.gov (United States)

    Payne, Sakeena J; Mitzner, Ron; Kunchala, Sudhir; Roland, Lauren; McGinn, Johnathan D

    2016-04-01

    To describe a 15-year single-institution experience of 41 cases of acute invasive fungal sinusitis (AIFRS), identify clinical indicators predictive of AIFRS, and discuss our approach to these high-acuity patients. Case series with chart review. Tertiary referral center; The Pennsylvania State University Hershey Medical Center. A retrospective review was performed for AIFRS consultations between September 1999 and March 2014. Variables reviewed included underlying condition, presenting symptoms, absolute neutrophil count, disease extent on examination, radiographic findings, medical treatment, biopsy results, surgical treatment, and outcomes. Univariate analysis was performed to determine variables significantly associated with AIFRS. Outcome measures were assessed and patient assessment algorithm developed. Of 131 patients evaluated, 41 were diagnosed with AIFRS; 92.7% had an underlying hematologic malignancy. Disease predictive variables included absolute neutrophil count <500/μL (P < .0001; sensitivity = 78%), mucosal abnormalities of middle turbinate (P < .0001; specificity = 88%) and septum (P < .0001; specificity = 97%), and specifically, necrosis of the middle turbinate (P < .0001; specificity = 97%). Twenty-five AIFRS patients (61%) survived until discharge; 25% (n = 10) expired secondary to AIFRS infection explicitly. This series represents one of the largest single-institution experiences of AIFRS published to date. Timely diagnosis is necessary to improve patient outcomes and limit morbidity. Maintaining a high index of suspicion in at-risk patient populations, followed by prompt evaluation and management, is crucial in suspected AIFRS. The presence or absence of certain findings appear to correlate with biopsy results and may aid in appropriately gauging clinical suspicion for the presence of AIFRS. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  7. Raising the Standard: A 15-Year Retrospective, 1987-2002.

    Science.gov (United States)

    National Board for Professional Teaching Standards, Detroit, MI.

    This report describes the past 15 years of work by the National Board for Professional Teaching Standards (NBPTS) to raise the standards for teacher quality. The NBPTS identified five core propositions that describe the knowledge, skills, and dispositions characterizing accomplished teaching. It created professional standards for K-12 teachers,…

  8. Your Child's Development: 1.5 Years (18 Months)

    Science.gov (United States)

    ... Kids For Parents MORE ON THIS TOPIC Your Child's Checkup: 1.5 Years (18 Months) Feeding Your 1- to 2-Year-Old Medical Care and Your 1- to 2-Year-Old Movement, Coordination, and Your 1- to 2-Year-Old Sleep and Your 1- to 2-Year-Old Growth and Your 1- to 2-Year-Old Communication ...

  9. Single-molecule magnet behavior with a single metal center enhanced through peripheral ligand modifications.

    Science.gov (United States)

    Jurca, Titel; Farghal, Ahmed; Lin, Po-Heng; Korobkov, Ilia; Murugesu, Muralee; Richeson, Darrin S

    2011-10-12

    Bis(imino)pyridine pincer ligands in conjunction with two isothiocyanate ligands have been used to prepare two mononuclear Co(II) complexes. Both complexes have a distorted square-pyramidal geometry with the Co(II) centers lying above the basal plane. This leads to significant spin-orbit coupling for the d(7) Co(II) ions and consequently to slow relaxation of the magnetization that is characteristic of Single-Molecule Magnet (SMM) behavior.

  10. Center for Applications of Single-Walled Carbon Nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Resasco, Daniel E

    2008-02-21

    This report describes the activities conducted under a Congressional Direction project whose goal was to develop applications for Single-walled carbon nanotubes, under the Carbon Nanotube Technology Center (CANTEC), a multi-investigator program that capitalizes on OU’s advantageous position of having available high quality carbon nanotubes. During the first phase of CANTEC, 11 faculty members and their students from the College of Engineering developed applications for carbon nanotubes by applying their expertise in a number of areas: Catalysis, Reaction Engineering, Nanotube synthesis, Surfactants, Colloid Chemistry, Polymer Chemistry, Spectroscopy, Tissue Engineering, Biosensors, Biochemical Engineering, Cell Biology, Thermal Transport, Composite Materials, Protein synthesis and purification, Molecular Modeling, Computational Simulations. In particular, during this phase, the different research groups involved in CANTEC made advances in the tailoring of Single-Walled Carbon Nanotubes (SWNT) of controlled diameter and chirality by Modifying Reaction Conditions and the Nature of the catalyst; developed kinetic models that quantitatively describe the SWNT growth, created vertically oriented forests of SWNT by varying the density of metal nanoparticles catalyst particles, and developed novel nanostructured SWNT towers that exhibit superhydrophobic behavior. They also developed molecular simulations of the growth of Metal Nanoparticles on the surface of SWNT, which may have applications in the field of fuell cells. In the area of biomedical applications, CANTEC researchers fabricated SWNT Biosensors by a novel electrostatic layer-by-layer (LBL) deposition method, which may have an impact in the control of diabetes. They also functionalized SWNT with proteins that retained the protein’s biological activity and also retained the near-infrared light absorbance, which finds applications in the treatment of cancer.

  11. Multidisciplinary approach to transvenous lead extraction: a single center's experience.

    Science.gov (United States)

    Maus, Timothy M; Shurter, Jesse; Nguyen, Liem; Birgersdotter-Green, Ulrika; Pretorius, Victor

    2015-04-01

    To evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. One university hospital. One hundred ninety-five patients scheduled for transvenous lead extraction. A multidisciplinary approach to transvenous lead extraction involving cardiac surgery, electrophysiology, perfusion, and cardiac anesthesiology. A case series of 351 lead extractions performed in 195 patients over a 42-month period. Indications, success rates, and complication rates were tracked and retrospectively evaluated and reported. Indications for lead extraction included 53.3% because of lead malfunction, 36.9% because of infection, with the remaining 9.7% from other categories such as venous stenosis. The lead extraction rate was 99.7%, with complete removal in 97.7%. The overall major complication rate was 3.08%. After an initial 1-year period of performing lead extractions, the overall major complication rate reduced to 1.23%. Transvenous lead extraction generally is a safe procedure, but not without complications. A multidisciplinary approach involving cardiac surgery, electrophysiology, and cardiac anesthesiology allows for successful management and the ability to rapidly manage major complications. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. LIVER TRANSPLANTATION. A SINGLE CENTER EXPERIENCE OF 100 CASES

    Directory of Open Access Journals (Sweden)

    A. M. Granov

    2012-01-01

    Full Text Available A single center experience of first 100 liver transplantations (LTs is summarized. Analysis of trends in cadaver donor population and waiting list status changes, and also of early and late postoperative complications are presented. 100 LTs were performed for 95 patients (pts, retransplantation – 4 pts; one patient received 3 liver transplants (female – 55 pts, male – 40 pts, mean age – 39.9 ± 12.1 years. Cumulative 1-year survival rate of pts by Kaplan–Meyer was 91%, 3-year – 83%. Biliary complications were revealed in 9% of pts during 2–9 months after LT. 77 pts have been regularly observed in outpatient clinic, mean age – 44 ± 9.2 years, male – 35, fema- le – 42, follow-up period – 1 months up to 13 years after LT. 3.9% remained invalid with limitation of ability to work, 61.8% have been working, 22.3% were capable to work, retirees were 10.5%. Development of preoperati- ve planning, adequate organ selection will allow to improve the results of LT. Study of hematopoietic stem cells role will expand tools of prognosis of posttransplant complications. 

  13. Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2014-01-01

    Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

  14. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  15. [Socio-demographic impact of 15 years of family planning].

    Science.gov (United States)

    Rosales Aujang, Enrique; Felguérez Flores, Jesús Alberto

    2005-08-01

    Familiar planning is an important branch of the preventive medicine that can have a great impact on the health of the humanity. The present study is an evaluation by a cross section of the effects obtained by the program of familiar planning during a period of 15 years in the Aguascalientes Delegation of the Mexican Institute of the Social Security, establishing therefore a diagnosis and identifying elements that can contribute in the suitable planning of strategies to improve the quality of the attention and to respond to social and health necessities of the population.

  16. Bilateral Ota nevus in a 15 years old patient

    Directory of Open Access Journals (Sweden)

    Savaş Öztürk

    2013-12-01

    Full Text Available Nevus of Ota is a dermal melanocytosis, clinically localizedon skin that is innervated by the first and secondbranches of the trigeminal nerve. It occurs almost entirelyin Asian people. The clinical manifestations are usuallyunilateral; only 5% of cases are bilateral. In this article,due to rarity of the case, a 15-year-old patient, who was diagnosedwith bilateral ota nevus, without having any dermatologicalcomplaints other than cosmetic appearenceand stains in her eyes and around was presented.Key words: Bilateral ota nevus, child, melanocytosis

  17. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

    Directory of Open Access Journals (Sweden)

    Ahmet Barış Durukan

    2012-08-01

    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  18. Famitinib in metastatic renal cell carcinoma: a single center study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wen; ZHOU Ai-ping; QIN Qiong; CHANG Chun-xiao; JIANG Hao-yuan; MA Jian-hui; WANG Jin-wan

    2013-01-01

    Background Famitinib is a novel and potent multitargeting receptor tyrosine kinase inhibitor.The phase I clinical study showed that famitinib was well tolerated and had a broad anti-tumor spectrum.The purpose of this study was to examine the efficacy and safety of famitinib for the treatment of metastatic renal cell carcinoma (mRCC).Methods The data of famitinib in treating patients with mRCC from the single-center phases Ⅰ and Ⅱ clinical trials were analyzed.Famitinib was administered orally at the dose of 13-30 mg once daily until tumor progression,occurrence of intolerable adverse reactions or withdrawal of the informed consent.Results A total of 24 patients with mRCC were treated including 17 patients at a dose of 25 mg once daily,4 patients at a dose of 27 mg and 1 patient each at a dose of 13 mg,20 mg and 30 mg,respectively.Twelve (50.0%) patients achieved partial response (PR) and 9 patients achieved stable disease (SD).Progressive disease was found in 3 (12.5%) patients.The disease control rate was 87.5%.The median follow-up time was 17.6 months; the median progression free survival (PFS) was 10.7 (95% Cl7.0-14.4) months; and the estimated median overall survival (OS) time was 33.0 (95% Cl8.7-57.3) months.The adverse drug reactions mainly included hypertension (54.1%),hand-foot skin reactions (45.8%),diarrhea (33.3%),mucositis (29.2%),neutropenia (45.8%),thrombocytopenia (29.2%),hyperlipidemia (41.7%) and proteinuria (41.7%).The incidence rate of grades 3 and 4 adverse events was low,mainly including hypertension 12.5%,hand-foot skin reactions 4.2%,neutropenia 4.2%,thrombocytopenia 4.2%,hyperlipidemia 4.2% and proteinuria 12.5%.Conclusions Famitinib has significant anti-tumor activity in mRCC.The common adverse reactions are generally manageable.

  19. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Shpend Idrizi

    2015-08-01

    Full Text Available BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74% of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg to 39.1 mmHg (20-80 mmHg. Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9% required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55% patients, and four (9% patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.

  20. Skin test reactivity among Danish children measured 15 years apart

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Porsbjerg, C;

    2006-01-01

    test (SPT) positivity in Danish children has changed from 1986 to 2001. METHODS: Serial cross-sectional studies of two different random population samples of children aged 7 to 17 years of age, living in urban Copenhagen, Denmark, were performed 15 years apart. The first cohort was investigated in 1986...... (n = 527) and the second in 2001 (n = 480). Skin test reactivity to nine common aeroallergens was measured at both occasions. RESULTS: The prevalence of positive SPT to at least one allergen decreased from 24.1% in 1986 to 18.9% in 2001, (p = 0.05). We found a declining prevalence of sensitization...... to most allergens tested, statistically significant; however, only for mugwort and Alternaria iridis. Among subjects, who were sensitized to only one allergen, we found significantly fewer individuals with reactions to D. pteronyssinus and mugwort. CONCLUSIONS: The prevalence of atopic sensitization...

  1. Attitudes toward the metric system 15 years later.

    Science.gov (United States)

    Gayton, W F; Hearns, J F; Elgee, L; Harvey, C

    2001-04-01

    This follow-up study investigated whether attitudes toward the metric system have changed over the last 15 years. 132 subjects ranging in age from 18 to 45 years participated by filling out a 7-item survey designed to measure attitudes toward the metric system. Each survey item was scored using a 5-point rating, e.g., "the change to the metric system will create more problems than it solves," 1: strongly agree and 5: strongly disagree. Scores were compared to those obtained for a similar sample in 1983. Comparisons using t tests indicated no significant differences between attitude scores from 1983 to 1998 for either men (t64 = .95) or women (t133 = .06).

  2. A 15-year epileptogenic period after perinatal brain injury.

    Science.gov (United States)

    Pisani, F; Pavlidis, E; Facini, C; La Morgia, C; Fusco, C; Cantalupo, G

    Seizures are a frequent acute neurological event in the neonatal period. Up to 12 to 18% of all seizures in newborns are due to perinatal stroke and up to 39% of affected children can then develop epilepsy in childhood. We report the case of a young patient who presented stroke-related seizures in the neonatal period and then developed focal symptomatic epilepsy at 15 years of age, and in whom the epileptic focus was found to co-localize with the site of his ischemic brain lesion. Such a prolonged silent period before onset of remote symptomatic epilepsy has not previously been reported. This case suggests that newborns with seizures due to a neonatal stroke are at higher risk of epilepsy and that the epileptogenic process in these subjects can last longer than a decade.

  3. Bullying victimization among 13 til 15 year old school children

    DEFF Research Database (Denmark)

    Due, Pernille; Holstein, Bjørn Evald

    2008-01-01

    AIM: to examine the prevalence of bullying victimization in 66 countries and territories from five continents based on data from two large international surveys: the 2001/2 Health Behavior in School-aged Children survey (HBSC) and the Global School-based Students Health Survey (GSHS). The surveys...... provide nationally representative, cross-sectional information on 13-15-year-old school children (N = 218,104). OUTCOME MEASURES: Bullying victimization, once or more within the past 2 months (HBSC)/30 days (GSHS). RESULTS: On average, 32.1% of the children were bullied at school at least once within...... the past 2 months in countries involved in the HBSC study and 37.4% of children were bullied at least one day within the past 30 days in countries involved in the GSHS study. In both surveys, a large variation in prevalence was found across countries. The lowest prevalence in the GSHS survey was observed...

  4. Corneal donations in South Africa: A 15-year review.

    Science.gov (United States)

    York, Nicholas J; Tinley, Christopher

    2017-07-28

    Corneal pathology is one of the leading causes of preventable blindness in South Africa (SA). A corneal transplant can restore or significantly improve vision in most cases. However, in SA there is a gross shortage of corneal tissue available to ophthalmologists. Little has been published describing the magnitude of the problem. To describe trends in the number of corneal donors per year in SA, the number of corneal transplants performed each year, the origin of donors, the allocation of corneas to the public or private sector, and the demographics of donors. This was a retrospective review of all corneal donations to SA eye banks over the 15-year period 1 January 2002 - 31 December 2016. There was a progressive year-on-year decline in corneal donors over the study period, from 565 per year in 2002 to 89 in 2016. As a direct result, there has been an 85.5% decrease in the number of corneal transplants performed per year using locally donated corneas, from 1 049 in 2002 to 152 in 2016. Of the donors, 48.8% originated from mortuaries, 39.0% from private hospitals and 12.2% from government hospitals; donors from mortuaries showed the most significant decline over the 15-year period, decreasing by 94.8%. Of donated corneas, 79.3% were allocated to the private sector and 21.7% to the public sector. Males comprised 69.1% of donors, while 77.2% were white, 14.0% coloured, 6.3% black and 2.5% Indian/Asian. Donor age demonstrated a bimodal peak at 25 and 55 years. The number of corneal donations in SA has declined markedly, causing the burden of corneal disease requiring transplantation to rise steadily. Population groups with a low donor rate may have cultural and other objections to corneal donation, which should be a major focus of future research and initiatives aimed at reversing the current trends.

  5. Pediatric Heart Transplantation: Report from a Single Center in China

    Institute of Scientific and Technical Information of China (English)

    Fei Li; Jie Cai; Yong-Feng Sun; Jin-Ping Liu; Nian-Guo Dong

    2015-01-01

    Background:Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Methods:This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2014.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Results:Nineteen pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 10 were male.The age at the time of transplantation ranged from 3 months to 18 years (median 15 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 38.0 kg).Pretransplant diagnosis included cardiomyopathy (14 cases),complex congenital heart disease (3 cases),and tumor (2 cases).All recipients received ABO-compatible donor hearts.Postoperative complications occurred in 12 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ-Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion:Orthotopic HTx is a promising therapeutic option with satisfying survival for the pediatric population in China with end-stage heart disease.

  6. Controlled Coupling of a Single Nitrogen-Vacancy Center to a Silver Nanowire

    DEFF Research Database (Denmark)

    Huck, Alexander; Kumar, Shailesh; Shakoor, Abdul

    2011-01-01

    We report on the controlled coupling of a single nitrogen-vacancy (NV) center to a surface plasmon mode propagating along a chemically grown silver nanowire (NW). We locate and optically characterize a single NV center in a uniform dielectric environment before we controllably position this emitter...

  7. Optical determination and magnetic manipulation of single nitrogen-vacancy color center in diamond nanocrystal

    CERN Document Server

    Lai, Ngoc Diep; Treussart, François; Roch, Jean-François

    2010-01-01

    The controlled and coherent manipulation of individual quantum systems is a fundamental key for the development of quantum information processing. The nitrogen-vacancy (NV) color center in diamond is a promising system since its photoluminescence is perfectly stable at room temperature and its electron spin can be optically read-out at the individual level. We review here the experiments currently realized in our laboratory, concerning the use of single NV color center as single photon source and the coherent magnetic manipulation of the electron spin associated to a single NV color center. Furthermore, we demonstrate a nanoscopy experiment based on saturation absorption e?ect, which allows to optically pin-point single NV color center at a sub-? resolution. This opens a possibility to independently address two or multiple magnetically-coupled single NV color centers, which is a necessary step toward the realization of a diamond-based quantum computer.

  8. Deterministic fabrication of dielectric loaded waveguides coupled to single nitrogen vacancy centers in nanodiamonds

    DEFF Research Database (Denmark)

    Siampour, Hamidreza; Kumar, Shailesh; Bozhevolnyi, Sergey I.

    We report on the fabrication of dielectric-loaded-waveguides which are excited by single-nitrogen-vacancy (NV) centers in nanodiamonds. The waveguides are deterministically written onto the pre-characterized nanodiamonds by using electron beam lithography of hydrogen silsesquioxane (HSQ) resist...... on silver-coated silicon substrate. Change in lifetime for NV-centers is observed after fabrication of waveguides and an antibunching in correlation measurement confirms that nanodiamonds contain single NV-centers....

  9. Financial Literacy of 15-Year-Olds: Results from PISA 2015. Data Point. NCES 2017-086

    Science.gov (United States)

    Gonzales, Patrick; Sen, Anindita

    2017-01-01

    On May 24, the National Center for Education Statistics released Financial Literacy of 15-year-olds: Results from PISA 2015. The PISA assessment of financial literacy measured students' knowledge and understanding of fundamental elements of the financial world, including financial concepts, products, and risks, and their ability to apply what they…

  10. Patterns of Weight Control Behavior among 15 year old Girls

    Science.gov (United States)

    Balantekin, Katherine N.; Birch, Leann L.; Savage, Jennifer S.

    2015-01-01

    Objective The objectives were to identify and predict patterns of weight control behavior in 15 year old (yo) girls and to examine weight control group differences in energy intake. Method Subjects included 166 girls assessed every 2 years (ys) from age 5 to 15. Latent class analysis was used to identify patterns of weight control behaviors. Antecedent variables (e.g. inhibitory control at 7ys), and concurrent variables (e.g. BMI and dietary intake at 15ys) were included as predictors. Assessments were a combination of survey, interview, and laboratory measures. Results LCA identified four classes of weight control behaviors, Non-dieters (26%), and three dieting groups: Lifestyle (16%), Dieters (43%), and Extreme Dieters (17%). Levels of restraint, weight concerns, and dieting frequency increased across groups, from Non-dieters to Extreme Dieters. BMI at 5ys and inhibitory control at 7ys predicted weight control group at 15ys; e.g. with every one-point decrease in inhibitory control, girls were twice as likely to be Extreme Dieters than Non-dieters. Girls in the Extreme Dieters group were mostly classified as under-reporters, and had the lowest self-reported intake, but ate significantly more in the laboratory. Discussion Among 15yo girls, “dieting” includes a range of both healthy and unhealthy behaviors. Risk factors for membership in a weight control groups are present as early as 5ys. Patterns of intake in the laboratory support the view that lower reported energy intake by Extreme Dieters is likely due under-reporting as an intent to decrease intake, not actual decreased intake. PMID:26284953

  11. 15 Years of Terra MODIS Instrument on-Orbit Performance

    Science.gov (United States)

    Xiong, X.; Salomonson, V.

    2014-12-01

    The first MODIS instrument, launched on-board the NASA EOS Terra spacecraft in December 1999, has successfully operated for nearly 15 years. MODIS observations have significantly contributed to the studies of many geophysical parameters of the earth's system and its changes over time. Dedicated effort made by the MODIS Characterization Support Team (MCST) to constantly monitor instrument operation, to calibrate changes in sensor response, to derive and update sensor calibration parameters, and to maintain and improve calibration algorithms has played an extremely important role to assure the quality of MODIS data products. MODIS was developed with overall improvements over its heritage sensors. Its observations are made in 36 spectral bands, covering wavelengths from visible to long-wave infrared. The reflective solar bands (1-19 and 26) are calibrated on-orbit by a solar diffuser (SD) panel and regularly scheduled lunar observations. The thermal emissive bands (20-25 and 27-36) calibration is referenced to an on-board blackbody (BB) source. On-orbit changes in the sensor spectral and spatial characteristics are tracked by a spectroradiometric calibration assembly (SRCA). This paper provides an overview of Terra MODIS on-orbit operation and calibration activities implemented from launch to present and the status of instrument health and functions. It demonstrates sensor on-orbit performance derived from its telemetry, on-board calibrators (OBC), and lunar observations. Also discussed in this paper are changes in sensor characteristics, corrections applied to maintain level 1B data quality, various challenging issues, and future improvements.

  12. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  13. Nanoimplantation and Purcell enhancement of single nitrogen-vacancy centers in photonic crystal cavities in diamond

    Energy Technology Data Exchange (ETDEWEB)

    Riedrich-Möller, Janine; Becher, Christoph, E-mail: christoph.becher@physik.uni-saarland.de [Universität des Saarlandes, Fachrichtung 7.2 (Experimentalphysik), Campus E 2.6, 66123 Saarbrücken (Germany); Pezzagna, Sébastien; Meijer, Jan [Universität Leipzig, Institut für Experimentalphysik II, Linnéstraße 5, 04103 Leipzig (Germany); Pauly, Christoph; Mücklich, Frank [Universität des Saarlandes, Fachrichtung 8.4 (Materialwissenschaft und Werkstofftechnik), Campus D 3.3, 66123 Saarbrücken (Germany); Markham, Matthew; Edmonds, Andrew M. [Element Six Ltd., Global Innovation Centre, Fermi Avenue, Harwell Oxford, Didcot OX11 0QR (United Kingdom)

    2015-06-01

    We present the controlled creation of single nitrogen-vacancy (NV) centers via ion implantation at the center of a photonic crystal cavity which is fabricated in an ultrapure, single crystal diamond membrane. High-resolution placement of NV centers is achieved using collimation of a 5 keV-nitrogen ion beam through a pierced tip of an atomic force microscope. We demonstrate coupling of the implanted NV centers' broad band fluorescence to a cavity mode and observe Purcell enhancement of the spontaneous emission. The results are in good agreement with a master equation model for the cavity coupling.

  14. Nanoimplantation and Purcell enhancement of single NV centers in photonic crystal cavities in diamond

    CERN Document Server

    Riedrich-Möller, Janine; Meijer, Jan; Pauly, Christoph; Mücklich, Frank; Markham, Matthew; Edmonds, Andrew M; Becher, Christoph

    2015-01-01

    We present the controlled creation of single nitrogen-vacancy (NV) centers via ion implantation at the center of a photonic crystal cavity which is fabricated in an ultrapure, single crystal diamond membrane. High-resolution placement of NV centers is achieved using collimation of a 5keV-nitrogen ion beam through a pierced tip of an atomic force microscope (AFM). We demonstrate coupling of the implanted NV centers' broad band fluorescence to a cavity mode and observe Purcell enhancement of the spontaneous emission. The results are in good agreement with a master equation model for the cavity coupling.

  15. Cardiac channelopathies in pediatric patients - 7-years single center experience.

    Science.gov (United States)

    Illikova, V; Hlivak, P; Hatala, R

    2015-01-01

    Channelopathies are associated with mutations of genes encoding proteins creating or interacting with the specialized ion channels in myocardial cell membranes, thus forming arrhythmogenic substrate predisposing the patient to sudden cardiac death. The study focuses the clinical and ECG presentation and management of children with channelopathies in Slovakia. Twenty-two children with suspected channelopathy were admitted to Children's Cardiac Center Bratislava in the years 2007-2014. Genetic testing was made in 19 patients. Fourteen patients were symptomatic. Long QT syndrome was genetically proven in eight and catecholaminergic polymorphic ventricular tachycardia in five patients. Twenty children are treated with beta-blockers, five in combination with mexiletine or flecainide. Nine patients received implantable cardiac defibrillator and one underwent left cardiac sympathetic denervation. Both clinical presentation and genetic testing must be considered in the diagnostic and therapeutic process of channelopathies. Early diagnosis allows for adequate treatment and lifestyle modification. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Framatome Owners Group achievement after 15 years of operation

    Energy Technology Data Exchange (ETDEWEB)

    Braquilanges, Bertrand de; Delporte, Rene [Electrabel s.a., boulevard du Regent 8, 1000 Bruxelles (Belgium); Van Schalkwyk, Andries C. [Eskom, PO Box 1091, Johannesburg 2001 (South Africa)

    2006-07-01

    with annual reports (e.g. Performance Indicators Report), Significant Events Reports, Materials Reports, Designer Newsletters or Technical Reports issued from the Joint Programs. Since year 2000, all this documentation has been accessible to FROG Members on a dedicated web site. This modern support of communication allows them also to permanently raise questions and to collect answers. Along those 15 years of operation, the FROG has evolved and has adapted to the needs. There is no doubt that new Memberships and new contents will join it. (authors)

  17. Impurity centers in LiF:Cu{sup +} single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Nepomnyashchikh, A I; Shalaev, A A; Subanakov, A K; Paklin, A S; Bobina, N S; Myasnikova, A S; Shendrik, R, E-mail: alshal@igc.irk.ru

    2010-11-15

    The single crystals LiF with copper impurity were grown by Czochralski method. The concentrations of Cu in the crystals were 0,0004-0,002%. In order to determine a copper valence impurity, measurements of the ESR, emission, excitation and absorption spectra were performed. We found emission peak at 410 nm and excitation peak at 250 nm. In agreement with reference, these peaks point to presence of Cu{sup +} in our samples. The mechanisms of capture and recombination providing process of thermoluminescence were recognized.

  18. Targets and Patented Drugs for Chemotherapy of Chagas Disease in the Last 15 Years-Period.

    Science.gov (United States)

    Duschak, Vilma G

    2016-01-01

    The American trypanosomiasis, Chagas disease, is a parasitic infection typically spread by triatomine vectors affecting millions of people all over Latin America. Existing chemotherapy is centered on the nitroaromatic compounds benznidazole and nifurtimox that provide unsatisfactory results and substantial side effects. So, the finding and exploration of novel ways to challenge this neglected disease is a main priority. The biologic and biochemical progress in the scientific knowledge of Trypanosoma cruzi in the period comprising last 15-years has increased the identification of multiple targets for Chagas´ disease chemotherapy. In the middle of the best encouraging targets for trypanocidal drugs, ergosterol biosynthesis pathway and cruzipain, a key cysteine protease (CP) of T. cruzi, have been pointed out. Unfortunately, recent clinical trials investigating the administration of pozoconazole and ravuconazole to chronic indeterminate Chagas disease patients revealed their inferiority compared to the standard drug Benznidazole. In view of the information gained in the preceding years, a reasonable approach for the fast development of novel anti-T. cruzi chemotherapy would be focused on K777, the cysteine proteinase inhibitor (CPI) near to enter to clinical trials, and founded on the clinical evaluation of combination of known drugs with existing trypanocidal agents to obtain more efficiency and less secondary effects. Top series of xanthine have been recently identified as clinical candidate for Chagas disease. In addition, trypanothione biosynthesis, thiol-dependant redox and polyamine metabolism, the glycolytic, glyconeogenic, pentose phosphate, lipidic and polyisoprenoid biosynthetic pathways, and the enzymes from biosynthetic glycoconjugates pathways have been studied. Several specific enzymes from these particular biosynthetic pathways such as hypoxanthine-guaninephosphoribosyl- transferase and farnesyl-pyrophosphate synthase, among others, have also been

  19. SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

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    S. V. Gautier

    2011-01-01

    Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

  20. Penile lichen sclerosus: An urologist's nightmare! - A single center experience

    Science.gov (United States)

    Singh, Jitendra Pratap; Priyadarshi, Vinod; Goel, Hemant Kumar; Vijay, Mukesh Kumar; Pal, Dilip Kumar; Chakraborty, Sudip; Kundu, Anup Kumar

    2015-01-01

    Purpose: Penile lichen sclerosus (LS) is a nagging condition and its progression result in devastating urinary and sexual problems and reduction in the quality-of-life. This study has been carried out to present our experience about this disease with simultaneous review of the available literature. Materials and Methods: This retrospective study has been done at a tertiary care center of eastern India. The data of 306 patients affected with LS were analyzed for clinical presentation, physical examination, investigations, and treatment offered. Results: Presenting symptoms were non-specific. The prepuce was most commonly involved location followed by glans and meatus. Urethral involvement was not isolated as the primary site. Circumcision was done in 237 patients, while 63 patients underwent meatotomy. Thirty-six of 39 cases of LS induced stricture were treated with buccal mucosal graft (BMG) either in one stage or in two stages. Conclusion: LS varies from being a highly aggressive disease of the penis and anterior urethra to a burnt out condition affecting just the meatus and surrounding glans. Early diagnosis and treatment are required to prevent its complication and associated morbidity. Management depends on the anatomical location of lesion, extent of involvement, rapidity of progression and its severity. Use of BMG in LS induced urethral stricture has shown encouraging results. PMID:26229314

  1. Solitary rectal ulcer syndrome: A single-center case series

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    Abdulaziz I AlGhulayqah

    2016-01-01

    Full Text Available Background/Aim: Solitary rectal ulcer syndrome (SRUS is a benign, chronic defecation disorder with varied presentations. The aim of this study is to summarize the clinical features, endoscopic findings, histological appearance, and treatment strategies associated with SRUS. Patients and Methods: This is a retrospective study of all patients diagnosed with SRUS at the King Faisal Specialist Hospital and Research Centre in Riyadh from January 2003 to December 2013. Cases were identified using the Department of Pathology database. Data were obtained from medical records that included clinical manifestation, endoscopic findings, and histopathological features. Results: Twenty patients were identified. The mean age was 42.5 years (±18.5 and 55% were females. Most of the patients presented with bleeding per rectum (85%, constipation (75%, and straining (50%, with a mean symptom duration of 26.7 months. The most common associated factors identified were constipation (75%, history of rectal surgery (25%, digital rectal manipulation (20%, and rectal prolapse (20%. Endoscopic findings included a single ulcer (50% and multiple ulcers (30%; 55% had a polypoidal appearance. On histopathology, there was surface ulceration (95%, fibrosis of the lamina propria (60%, distorted architecture (55%, and muscle hypertrophy with increased mucin production (50%. Patients were treated conservatively and none required surgery. Conclusion: SRUS is a rare disorder with variable clinical presentations. Stool softeners, a high fiber diet in addition to topical mesalamine, and biofeedback proved to be effective in this patient population.

  2. Performance characteristics of retrograde single-balloon endoscopy: A single center experience

    Institute of Scientific and Technical Information of China (English)

    Kaci E Christian; Karan Kapoor; Eric M Goldberg

    2016-01-01

    AIM: To evaluate the technical success, diagnostic yield(DY) and therapeutic potential of retrograde single balloon enteroscopy(rS BE). METHODS: A retrospective review of 136 rS BE procedures performed at a tertiary academic referral center from January 2006 and September 2013 was completed. Patient characteristics including age, gender and inpatient status were collected. The indication for the procedure was categorized into one of three groups: Obscure gastrointestinal bleeding(GIB), evaluation for Crohn’s disease and abnormal imaging. Procedural characteristics including insertion depth(ID), procedure time, concordance with pre-procedural imaging and complications were also recorded. Lastly, DY, defined as the percentage of cases producing either a definitive diagnosis or findings that could explain clinical symptoms and therapeutic yield(TY), defined as the percentage of cases in which a definitive intervention was performed, were determined. Mucosal tattooing and biopsy alone were not included in the TY. RESULTS: A total of 136 rS BE procedures were identified. Mean patient age was 57.5(± 16.2) years, 67(49.2%) were male, and 110(80.9%) procedures were performed on an outpatient basis. Indications for rS BE included GIB in 55(40.4%), evaluation of inflammatory bowel disease(IBD) in 29(21.3%), and imaging suggestive of pathology other than GIB or IBD in 43(31.6%). Nine(6.6%) rS BEs were performed for other indications. Mean ID was 68.3(± 39.3) cm proximal to the ileocecal valve and mean time to completion was 41.7(± 15.5) min. Overall, 73(53.7%) cases were diagnostic and 25(18.4%) cases were therapeutic in which interventions(argon plasma coagulation, stricture dilatation, polypectomy, etc.) were performed. Pre-procedural imaging was performed in 88(64.7%) patients. Endoscopic concordance of positive imaging findings was seen in 31(35.2%) cases. Follow up data was available in 93(68.4%) patients; 2(2.2%) reported post-procedural abdominal pain within 30 d

  3. Efficient coupling of a single diamond color center to propagating plasmonic gap modes

    DEFF Research Database (Denmark)

    Kumar, Shailesh; Huck, Alexander; Andersen, Ulrik L

    2013-01-01

    We report on coupling of a single nitrogen-vacancy (NV) center in a nanodiamond to the propagating gap mode of two parallel placed chemically grown silver nanowires. The coupled NV-center nanowire system is made by manipulating nanodiamonds and nanowires with the tip of an atomic force microscope...

  4. Familial Mediterranean fever in childhood: a single-center experience.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Adrovic, Amra; Sinoplu, Ada Bulut; Yucel, Gozde; Pamuk, Gizem; Aydın, Aslı Kirectepe; Dasdemir, Selcuk; Turanlı, Eda Tahir; Buyru, Nur; Kasapcopur, Ozgur

    2017-08-21

    The aim of this study is to present demographic and clinical features, MEFV mutation variations, and treatment response of a large number of pediatric familial Mediterranean fever (FMF) patients from a single tertiary centre. Moreover, we aimed to investigate the current outcome of FMF, namely frequency of amyloidosis in children with FMF. We evaluated 708 FMF patients who were followed up in our clinic and who were under colchicine treatment for at least 6 months. The data were recorded from patient records and also verified by negotiations with patients and parents. The male/female proportion of the cohort was 1.05/1 (n = 362/346). Abdominal pain (89.5%, n = 634) was the most common manifestation of FMF episodes, followed by fever (88.8%, n = 629) and arthritis (40.7%, n = 288). However, arthritis in 23 (8%) of the 288 cases was not self-limited; and they subsequently diagnosed with juvenile idiopathic arthritis in addition to FMF. Homozygote or heterozygote M694V mutation was more frequent in patients with arthritis (63.2%) and chronic arthritis (69.6%) than the whole cohort (53.8%). Erythrocyte sedimentation rate and CRP level were in high levels even during attack-free period in 13.9% (n = 97/697) and 11% (n = 78/670) of the patients, respectively. Proteinuria was found in ten patients (1.4%). Amyloidosis was confirmed by renal biopsy in only two of these cases who were homozygous for M694V and compound heterozygous for M694V/M680I. 47 (6.6%) subjects were considered as colchicine resistant. Homozygote M694V mutation was the most frequent mutation in those resistant cases (63.8%, n = 30), followed by compound heterozygote mutation of M694V/M680I (6.3%, n = 3). Homozygous M694V mutation are still the most frequent mutation and associated with the most severe clinical picture and the worst outcome in Turkish children. M694V genotype seems to be more frequently associated with arthritis as well as with chronic arthritis than other genotypes

  5. Perioperative Feeding Approaches in Single Ventricle Infants: A Survey of 46 Centers.

    Science.gov (United States)

    Slicker, Julie; Sables-Baus, Sharon; Lambert, Linda M; Peterson, Laura E; Woodard, Frances K; Ocampo, Elena C

    2016-12-01

    Background Feeding dysfunction occurs commonly in infants with single ventricle heart disease and impacts growth and long-term outcomes. Little evidence exists to guide safe feeding in this population. This study surveyed centers participating in the National Pediatric Cardiology Quality Improvement Collaborative to assess prevailing feeding practices amongthose caring for single ventricle neonates. Methods Web-based survey of 56 pediatric cardiac surgical centers was conducted. Questions addressed peri-operative feeding approaches and responses were presented and analyzed descriptively. Results Of 56 centers, 46 (82%) completed a survey. Preoperative feeding was common in single ventricle infants (30/46; 65%), routes varied. Centers who did not feed infants preoperatively cited the risk of necrotizing enterocolitis (16/16; 100%), presence of umbilical artery catheter (12/16; 75%), and prostaglandin infusion (9/16; 56%) as main concerns. 67% of centers reported no specific vital sign thresholds for withholding enteral feedings. In the postoperative period, most centers used an "internal guideline" (21/46; 46%) or an "informal practice" (15/46; 33%) to determine feeding readiness. Approaches to findings were significantly different among centers. About 40% of centers did not send patients home with feeding tubes, and there was no clear consensus between preferred feeding tube modality at discharge. Conclusion Considerable variation exists in feeding practices for infants with single ventricle congenital heart disease among 46 centers participating in a quality improvement collaborative. Although most centers generally feed infants preoperatively, feeding practices remain center-specific. Variability continues in the immediate post-operative and interstage periods. Further opportunities exist for investigation, standardization and development of best-practice feeding guidelines.

  6. Nanoscale fluorescence lifetime imaging of an optical antenna with a single diamond NV center.

    Science.gov (United States)

    Beams, Ryan; Smith, Dallas; Johnson, Timothy W; Oh, Sang-Hyun; Novotny, Lukas; Vamivakas, A Nick

    2013-08-14

    Solid-state quantum emitters, such as artificially engineered quantum dots or naturally occurring defects in solids, are being investigated for applications ranging from quantum information science and optoelectronics to biomedical imaging. Recently, these same systems have also been studied from the perspective of nanoscale metrology. In this letter, we study the near-field optical properties of a diamond nanocrystal hosting a single nitrogen vacancy center. We find that the nitrogen vacancy center is a sensitive probe of the surrounding electromagnetic mode structure. We exploit this sensitivity to demonstrate nanoscale fluorescence lifetime imaging microscopy (FLIM) with a single nitrogen vacancy center by imaging the local density of states of an optical antenna.

  7. Long-term results of pneumatic dilation for achalasia: A 15 years' experience

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; Jannis Kountouras; George Paroutoglou; Athanasios Beltsis; Christos Zavos; Basilios Papaziogas; Kostas Mlimidis

    2005-01-01

    AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation.METHODS: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy,barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score.The median dysphagia-free duration was calculated by Kaplan-Meier analysis.RESULTS: Symptoms were dysphagia (n = 39, 100%),regurgitation (n =23, 58.7%), chest pain (n = 4, 10.2%),and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61%and 58.3% after 5, 10 and 15 years respectively.CONCLUSION: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.

  8. DISTRIBUTION OF CONGENITAL HEART DISEASES AT TERTIARY CARE CENTER: SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vaishali

    2016-02-01

    Full Text Available BACKGROUND The current study was undertaken at a tertiary care center, Bhopal, MP, India, with the objective of establishing frequency of occurrence of congenital heart diseases by echocardiography. MATERIALS AND METHOD 10,000 consecutive cases undergoing Echo Color Doppler in the Cardiology Department Hamidia Hospital, Bhopal, between 1st Jan 2009 and July 2011 were analysed. Echo CD was performed by consultant cardiologist using Acuson Aspen Color Doppler machine following the ASE guidelines. RESULTS AND CONCLUSIONS In the present study out of 10,000consecutive cases undergoing echo 648 were identified to having congenital heart diseases. Isolated VSD (30.5%, isolated ASD (23.6% PDA (9% and TOF (8.3% were commonest defect observed. Most common congenital heart disease found in the present study is VSD and is most prevalent in males and is highest among 0-5 yrs.

  9. Energy Management of Hybrid Electric Vehicles: 15 years of development at the Ohio State University

    Directory of Open Access Journals (Sweden)

    Rizzoni Giorgio

    2015-01-01

    Full Text Available The aim of this paper is to document 15 years of hybrid electric vehicle energy management research at The Ohio State University Center for Automotive Research (OSUCAR. Hybrid Electric Vehicle (HEV technology encompasses many diverse aspects. In this paper we focus exclusively on the evolution of supervisory control strategies for on-board energy management in HEV. We present a series of control algorithms that have been developed in simulation and implemented in prototype vehicles for charge-sustaining HEVs at OSU-CAR. These solutions span from fuzzy-logic control algorithms to more sophisticated model-based optimal control methods. Finally, methods developed for plug-in HEVs energy management are also discussed

  10. Clinicopathologic spectrum of Waldenström′s macroglobulinemia: A single center experience

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    Sajid Raihan

    2010-07-01

    Full Text Available Waldenström′s Macroglobulinemia (WM is a B cell neoplasm characterized by infiltration of the bone marrow by a lymphoplasmacytic infiltrate and an IgM monoclonal gammopathy. We report a 15-year review of patients diagnosed with WM at our center. A total of 18 patients were diagnosed and treated at our center during the study period. Neurological symptoms were seen in almost 95% while B symptoms were present in almost 80% of patients. More than two-thirds of patients were anemic at the time of presentation and more than 90% showed bone marrow infiltration with lymphoplasmacytoid cells. Anemia, B symptoms, splenomegaly and neurological symptoms were the primary reasons in the majority of patients to initiate treatment. Chlorambucil was the primary treatment in more than half the patients followed by CVP. The median overall survival in all patients was 29 months (range 22-81 months. WM is a rare disorder and novel therapeutic modalities need to be identified to improve survival in these patients.

  11. Color center fluorescence and spin manipulation in single crystal, pyramidal diamond tips

    Science.gov (United States)

    Nelz, Richard; Fuchs, Philipp; Opaluch, Oliver; Sonusen, Selda; Savenko, Natalia; Podgursky, Vitali; Neu, Elke

    2016-11-01

    We investigate bright fluorescence of nitrogen (NV)- and silicon-vacancy color centers in pyramidal, single crystal diamond tips, which are commercially available as atomic force microscope probes. We coherently manipulate NV electronic spin ensembles with T2 = 7.7(3) μs. Color center lifetimes in different tip heights indicate effective refractive index effects and quenching. Using numerical simulations, we verify enhanced photon rates from emitters close to the pyramid apex rendering them promising as scanning probe sensors.

  12. Color center fluorescence and spin manipulation in single crystal, pyramidal diamond tips

    CERN Document Server

    Nelz, Richard; Opaluch, Oliver; Sonusen, Selda; Savenko, Natalia; Podgursky, Vitali; Neu, Elke

    2016-01-01

    We investigate bright fluorescence of nitrogen (NV)- and silicon-vacancy color centers in pyramidal, single crystal diamond tips which are commercially available as atomic force microscope probes. We coherently manipulate NV electronic spin ensembles with $T_2 = 7.7(3)\\,\\mu$s. Color center lifetimes in different tip heights indicate effective refractive index effects and quenching. Using numerical simulations, we verify enhanced photon rates from emitters close to the pyramid apex; a situation promising for scanning probe sensing.

  13. Ten- to 15-year results of the Oxford Phase III mobile unicompartmental knee arthroplasty

    Science.gov (United States)

    Lisowski, L. A.; Meijer, L. I.; van den Bekerom, M. P. J.; Pilot, P.; Lisowski, A. E.

    2016-01-01

    Aims The interest in unicompartmental knee arthroplasty (UKA) for medial osteoarthritis has increased rapidly but the long-term follow-up of the Oxford UKAs has yet to be analysed in non-designer centres. We have examined our ten- to 15-year clinical and radiological follow-up data for the Oxford Phase III UKAs. Patients and Methods Between January 1999 and January 2005 a total of 138 consecutive Oxford Phase III arthroplasties were performed by a single surgeon in 129 patients for medial compartment osteoarthritis (71 right and 67 left knees, mean age 72.0 years (47 to 91), mean body mass index 28.2 (20.7 to 52.2)). Both clinical data and radiographs were prospectively recorded and obtained at intervals. Of the 129 patients, 32 patients (32 knees) died, ten patients (12 knees) were not able to take part in the final clinical and radiological assessment due to physical and mental conditions, but via telephone interview it was confirmed that none of these ten patients (12 knees) had a revision of the knee arthroplasty. One patient (two knees) was lost to follow-up. Results The mean follow-up was 11.7 years (10 to 15). A total of 11 knees (8%) were revised. The survival at 15 years with revision for any reason as the endpoint was 90.6% (95% confidence interval (CI) 85.2 to 96.0) and revision related to the prosthesis was 99.3% (95% CI 97.9 to 100). The mean total Knee Society Score was 47 (0 to 80) pre-operatively and 81 (30 to 100) at latest follow-up. The mean Oxford Knee Score was 19 (12 to 40) pre-operatively and 42 (28 to 55) at final follow-up. Radiolucency beneath the tibial component occurred in 22 of 81 prostheses (27.2%) without evidence of loosening. Conclusion This study supports the use of UKA in medial compartment osteoarthritis with excellent long-term functional and radiological outcomes with an excellent 15-year survival rate. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):41–7. PMID:27694515

  14. Increasing the photon collection rate from a single NV center with a silver mirror

    DEFF Research Database (Denmark)

    Israelsen, Niels Møller; Kumar, Shailesh; Tawfieq, Mahmoud

    2014-01-01

    In the pursuit of realizing quantum optical networks, a large variety of different approaches have been studied to achieve a single photon source on-demand. The common goal for these approaches is to harvest all the emission from a quantum emitter into a single spatial optical mode while...... maintaining a high signal-to-noise ratio. In this work, we use a single nitrogen vacancy center in diamond as a quantum emitter operating at ambient conditions and we demonstrate an increased photon count rate up to a factor of 1.76 by placing a silver mirror fabricated on the end facet of an optical fiber...

  15. Acute post-infectious glomerulonephritis in adults: A single center report

    Directory of Open Access Journals (Sweden)

    Mouna Hamouda

    2014-01-01

    Full Text Available Acute post-infectious glomerulonephritis (APIGN is uncommonly seen in adults; its incidence is progressively declining, particularly in developed countries. The aim of this study was to evaluate the epidemiological, clinical and biologic features of APIGN in a Tunisian center. A retrospective descriptive analytic study was carried out on 50 patients aged more than 15 years who were admitted to the Monastir Hospital between 1991 and 2007, with a diagnosis of APIGN. There were more males than females (66% vs. 34%, and the mean age of the patients was 36.8 ± 10 years. Only 10% had an immunocompromised background, including diabetes. The most common site of infection was upper respiratory tract, followed by skin and pneumonia. The most common causative agent was Streptococcus (66%, followed by Staphylococcus (12%. 73.8% of the patients had low C3 complement levels. The mean peak serum creatinine was 190 μmol, and 4% of patients required acute dialysis. The patients were followed-up for a mean period of 18 months (range, 0.16-97 months. During follow-up, of the 46 patients reviewed in the consultation, the majority showed complete remission, 12 patients had persisting abnormalities such as hypertension in 17%, chronic renal failure in 8% and proteinuria in 6.5%, and one patient had concomitant hypertension and chronic renal failure. Our study suggests that APIGN is still endemic in some parts of the world such as Tunisia, and our data showed a favorable prognosis in adults.

  16. [Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up].

    Science.gov (United States)

    López Rodríguez, F J; Voces, R; Lima, P; Reyes, G; Silva, J; Ruiz, M; Rico, M; González De Diego, F; Fortuny, R; Garrido, G; González Santos, J M; Albertos, J; Fernández Calella, D; Vallejo, J L

    2001-07-01

    Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries. To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one. A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose. Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60). The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event

  17. ESWL for difficult bile duct stones:A 15-year single centre experience

    Institute of Scientific and Technical Information of China (English)

    Rosangela; Muratori; Francesco; Azzaroli; Federica; Buonfiglioli; Flavio; Alessandrelli; Paolo; Cecinato; Giuseppe; Mazzella; Enrico; Roda

    2010-01-01

    AIM:To evaluate the efficacy of extracorporeal shock wave lithotripsy(ESWL)for the management of refractory bile duct cholelithiasis in a third level referral centre.METHODS:The clinical records of all patients treated with a second generation electromagnetic lithotripter (Lithostar Plus,SIEMENS)from October 1990 to April 2005 were evaluated.All patients were monitored during the procedure and antibiotics were administered in case of cholangitis.Theχ 2 test and logistic regression analysis were performed as...

  18. Primary spinal tumors in childhood: A single institution 15 year experience

    Science.gov (United States)

    Hung, Po-Cheng; Wu, Chieh-Tsai; Jaing, Tang-Her; Sheen, Jiunn-Ming; Chou, Ming-Liang; Lin, Kuang-Lin

    2016-01-01

    Background: Pediatric primary spinal tumors (PST) are fairly uncommon, with little available data regarding incidence and outcomes. Materials and Methods: We conducted a retrospective review of the 22 consecutive patients less than 18 years old diagnosed with PST between March 1997 and May 2011 and treated at Chang Gung Children Hospital. All patients had undergone magnetic resonance imaging (MRI) for pre-operative evaluation and operations for PST. The extent of tumor removal was assessed by surgical report by the neurosurgeon or by post-operative MRI if available. Results: Ten of them had intramedullary tumors and 12 had intradural extramedullary tumors. All patients were treated with surgery to the primary site. A total of 15 patients underwent gross total tumor resection and seven patients received post-operative radiotherapy. Five patients received adjuvant chemotherapy for their primary tumor. Fourteen patients (64%) survived from study entry without tumor progression. Conclusions: PST encompassed a diverse group of pathologic entities that differ markedly based on the location and age of the children. Total resection of pediatric PST in children could be performed with acceptable risk and satisfactory long-term results. PMID:27695552

  19. Fifteen years of kidney biopsies in children: A single center in Egypt

    Directory of Open Access Journals (Sweden)

    Ashraf Bakr

    2014-01-01

    Full Text Available This study retrospectively investigates the indications and results of renal biopsy in children to determine the patterns of childhood kidney disease in a single tertiary children′s hospital in Egypt. We included all the patients who underwent ultrasound-guided renal biopsy from 1998 to 2012. All the kidney biopsies were studied under light microscopy, while immunofluorescence and electron microscopy were performed when indicated. A total of 1246 renal biopsies were performed over 15 years, on 1096 patients. The mean age of the patients at the time of biopsy was 9.2 ± 3.7 years. The main indication for a biopsy was the steroid-resistant nephrotic syndrome (n = 354, 28.4%, followed by the atypical nephrotic syndrome (n = 250, 20.1%, and renal abnormalities in the systemic diseases (n = 228, 18.3 %. In the 1226 pathologically diagnosed specimens, primary glomerulonephritis was the most common finding (n = 826, 67.4%, followed by secondary glomerulonephritis (n = 238, 19.4%. The most common causes of primary glomerulonephritis were Minimal Change Disease (MCD (n = 267, 21.8%, diffuse proliferative glomerulonephritis (n = 188, 15. 3%, and focal proliferative glomerulonephritis (n = 164, 13.3%. Lupus nephritis (n = 209, 17% was the most common cause of secondary glomerulonephritis. We conclude that the steroid-resistant nephrotic syndrome was the most frequent indication for biopsy and minimal change disease was the most common histopathological finding in our population.

  20. Brief Report: Pregnant by Age 15 Years and Substance Use Initiation among US Adolescent Girls

    Science.gov (United States)

    Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Spitznagel, Edward L.; Schootman, Mario; Cottler, Linda B.; Bierut, Laura Jean

    2012-01-01

    We examined substance use onset and associations with pregnancy by age 15 years. Participants were girls ages 15 years or younger (weighted n = 8319) from the 1999-2003 Youth Risk Behavior Surveillance System (YRBS). Multivariable logistic regression examined pregnancy as a function of substance use onset (i.e., age 10 years or younger, 11-12,…

  1. Performance characteristics of single effect lithium bromide/ water absorption chiller for small data centers

    Science.gov (United States)

    Mysore, Abhishek Arun Babu

    A medium data center consists of servers performing operations such as file sharing, collaboration and email. There are a large number of small and medium data centers across the world which consume more energy and are less efficient when compared to large data center facilities of companies such as GOOGLE, APPLE and FACEBOOK. Such companies are making their data center facilities more environmental friendly by employing renewable energy solutions such as wind and solar to power the data center or in data center cooling. This not only reduces the carbon footprint significantly but also decreases the costs incurred over a period of time. Cooling of data center play a vital role in proper functioning of the servers. It is found that cooling consumes about 50% of the total power consumed by the data center. Traditional method of cooling includes the use of mechanical compression chillers which consume lot of power and is not desirable. In order to eliminate the use of mechanical compressor chillers renewable energy resources such as solar and wind should be employed. One such technology is solar thermal cooling by means of absorption chiller which is powered by solar energy. The absorption chiller unit can be coupled with either flat plate or evacuated tube collectors in order to achieve the required inlet temperature for the generator of the absorption chiller unit. In this study a modular data center is considered having a cooling load requirement of 23kw. The performance characteristics of a single stage Lithium Bromide/ water refrigeration is presented in this study considering the cooling load of 23kw. Performance characteristics of each of the 4 heat exchangers within the unit is discussed which helps in customizing the unit according to the users' specific needs. This analysis helps in studying the importance of different properties such as the effect of inlet temperatures of hot water for generator, inlet temperatures of cooling water for absorber and

  2. A simple F-center laser spectrometer for continuous single frequency scans

    Science.gov (United States)

    Nelson, David D., Jr.; Schiffman, Aram; Lykke, Keith R.; Nesbitt, David J.

    1988-12-01

    We report a simple and novel scheme for continuous, single frequency scanning of a commercial F-center laser without any computer interfacing. The scheme utilizes galvo tuning of the cavity length with intracavity CaF 2 Brewster plates with servo loop control of the intracavity etalon. This permits continuous tuning of the F-center frequency over 0.8 cm -1 under complete manual control, as well as arbitrarily long, concatenated scans, and trivial interfacing to a data acquisition system. This scanning spectrometer operation is demonstrated on direct absorption of atomic bromine.

  3. A 15-Year Time-series Study of Tooth Extraction in Brazil.

    Science.gov (United States)

    Cunha, Maria Aparecida Goncalves de Melo; Lino, Patrícia Azevedo; Santos, Thiago Rezende Dos; Vasconcelos, Mara; Lucas, Simone Dutra; Abreu, Mauro Henrique Nogueira Guimarães de

    2015-11-01

    Tooth loss is considered to be a public health problem. Time-series studies that assess the influence of social conditions and access to health services on tooth loss are scarce.This study aimed to examine the time-series of permanent tooth extraction in Brazil between 1998 and 2012 and to compare these series in municipalities with different Human Development Index (HDI) scores and with different access to distinct primary and secondary care.The time-series study was performed between 1998 and 2012, using data from the Brazilian National Health Information System. Time-series study was performed between 1998 and 2012. Two annual rates of tooth extraction were calculated and evaluated separately according to 3 parameters: the HDI, the presence of a Dental Specialty Center, and coverage by Oral Health Teams. The time-series was analyzed using a linear regression model.An overall decrease in the tooth-loss tendencies during this period was observed, particularly in the tooth-extraction rate during primary care procedures. In the municipalities with an HDI that was lower than the median, the average tooth-loss rates were higher than in the municipalities with a higher HDI. The municipalities with lower rates of Oral Health Team coverage also showed lower extraction rates than the municipalities with higher coverage rates.In general, Brazil has shown a decrease in the trend to extract permanent teeth during these 15 years. Increased human development and access to dental services have influenced tooth-extraction rates.

  4. Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

    Directory of Open Access Journals (Sweden)

    John Monagle

    2015-01-01

    Full Text Available Background: Pulmonary hypertension (PH in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%. Aim: To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses. Materials and Methods: A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly. Results: 19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice. Conclusion: Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality.

  5. Single Defect Centers in Diamond Nanocrystals as Quantum Probes for Plasmonic Nanostructures

    CERN Document Server

    Schell, Andreas W; Hanke, Tobias; Leitenstorfer, Alfred; Bratschitsch, Rudolf; Benson, Oliver; Aichele, Thomas

    2011-01-01

    We present two applications of a single nitrogen vacancy center in a nanodiamond as quantum probe for plasmonic nanostructures. Coupling to the nanostructures is achieved in a highly controlled manner by picking up a pre-characterized nanocrystal with an atomic force microscope and placing it at the desired position. Local launching of single excitations into a nanowire with a spatial control of few nanometers is demonstrated. Further, a two dimensional map of the electromagnetic environment of a plasmonic bowtie antenna was derived, resembling an ultimate limit of fluorescence lifetime nanoscopy.

  6. Deterministic coupling of a single nitrogen vacancy center to a photonic crystal cavity

    CERN Document Server

    Englund, Dirk; Rivoire, Kelley; Hatami, Fariba; Vuckovic, Jelena; Park, Hongkun; Lukin, Mikhail D

    2010-01-01

    We describe and experimentally demonstrate a technique for deterministic coupling between a photonic crystal (PC) nanocavity and single emitters. The technique is based on in-situ scanning of a PC cavity over a sample and allows the positioning of the cavity over a desired emitter with nanoscale resolution. The power of the technique, which we term a Scanning Cavity Microscope (SCM), is demonstrated by coupling the PC nanocavity to a single nitrogen vacancy (NV) center in diamond, an emitter system that provides optically accessible electron and nuclear spin qubits.

  7. Controlling single diamond NV color center photoluminescence spectrum with a Fabry-Perot microcavity

    CERN Document Server

    Dumeige, Yannick; Grangier, Philippe; Treussart, François; Roch, Jean-François

    2010-01-01

    We present both theoretical and experimental results on fluorescence of single defect centers in diamond nanocrystals embedded in a planar dielectric microcavity. From a theoretical point of view, we show that the overall fluorescence collection efficiency using moderate numerical aperture microscope objective can be enhanced by using a low quality factor microcavity. This could be used in particular for low temperature applications where the numerical aperture of collection microscope objectives is limited due to the experimental constraints. We experimentally investigate the control of the fluorescence spectrum of the emitted light from a single center. We show the simultaneous narrowing of the room temperature broadband emission spectrum and the increase of the fluorescence spectral density.

  8. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A

    2015-01-01

    with the purpose of increasing volume, to increase surgical safety and facilitate follow-up. METHODS: Prospective data were recorded in the Danish Gynecological Cancer Database of all Vaginal Radical Trachelectomies (VRT) performed in Denmark between 2002 and 2013. Oncologic, fertility and obstetrical outcomes......OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... referral study confirms the oncological safety of Vaginal Radical Trachelectomy. The complete follow-up regarding reproductive data, reveals a surprisingly extensive need of fertility treatment and due to the rate of prematurity, these pregnancies must be regarded as high-risk pregnancies....

  9. Cytomegalovirus Reactivation in Adult Recipients of Autologous Stem Cell Transplantation: a Single Center Experience

    OpenAIRE

    Al-Rawi, Omar; Abdel-Rahman, Fawzi; Al-Najjar, Rula; Abu-Jazar, Husam; Salam, Mourad; Saad, Mustafa

    2015-01-01

    Introduction Cytomegalovirus (CMV) reactivation and infection are well-recognized complications after allogeneic stem cell transplantation (SCT). Only a few studies have addressed CMV reactivation after autologous SCT (ASCT). Methods We retrospectively reviewed medical records of 210 adult patients who underwent ASCT for lymphoma or multiple myeloma (MM) at a single center from January 1st, 2007 until December 31st, 2012. All patients were monitored weekly with CMV antigenemia test till day 4...

  10. Controlling the Coupling of a Single Nitrogen Vacancy Center to a Silver Nanowire

    DEFF Research Database (Denmark)

    Huck, Alexander; Kumar, Shailesh; Shakoor, Abdul;

    2011-01-01

    -linear interaction at the level of a few photons. In our contribution we demonstrate the controlled coupling of a single nitrogen vacancy (NV) center in a diamond nano crystal to a nanowire made of silver. This is in contrast to previous realizations, where the nanowire dipole system was assembled randomly. Ultimate...... control over the relative nanowire diamond nano-crystal position is achieved by using an atomic force microscope (AFM) in contact mode operation....

  11. Causes and outcomes of revisional bariatric surgery: initial experience at a single center

    OpenAIRE

    2014-01-01

    Purpose Bariatric surgery has become more prevalent owing to the worldwide obesity epidemic. With the growing number of bariatric procedures performed annually, the requirement for revisional and secondary operations is increasing accordingly. This study aimed to evaluate the initial experience of revisional bariatric surgery at a single specialized center. Methods A retrospective review of the prospectively established database identified all patients who underwent revisional bariatric surge...

  12. Chromogranin A as serum marker for gastroenteropancreatic neuroendocrine tumors: a single center experience and literature review.

    OpenAIRE

    Christoph J Auernhammer; Christine Spitzweg; Burkhard Göke; Hoffmann, Johannes N.; Herrmann, Karin A.; Alexander Haug; Michael Vogeser; Axel Kuttner; Michael Lauseker; Svenja Nölting

    2012-01-01

    The aim of this study was to assess the clinical sensitivities of the tumor markers chromogranin A (CgA), urinary 5-hydroxyindoleacetic acid (5-HIAA) and alkaline phosphatase (AP) in neuroendocrine tumors (NETs) of the GastroEnteroPancreatic-(GEP-) system depending on tumor primary location and metastatic spread. In a retrospective single-center series, sensitivities were evaluated in serum samples from 110 patients with midgut (n = 62) and pancreatic (n = 48) NETs. CgA levels were analyzed b...

  13. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

    Energy Technology Data Exchange (ETDEWEB)

    Chatziioannou, A.; Gargas, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Malagari, K. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Kornezos, I., E-mail: kornezos@gmail.com [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Ioannidis, I.; Primetis, E. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Moschouris, H. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Gouliamos, A.; Mourikis, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece)

    2012-09-15

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials.

  14. Cavity-Enhanced Single-Photon Source Based on the Silicon-Vacancy Center in Diamond

    Science.gov (United States)

    Benedikter, Julia; Kaupp, Hanno; Hümmer, Thomas; Liang, Yuejiang; Bommer, Alexander; Becher, Christoph; Krueger, Anke; Smith, Jason M.; Hänsch, Theodor W.; Hunger, David

    2017-02-01

    Single-photon sources are an integral part of various quantum technologies, and solid-state quantum emitters at room temperature appear to be a promising implementation. We couple the fluorescence of individual silicon-vacancy centers in nanodiamonds to a tunable optical microcavity to demonstrate a single-photon source with high efficiency, increased emission rate, and improved spectral purity compared to the intrinsic emitter properties. We use a fiber-based microcavity with a mode volume as small as 3.4 λ3 and a quality factor of 1.9 ×1 04 and observe an effective Purcell factor of up to 9.2. Furthermore, we study modifications of the internal rate dynamics and propose a rate model that closely agrees with the measurements. We observe lifetime changes of up to 31%, limited by the finite quantum efficiency of the emitters studied here. With improved materials, our achieved parameters predict single-photon rates beyond 1 GHz.

  15. Hereditary multiple exostoses in a 15-year-old boy: A case report ...

    African Journals Online (AJOL)

    2016-09-06

    Sep 6, 2016 ... Methods: A case report of a 15- year-old Nigerian male with ... development of multiple osteochondromas (exostoses) and is frequently .... mon phenomena, the pattern of spontaneous resolution, .... compression. Report of two.

  16. Physical Activity in U.S. Youth Aged 12-15 Years, 2012

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Physical Activity in U.S. Youth Aged 12–15 Years, 2012 ... percentage of youth engaged in moderate-to-vigorous physical activity for at least 60 minutes each day? About ...

  17. Cost analysis of awake versus asleep deep brain stimulation: a single academic health center experience.

    Science.gov (United States)

    Jacob, R Lorie; Geddes, Jonah; McCartney, Shirley; Burchiel, Kim J

    2016-05-01

    OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial data for patients receiving a neurostimulator lead implant (from the first quarter of 2009 to the second quarter of 2014) were collected and analyzed. Inpatient charges included those associated with International Classification of Diseases, Ninth Revision (ICD-9) procedure code 0293 (implantation or replacement of intracranial neurostimulator lead). Outpatient charges included all preoperative charges ≤ 30 days prior to implant and all postoperative charges ≤ 30 days after implant. The cost of care based on reported charges and a cost-to-charge ratio was estimated. The UHC database was queried (January 2011 to March 2014) with the same ICD-9 code. Procedure cost data across like hospitals (27 UHC hospitals) conducting similar DBS procedures were compared. RESULTS Two hundred eleven DBS procedures (53 awake and 158 asleep) were performed at a single US academic health center during the study period. The average patient age ( ± SD) was 65 ± 9 years old and 39% of patients were female. The most common primary diagnosis was Parkinson's disease (61.1%) followed by essential and other forms of tremor (36%). Overall average DBS procedure cost was $39,152 ± $5340. Asleep DBS cost $38,850 ± $4830, which was not significantly different than the awake DBS cost of $40,052 ± $6604. The standard deviation for asleep DBS was significantly lower (p ≤ 0.05). In 2013, the median cost for a neurostimulator implant lead was $34,052 at UHC-affiliated hospitals that performed at least 5 procedures a year. At Oregon Health & Science University, the median cost was $17,150 and the observed single academic health center cost for a neurostimulator lead implant was

  18. CARDIAC RUPTURE IN MYOCARDIAL INFARCTION: INCIDENCE AND PREDISPOSING FACTORS (15 YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    V. A. Shulman

    2015-12-01

    Full Text Available Aim. To evaluate the incidence of cardiac rupture (CR in patients with acute myocardial infarction (MI as well as predisposing factors during 15-year follow-up.Material and methods. 1453 patients with acute MI who were admitted to Krasnoyarsk cardiological center during 1989, 1993 and 2003 years were studied. All patients were divided into three groups: group I - 447 patients, who were on treatment in 1989, group II - 475 patients of 1993, and group III – 531 patients of 2003. There were no differences in groups on patient sex, location and depth of MI, previous MI, arrhythmias, heart failure and diabetes mellitus.Results. CR was found in 18 of 447 patients (4% of group I (1989, in 16 of 475 patients (3,4% of group II (1993 and in 10 of 531 patients (1,9% of group 3 (2003, (p1,3 <0,05. Incidence of CR significantly decreased from 1989 to 2003 in female patients (7,2%; 5,7% and 1,6% in 1989, 1993 and 2003, respectively; p1,3 < 0,01, p2,3 < 0,05. Incidence of CR in male patients didn’t changed (2,5%, 1,8% and 2,1%, respectively. The average blood pressure (BP during the first day of MI in female patients was higher than this in male ones in 1989 and 1993. There were no significant differences in BP between women and men in 2003. Heart rate (HR during the first day of MI in female patients was higher than this in male patients in 1989. However in 1993 and 2003 there were no differences in HR between women and men. MI therapy more often included betablockers, angiotensin converting enzyme inhibitors, intravenous nitrates, statins, thrombolythics and anticoagulants in 2003 than in 1989 and 1993.Conclusion. Effective BP and HR control is the most effective way to prevent CR in patients with MI.

  19. CARDIAC RUPTURE IN MYOCARDIAL INFARCTION: INCIDENCE AND PREDISPOSING FACTORS (15 YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    V. A. Shulman

    2007-01-01

    Full Text Available Aim. To evaluate the incidence of cardiac rupture (CR in patients with acute myocardial infarction (MI as well as predisposing factors during 15-year follow-up.Material and methods. 1453 patients with acute MI who were admitted to Krasnoyarsk cardiological center during 1989, 1993 and 2003 years were studied. All patients were divided into three groups: group I - 447 patients, who were on treatment in 1989, group II - 475 patients of 1993, and group III – 531 patients of 2003. There were no differences in groups on patient sex, location and depth of MI, previous MI, arrhythmias, heart failure and diabetes mellitus.Results. CR was found in 18 of 447 patients (4% of group I (1989, in 16 of 475 patients (3,4% of group II (1993 and in 10 of 531 patients (1,9% of group 3 (2003, (p1,3 <0,05. Incidence of CR significantly decreased from 1989 to 2003 in female patients (7,2%; 5,7% and 1,6% in 1989, 1993 and 2003, respectively; p1,3 < 0,01, p2,3 < 0,05. Incidence of CR in male patients didn’t changed (2,5%, 1,8% and 2,1%, respectively. The average blood pressure (BP during the first day of MI in female patients was higher than this in male ones in 1989 and 1993. There were no significant differences in BP between women and men in 2003. Heart rate (HR during the first day of MI in female patients was higher than this in male patients in 1989. However in 1993 and 2003 there were no differences in HR between women and men. MI therapy more often included betablockers, angiotensin converting enzyme inhibitors, intravenous nitrates, statins, thrombolythics and anticoagulants in 2003 than in 1989 and 1993.Conclusion. Effective BP and HR control is the most effective way to prevent CR in patients with MI.

  20. A center frequency adjustable narrow band filter for the detection of weak single frequency signal.

    Science.gov (United States)

    Xin, Yunhong; Xiang, ZhenMing; Dong, LeMing; Zhu, Bing; Cao, Hui; Fang, Yu

    2014-04-01

    We describe and implement a center frequency adjustable narrow band filter based on the crystal filter for the detection of weak single frequency signal. It is formed by a multiplier, a direct digital frequency synthesizer, a multi-stage crystal bandpass filter, and a micro control unit which is used to set the center frequency of the filter. A theoretical study is proposed and experimentally validated. The test results show that the 3 db and 20 db bandwidths are 0.84 Hz and 2.73 Hz, respectively, and the filter system can effectively detect the signal with amplitude below 1 μV and a frequency which ranges from 10 Hz to the frequency that is mainly limited by the components applied.

  1. Dynamic stabilization of the optical resonances of single nitrogen-vacancy centers in diamond

    CERN Document Server

    Acosta, V M; Faraon, A; Huang, Z; Fu, K -M C; Stacey, A; Simpson, D A; Tomljenovic-Hanic, S; Greentree, A D; Prawer, S; Beausoleil, R G

    2011-01-01

    We report electrical tuning by the Stark effect of the excited-state structure of single nitrogen-vacancy (NV) centers located less than ~100 nm from the diamond surface. The zero-phonon line (ZPL) emission frequency is controllably varied over a range of 300 GHz. Using high-resolution emission spectroscopy, we observe electrical tuning of the strengths of both cycling and spin-altering transitions. Under resonant excitation, we apply dynamic feedback to stabilize the ZPL frequency, nearly eliminating spectral diffusion on timescales greater than ~50 ms.

  2. Electron impact ionization of liquid and gaseous water: a single-center partial-wave approach

    Energy Technology Data Exchange (ETDEWEB)

    Champion, C [Universite Paul Verlaine-Metz, Laboratoire de Physique Moleculaire et des Collisions, ICPMB (FR CNRS 2843), Institut de Physique, 1 bd Arago, 57078 Metz Cedex 3 (France)], E-mail: champion@univ-metz.fr

    2010-01-07

    In this work, we report a unified methodology to express the molecular wavefunctions of water in both vapor and liquid phases by means of a single-center approach. These latter are then used as input data in a theoretical treatment-previously published and successfully tested-for describing the water ionization process in the first Born approximation (Champion et al 2006 Phys. Rev. A 73 012717). The multi-differential and total cross sections also obtained are reported for the two thermodynamical phases investigated and compared to the rare existing experimental and theoretical data.

  3. Extinction of Light and Coherent Scattering by a Single Nitrogen-Vacancy Center in Diamond

    CERN Document Server

    Tran, Thai Hien; Gerhardt, Ilja

    2016-01-01

    Coherently scattered light from a single quantum system promises to get a valuable quantum resource. In this letter an external laser field is efficiently coupled to a single nitrogen vacancy (NV-)center in diamond. By this it is possible to detect a direct extinction signal and estimate the NV's extinction cross-section. The exact amount of coherent and incoherent photons is determined against the saturation parameter, and reveals the optimal point of generating coherently scattered photons and an optimal point of excitation. A theoretical model of spectral diffusion allows to explain the deviation to an atom in free-space. The introduced experimental techniques are used to determine the properties of the tight focusing in an interference experiment, and allow for a direct determination of the Gouy-phase in a strongly focused beam.

  4. Postural reactions of girls and boys aged 12–15 years evaluated using the Romberg test

    Directory of Open Access Journals (Sweden)

    Jacek Wilczyński

    2016-07-01

    Full Text Available Introduction : The complex system controlling human posture includes a gaze stabilisation system, which comprises the control of direction and visual acuity during head and body movements, and a posture stabilisation system, keeping the body in balance at rest and in movement. Aim of the research: To analyse the postural reaction of SOX and SOY using the Romberg test with eyes open (EO and closed (CE in girls and boys aged 12–15 years. Material and methods : The study included 503 students of Primary School No. 13 and School No. 4 in Starachowice. Postural reactions were tested on a Cosmogamma platform by Emildue R50300. Postural reactions were analysed, and mean sway X (MSX and mean sway Y (MSY were calculated. Results: Analysis of variance showed significant differences of MSX only between girls and boys (p < 0.036. MSX was significantly lower in girls in both tests with EO and CE. Although there was no apparent significant difference of MSX between the Romberg test with EO and CE, a slight progression was observed in the test with CE. Analysis of variance of MSY with a single classification showed a significant effect of study options (p < 0.048, a significant interaction of gender and options of the study (p < 0.048, and a significant interaction of age and options of the study (p < 0.026. Analysis of variance of MSY showed a significant progression of MSY in the test with CE. Conclusions : Our research showed that balance with CE does not worsen, so it can be assumed that children have limited skills of using vision to maintain balance because there is a lack of appropriate coordination between vision and motor abilities, which in children are in development.

  5. INFECTIONS IN THE INTENSIVE CARE UNIT FOLLOWING LIVER TRANSPLANTATION: PROFILE OF A SINGLE CENTER

    Directory of Open Access Journals (Sweden)

    E. Otan

    2013-01-01

    Full Text Available Introduction. Despite the advances in antibiotherapy and critical care management, infectious complications remain among the leading complications after liver transplantation related with mortality and morbidity. This study analysis the incidence and pattern of infections and possible prognostic factors of infectious compli- cations retrospectively in a single center. Patients and Methods. Results of 30 consecutive patients with a primary liver transplantation history in a single center between August 2011 and August 2012 and a positive culture result in the first month in the ICU were analysed retrospectively. Results. During the first 1 month stay in the ICU postoperatively 30 (13,63% patients had at least 1 infection. Total number of infections were 68. Mortality rate of the infected patients was 53,3% (n = 16. Among these infections, 25 (36,76% of them were in deep surgical sites. Eighteen of the 30 patients (60% were infected with a single microorganism. Eleven patients (36,66% had a single infection episode. Microorganism were gram negative in 52 (76,47% of the infections, gram positive in 14 (20,58% of the infections, rest of the 2 (2,94% infections were due to Candidiasis. Among the possible risk factors contributing to mortality, there was a statistically significant dif- ference (p < 0,001 between the platelet counts of the mortality and surviving groups of the patients. Conclu- sion. Infections are among the preventable risk factors for mortality and morbidity after liver transplantation. Our data reveals a significant relation between trombocytopenia and mortality among the infected patients. Further studies focusing on this relation would expose the mechanisms and any possible contribution in cli- nical management of the patients. 

  6. New method for introducing nanometer flux pinning centers into single domain YBCO bulk superconductors

    Energy Technology Data Exchange (ETDEWEB)

    Yang, W.M., E-mail: yangwm@snnu.edu.cn; Wang, Miao

    2013-10-15

    Highlights: • Single domain YBCO bulks with Bi{sub 2}O{sub 3} additions fabricated by TSIG process. • Nanoscale Y{sub 2}Ba{sub 4}CuBiOx(YBi2411) particles introduced by Bi{sub 2}O{sub 3} additions. • The YBi2411 particles are about 150 nm, can act as effective flux pinning centers. • The optimal addition of Bi{sub 2}O{sub 3} is 0.7wt% to achieve higher levitation force. • The result is helpful to improve the quality of REBCO bulk superconductors. -- Abstract: Single domain YBCO superconductors with different additions of Bi{sub 2}O{sub 3} have been fabricated by top seeded infiltration and growth process (TSIG). The effect of Bi{sub 2}O{sub 3} additions on the growth morphology, microstructure and levitation force of the YBCO bulk superconductor has been investigated. The results indicate that single domain YBCO superconductors can be fabricated with the additions of Bi{sub 2}O{sub 3} less than 2 wt%; Bi{sub 2}O{sub 3} can be reacted with Y{sub 2}BaCuO{sub 5} and liquid phase and finally form Y{sub 2}Ba{sub 4}CuBiO{sub x}(YBi2411) nanoscale particles; the size of the YBi2411 particles is about 100 nm, which can act as effective flux pinning centers. It is also found that the levitation force of single domain YBCO bulks is increasing from 13 N to 34 N and decreasing to 11 N with the increasing of Bi{sub 2}O{sub 3} addition from 0.1 wt% to 0.7 wt% and 2 wt%. This result is helpful for us to improve the physical properties of REBCO bulk superconductors.

  7. De novo cancers following liver transplantation: a single center experience in China.

    Science.gov (United States)

    Yu, Songfeng; Gao, Feng; Yu, Jun; Yan, Sheng; Wu, Jian; Zhang, Min; Wang, Weilin; Zheng, Shusen

    2014-01-01

    De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female) after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32%) cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05%) cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  8. Influence of Microwave Detuning on Ramsey Fringes of a Single Nitrogen Vacancy Center Spin in Diamond

    Institute of Scientific and Technical Information of China (English)

    HU Xin; LIU Gang-Qin; XU Zhang-Cheng; PAN Xin-Yu

    2012-01-01

    We investigate the Ramsey fringes of a single electron spin of the nitrogen-vacancy center in diamond with different microwave radiation frequency detunings.The fast Fourier transform demonstrates that the Ramsey fringes consist of three components caused by hyperfine interaction with 14N nuclear spin,and the Ramsey fringes cannot be well explained without the phase term of the three components,which has not been mentioned before.Each phase is determined by the microwave frequency detuning and the resonant Rabi frequency as well as the π/2 pulse.%We investigate the Ramsey fringes of a single electron spin of the nitrogen-vacancy center in diamond with different microwave radiation frequency detunings. The fast Fourier transform demonstrates that the Ramsey fringes consist of three components caused by hyperfine interaction with 14N nuclear spin, and the Ramsey fringes cannot be well explained without the phase term of the three components, which has not been mentioned before. Each phase is determined by the microwave frequency detuning and the resonant Rabi frequency as well as the π/2 pulse.

  9. Thermal annealing study of F center clusters in LiF single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Izerrouken, M., E-mail: izerrouken@yahoo.co [Centre de Recherche Nucleaire de Draria (CRND), BP 43, Sebbala, Draria, Alger (Algeria); Guerbous, L. [Centre de Recherche Nucleaire d' Alger (CRNA), 2 Bd Frantz Fanon, BP 399, Alger gare (Algeria); Meftah, A. [LRPCSI, Universite 20 Aout 55 route d' El-Hadaik, BP 26, 21000 Skikda (Algeria)

    2010-01-21

    The present work is devoted to study the thermal annealing process of F center clusters (F{sub n}) induced in LiF single crystal under high-dose gamma-rays and high reactor neutrons fluence irradiations. With heating under argon atmosphere, the F-type center aggregates and gives rise to a new absorption band at 500 nm attributed to Li colloids. The optical density associated with F{sub 2} center observed in gamma-ray irradiated LiF decreases with increasing annealing temperature and exhibits two distinct annealing processes with activation energies E{sub 1}=0.9+-0.3 eV and E{sub 2}=1.6+-0.5 eV. Also, it is clear from the results that the F{sub 3}{sup +} and F{sub 2} emission bands positions are affected by the irradiated dose. Reactor neutrons irradiation induces large Li colloids. These colloids persist even after annealing at 450 deg. C.

  10. Two Independent Orthogonal Stereomutations at a Single Asymmetric Center: A Narcissistic Couple.

    Science.gov (United States)

    Gillick-Healy, Malachi W; Jennings, Elizabeth V; Müller-Bunz, Helge; Ortin, Yannick; Nikitin, Kirill; Gilheany, Declan G

    2017-02-16

    The energy barriers in our recently discovered Walden-type inversion of chlorophosphonium salts are similar to those for Cope rearrangements of caged cyclic hydrocarbons. Therefore, we have designed a molecular system that integrates the two processes, thereby producing the first embodiment of a chemical species that can undergo two entirely different and independent stereomutation mechanisms at the same nominal asymmetric center. Thus, the energy barrier to the rearrangement of 9-phenyl-9-phosphabarbaralane oxide, which is easily prepared by a new high-yielding synthesis, was found to be roughly 11 kcal mol(-1) . This value is in contrast to the parent barbaralane (7.3 kcal mol(-1) ) but in good agreement with our computational results for the rearrangement barriers. Crucially, in the corresponding chlorophosphonium derivative, two stereomutations occur simultaneously: a fast Cope rearrangement (barrier ≈12 kcal mol(-1) ) and a slow Walden-type inversion of the phosphorus center (barrier ≈21 kcal mol(-1) ). The computational model also revealed a relationship between the Cope rearrangement barrier and the bridgehead distance. The phenomenon of two independent and geometrically orthogonal stereomutations at a single asymmetric center provided important general insights into reaction pathway bifurcation, microscopic reversibility, and dynamic stereochemistry. This first example of coexisting alternative mechanisms that involve covalent bonds may encourage the design of new types of dynamic molecular structures.

  11. Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran

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    Aliyeh Sargazi

    2016-01-01

    Full Text Available Objective: To determine the economic burden of road traffic accidents (RTAs in patients admitted to a single center in south eastern Iran. Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3% men and 482 (41.7% women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.

  12. Early Correction of Common Atrioventricular Septal Defects: A Single-Center 20-Year Experience.

    Science.gov (United States)

    Vida, Vladimiro L; Tessari, Chiara; Castaldi, Biagio; Padalino, Massimo A; Milanesi, Ornella; Gregori, Dario; Stellin, Giovanni

    2016-12-01

    Over the past 20 years our policy has been to electively repair common atrioventricular canal defects (CAVCD) in patients between 8 and 12 weeks of age. We sought to evaluate the results of our past 20-year experience. From January 1992 to April 2014, 159 consecutive patients underwent CAVCD repair (133 patients had complete CAVCD and 26 patients had a transitional form of CAVCD). Surgical repair was accomplished with a double-patch (n = 137 [86%]) or a modified single patch (n = 22 [14%]) technique. Median age at operation was 96 days (interquartile range [IQR], 73-128 days); 90 patients were younger than 3 months of age. There were 3 operative (1.9%) and 12 late (7.7%) deaths. Median follow-up time after repair was 8.2 years (IQR, 3.6-15 years). Twenty patients (13%) required reoperation-16 (10%) for left atrioventricular valve (LAVV) regurgitation. Reoperation on the LAVV was more frequent in patients with a dysplastic LAVV preoperatively (p = 0.01; odds ratio [OR], 4.2; 95% confidence interval [CI], 1.33-13.5) and in patients who underwent closure for an absent/incomplete cleft at the time of repair (p = 0.01; OR, 5.4; 95% CI, 1.4-21). Late LAVV performance (regurgitation greater than or equal to moderate or the need for reoperation), including late deaths and patients who underwent reoperation, was significantly worse in patients older than 3 months at repair (10 of 83 patients [12%] versus 20 of 73 patients [27%]; hazard ratio [HR], 2.71; 95% CI, 1.19-6.19) and in patients with LAVV dysplasia (19 of 68 patients [28%] versus 11 of 88 patients [12%]; HR, 3; 95% CI, 1.53-8.51). Individualized early repair of CAVCD is safe and beneficial, with good early and long-term results. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Prognostic Factors and Treatment Outcomes of Parotid Gland Cancer: A 10-Year Single-Center Experience.

    Science.gov (United States)

    Chang, Jae Won; Hong, Hyun Jun; Ban, Myung Jin; Shin, Yoo Seob; Kim, Won Shik; Koh, Yoon Woo; Choi, Eun Chang

    2015-12-01

    To investigate the treatment outcomes of parotid gland cancer at a single center over a 10-year period and to evaluate the prognostic significance of maximum standardized uptake value. Retrospective case series with chart review. Academic care center. Ninety-eight patients with primary parotid gland cancer who were surgically treated at Yonsei University Head & Neck Cancer Clinic between January 1999 and December 2008 were analyzed. Patient data were collected retrospectively from medical charts. The investigators analyzed the association of clinicopathological factors and maximum standardized uptake value on (18)F-fluorodeoxyglucose positron emission tomography-computed tomography scan with disease-specific survival. Mean patient age was 49.7 years. Mean follow-up was 48.8 months. Thirty-three, 40, 30, and 23 patients had stage I, II, III, and IVA disease, respectively. Mucoepidermoid carcinoma was the most common histologic type (34.7%), followed by acinic cell carcinoma (27.6%). Eighteen patients (18.4%) experienced recurrences (mean recurrence gap, 20.6 months; range, 2-87 months). Five- and 10-year disease-specific survival rates were 93.6% and 81.8%, respectively. In the univariate analysis, pathologic T stage, pathologic lymph node status, resection margin, external parenchymal extension, and maximum standardized uptake value were significantly associated with disease-specific survival. Pathologic lymph node status and maximum standardized uptake value were independent prognostic factors in the multivariate analysis. Our single-center experience with parotid gland cancer treatment is consistent with the literature. Cervical lymph node metastasis and high maximum standardized uptake value are associated with poor survival in parotid gland cancer. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  14. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

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    Daša Perko

    2015-01-01

    Full Text Available PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children’s Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63% boys and 31 (37% girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27% patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture.

  15. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

    Science.gov (United States)

    Perko, Daša; Debeljak, Maruša; Toplak, Nataša; Avčin, Tadej

    2015-01-01

    PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children's Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63%) boys and 31 (37%) girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27%) patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture. PMID:25821352

  16. Risk Factors of Obesity in Children 5-15 Years Old

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    Ratu Ayu Dewi Sartika

    2011-06-01

    Full Text Available Obesity is the result of positive energy balance for long periods of time. The problem of obesity can occur at the age of children, teens to adults. The purpose of this study is to identify the most dominant factor of obesity in children (5-15 years using Basic Health Research in 2007. The proportion of obesity (percentile >95 in children (5-15 years old was 8.3%. The risk factor which mostly associated with obesity was the level of education after being controlled by sex, father's obesity, exercise and smoking habits and intake of protein. To overcome obesity problem in children (5-15 years old, it is needed to provide health education for children from an early age through enhanced IEC (Information, Education and Communication such as anti smoking program, love of fiber (vegetables and fruits and develop a culture of sport activities.

  17. Size effects of nano-scale pinning centers on the superconducting properties of YBCO single grains

    Science.gov (United States)

    Moutalbi, Nahed; Noudem, Jacques G.; M'chirgui, Ali

    2014-08-01

    High pinning superconductors are the most promising materials for power engineering. Their superconducting properties are governed by the microstructure quality and the vortex pinning behavior. We report on a study of the vortex pinning in YBa2Cu3O7-x (YBCO) single grain with defects induced through the addition of insulating nano-particles. In order to improve the critical current density, YBCO textured bulk superconductors were elaborated using the Top Seeded Melt Texture and Growth process with different addition amounts of Al2O3 nano-particles. Serving as strong pinning centers, 0.05% excess of Al2O3 causes a significant enhancement of the critical current density Jc under self field and in magnetic fields at 77 K. The enhanced flux pinning achieved with the low level of alumina nano-particles endorses the effectiveness of insulating nano-inclusions to induce effectives pinning sites within the superconducting matrix. On the other side, we focused on the effect of the size of pinning centers on the critical current density. This work was carried out using two batches of alumina nano-particles characterized by two different particle size distributions with mean diameters PSD1 = 20 nm and PSD2 = 2.27 μm. The matching effects of the observed pinning force density have been compared. The obtained results have shown that the flux pinning is closely dependent on the size of the artificial pinning centers. Our results suggest that the optimization of the size of the artificial pinning centers is crucial to a much better understanding of the pinning mechanisms and therefore to insure high superconducting performance for the practical application of superconducting materials.

  18. Diamond nanocrystals hosting single nitrogen-vacancy color centers sorted by photon-correlation near-field microscopy.

    Science.gov (United States)

    Sonnefraud, Yannick; Cuche, Aurélien; Faklaris, Orestis; Boudou, Jean-Paul; Sauvage, Thierry; Roch, Jean-François; Treussart, François; Huant, Serge

    2008-03-15

    Diamond nanocrystals containing highly photoluminescent color centers are attractive, nonclassical, and near-field light sources. For near-field applications, the size of the nanocrystal is crucial, since it defines the optical resolution. Nitrogen-vacancy (NV) color centers are efficiently created by proton irradiation and annealing of a nanodiamond powder. Using near-field microscopy and photon statistics measurements, we show that nanodiamonds with sizes down to 25 nm can hold a single NV color center with bright and stable photoluminescence.

  19. 77 FR 30294 - Award of a Single Source Cooperative Agreement Grant to the Congressional Hunger Center in...

    Science.gov (United States)

    2012-05-22

    ... Grant to the Congressional Hunger Center in Washington, DC AGENCY: Office of Policy, Research and... single source cooperative agreement to the Congressional Hunger Center in Washington, DC to support a Bill Emerson National Hunger Fellow. C.F.D.A. Number: 93.647. Statutory Authority: The award...

  20. Tobacco use among students aged 13–15 years in Greece: the GYTS project

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    Papastergiou Panagiotis

    2007-01-01

    Full Text Available Abstract Background Data on the prevalence of tobacco use among teenagers in Greece are limited. We examined the prevalence of smoking among middle-school students in Greece using the Global Youth Tobacco Survey (GYTS. Methods The Global Youth Tobacco Survey was implemented in Greece during the academic year 2004 – 2005 by the University of Thessaly and the National School of Public Health. Data were collected using the GYTS self-administered anonymous questionnaire, which was distributed by specifically trained field workers to a nationally representative sample of middle-school students aged 13–15 years (through randomly selected schools and classes, randomly selected through a two-stage cluster sample design. Data processing and statistical analyses were performed at the Centers for Disease Control and Prevention (CDC. Results About one third of the students 32.1% (29.4 – 35.0 reported that they had tried tobacco in the past, while 16.2% (14.3 – 18.4 reported being current users of tobacco products. In addition, 1 in 4 of ever smokers reported that they began smoking before the age of 10 years old. Almost 1 in 5 never smokers reported being susceptible to initiate smoking in the next year and about 89.8% (88.3 – 91.1 of the respondents were exposed to environmental tobacco smoke in their homes and 94.1% (93.2 – 94.9 in public places. Finally, a strikingly high number of students 95% (89.5 – 97.7 reported that they were able to buy their own cigarettes without restrictions. Conclusion The results of the GYTS show that the prevalence of smoking in middle-school children is alarmingly high in Greece. Smoking among young people constitutes a significant problem that is destined to worsen in the absence of any comprehensive efforts focused on strict anti-smoking legislation, policies and tobacco control interventions targeting children at a young age.

  1. Impact of Changes in Perinatal Care on Neonatal Respiratory Outcome and Survival of Preterm Newborns: An Overview of 15 Years

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    Filipa Flor-de-Lima

    2012-01-01

    Full Text Available Survival and outcomes for preterm infants with respiratory distress syndrome (RDS have improved over the past 30 years. We conducted a study to assess the changes in perinatal care and delivery room management and their impact on respiratory outcome of very low birth weight newborns, over the last 15 years. A comparison between two epochs was performed, the periods before and after 2005, when early nasal continuous positive airway pressure (NCPAP and Intubation-SURfactant-Extubation (INSURE were introduced in our center. Three hundred ninety-five clinical records were assessed, 198 (50.1% females, gestational age 29.1 weeks (22–36, and birth weight 1130 g (360–1498. RDS was diagnosed in 247 (62.5% newborns and exogenous surfactant was administered to 217 (54.9%. Thirty-three (8.4% developed bronchopulmonary dysplasia (BPD, and 92 (23% were deceased. With the introduction of early NCPAP and INSURE, there was a decrease on the endotracheal intubation need and invasive ventilation (P<0.0001, oxygen therapy (P=0.002, and mortality (P<0.0001. The multivariate model revealed a nonsignificant reduction in BPD between the two epochs (OR=0.86; 95% CI 0.074–9.95; P=0.9. The changes in perinatal care over the last 15 years were associated to an improvement of respiratory outcome and survival, despite a nonsignificant decrease in BPD rate.

  2. Psychosocial Precursors and Correlates of Differing Internalizing Trajectories from 3 to 15 Years

    Science.gov (United States)

    Letcher, Primrose; Smart, Diana; Sanson, Ann; Toumbourou, John W.

    2009-01-01

    Psychosocial precursors and correlates of parent-reported internalizing behavior trajectories across the age span of 3-15 years were explored using a community-based cohort of Australian children. Six internalizing trajectories had previously been identified for both girls (N = 810) and boys (N = 874) in this sample, comprising stable low, high,…

  3. Energy choices for the next 15 years: a view from europe.

    Science.gov (United States)

    L-Zaleski, C P

    1979-03-02

    A European perception of the world energy situation and its likely evolution during the next two decades is presented. French energy policy is then discussed as a possible set of consistent choices that can be made to deal with the energy situation in a regional context for the next 15 years.

  4. Characteristics of 15-Year-Old Students Predicting Scientific Literacy Skills in Turkey

    Science.gov (United States)

    Demir, Ergül

    2016-01-01

    Since 2003, Turkey regularly participates in PISA. According to the PISA 2012 results, 15-year-old students in Turkey performed below both OECD countries and participating countries. Defining the relations between students' characteristics and their scientific literacy skills is thought to provide deeper understanding for the nature of this…

  5. Children Treated for Nocturnal Enuresis: Characteristics and Trends over a 15-Year Period

    Science.gov (United States)

    Kushnir, Jonathan; Kushnir, Baruch; Sadeh, Avi

    2013-01-01

    Background: Nocturnal Enuresis (NE) is one of the most prevalent childhood disorders and has significant negative psychosocial impact on the child and family. Objective: To assess the characteristics of children with NE and trends over a 15-year period. Methods: The study included 18,677 children [11,205 (60%) boys and 7,472 (40%) girls] referred…

  6. The Relationship between Bible Reading and Attitude toward Substance Use among 13-15 Year Olds

    Science.gov (United States)

    Francis, Leslie J.

    2002-01-01

    The relationship between Bible reading and attitude toward drug use is examined among a sample of 25,888 teenagers, 13-15 year olds, throughout England and Wales. Information about sex, age, personality, belief in God, and church attendance was also considered. The conclusion is that Bible reading makes a small but significant contribution to…

  7. Children Treated for Nocturnal Enuresis: Characteristics and Trends over a 15-Year Period

    Science.gov (United States)

    Kushnir, Jonathan; Kushnir, Baruch; Sadeh, Avi

    2013-01-01

    Background: Nocturnal Enuresis (NE) is one of the most prevalent childhood disorders and has significant negative psychosocial impact on the child and family. Objective: To assess the characteristics of children with NE and trends over a 15-year period. Methods: The study included 18,677 children [11,205 (60%) boys and 7,472 (40%) girls] referred…

  8. Pulmonary function change in patients with Sauropus androgynus-related obstructive lung disease 15 years later

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    Chih-Ying Ou

    2013-10-01

    Conclusion: After an acute deterioration, patients with S androgynus-related obstructive lung disease had a stationary pulmonary function over a period of 15 years, and their clinical manifestations were less severe than age- and FEV1-matched COPD patients. A further study with a larger sample size may be needed to confirm these findings.

  9. Five Years of Tamoxifen Continues to Benefit Women 15 Years after Treatment

    Science.gov (United States)

    In a large randomized clinical trial, women with early-stage breast cancer who received 5 years of adjuvant treatment with tamoxifen had better outcomes up to 15 years after the start of treatment than those who received 2 years of tamoxifen therapy.

  10. Development of Face Recognition in 5- to 15-Year-Olds

    Science.gov (United States)

    Kinnunen, Suna; Korkman, Marit; Laasonen, Marja; Lahti-Nuuttila, Pekka

    2013-01-01

    This study focuses on the development of face recognition in typically developing preschool- and school-aged children (aged 5 to 15 years old, "n" = 611, 336 girls). Social predictors include sex differences and own-sex bias. At younger ages, the development of face recognition was rapid and became more gradual as the age increased up…

  11. The outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using hamstring tendon autograft for 'isolated' anterior cruciate ligament rupture.

    Science.gov (United States)

    Bourke, H E; Gordon, D J; Salmon, L J; Waller, A; Linklater, J; Pinczewski, L A

    2012-05-01

    The purpose of this study was to report the outcome of 'isolated' anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with 'isolated' ACL rupture underwent four-strand hamstring tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged surgery and patients with > 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an 'isolated' rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.

  12. A single-stage optical load-balanced switch for data centers.

    Science.gov (United States)

    Huang, Qirui; Yeo, Yong-Kee; Zhou, Luying

    2012-10-22

    Load balancing is an attractive technique to achieve maximum throughput and optimal resource utilization in large-scale switching systems. However current electronic load-balanced switches suffer from severe problems in implementation cost, power consumption and scaling. To overcome these problems, in this paper we propose a single-stage optical load-balanced switch architecture based on an arrayed waveguide grating router (AWGR) in conjunction with fast tunable lasers. By reuse of the fast tunable lasers, the switch achieves both functions of load balancing and switching through the AWGR. With this architecture, proof-of-concept experiments have been conducted to investigate the feasibility of the optical load-balanced switch and to examine its physical performance. Compared to three-stage load-balanced switches, the reported switch needs only half of optical devices such as tunable lasers and AWGRs, which can provide a cost-effective solution for future data centers.

  13. Psychopathology and attrition in the Baltimore ECA 15-year follow-up 1981-1996.

    Science.gov (United States)

    Badawi, M A; Eaton, W W; Myllyluoma, J; Weimer, L G; Gallo, J

    1999-02-01

    Predictors of non-response were investigated in a 15-year follow-up (1981-1996) of 3,481 individuals in a probability sample from the household population of East Baltimore. Demographics (age, sex, race, education, marital status, and unemployment), household factors (living arrangements, household income, household size, and number of children), cultural variables (ancestral ethnicity and foreign language), social variables (social support and networks, committing felony, carrying a weapon, using an alias, and wandering), health factors (physical illness, health insurance, medical assistance, Medicare, receiving disability benefits, social security, and welfare), interviewer's observation, and psychopathologic variables (mental disorders, suicide behavior, comorbidity, and drug use) were collected at baseline in 1981 and in 1982, then linked to follow-up data between 1993 and 1996. A tracing process involving mail, phone, criss-cross directories, motor vehicle administration records, a commercial credit bureau, the state criminal justice system, hospital records, the US National Death Index, and field tracing were used to locate the original sample. A total of 3,066 respondents of the original sample (88.1%) were traced. Non-response was categorized into Sample Mortality (that part of the original sample that died during follow-up), Sample Loss (that part of the original sample that survived but could not be found) and Refusal (that part of the original sample that survived and was found but refused to participate). Stratified analysis and adjusted multiple logistic regression modeling found sample mortality and sample loss were strongly influenced by individual and household variables and by psychopathology. Sample mortality was influenced by specific mental disorders or conditions as mania, drug abuse/dependency, antisocial personality, cognitive impairment, alcohol abuse/dependency, phobia, drug use (except PCP), and comorbidity. Household factors protective

  14. De novo cancers following liver transplantation: a single center experience in China.

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    Songfeng Yu

    Full Text Available BACKGROUND: De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. AIMS: The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. METHODS: 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. RESULTS: A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32% cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05% cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. CONCLUSIONS: Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  15. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jeong-Ho [Keimyung University Dongsan Medical Center, Department of Neurology (Korea, Republic of); Kang, Jihoon; Yeo, Min-Ju; Kim, Beom Joon; Jang, Min Uk; Bae, Hee-Joon [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of); Kwon, O-Ki; Hwang, Gyo Jun; Oh, Chang Wan [Seoul National University Bundang Hospital, Department of Neurosurgery (Korea, Republic of); Jung, Cheolkyu [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of); Lee, Ji Sung [Soonchunhyang University Medical Center, Biostatistical Consulting Unit (Korea, Republic of); Han, Moon-Ku, E-mail: mkhan@snu.ac.kr [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of)

    2015-04-15

    PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.

  16. Sensing of single nuclear spins in random thermal motion with proximate nitrogen-vacancy centers

    Science.gov (United States)

    Bruderer, M.; Fernández-Acebal, P.; Aurich, R.; Plenio, M. B.

    2016-03-01

    Nitrogen-vacancy (NV) centers in diamond have emerged as valuable tools for sensing and polarizing spins. Motivated by potential applications in chemistry, biology, and medicine, we show that NV-based sensors are capable of detecting single spin targets even if they undergo diffusive motion in an ambient thermal environment. Focusing on experimentally relevant diffusion regimes, we derive an effective model for the NV-target interaction, where parameters entering the model are obtained from numerical simulations of the target motion. The practicality of our approach is demonstrated by analyzing two realistic experimental scenarios: (i) time-resolved sensing of a fluorine nuclear spin bound to an N-heterocyclic carbene-ruthenium (NHC-Ru) catalyst that is immobilized on the diamond surface and (ii) detection of an electron spin label by an NV center in a nanodiamond, both attached to a vibrating chemokine receptor in thermal motion. We find in particular that the detachment of a fluorine target from the NHC-Ru carrier molecule can be monitored with a time resolution of a few seconds.

  17. [TRENDS OF PERMANENT PACEMAKER IMPLANTATION IN A SINGLE CENTER OVER A 20-YEAR PERIOD].

    Science.gov (United States)

    Antonelli, Dante; Ilan, Limor Bushar; Freedberg, Nahum A; Feldman, Alexander; Turgeman, Yoav

    2015-05-01

    To review the changes in permanent pacemaker implantation indications, pacing modes and patients' demographics over a 20-year period. We retrospectively retrieved data on patients who underwent first implantation of the pacemaker between 1-1-1991 and 31-12-2010. One thousand and nine (1,009) patients underwent a first pacemaker implantation during that period; 535 were men (53%), their mean age was 74.6±19.5 years; the highest rate of implanted pacemaker was in patients ranging in age from 70-79 years, however there was an increasing number of patients aged over 80 years. The median survival time after initial pacemaker implantation was 8 years. Syncope was the most common symptom (62.5%) and atrioventricular block was the most common electrocardiographic indication (56.4%) leading to pacemaker implantation. There was increased utilization of dual chamber and rate responsive pacemakers over the years. There was no difference regarding mode selection between genders. Pacemaker implantation rates have increased over a 20-year period. Dual chamber replaced most of the single ventricular chamber pacemaker and rate responsive pacemakers became the norm. The data of a small volume center are similar to those reported in pacemaker surveys of high volume pacemaker implantation centers. They confirm adherence to the published guidelines for pacing.

  18. Narrow-band single photon emission at room temperature based on a single Nitrogen-vacancy center coupled to an all-fiber-cavity

    CERN Document Server

    Albrecht, Roland; Pauly, Christoph; Mücklich, Frank; Schell, Andreas W; Engel, Philip; Schröder, Tim; Benson, Oliver; Reichel, Jakob; Becher, Christoph

    2014-01-01

    We report the realization of a device based on a single Nitrogen-vacancy (NV) center in diamond coupled to a fiber-cavity for use as single photon source (SPS). The device consists of two concave mirrors each directly fabricated on the facets of two optical fibers and a preselected nanodiamond containing a single NV center deposited onto one of these mirrors. Both, cavity in- and output are directly fiber-coupled and the emission wavelength is easily tunable by variation of the separation of the two mirrors with a piezo-electric crystal. By coupling to the cavity we achieve an increase of the spectral photon rate density by two orders of magnitude compared to free-space emission of the NV center. With this work we establish a simple all-fiber based SPS with promising prospects for the integration into photonic quantum networks.

  19. Incidence of acute endophthalmitis after intravitreal bevacizumab injection in a single clinical center.

    Science.gov (United States)

    Falavarjani, Khalil Ghasemi; Modarres, Mehdi; Hashemi, Masih; Parvaresh, Mohammad M; Naseripour, Masood; Zare-Moghaddam, Abbas; Nekoozadeh, Shahbaz

    2013-05-01

    To assess the rate of infectious endophthalmitis in a single clinical center in Iran and to compare the rate of endophthalmitis in patients receiving postinjection antibiotics with those who did not. A retrospective chart review of patients who received intravitreal injections of bevacizumab was undertaken. Cases of clinical diagnoses of endophthalmitis were reviewed. Bevacizumab was obtained at the time of injection from a commercially available vial after aseptic cleansing of the rubber cover. Five patients (six eyes) developed clinical endophthalmitis after the intravitreal bevacizumab injection. The risk per injection was 0.10% (6/5,901). One culture-positive case was found overall. Postinjection antibiotic drops were prescribed for 68% of eyes. All endophthalmitis cases were among those who received postoperative antibiotic eye drops. The difference in the rates of endophthalmitis between those receiving postinjection antibiotics and those who did not was not statistically significant (P = 0.18). A low risk of endophthalmitis consistent with the range of previous studies was observed notwithstanding the usage of multiple use of a single vial. Postinjection antibiotic drops may not be necessary.

  20. Dynamic Characteristic Analysis of Spinal Motor Control Between 11- and 15-Year-Old Children.

    Science.gov (United States)

    Chow, Daniel H; Lau, Newman M

    2016-07-01

    Spinal motor control can provide substantial insight for the causes of spinal musculoskeletal disorders. Its dynamic characteristics however, have not been fully investigated. The objective of this study is to explore the dynamic characteristics of spinal motor control via the fractional Brownian motion mathematical technique. Spinal curvatures and repositioning errors of different spinal regions in 64 children age 11- or 15-years old during upright stance were measured and compared for the effects of age and gender. With the application of the fractional Brownian motion analytical technique to the changes of spinal curvatures, distinct persistent movement behaviors could be determined, which could be interpreted physiologically as open-loop behaviors. Moreover, it was found that the spinal motor control of 15-year-old children was better than that of 11-year-old children with smaller repositioning error and less curvature variability as well as shorter response time and smaller curvature deformation.

  1. The prevalence of Iron Deficiency and Its Anemia in 1-5 Years Old Children and Their Mothers in Birjand City

    OpenAIRE

    Azita Fesharakinia

    2014-01-01

    Background &Objective: Micronutrient deficiencies are the most common nutritional disorders in the world in which iron deficiency is the most important one. This study was done for investigating the prevalence of iron deficiency and its anemia in children and their mothers in Birjand city in 2011.Materials & Methods: 143 children of 1-5 years old who referred to the health care centers of Birjand city were chosen by multistage cluster random sampling method and both the children and mothers w...

  2. The prevalence of Iron Deficiency and Its Anemia in 1-5 Years Old Children and Their Mothers in Birjand City

    OpenAIRE

    Azita Fesharakinia

    2014-01-01

    Background &Objective: Micronutrient deficiencies are the most common nutritional disorders in the world in which iron deficiency is the most important one. This study was done for investigating the prevalence of iron deficiency and its anemia in children and their mothers in Birjand city in 2011.Materials & Methods: 143 children of 1-5 years old who referred to the health care centers of Birjand city were chosen by multistage cluster random sampling method and both the children and mothers w...

  3. Phase II TPDCV protocol for pediatric low-grade hypothalamic/chiasmatic gliomas: 15-year update

    Science.gov (United States)

    Mishra, Kavita K.; Squire, Sarah; Lamborn, Kathleen; Banerjee, Anuradha; Gupta, Nalin; Wara, William M.; Prados, Michael D.; Berger, Mitchel S.

    2010-01-01

    To report long-term results for children with low-grade hypothalamic/chiasmatic gliomas treated on a phase II chemotherapy protocol. Between 1984 and 1992, 33 children with hypothalamic/chiasmatic LGGs received TPDCV chemotherapy on a phase II prospective trial. Median age was 3.0 years (range 0.3–16.2). Twelve patients (36%) underwent STRs, 14 (42%) biopsy only, and seven (21%) no surgery. Twenty patients (61%) had pathologic JPAs, nine (27%) grade II gliomas, and four (12%) no surgical sampling. Median f/u for surviving patients was 15.2 years (range 5.3–20.7); 20 of the 23 surviving patients had 14 or more years of follow-up. Fifteen-year PFS and OS were 23.4 and 71.2%, respectively. Twenty-five patients progressed, of whom 13 are NED, two are AWD, and 10 have died. All children who died were diagnosed and first treated at age three or younger. Age at diagnosis was significantly associated with relapse and survival (P = 0.004 for PFS and P = 0.037 for OS). No PFS or OS benefit was seen with STR versus biopsy/no sampling (P = 0.58 for PFS, P = 0.59 for OS). For patients with JPAs and WHO grade II tumors, the 15-year PFS was 18.8 and 22.2% (P = 0.95) and 15-year OS was 73.7 and 55.6% (P = 0.17), respectively. Upfront TPDCV for children with hypothalamic/chiasmatic LGGs resulted in 15-year OS of 71.2% and 15-year PFS of 23.4%. No survival benefit is demonstrated for greater extent of resection. Age is a significant prognostic factor for progression and survival. PMID:20221671

  4. Growth and Yield of 15-Year Plantations of Pine, Spruce and Birch in Agricultural Land

    Directory of Open Access Journals (Sweden)

    Daugaviete Mudrite

    2017-07-01

    Full Text Available The growth data and the potential returns from 15-year-old plantations of pine Pinus sylvestris L. (6 trial sites, spruce Picea abies Karst L. (9 trial sites and silver birch Betula pendula Roth (13 trial sites, established in abandoned agricultural lands in a variety of soil types (sod calcareous, anthrosols, podzolic, podzols, gley, podzolic gley, alluvial, using the planting density 2,500 and 3,300 and also 5,000 trees/ha are analysed.

  5. Trisomy 18 mosaicism in a 15-year-old boy with normal intelligence and short stature

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-08

    We report a 15-year-old boy with mosaicism for trisomy 18 and normal intelligence. Approximately 50% of his leukocytes are trisomic. This patient represents the sixth report of an individual with trisomy 18 mosaicism and normal intelligence. Those individuals with trisomy 18 mosaicism and normal intelligence need to be advised of increased risks for offspring with chromosome abnormalities and offered the option of prenatal diagnosis for cytogenetic anomalies. 6 refs.

  6. RADICAL RETROPUBIC PROSTATECTOMY: THE FIRST RUSSIAN EXPERIENCE OF 15-YEAR FOLLOW-UP AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2014-07-01

    Full Text Available The results of the maximum of more than 15 years of follow-up of Russia’s first large series of patients after radical retropubic prostatectomy (RPE were traced. The data of 1367 patients who had undergone RPE at the Clinic of Urology, S.P. Kirov Military Medical Academy, in 1997 to 2003 and at the Clinic of Urology, Russian Medical Academy of Postgraduate Education, in 2001 to 2010 were retrospectively studied. After excluding 626 patients who had an incomplete set of preoperative/postoperative characteristics, a postoperative follow-up of < 6 months, neoadjuvant hormonal or radiation therapy, the trial included 741 patients. Their median age at surgery was 64 years (interquartile range (IQR: 59-68; median prostatespecific antigen (PSA, 8.7 ng/ml (IQR: 6.2-14; median follow-up, 65 months (IQR: 50-87; the maximum follow-up period, 189 months. Out of the 741 patients, 30.2, 28.3, and 41.5% were referred to as D’Amico classification low-, moderate-, and high-risk groups, respectively. Five-, 10-, and 15-year relapse-free survival rates were 80.3, 74.7, and 66.7%; 5-, 10-, and 15-year cancer-specific survival rates were 98.3, 95.9, and 85.7%; and 5-, 10-, and 15-year overall survival rates were 92.5, 81.4, and 64.3%, respectively. The significant predictors of biochemical recurrence were a preoperative PSA level of 10.1–20 ng/ml (p = 0.041, > 20 ng/ml (p = 0.003; pathological stage pT3b–4N0 (p = 0.006 and any stage pT N1 (p = 0.003. Further investigations are needed to identify groups of patients who will have the most benefit from surgery.

  7. RADICAL RETROPUBIC PROSTATECTOMY: THE FIRST RUSSIAN EXPERIENCE OF 15-YEAR FOLLOW-UP AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2013-01-01

    Full Text Available The results of the maximum of more than 15 years of follow-up of Russia’s first large series of patients after radical retropubic prostatectomy (RPE were traced. The data of 1367 patients who had undergone RPE at the Clinic of Urology, S.P. Kirov Military Medical Academy, in 1997 to 2003 and at the Clinic of Urology, Russian Medical Academy of Postgraduate Education, in 2001 to 2010 were retrospectively studied. After excluding 626 patients who had an incomplete set of preoperative/postoperative characteristics, a postoperative follow-up of < 6 months, neoadjuvant hormonal or radiation therapy, the trial included 741 patients. Their median age at surgery was 64 years (interquartile range (IQR: 59-68; median prostatespecific antigen (PSA, 8.7 ng/ml (IQR: 6.2-14; median follow-up, 65 months (IQR: 50-87; the maximum follow-up period, 189 months. Out of the 741 patients, 30.2, 28.3, and 41.5% were referred to as D’Amico classification low-, moderate-, and high-risk groups, respectively. Five-, 10-, and 15-year relapse-free survival rates were 80.3, 74.7, and 66.7%; 5-, 10-, and 15-year cancer-specific survival rates were 98.3, 95.9, and 85.7%; and 5-, 10-, and 15-year overall survival rates were 92.5, 81.4, and 64.3%, respectively. The significant predictors of biochemical recurrence were a preoperative PSA level of 10.1–20 ng/ml (p = 0.041, > 20 ng/ml (p = 0.003; pathological stage pT3b–4N0 (p = 0.006 and any stage pT N1 (p = 0.003. Further investigations are needed to identify groups of patients who will have the most benefit from surgery.

  8. Prevalence of Malocclusion in 13-15 Year-old Adolescents in Tabriz

    OpenAIRE

    Ahangar Atashi, Mohammad Hossein

    2007-01-01

    Background and aims Malocclusion with its great hazardous effects seems to have become more prevalent in recent decades; therefore, the present study was carried out to assess the prevalence of different malocclusions among 13-15 year-old adolescents in Tabriz. Materials and methods The subjects in the present study consisted of 398 adolescents aged 13-15, who were randomly selected from 5 different districts of the city. Students who had previous orthodontic treatment or extraction of any pe...

  9. Fatal pulmonary thromboembolism associated with hemoglobin SC disease in a 15 year-old boy

    Directory of Open Access Journals (Sweden)

    Thiago Trolez Amancio

    2011-09-01

    Full Text Available We report a case of hemoglobin SC disease complicated by fatal pulmonarythromboembolism in a 15 year-old Brazilian boy, submitted to autopsy. Thiscase shows the importance of early diagnosis and treatment of sickle celldisease, which generates systemic involvement in youth and the importanceof considering the hypercoagulability in these patients. The autopsy was veryinstructive, revealing the florid morphologic aspect of sickle cell disease andits complications.

  10. Marine Mammal Strandings and Environmental Changes: A 15-Year Study in the St. Lawrence Ecosystem

    OpenAIRE

    Marie-Hélène Truchon; Lena Measures; Vincent L'Hérault; Jean-Claude Brêthes; Peter S Galbraith; Michel Harvey; Sylvie Lessard; Michel Starr; Nicolas Lecomte

    2013-01-01

    Understanding the effects of climatic variability on marine mammals is challenging due to the complexity of ecological interactions. We used general linear models to analyze a 15-year database documenting marine mammal strandings (1994-2008; n = 1,193) and nine environmental parameters known to affect marine mammal survival, from regional (sea ice) to continental scales (North Atlantic Oscillation, NAO). Stranding events were more frequent during summer and fall than other seasons, and have i...

  11. Patients With Chronic Three-Vessel Disease in a 15-Year Follow-Up Study

    OpenAIRE

    2014-01-01

    Abstract Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin–angiotensin–aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were ob...

  12. Hamartoma of the urinary bladder in a 15-year-old boy

    OpenAIRE

    Al Shahwani, Noora; Alnaimi, Abdulla Rashid; Ammar, Adham; Al-ahdal, Esra M.

    2016-01-01

    Hamartoma of the bladder is an unusual entity described in only eleven patients to date. It may present as painless hematuria, irritative urinary tract symptoms, or inability to void or it may be diagnosed incidentally. Hamartoma of the bladder may be isolated or occur as part of a syndrome. No isolated bladder hamartoma to date has shown malignant potential. We describe here a bladder hamartoma in a 15-year-old boy.

  13. Hamartoma of the urinary bladder in a 15-year-old boy

    Science.gov (United States)

    Al Shahwani, Noora; Alnaimi, Abdulla Rashid; Ammar, Adham; Al-ahdal, Esra M.

    2016-01-01

    Hamartoma of the bladder is an unusual entity described in only eleven patients to date. It may present as painless hematuria, irritative urinary tract symptoms, or inability to void or it may be diagnosed incidentally. Hamartoma of the bladder may be isolated or occur as part of a syndrome. No isolated bladder hamartoma to date has shown malignant potential. We describe here a bladder hamartoma in a 15-year-old boy. PMID:27274896

  14. Liver transplantation for biliary atresia: A single-center study from mainland China.

    Science.gov (United States)

    Li, Qi-Gen; Wan, Ping; Zhang, Jian-Jun; Chen, Qi-Min; Chen, Xiao-Song; Han, Long-Zhi; Xia, Qiang

    2015-08-28

    To summarize our single-center experience with liver transplantation (LT) for biliary atresia (BA). From October 2006 to December 2012, 188 children with BA were analyzed retrospectively. The stage I group (from October 2006 to December 2010) comprised the first 74 patients, and the stage II group (from January 2011 to December 2012) comprised the remaining 114 patients. Finally, 123 liver transplants were performed in 122 (64.9%) patients, whereas 66 patients did not undergo LT due to denial by their parents or lack of suitable liver grafts. The selection of graft types depended on the patients' clinical status and whether a suitable living donor was available. The characteristics of patients in stages I and II were described, and the surgical outcomes of LT recipients were compared between the two stages. The Kaplan-Meier method was used to estimate the cumulative patient and graft survival rates, and the equality of survival distributions was evaluated using the log-rank test. The 188 children consisted of 102 boys and 86 girls. Their ages ranged from 3 to 144 mo with a median of 8 mo. One hundred and fifteen (61.2%) patients were born in rural areas. Comparing stage I and stage II patients, the proportion of patients referred by pediatricians (43.2% vs 71.1%, respectively; P transplantation recipients (n = 102), the incidence of surgical complications was significantly reduced (34.1% vs 15.5%, respectively; P = 0.029) and survival rates of patients and grafts were greatly improved (81.8% vs 89.7%, respectively, at 1 year; 75.0% vs 87.8%, respectively, at 3 years; P = 0.107) from stage I to stage II. The status of surgical treatments for BA has been changing in mainland China. Favorable midterm outcomes after LT were achieved as centers gained greater technical experience.

  15. The Pattern of Juvenile Idiopathic Arthritis in a Single Tertiary Center in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohammad H. Al-Hemairi

    2016-01-01

    Full Text Available Introduction. Juvenile Idiopathic Arthritis (JIA is the most common chronic arthritis in children. Our aim is to describe demographic, clinical, and laboratory characteristics and treatment of JIA patients followed up in Pediatric Rheumatology clinic in a tertiary center in Saudi Arabia. Methods. Medical records of all patients who are followed up between January 2007 and January 2015 were retrospectively reviewed. Data were collected about demographic, clinical, and laboratory features and treatment. Results. Total patients were 82, males were 31 (37.8%, and mean age of JIA onset was 7.1 ± 3.6 yr. Mean follow-up duration was 2.67±1.6 yr. Systemic onset JIA (SoJIA was the commonest (36.5%, followed by polyarticular in 29.2% and oligoarticular in 28%. Large and small joints are involved in 76 (92% and 30 (36.6%, respectively. Main extra-articular feature was fever in 34 (41.4%. Uveitis was diagnosed in 7 (8.5% and in 5 (21.7% of oligoarticular JIA. Anemia was found in 49 (59.7%, high ESR in 45 (54.8%, and leukocytosis and thrombocytosis in 33 (40.2%. Positive ANA was found in 30 (36.5% mainly in oligoarticular subtype as 12 (52% patients (out of 23 had this positive test. 9 patients (10.9% required NSAIDs only, 6 patients (7.3% required NSAIDs and intra-articular steroids only, and 19 (23% required NSAIDs, methotrexate, steroids, and biologics. Conclusion. SoJIA is the most common JIA subtype in our study. A population based rather than a single center study will give more details about JIA characteristics in Saudi Arabia

  16. Outcomes of adult-to-adult living donor liver transplantation:a single center experience

    Institute of Scientific and Technical Information of China (English)

    FENG Xi; YUAN Ding; WEI Yong-gang; LI Fu-qiang; WEN Tian-fu; ZENG Yong; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing; YANG Jia-yin; MA Yu-kui; CHEN Zhe-yu; YE Hui; YAN Lü-nan; LI Bo

    2009-01-01

    Background Since January 2002,adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers.This study presents a detailed analysis of the outcomes of AALDLT in a single center.Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007.Among these,67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts.Three-dimensional volumetric computed tomography,magnetic resonance imaging with angiography and cholangiography were performed preoperatively.Recipient operation time,intraoperative transfusion requirement,length of intensive care unit stay,length of hospital stay,liver function tests,coagulation tests and surgical outcomes were routinely investigated throughout this study.Results All donors survived the procedure with an overall complication rate of 15.3%.Overall recipient 1-year survival and complication rates were 87.1% and 34.2%,respectively.Among the 70 cases,average graft recipient weight ratio was 0.94% (0.72%-1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74%-71.68%).All residual liver volumes exceeded 35%.Liver function and coagulation recovered rapidly within the first 7 days after transplantation.Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease.Patient selection and timely decision-making for transplantation are essential in achieving good outcomes.With accumulation of experience in surgery and clinical management,timely feedback and proper modification,we foresee better outcomes in the future.

  17. Ipsilateral idiopathic gingival enlargement and it's management using conventional gingivectomy and diode laser: A recurrent case after 15 years.

    Science.gov (United States)

    Devi, Potharaju Kamala; Kumar, Gudi Pavan; Bai, Yendluri Durga; Ammaji, Annamdevula Durga

    2013-05-01

    Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. The severity of the overgrowth can range from a solitary isolated mass to a more generalized and diffused enlargement. The etiopathogenesis of this bizarre condition is poorly understood and has been attributed to various factors. It can present as a single disorder or may manifest as part of a syndrome. This case reports an ipsilateral diffused idiopathic gingival enlargement in a middle aged adult recurring after a gap of 15 years. External bevel gingivectomy on the buccal aspects of maxillary and mandibular gingiva and diode laser for excision of the enlarged tissue on the lingual/palatal aspect was carried out to eliminate the excessive tissue. Periodic recalls showed maintenance of good oral hygiene and 1 year follow-up revealed no recurrence.

  18. Motor vehicle fatal crash profiles of 13-15-year-olds.

    Science.gov (United States)

    Williams, Allan F; Tison, Julie

    2012-04-01

    The goal was to provide a description of fatal crashes involving 13-15-year-old drivers and passengers. Information was obtained from the Fatality Analysis Reporting System for 2005-2009. The 1,994 passenger deaths during the 2005-2009 period far exceeded the number of driver deaths (299) or the number of drivers in fatal crashes (744). Passenger deaths occurring with teenage drivers, particularly 16-17-year-olds, increased with passenger age. Most 13-15-year-old drivers in crashes were driving either with no license or permit (63%), or with a permit but without required adult presence (10 percent). Fatal crashes involving illegal driving were most likely to involve high-risk actions such as speeding and nonuse of belts. Supervised learners were few in number (about 12 per year) and had the lowest rates of high-risk actions. The main issues for 13-15-year-olds' motor vehicle deaths are passenger deaths and driving without a license or adult supervision. Parents, pediatricians, and others need to recognize the increase in motor vehicle occupant deaths that occurs in the early teen years. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

  19. Rapid steroid discontinuation for pediatric renal transplantation: a single center experience.

    Science.gov (United States)

    Lau, Keith K; Haddad, Maha N; Berg, Gerre M; Perez, Richard V; Butani, Lavjay

    2007-08-01

    To determine the outcomes of pediatric renal transplant recipients who received immunosuppression consisting of early withdrawal of corticosteroids at a single Northern California center. Protocols using minimal steroid exposure have been recently reported in adult transplant recipients with successful results. We examined the outcomes of pediatric renal transplant recipients who were managed at our center using a protocol with very early discontinuation of steroids after renal transplantation. We retrospectively studied the medical records of all renal transplant recipients followed at the Children's Hospital at the University of California, Davis Medical Center from 01/2004 to 12/2005. All patients were less than 18 yr of age at the time of transplantation. The immunosuppressive protocol included three tapering daily doses of methylprednisolone, together with five doses of thymoglobulin followed by maintenance therapy with tacrolimus and MMF. Eight patients with equal numbers of males and females were transplanted during this time period. There were equal numbers of Caucasians, African-Americans, Hispanics, and Asians. A total of 37.5% (3/8) of the subjects received preemptive transplantation, 25% (2/8) received peritoneal, and 37.5% (3/8) received hemodialysis before transplantation. The median (range) age at transplantation was 12.3 (3.1-16.0) year with a follow-up of 1.7 (0.9-2.8) year. At one yr post-transplantation, 57% (4/7) of patients still required anti-hypertensives. Three children required erythropoietin supplementation after transplantation. The mean delta height standard deviation score at 12 months was 0.20 +/- 0.56. There were no episodes of clinical acute rejection. One patient switched from tacrolimus to sirolimus due to biopsy-proven CAN. No patient became diabetic or required hypoglycemic agents. Surveillance biopsies showed no subclinical acute rejection in any patient. Steroid-free immunosuppression is safe in children after renal

  20. Outcome of deceased donor renal transplantation - A single-center experience from developing country

    Directory of Open Access Journals (Sweden)

    Himanshu V Patel

    2013-01-01

    Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

  1. A Single-Center, Adult Chronic Intestinal Failure Cohort Analyzed According to the ESPEN-Endorsed Recommendations, Definitions, and Classifications

    DEFF Research Database (Denmark)

    Brandt, Christopher Filtenborg; Tribler, Siri; Hvistendahl, Mark

    2017-01-01

    BACKGROUND/AIMS: The objective of this study was to describe a clinically well-defined, single-center, intestinal failure (IF) cohort based on a template of definitions and classifications endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A cross-sectional, ......BACKGROUND/AIMS: The objective of this study was to describe a clinically well-defined, single-center, intestinal failure (IF) cohort based on a template of definitions and classifications endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A cross...

  2. A single residue controls electron transfer gating in photosynthetic reaction centers

    Science.gov (United States)

    Shlyk, Oksana; Samish, Ilan; Matěnová, Martina; Dulebo, Alexander; Poláková, Helena; Kaftan, David; Scherz, Avigdor

    2017-03-01

    Interquinone QA- → QB electron-transfer (ET) in isolated photosystem II reaction centers (PSII-RC) is protein-gated. The temperature-dependent gating frequency “k” is described by the Eyring equation till levelling off at T ≥ 240 °K. Although central to photosynthesis, the gating mechanism has not been resolved and due to experimental limitations, could not be explored in vivo. Here we mimic the temperature dependency of “k” by enlarging VD1-208, the volume of a single residue at the crossing point of the D1 and D2 PSII-RC subunits in Synechocystis 6803 whole cells. By controlling the interactions of the D1/D2 subunits, VD1-208 (or 1/T) determines the frequency of attaining an ET-active conformation. Decelerated ET, impaired photosynthesis, D1 repair rate and overall cell physiology upon increasing VD1-208 to above 130 Å3, rationalize the >99% conservation of small residues at D1-208 and its homologous motif in non-oxygenic bacteria. The experimental means and resolved mechanism are relevant for numerous transmembrane protein-gated reactions.

  3. Alemtuzumab in lung transplantation: an open-label, randomized, prospective single center study.

    Science.gov (United States)

    Jaksch, P; Ankersmit, J; Scheed, A; Kocher, A; Muraközy, G; Klepetko, W; Lang, G

    2014-08-01

    Induction therapy with alemtuzumab followed by lower maintenance immunosuppression (IS) has been associated with reduced morbidity and mortality in abdominal and heart transplantation (TX). In the current study, alemtuzumab, in combination with reduced levels of maintenance IS, was compared to thymoglobulin in combination with standard IS. Sixty consecutive patients who underwent lung transplantation (LUTX) at a single center were prospectively randomized in two groups: group A received alemtuzumab in conjunction with reduced doses of tacrolimus, steroids and mycophenolate mofetil. Group B received thymoglobulin in association with standard dose IS. Patient and graft survival, freedom from acute cellular rejection (ACR), lymphocytic bronchiolitis, bronchiolitis obliterans syndrome, kidney function, infectious complications and posttransplant lymphoproliferative disorder were analyzed. Alemtuzumab induction therapy resulted in complete the absence of ACR episodes ≥ A2 within the first year post-TX. The difference to thymoglobulin was significant (alemtuzumab 0 vs. ATG 0.33; p = 0.019). All other factors studied did not show any differences between the two groups. Alemtuzumab induction therapy after LUTX in combination with reduced maintenance IS significantly reduces higher-grade rejection rates. This novel therapeutic agent had no impact on survival, infections rates, kidney function and incidence of malignancies.

  4. High-fat diets and seizure control in myoclonic-astatic epilepsy: a single center's experience.

    Science.gov (United States)

    Simard-Tremblay, Elisabeth; Berry, Patricia; Owens, Aaron; Cook, William Byron; Sittner, Haley R; Mazzanti, Marta; Huber, Jennifer; Warner, Molly; Shurtleff, Hillary; Saneto, Russell P

    2015-02-01

    To determine the efficacy of the Modified Atkins Diet (MAD) and Ketogenic Diet (KD) in seizure control within a population of myoclonic-astatic epilepsy (MAE) patients. This was a retrospective, single center study evaluating the seizure control by high fat diets. Seizure diaries kept by the parents performed seizure counts. All patients met the clinical criteria for MAE. Nine patients met the clinical criteria. We found that both the MAD and KD were efficacious in complete seizure control and allowed other medications to be stopped in seven patients. Two patients had greater than 90% seizure control without medications, one on the KD and the other on the MAD. Seizure freedom has ranged from 13 to 36 months, and during this time four patients have been fully weaned off of diet management. One patient was found to have a mutation in SLC2A1. Our results suggest that strictly defined MAE patients respond to the MAD with prolonged seizure control. Some patients may require the KD for seizure freedom, suggesting a common pathway of increased requirement for fats. Once controlled, those fully responsive to the Diet(s) could be weaned off traditional seizure medications and in many, subsequently off the MAD or KD. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Sunflower domestication alleles support single domestication center in eastern North America.

    Science.gov (United States)

    Blackman, Benjamin K; Scascitelli, Moira; Kane, Nolan C; Luton, Harry H; Rasmussen, David A; Bye, Robert A; Lentz, David L; Rieseberg, Loren H

    2011-08-23

    Phylogenetic analyses of genes with demonstrated involvement in evolutionary transitions can be an important means of resolving conflicting hypotheses about evolutionary history or process. In sunflower, two genes have previously been shown to have experienced selective sweeps during its early domestication. In the present study, we identified a third candidate early domestication gene and conducted haplotype analyses of all three genes to address a recent, controversial hypothesis about the origin of cultivated sunflower. Although the scientific consensus had long been that sunflower was domesticated once in eastern North America, the discovery of pre-Columbian sunflower remains at archaeological sites in Mexico led to the proposal of a second domestication center in southern Mexico. Previous molecular studies with neutral markers were consistent with the former hypothesis. However, only two indigenous Mexican cultivars were included in these studies, and their provenance and genetic purity have been questioned. Therefore, we sequenced regions of the three candidate domestication genes containing SNPs diagnostic for domestication from large, newly collected samples of Mexican sunflower landraces and Mexican wild populations from a broad geographic range. The new germplasm also was genotyped for 12 microsatellite loci. Our evidence from multiple evolutionarily important loci and from neutral markers supports a single domestication event for extant cultivated sunflower in eastern North America.

  6. Has the prevalence of cholesterol gallstones increased in Korea? A preliminary single-center experience.

    Science.gov (United States)

    Kim, Ju Wan; Oh, Hyoung-Chul; Do, Jae Hyuk; Choi, Yoo-Shin; Lee, Seung Eun

    2013-10-01

    We aimed to determine the prevalence of cholesterol gallstones, the compositional changes of gallstones and its predisposing factors in Korea with this single-center study. Data of 365 patients who underwent cholecystectomy for cholecystolithiasis from July 2008 to September 2011 were reviewed. Based on the compositional analysis of the gallstones, patients were assigned to either cholesterol gallstone group or pigment gallstone group. The characteristics of the patients and the gallstones were summarized and compared. After eight patients with mixed gallstones were excluded, 357 patients were enrolled in the study, including cholesterol gallstones in 175 (49.0%) and pigment gallstones in 182 (51.0%). The number of patients with cholecystolithiasis increased but the prevalence of cholesterol gallstone decreased with age. Compared with the pigment gallstone group, the cholesterol gallstone group was associated with young age (gallstones in Korea has been stationary so far, but may change in the future since cholesterol gallstones are increasingly prevalent in the young generation. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

  7. Post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation: a single-center experience.

    Science.gov (United States)

    Luo, Lan; Zhang, Lin; Cai, Bo; Li, Honghua; Huang, Wenrong; Jing, Yu; Zhu, Haiyan; Zhao, Yu; Bo, Jian; Wang, Quanshun; Han, Xiaoping; Yu, Li; Gao, Chunji

    2014-01-08

    Post-transplant lymphoproliferative disease (PTLD) is a rare and serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) or solid organ transplantation. We conducted a retrospective analysis of the occurrence of post-transplant lymphoproliferative disease in allo-HSCT recipients over 12 years in a single center in China. A total of 343 patients received allo-HSCT. The conditioning therapy consisted of a busulfan/cyclophosphamide-based regimen, a fludarabine/cyclophosphamide-based regimen, or total-body irradiation and cyclophosphamide. In transplantations from unrelated donors and haplo-identical donors, patients also received antithymocyte globulin (ATG) or thymoglobulin as part of the conditioning. Five of the 343 patients (1.46%) were diagnosed with PTLD and all 5 were given ATG as part of conditioning. Among these 5 patients, 4 had lymphoid neoplasm before transplantation. EBV-positivity was confirmed in 4 patients. All 5 PTLD patients received reduction of immunosuppression (RI) as fundamental therapy. At follow-up on April 1, 2013, 1 patient had survived for 2 years and 1 had survived for 9 years. The correlation of PTLD with ATG and underlying diseases were examined by statistical analysis using the chi-squared test or Fisher's exact test (P=0.011 and 0.025, respectively). Although only 1.46% of patients progressed to PTLD associated with ATG and underlying diseases, the mortality was still high. Moreover, RI can be an effective therapy for PTLD patients, but other approaches should be further explored.

  8. Urinary stone analysis on 12,846 patients: a report from a single center in China.

    Science.gov (United States)

    Wu, Wenqi; Yang, Bicheng; Ou, Lili; Liang, Yeping; Wan, Shawpong; Li, Shujue; Zeng, Guohua

    2014-02-01

    We reported a retrospective review of the urinary stone compositions in 12,846 patients. Data on urinary stone compositions analyzed between January 2003 and December 2012 in our center were collected. Infrared spectroscopy was used for stone analysis. Predominant stone component was recorded. Patients were divided into four age groups: 0-18, 19-40, 41-60, and 61-92, and five categories by components. In order to determine the change of stone characteristics with respect to time, data were also divided into two periods, 2003-2007 and 2008-2012. A total of 12,846 stones were included in this study. The age of the patients ranged from 1 to 92 years with 7,736 males and 5,110 females. Stone made of single component was rare, 2.61%. Calcium oxalate stone was the most common component at 82.56%. Calcium oxalate and uric acid stones were more common in male than in female. The incidence of calcium phosphate stones and uric acid stones had increased during the past 5 years, while calcium oxalate stones decreased. We found the highest incidence of stone disease in the 41-60 years old group and the lowest in the 1-18 years old for both genders. Calcium oxalate was the dominant component in every group but was more prevalent in 19-40 years group. The percentage of magnesium ammonium phosphate stone and uric acid stone increased with age.

  9. Clinical staging and survival in refractory celiac disease: a single center experience.

    Science.gov (United States)

    Rubio-Tapia, Alberto; Kelly, Darlene G; Lahr, Brian D; Dogan, Ahmet; Wu, Tsung-Teh; Murray, Joseph A

    2009-01-01

    Refractory celiac disease (RCD) occurs when both symptoms and intestinal damage persist or recur despite strict adherence to a gluten-free diet. In RCD, the immunophenotype of intraepithelial lymphocytes may be normal and polyclonal (RCD I) or abnormal and monoclonal (RCD II). The aim is to describe the clinical characteristics, treatment, and long-term outcome in a large single-center cohort of patients with RCD. We compared the clinical characteristics and outcome in 57 patients with RCD: 42 with RCD I and 15 with RCD II. Fifteen of 57 patients died during follow-up (n=8 with RCD I and n=7 with RCD II), each within the first 2 years after RCD diagnosis. The overall 5-year cumulative survival is 70%, 80%, and 45% for the entire cohort, RCD I, and RCD II, respectively. The refractory state itself and enteropathy-associated T-cell lymphoma (EATL) were the most common causes of death, respectively. A new staging system is proposed based on the cumulative effect of 5 prognostic factors investigated at the time of the refractory state diagnosis: for patients in stages I, II, and III, the 5-year cumulative survival rate was 96%, 71%, and 19%, respectively (PRCD is associated with high mortality with RCD II having an especially poor prognosis because of the development of EATL. A new staging model is proposed that may improve the precision of prognosis in patients with RCD.

  10. Patterns of Early Rejection in Renal Retransplantation: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Lan Zhu

    2016-01-01

    Full Text Available It has been reported that kidney retransplant patients had high rates of early acute rejection due to previous sensitization. In addition to the acute antibody-mediated rejection (ABMR that has received widespread attention, the early acute T-cell-mediated rejection (TCMR may be another important issue in renal retransplantation. In the current single-center retrospective study, we included 33 retransplant patients and 90 first transplant patients with similar protocols of induction and maintenance therapy. Analysis focused particularly on the incidence and patterns of early acute rejection episodes, as well as one-year graft and patient survival. Excellent short-term clinical outcomes were obtained in both groups, with one-year graft and patient survival rates of 93.9%/100% in the retransplant group and 92.2%/95.6% in the first transplant group. Impressively, with our strict immunological selection and desensitization criteria, the retransplant patients had a very low incidence of early acute ABMR (6.1%, which was similar to that in the first transplant patients (4.4%. However, a much higher rate of early acute TCMR was observed in the retransplant group than in the first transplant group (30.3% versus 5.6%, P<0.001. Acute TCMR that develops early after retransplantation should be monitored in order to obtain better transplant outcomes.

  11. The pregnancy rate and live birth rate after kidney transplantation: a single-center experience.

    Science.gov (United States)

    Fontana, I; Santori, G; Fazio, F; Valente, U

    2012-09-01

    Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). Kidney transplantation recipients live longer and have better quality of life than patients on dialysis. Hypothalamic gonadal dysfunction in females who have ESRD may be reversed within the first few months after kidney transplantation, such as the ability to have children. Despite thousands of successful pregnancies in transplantation recipients, there is limited information about it. In this study, we evaluated the pregnancy rates and live birth rates in women (n = 133) who underwent kidney transplantation in our center from 1983 to 2010. Recipients of a second kidney transplantation and recipients of multiorgan transplantations were excluded. We observed 33 pregnancies with 11 live births (33.3%), 12 spontaneous abortions (36.36%), and 10 therapeutic abortions (30.3%). The pregnancy rate was 18%. The live birth rate was 33.3%. Therapeutic abortions were 36.3%, and the pregnancies resulting in fetal loss were 30.3%. The pregnancies were identified in 32 women. The majority of women (n = 32; 96.9%) had a single pregnancy, whereas 1 woman (3.1%) had two pregnancies. In our series, the pregnancy rates for kidney transplantation recipients were markedly lower and decreased more rapidly than those reported in the general population.

  12. Laparoscopic vs open donor nephrectomy: Lessons learnt from single academic center experience

    Science.gov (United States)

    Tsoulfas, Georgios; Agorastou, Polyxeni; Ko, Dicken S C; Hertl, Martin; Elias, Nahel; Cosimi, AB; Kawai, Tatsuo

    2017-01-01

    AIM To compare laparoscopic and open living donor nephrectomy, based on the results from a single center during a decade. METHODS This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital, Harvard Medical School, Boston, between 1/1998 - 12/2009. Overall there were 490 living donors, with 279 undergoing laparoscopic living donor nephrectomy (LLDN) and 211 undergoing open donor nephrectomy (OLDN). Demographic data, operating room time, the effect of the learning curve, the number of conversions from laparoscopic to open surgery, donor preoperative glomerular filtration rate and creatinine (Cr), donor and recipient postoperative Cr, delayed graft function and donor complications were analyzed. Statistical analysis was performed. RESULTS Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time, donor preoperative renal function, donor and recipient postoperative kidney function, delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed, there was a statistically significant difference regarding operating time in favor of the LLDN, pointing out the importance of the learning curve. Furthermore, another significant difference between the two groups was the decreased length of stay for the LLDN (2.87 d for LLDN vs 3.6 d for OLDN). CONCLUSION Recognizing the importance of the learning curve, this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor. PMID:28101451

  13. A single residue controls electron transfer gating in photosynthetic reaction centers

    Science.gov (United States)

    Shlyk, Oksana; Samish, Ilan; Matěnová, Martina; Dulebo, Alexander; Poláková, Helena; Kaftan, David; Scherz, Avigdor

    2017-01-01

    Interquinone QA− → QB electron-transfer (ET) in isolated photosystem II reaction centers (PSII-RC) is protein-gated. The temperature-dependent gating frequency “k” is described by the Eyring equation till levelling off at T ≥ 240 °K. Although central to photosynthesis, the gating mechanism has not been resolved and due to experimental limitations, could not be explored in vivo. Here we mimic the temperature dependency of “k” by enlarging VD1-208, the volume of a single residue at the crossing point of the D1 and D2 PSII-RC subunits in Synechocystis 6803 whole cells. By controlling the interactions of the D1/D2 subunits, VD1-208 (or 1/T) determines the frequency of attaining an ET-active conformation. Decelerated ET, impaired photosynthesis, D1 repair rate and overall cell physiology upon increasing VD1-208 to above 130 Å3, rationalize the >99% conservation of small residues at D1-208 and its homologous motif in non-oxygenic bacteria. The experimental means and resolved mechanism are relevant for numerous transmembrane protein-gated reactions. PMID:28300167

  14. Retrospective Single Center Study of Granulocyte Monocyte Adsorption Apheresis Treatment in Inflammatory Bowel Disease.

    Science.gov (United States)

    Edfors, Kajsa; Ståhlberg, Dagny; Söderman, Charlotte

    2016-02-01

    Patients with active inflammatory bowel disease (IBD) have elevated and activated myeloid leukocytes, which infiltrate the intestinal mucosa. A significant proportion of IBD patients do not respond adequately to conventional treatment regimes. Studies have suggested that treatment with granulocyte monocyte apheresis (GMA) could be a safe and efficacious alternative for these patients. We evaluated the efficacy and safety of granulocyte/monocyte apheresis in patients with IBD in a retrospective cohort study, conducted from a single center in Stockholm. Clinical details from consecutive apheresis treated patients were retrospectively reviewed from 2004 to 2012. A total of 37 patients were included, 23 patients with ulcerative colitis (UC) and 14 with Crohn's disease (CD). Clinical response was seen in 11 patients (30%) and complete remission in 11 patients (30%). The remission rate was higher in UC patients compared to CD patients, 39% (N = 9) and 14% (N = 2) respectively. A total of 9 patients experienced adverse events. Most frequently reported was headache (N = 4). GMA seems to be a valuable adjuvant treatment regime in the care of patients with refractory IBD.

  15. Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center.

    Science.gov (United States)

    Elander, Johanna; Nekludov, Michael; Larsson, Agneta; Nordlander, Britt; Eksborg, Staffan; Hydman, Jonas

    2016-12-01

    To provide retrospective, descriptive information on patients with cervical necrotizing fasciitis treated at a single center during the years 1998-2014, and to evaluate the outcome of a newly introduced treatment strategy. Retrospective analysis of clinical data obtained from medical records. Mortality, pre-morbidity, severity of illness, primary site of infection, type of bacteria, time parameters. The observed 3-month mortality was 6/59 (10 %). The most common initial foci of the infection were pharyngeal, dental or hypopharyngeal. The most common pathogen was Streptococcus milleri bacteria within the Streptococcus anginosus group (66 % of the cases). Using a combined treatment with early surgical debridement combined with hyperbaric oxygen treatment, it is possible to reduce the mortality rate among patients suffering from cervical necrotizing fasciitis, compared to the expected mortality rate and to previous historical reports. Data indicated that early onset of hyperbaric oxygen treatment may have a positive impact on survival rate, but no identifiable factor was found to prognosticate outcome.

  16. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  17. A single-center analysis of Henoch-Schonlein purpura nephritis with nephrotic proteinuria in children.

    Science.gov (United States)

    Feng, Dan; Huang, Wen-Yan; Hao, Sheng; Niu, Xiao-Ling; Wang, Ping; Wu, Ying; Zhu, Guang-Hua

    2017-03-04

    In children with Henoch-Schonlein purpura nephritis (HSPN), the degree of proteinuria has been proven to be not only a sign of kidney damage, but also an accelerator of kidney disease progression. Nephrotic proteinuria at disease onset has been proposed as a predictor of a poor renal outcome. This study aims to assess the clinical and pathological features of HSPN with nephrotic proteinuria in a single center. One hundred thirty-seven patients with HSPN who visited Shanghai Children's Hospital from January 2009 to December 2013 were retrospectively reviewed. The patients were divided into 2 groups based on the 24-h urinary protein levels: nephrotic proteinuria group (NP group: 24-h urinary protein ≥50 mg/kg) and non-nephrotic proteinuria group (NNP group: 24-h urinary protein  0.05). The serum albumin and IgG levels of the NP group were significantly lower; however, their blood urea nitrogen and cystatin C levels were higher. The ISKDC grades were mainly above grade III. The prognosis of the NP group was associated with clinical classification and improved after a timely and early treatment.

  18. Validity of Ski Skating Center-of-Mass Displacement Measured by a Single Inertial Measurement Unit.

    Science.gov (United States)

    Myklebust, Håvard; Gløersen, Øyvind; Hallén, Jostein

    2015-12-01

    In regard to simplifying motion analysis and estimating center of mass (COM) in ski skating, this study addressed 3 main questions concerning the use of inertial measurement units (IMU): (1) How accurately can a single IMU estimate displacement of os sacrum (S1) on a person during ski skating? (2) Does incorporating gyroscope and accelerometer data increase accuracy and precision? (3) Moreover, how accurately does S1 determine COM displacement? Six world-class skiers roller-ski skated on a treadmill using 2 different subtechniques. An IMU including accelerometers alone (IMU-A) or in combination with gyroscopes (IMU-G) were mounted on the S1. A reflective marker at S1, and COM calculated from 3D full-body optical analysis, were used to provide reference values. IMU-A provided an accurate and precise estimate of vertical S1 displacement, but IMU-G was required to attain accuracy and precision of < 8 mm (root-mean-squared error and range of displacement deviation) in all directions and with both subtechniques. Further, arm and torso movements affected COM, but not the S1. Hence, S1 displacement was valid for estimating sideways COM displacement, but the systematic amplitude and timing difference between S1 and COM displacement in the anteroposterior and vertical directions inhibits exact calculation of energy fluctuations.

  19. Determinants of intelligence in childhood-onset epilepsy: a single-center study.

    Science.gov (United States)

    Park, Jungmee; Yum, Mi-Sun; Choi, Hae-won; Kim, Eun Hee; Kim, Hyo Won; Ko, Tae-Sung

    2013-10-01

    The purpose of this study was to quantify the intelligence of children with epilepsy and to determine the clinical factors associated with intellectual impairment. The medical records of patients diagnosed with childhood-onset epilepsy at a single tertiary medical center in Korea between 2006 and 2011 were retrospectively reviewed. The Korean Education Development Institute-Wechsler Intelligence Scale for Children or Korean Wechsler Intelligence Scale for adults was used to quantify the level of intelligence. Age at seizure onset, etiology, epilepsy duration, number of seizures in the last year, use of antiepileptic drugs, EEG/MRI findings, and epilepsy classification were recorded. The association between clinical factors and the intelligence was determined using logistic regression. Three hundred and twenty-two patients were included in the analysis. One hundred and seventy-six (54.7%) patients had low intelligence (intelligence quotient [IQ]intelligence in multivariate logistic regression (pintelligence in children with idiopathic epilepsy. The most important factors associated with low intelligence in childhood-onset epilepsy are the underlying etiology and, in cryptogenic and symptomatic epilepsy, seizure burden. The results of this study underscore the importance of seizure control to alleviate the harmful impact of epilepsy on cognition. © 2013.

  20. Relevance of blood cultures in acute pyelonephritis in a single-center retrospective study.

    Science.gov (United States)

    Ledochowski, Stanislas; Abraham, Paul-Samuel; Jacob, Xavier; Dumitrescu, Oana; Lina, Gérard; Lepape, Alain; Piriou, Vincent; Wallet, Florent; Friggeri, Arnaud

    2015-08-01

    Pyelonephritides are frequently encountered diagnosis in Emergency Departments. Urinalyses have a central place in the management of this situation but the usefulness of blood cultures is not clear. We conducted a single-center retrospective study of 24 months to study the microbiological relevance of blood cultures in pyelonephritis. We included patients with blood cultures (BC) and urine cultures (UC) drawn at the same time, if they were not exposed to antibiotics prior to these tests. Of our 264 patients, 39 (15 %) had no bacteriological documentation. There were 83 (31 %) bacteremic patients. Seven patients had contaminated or sterile UC with positive BC. Four patients had positive UC and BC with the latter allowing identification of a pathogen absent from the UC (n = 1) or identifying the main pathogen in three cases. A total of 11 patients theoretically benefited from BC representing 4.2 % of our population. Excluding one patient who was known to be infected with multi-drug resistant bacteria, all empirical antibiotics regimens were effective against the identified pathogens. We did not reveal any significant therapeutic impact of blood cultures in the management of pyelonephritis, when BC and UC are performed before any antimicrobials treatment.

  1. Does the United States economy affect heart failure readmissions? A single metropolitan center analysis.

    Science.gov (United States)

    Thompson, Keith A; Morrissey, Ryan P; Phan, Anita; Schwarz, Ernst R

    2012-08-01

    To determine the effects of the US economy on heart failure hospitalization rates. The recession was associated with worsening unemployment, loss of private insurance and prescription medication benefits, medication nonadherence, and ultimately increased rates of hospitalization for heart failure. We compared hospitalization rates at a large, single, academic medical center from July 1, 2006 to February 28, 2007, a time of economic stability, and July 1, 2008 to February 28, 2009, a time of economic recession in the United States. Significantly fewer patients had private medical insurance during the economic recession than during the control period (36.5% vs 46%; P = 0.04). Despite this, there were no differences in the heart failure hospitalization or readmission rates, length of hospitalization, need for admission to an intensive care unit, in-hospital mortality, or use of guideline-recommended heart failure medications between the 2 study periods. We conclude that despite significant effects on medical insurance coverage, rates of heart failure hospitalization at our institution were not significantly affected by the recession. Additional large-scale population-based research is needed to better understand the effects of fluctuations in the US economy on heart failure hospitalization rates. © 2012 Wiley Periodicals, Inc.

  2. Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yun Young; Song, Jang Hyeon; Kim, Yong Tae; Yim, Nam Yeol; Kim, Jae Kyu; Lee, Ho Kyun; Choi, Soo Jin Na; Chung, Sang Young [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Kim, Soo Hyun; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine, Hwasun (Korea, Republic of)

    2013-02-15

    To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed. A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7). EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

  3. [LOCATION CHANGE OF ROTATION CENTER AFTER SINGLE SEGMENTAL CERVICAL DISC REPLACEMENT WITH ProDisc-C].

    Science.gov (United States)

    Lou, Jigang; Liu, Hao; Rong, Xin; Gong, Quan; Song, Yueming; Li, Tao

    2015-01-01

    To evaluate the effectiveness of the single segmental cervical disc replacement with ProDisc-C, and to explore the location change of the flexion/extension center of rotation (COR) of the target level as well as its clinical significance. Between June 2010 and February 2012, 23 patients underwent single segmental cervical disc replacement with ProDisc-C, and the clinical data were retrospectively analyzed. Of 23 patients, 9 were male, and 14 were female with the age range from 27 to 65 years (mean, 45 years), and the disease duration ranged from 10 to 84 months (mean, 25 months). There were 15 patients with radiculopathy, 5 patients with myelopathy, and 3 patients with mixed cervical spondylosis. The involved segments were C4,5 in 5 cases, C5,6 in 14 cases, and C6,7 in 4 cases. Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were adopted to evaluate the effectiveness. Preoperative and Postoperative radiographic parameters, such as cervical overall range of motion (ROM), target segmental ROM, the adjacent segmental ROM, and intervertebral height were compared. Besides, the location changes of the COR of the target level were further analyzed by the alteration of its coordinates (COR-X, COR-Y), and the relationships between the location changes of the COR and the effectiveness or the radiographic results were analyzed. All the operations were completed successfully; 1 case had hoarseness after operation, which disappeared at 3 months after operation. All cases were followed up 18.3 months on average (range, 6-36 months). There was no device migration, loosening, subsidence, or fracture at last follow-up. The JOA score increased significantly and the NDI score decreased significantly at last follow-up when compared with preoperative scores (P 0.05); while the intervertebral height and the COR-X increased significantly (P 0.05). According to whether the difference of the COR-X between pre- and post-operation was less than the average value

  4. Respiratory disease and climatic seasonality in children under 15 years old in a town in the Brazilian Amazon.

    Science.gov (United States)

    Rosa, Antonia Maria; Ignotti, Eliane; Botelho, Clóvis; Castro, Hermano Albuquerque de; Hacon, Sandra Souza

    2008-01-01

    To analyze the climatic seasonality of primary care visits for respiratory disease (RD) in children less than 15 years old. This was a descriptive, epidemiological study based on data from the municipal records of primary care events from basic healthcare centers for the period 2004-2005, for the municipality of Tangará da Serra (MT), Brazil. Population estimates were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IGBE), and data on temperature and relative humidity of the air, from the National Meteorology Institute (Instituto Nacional de Meteorologia, INMET). Mean rates of primary care visits for RD were calculated according to sex, age group and anatomic location of complaint. The ratio of dry season to rainy season visits was calculated according to anatomic location of the RD. Data were analyzed using Epi-Info 3.2, testing differences between proportions using the chi-square test to a significance level of 5%. Male children had an almost 50% greater (37.3/25.0) rate of primary care visits for diseases of the lower respiratory tract than did females. The rates of primary care visits due to RD in children under 15 years of age varied as age increased, varying from 457.7 per thousand of children less than 1 year of age to 133.5 per thousand in the 10 to 14 years-of-age group. During the dry season there were an average of 21% (4,148/5,231) fewer visits for RD (p = 0.000). Peaks in numbers of visits were observed during the months of March and August, being more accentuated in March, which is the wet season in the region. Primary care visits for RD, especially those due to upper airway diseases, are related to the rainy season in this municipality.

  5. Tobacco Use Among Students Aged 13-15 Years in South Korea: The 2013 Global Youth Tobacco Survey

    Science.gov (United States)

    Kim, Yoonjung; Lee, Jihye; Kashiwabara, Mina

    2017-01-01

    Objectives We examined the prevalence of tobacco use and exposure to secondhand smoke among middle-school students in Korea using the Global Youth Tobacco Survey (GYTS) in 2013. Methods The GYTS in Korea was conducted between July and August 2013 by the Korea Centers for Disease Control and Prevention. Data were collected using a self-administered anonymous questionnaire from a nationally representative sample of middle-school students aged 13-15 years in sampled classrooms. Results The GYTS in Korea was completed by 4235 students aged 13-15 years in 43 middle schools. Approximately one in five of the students (17.8%) reported that they had tried cigarettes in the past, while 5.2% reported currently being cigarette smokers. Current cigarette smoking was higher in boys (7.5%) than in girls (2.6%). Of the students, 29.7% had been exposed to secondhand smoke at home, 47.4% inside enclosed public places, and 53.9% in outdoor public places. Of the current cigarette smokers, 25.7% bought their cigarettes from a store despite a law prohibiting this. Additionally, 58.0% of students noticed point-of-sale tobacco advertisements or promotions, 66.8% of current cigarette smokers wanted to stop smoking, and 70.9% of students had been taught about the dangers of tobacco use in school. Conclusions These findings provide an opportunity to develop, implement, and evaluate a comprehensive tobacco control policy. The results suggest that youth have relatively easy access to cigarettes and are regularly exposed to secondhand smoke in public places, as well as to point-of-sale tobacco advertisements and promotions. Strict enforcement of the ban on tobacco sales to youth, expanding smoke-free areas, and advertising bans are needed to reduce tobacco use among youth. PMID:28173685

  6. Single-port laparoscopic cholecystectomy vs standard laparoscopic cholecystectomy:A non-randomized,agematched single center trial

    Institute of Scientific and Technical Information of China (English)

    Yoen; TK; van; der; Linden; Koop; Bosscha; Hubert; A; Prins; Daniel; J; Lips

    2015-01-01

    AIM: To compare the safety of single-port laparoscopic cholecystectomies with standard four-port cholecystectomies.METHODS: Between January 2011 and December 2012 datas were gathered from 100 consecutive patients who received a single-port cholecystectomy. Patient baseline characteristics of all 100 single-port cholecystectomies were collected(body mass index, age, etc.) in a database. This group was compared with 100 age-matched patients who underwent a conventional laparoscopic cholecystectomy in the same period. Retrospectively, per- and postoperative data were added. The two groups were compared to each other using independent t-tests and χ2-tests, P values below 0.05 were considered significantly different.RESULTS: No differences were found between both groups regarding baseline characteristics. Operating time was significantly shorter in the total single-port group(42 min vs 62 min, P < 0.05); in procedures performed by surgeons the same trend was seen(45 min vs 59 min, P < 0.05). Peroperative complications between both groups were equal(3 in the single-port group vs 5 in the multiport group; P = 0.42). Although not significant less postoperative complications were seen in the single-port group compared with the multiport group(3 vs 9; P = 0.07). No statistically significant differences were found between both groupswith regard to length of hospital stay, readmissions and mortality. CONCLUSION: Single-port laparoscopic cholecystectomy has the potential to be a safe technique with a low complication rate, short in-hospital stay and comparable operating time. Single-port cholecystectomy provides the patient an almost non-visible scar while preserving optimal quality of surgery. Further prospective studies are needed to prove the safety of the single-port technique.

  7. Prevalence of Tuberculosis among Veterans, Military Personnel and their Families in East Azerbaijan Province Violators of the last 15 Years.

    Science.gov (United States)

    Azad Aminjan, Maboud; Moaddab, Seyyed Reza; Hosseini Ravandi, Mohammad; Kazemi Haki, Behzad

    2015-10-01

    Nowadays in the world, tuberculosis is the second largest killer of adults after HIV. Due to the location of presidios that is mostly located in hazardous zones soldiers and army personnel are considered high risk, therefore we decided to determine the prevalence of tuberculosis status in this group of people. This was a cross-sectional descriptive research that studied the prevalence of pulmonary tuberculosis in soldiers and military personnel in the last 15 years in tuberculosis and lung disease research center at Tabriz University of Medical Sciences. The statistical population consisted of all the soldiers and military personnel. The detection method in this study was based on microscopic examination following Ziehl-Neelsen Stain and in Leuven Stein Johnson culturing. Descriptive statistics was used for statistical analysis and statistical values less than 0.05 were considered significant. By review information in this center since the 1988-2013 with 72 military personnel suffering from tuberculosis, it was revealed that among them 30 women, 42 men, 14 soldiers, 29 family members, and 29 military personnel are pointed. A significant correlation was found between TB rates among military personnel and their families. Although in recent years, the national statistics indicate a decline of tuberculosis, but the results of our study showed that TB is still a serious disease that must comply with the first symptoms of tuberculosis in military personnel and their families that should be diagnosed as soon as possible.

  8. Marginal living donor in kidney transplantation: experience in a Chinese single center

    Institute of Scientific and Technical Information of China (English)

    LI Gang; WANG Yun-peng; MA Lu-lin; ZHANG Jing; ZHANG Hong-xian; HUANG Yi; HOU Xiao-fei

    2013-01-01

    Background Living donor kidney transplantation is becoming popular in China,whereas,in clinical situations,some kidney donors may be sub-optimal,namely marginal living donor.The present study aimed to evaluate the safety and efficacy of marginal living donor kidney transplantation in a Chinese single center.Methods Between January 2001 and December 2009,888 kidney transplantations were performed in our center; 149were living donor kidney transplantations.The living donors and recipients were followed up regularly after the operation.Of the living donors,30 donors were marginal,who were older than 60 years or suffered from kidney anomaly or some benign diseases.Among the non-marginal living kidney transplantations,58 donors and recipients had complete perioperative and follow-up data.We compared the marginal and non-marginal living donor kidney transplantations with regard to donor age,follow-up period,donor's serum creatinine at the last follow-up,recipient's serum creatinine at the last follow-up,and graft survival at the last follow-up.Results The mean age of donors in the marginal and non-marginal living donors were (55±9) (37-66) and (43±12) (30-59) years.The mean follow-up times of the marginal and non-marginal groups were (26.4±13.4) months and (28.8±14.8)months.The donor and recipient serum creatinine levels at the last follow-up were (1.16±0.20) mg/dl and (1.30±0.24) mg/dl in the marginal group,and (1.12±0.32) mg/dl and (1.34±0.32) mg/dl in the non-marginal group.Three recipients in the marginal group and five recipients in the non-marginal group had acute rejection episodes during the first year.Actuarial 3-year graft survival was 96.7% in the marginal group and 100% in the non-marginal group.No significant differences were detected between the two groups with regard to these data.Conclusion Utilization of highly selective marginal living donors can be a safe,feasible,and effective way for the treatment of patients with end stage renal disease.

  9. Tooth brushing among 11- to 15-year-olds in Denmark

    DEFF Research Database (Denmark)

    Bast, L. S.; Holstein, B. E.; Nordahl, Helene

    2015-01-01

    both separately and combined. Methods: The study population was 11-15 year-olds chosen from a clustered random sample of schools. Univariate and multivariate logistic regression analyses estimated the separate and combined effects of migration status and social class on less than twice daily tooth...... groups of immigrants and descendants. Conclusion: The study shows that both non-Danish origin and low social class increases the risk of infrequent tooth brushing among school-aged children. The study calls for in depth analyses of the processes which influence young people’s tooth brushing habits...

  10. Youth and acne - a survey among 14- and 15-year-olds

    OpenAIRE

    2005-01-01

    Acne is a condition which can give both physical and psychological scars. Young persons are vulnerable to the negative effects of acne. Our survey investigates whether the knowledge about causes and treatment of acne is satisfactory among 14- and 15-year-olds. How does acne effect their self-esteem and well-being in school? Is there a need for information and how is their help-seeking behaviour? Our survey included 304 students from 5 different schools. The response rate was 99%. ...

  11. Gouty arthritis in a 15-year-old girl with Bartter′s syndrome

    Directory of Open Access Journals (Sweden)

    Derakhshan Nima

    2010-01-01

    Full Text Available A 15-year-old girl, a known case of Bartter′s syndrome (BS for 7 years, developed severe pain in her right knee and right and left ankle. Her older sister had BS and developed end-stage renal disease (ESRD at the age of 14 years. Her serum uric acid was 12.6 mg/dL, 6 months ago, and 15.4 mg/dL in her recent lab data. Hyperuricemia and gouty arthritis are commonly seen in adults with BS, but to our knowledge there is no report of gouty arthritis in pediatric literature.

  12. 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2)

    DEFF Research Database (Denmark)

    Eskelund, Christian W.; Kolstad, Arne; Jerkeman, Mats;

    2016-01-01

    , developed by the Nordic Lymphoma Group. We here present the 15-year updated results of the Nordic MCL2 study after a median follow-up of 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, respectively. The MCL International......In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first-line regimens containing cytarabine, rituximab and consolidation with high-dose-therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen...

  13. Clear cell adenocarcinoma of the ulterine cervix in a 15 year old girl: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Joon; Kim, Jee Eun; KIm, Hyung Sik; Choi, Hye Young [Dept. of Radiology, Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2013-10-15

    Cervical cancer is rare in the pediatric population. In cases of cervical cancer, adenocarcinoma is predominantly reported. Clear cell adenocarcinoma (CCAC) of the uterine cervix is a very rare tumor and accounts for only 4% of all adenocarcinomas of the uterine cervix. Risk factors and pathogenesis of this disease are not exactly revealed. The intrauterine exposure to diethylstilbestrol (DES) and associated non-steroidal estrogen during pregnancy before 18 weeks is the only known risk factor. This study reports the imaging finding of primary uterine cervical tumor in a 15-year-old girl, who was finally diagnosed with CCAC, with no maternal history of DES exposure in utero.

  14. Reticulitermes urbis in Bagnacavallo (Ravenna, Northern Italy: a 15-year experience in termite control

    Directory of Open Access Journals (Sweden)

    Roberto Ferrari

    2011-08-01

    Full Text Available We relate and discuss the application of a monitoring-baiting program with the IGR hexaflumuron to termite control in Bagnacavallo (Ravenna, Northern Italy, where a massive Reticulitermes urbis infestation existed in the old town. Termite control was carried out in different zones over a period of 15 years, starting from the centre of the infested area and extending towards the peripheral areas. The treatment succeeded in eliminating termites from Bagnacavallo old town, using a total of 63 g of hexaflumuron.

  15. [Health surveillance in a steel making industry with electric arc furnace: 15 years of experience].

    Science.gov (United States)

    Corti, P

    2012-01-01

    This paper analyzes the results of health surveillance carried out in an electric steel mill for 15 years. We have analyzed the trend of audiometry, spirometry and main indicators of exposure to chemical risk: serum lead, urinary OH-pyrene, erythrocyte ZPP, and the results of risk assessment of stress work related. The analyses of the trend of audiometry, spirometry and biological monitoring shows an important improving in the working environment due to the progressive automation of production steps in the course of several years, consistent and correct use of DPI, information and training.

  16. Gingival recession in school kids aged 10-15 years in Udaipur, India

    Directory of Open Access Journals (Sweden)

    Mathur Anmol

    2009-01-01

    Full Text Available Aim : The study aimed to determine the incidence of gingival recession in the mandibular central incisor region among school children aged 10-15 years in Udaipur (India. Materials and Methods : A sample of 1800 males and female kids were examined in a mobile dental unit. World Health Organisation (WHO rules and standards were followed. Result : Gingival recession, when compared, with respect to age, mean clinical crown length, anterior crowding and frenal involvement was significant (p less than 0.00 with respect to affected teeth.

  17. Plummer-Vinson syndrome in a 15-year-old boy.

    Science.gov (United States)

    Dinler, Gönül; Tander, Burak; Kalayci, Ayhan Gazi; Rizalar, Riza

    2009-01-01

    Plummer-Vinson syndrome presents as a classical triad of dysphagia, iron deficiency anemia and upper esophageal web(s). The syndrome usually occurs in adults, and is rare in childhood. We report a case of this syndrome occurring in a 15-year-old boy. He presented with dysphagia and anemia. Radiological examination showed the presence of webs at the cervical esophagus. The boy was treated with endoscopic balloon dilation and iron supplementation and remains in good general condition six months after the treatment.

  18. Students (ages 6, 10, and 15 years in six countries knowledge of animals

    Directory of Open Access Journals (Sweden)

    Patricia Patrick

    2013-04-01

    Full Text Available This article considers the knowledge students (ages 6, 10, and 15 years have of animals from a cross-cultural perspective. Students from six countries (Brazil, England, Finland, Iceland, Portugal, and the United States of America were asked to free-list as many animals as possible and state where they had seen or learned about the animals. The results were analyzed and they indicate that 1 Students are aware of animals. 2 Students are more aware of mammals as examples of animals. 3 There is a globally shared folk biological knowledge of animals. 4 Students learn about animals during sociocultural interactions. The educational implications are discussed.

  19. A 15-year randomized controlled study of a reduced shrinkage stress resin composite.

    Science.gov (United States)

    van Dijken, Jan W V; Lindberg, Anders

    2015-09-01

    The aim of this randomized controlled study was to evaluate the long term effectiveness of a reduced shrinkage stress resin composite in Class II restorations. The material was compared intra-individually with a microhybrid resin composite. Each of 50 patients with at least one pair of two similar sized Class II cavities participated (22 female, 28 male, mean age 43 years, range 18-64). Each participant received in each pair, in a randomized way, one Class II restoration performed with a reduced shrinkage stress resin composite (InTen-S) and the other restoration with a microhybrid resin composite restoration (Point 4). Both restorations were placed with an etch-and-rinse bonding system and an oblique layering technique. A total of 106 restorations, 33 premolar and 73 molars, were placed. The restorations were evaluated blindly each year using modified USPHS criteria. The overall performance of the experimental restorations was tested after intra-individual comparison using the Friedmańs two-way analysis of variance test. The hypothesis was rejected at the 5% level. At 15 years, 91 restorations were evaluated. The drop out frequency was 15 restorations (5 male, 3 female participants; 2 premolar and 13 molar restorations). Except for 2 participants, who reported slight symptoms during a few weeks after placement, no post-operative sensitivity was observed at the recalls. The overall success rate at 15 years was 77%. Twenty-one non acceptable restorations were observed during the 15 years follow up, 10 InTen-S (21.7%) and 11 Point 4 (24.4%) restorations (p>0.05). Annual failure rates for the resin composites were 1.5% and 1.6%, respectively. The main reasons for failure were secondary caries (8) and resin composite fracture (7). The differences between premolar vs. molar restorations and between restorations in male vs. female participants were not significant. Significant differences were observed between 2-surface vs. 3-surface restorations. During the 15-year

  20. [Relapse of bleeding ulcer in a 15 year-old boy with collagenous gastritis].

    Science.gov (United States)

    Haase, Anne-Mette; Kelsen, Jens

    2012-06-18

    Collagenous gastritis (CG) is a rare disorder. Two patient groups are known: 1) Children and young adults, presenting with anaemia and abdominal pain, and 2) adults presenting with watery diarrhoea. In the latter group, CG is frequently associated with collagenous colitis and/or coeliac disease. This case concerns a 15-year-old boy with a bleeding ulcer. The biopsies from corpus ventriculi showed a thickened subepithelial collagen band (> 10 micrometres), and the patient was diagnosed with CG. Ulcers are rarely linked to CG. CG should be considered when ulcers are found in children and young adults.

  1. The impact of job satisfaction on the risk of disability pension. A 15-year prospective study.

    Science.gov (United States)

    Labriola, Merete; Feveile, Helene; Christensen, Karl Bang; Bültmann, Ute; Lund, Thomas

    2009-09-01

    To identify the impact of job satisfaction on the risk of disability pension. A total of 8,338 employees were sampled from the total working population in Denmark. They were interviewed regarding age, gender, job satisfaction and health behaviour. Interview data were merged with national register data on granted disability pension for up to 15 years after baseline data collection. The study found a statistically significant association between low job satisfaction and disability pension for women when adjusted for age, smoking status and BMI. Based on the results, investing in giving workers a satisfying work environment could be a low-cost way of improving employee health and prolonging labour market participation.

  2. Surgical Treatment of Implants Affected by Periimplantitis After 15 Years of Loading: A Case Report.

    Science.gov (United States)

    Nícoli, Lélis Gustavo; Pigossi, Suzane Cristina; Marcantonio, Cláudio; Leal Zandim-Barcelos, Daniela; Marcantonio, Elcio

    2016-04-01

    The aim of this case report is to describe the surgical treatment of 2 implants affected by periimplantitis after 15 years of loading. The treatment included mechanical and chemical decontamination with topical application of tetracycline associated with a regenerative approach. Both defects were filled with particulate autogenous bone from tuber and covered with resorbable collagen membrane. The follow-up of 30 and 13 months of the implants 24 and 14, respectively, showed an absence of clinical signs of periimplant inflammation and near-complete bone regeneration. The therapy approach was effective in eliminating periimplant inflammation and promoting bone gain around the implants.

  3. Endoscopic Removal of a Nitinol Mesh Stent from the Ureteropelvic Junction after 15 Years

    Directory of Open Access Journals (Sweden)

    Tomaž Smrkolj

    2015-01-01

    Full Text Available We report a rare case of a patient with a large stone encrusted on a nitinol mesh stent in the ureteropelvic junction. The stent was inserted in the year 2000 after failure of two pyeloplasty procedures performed due to symptomatic ureteropelvic junction stenosis. By combining minimally invasive urinary stone therapies—extracorporeal shock wave lithotripsy, semirigid ureterorenoscopy with laser lithotripsy, and percutaneous nephrolithotomy—it was possible to completely remove the encrusted stone and nitinol mesh stent that was implanted for 15 years, rendering the patient symptom and obstruction free.

  4. The impact of job satisfaction on the risk of disability pension. A 15-year prospective study

    DEFF Research Database (Denmark)

    Labriola, Merete; Feveile, Helene; Christensen, Karl Bang

    2009-01-01

    OBJECTIVES: To identify the impact of job satisfaction on the risk of disability pension. METHODS: A total of 8,338 employees were sampled from the total working population in Denmark. They were interviewed regarding age, gender, job satisfaction and health behaviour. Interview data were merged...... with national register data on granted disability pension for up to 15 years after baseline data collection. RESULTS: The study found a statistically significant association between low job satisfaction and disability pension for women when adjusted for age, smoking status and BMI. CONCLUSIONS: Based...

  5. Neuroretinitis with Branch Retinal Artery Occlusion in a 15-Year-Old Female

    Directory of Open Access Journals (Sweden)

    Sina Ahmadi

    2013-11-01

    Full Text Available We report a case of Bartonella henselae neuroretinitis with significant disc and peripapillary edema, branch retinal artery occlusion without macula involvement and well preserved central vision. A 15-year-old female presented with loss of vision over 4 weeks in the left eye. She had a history of cat exposure, but a cat scratch, insect bite or conjunctivitis was not reported. An inferotemporal arcuate scotoma developed during the acute phase and persisted over the course of the follow-up.

  6. Visual illusions on the Internet: 15 years of change in technology and user behavior.

    Science.gov (United States)

    Bach, Michael

    2014-01-01

    Abstract. Looking back over 15 years of demonstrating visual phenomena and optical illusions on the Internet, I will discuss two major topics. The first concerns the methodology used to present interactive visual experiments on the web, with respect to (a) wide accessibility, ie independent of browser and platform, (b) capable and elegant graphic user interface, (c) sufficient computational power, (d) ease of development and, finally, (e) future-proofing in an ever-changing online environment. The second major topic addresses some aspects of user behaviour, mainly temporal patterns (eg changes over weeks. years, long-term), which reveal that there are more visitors during office hours.

  7. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  8. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  9. Clinical outcomes of 11,436 kidney transplants performed in a single center - Hospital do Rim.

    Science.gov (United States)

    Pestana, José Medina

    2017-08-28

    Kidney transplantation is considered a cost-effective treatment compared to dialysis but accounts for a significant percentage of the public health care resources. Therefore, efficient systems capable of performing high number of procedures are attractive and sustainable. The aim of this study was to evaluate clinical outcomes of 11,436 kidney transplants regularly performed in a single transplant dedicated center over the last 18 years. This was a retrospective study performed in a single specialized transplant center. All consecutive patients who underwent transplantation between 08/18/1998 and 12/31/2015 were included in the analysis. The annual number of transplants increased from 394 in 1999 to 886 in 2015, with a progressive reduction in the proportion of living donor kidney transplants (70% vs. 23%) and yielding over 8869 patients in regular follow up. Of 11,707 kidney transplants performed, 5348 (45.7%) were from living, 3614 (30.9%) standard and 1618 (13.8%) expanded criteria deceased donors, 856 (7.3%) pediatric and 271 (2.3%) simultaneous kidney-pancreas transplants. Comparing 1998-2002 and 2011-2014, five-years graft survival increased for kidney transplants performed with living donors (83.3% vs. 93.1%, p transplants, in the cumulative number of patients in follow up and a shift from living related to deceased donor kidney transplants, with associated progressive increase in patient and graft survivals. Transplante renal é considerado um tratamento custo-efetivo comparado à diálise e representa uma porcentagem significativa dos recursos de saúde pública. Dessa forma, sistemas eficientes e capazes de realizar um elevado número de procedimentos, são atraentes e sustentáveis. O objetivo deste estudo foi avaliar os desfechos clínicos de 11.436 transplantes renais realizados em um centro único de transplante nos últimos 18 anos. Trata-se de um estudo retrospectivo realizado em centro único e especializado em transplante renal. Todos os pacientes

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

    Directory of Open Access Journals (Sweden)

    Kiralj Aleksandar I

    2015-01-01

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

  11. Immunosuppressive therapy in patients with aplastic anemia: a single-center retrospective study.

    Directory of Open Access Journals (Sweden)

    Hasan Jalaeikhoo

    Full Text Available Aplastic anemia (AA is a rare disease in which hematopoietic stem cells are severely diminished resulting in hypocellular bone marrow and pancytopenia. Etiology of AA includes auto immunity, toxins, infection, ionizing radiation, drugs and rare genetic disorders, but in the majority of cases no cause can be identified. In the present study we assessed response rate, survival, relapse and clonal evolution in patients with AA treated with immunosuppressive therapy.Patients with AA who received immunosuppressive therapy between May 1998 and September 2013 were included in this study. Patients with non-severe AA (NSAA were treated with cyclosporine (CsA and danazol while patients with severe AA (SAA as well as patients with NSAA who progressed to SAA after beginning of the treatment, were candidates for receiving antithymocyte globulin in addition to CsA and danazol.Among the 63 studied patients, 29 (46% had NSAA and 34 (54% had SAA. Three months after treatment, overall response was 58.6% in NSAA and 12.9% in patients with SAA. Survival of all patients at 5, 10 and 15 years were 73%, 55% and 49%, respectively. Survival rates were significantly higher in patients with NSAA compared to patients with SAA as well as in patients who responded at 6 months compared to non-responders. The relapse risk was 39.7% at 10 years. Relapse occurred in patients who discontinued the therapy more than those who continued taking CsA (p value<0.01. The risk of clonal evolution was 9.9% at 10 years and 22.8% at 15 years after treatment.This long-term retrospective study indicated that immunosuppressive therapy should be recommended to patients with AA. Also, our experience indicated that immunosuppressive therapy should not be discontinued after response to therapy in patients with both NSAA and SAA due to high risk of relapse. Low dose of CsA should be continued indefinitely.

  12. Second-Line Immunosuppressive Treatment of Childhood Nephrotic Syndrome: A Single-Center Experience

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    J. Kim

    2014-01-01

    Full Text Available Objective: Most cases of idiopathic nephrotic syndrome in childhood are responsive to corticosteroids. However, there is a small group of children that demonstrate steroid resistance (steroid-resistant nephrotic syndrome; SRNS, steroid dependence, or that frequently relapse (frequent-relapse steroid-sensitive nephrotic syndrome; FR-SSNS which are more clinically difficult to treat. Therefore, second-line immunosuppressants, such as alkylating agents, calcineurin inhibitors, antimetabolites and, more recently, rituximab, have been used with varying success. The objective was to evaluate the response rates of various second-line therapies in the treatment of childhood nephrotic syndrome. Study Design: A retrospective chart review of pediatric subjects with idiopathic nephrotic syndrome was conducted at a single tertiary care center (2007-2012. Drug responses were classified as complete response, partial response, and no response. Results: Of the 188 charts reviewed, 121 children were classified as SSNS and 67 children as SRNS; 58% were classified as FR-SSNS. Sixty-five subjects were diagnosed with focal segmental glomerulosclerosis via biopsy. Follow-up ranged from 6 months to 21 years. The combined rate of complete and partial response for mycophenolate mofetil (MMF was 65% (33/51 in SSNS and 67% (6/9 in SRNS. For tacrolimus, the response rate was 96% (22/23 for SSNS and 77% (17/22 for SRNS. Eighty-three percent (5/6 of SSNS subjects treated with rituximab went into complete remission; 60% relapsed after B-cell repletion. Eight refractory subjects were treated with combined MMF/tacrolimus/corticosteroid therapy with a 75% response rate. Conclusion: Our experience demonstrates that older medications can be replaced with newer ones such as MMF, tacrolimus, and rituximab with good outcomes and better side effect profiles. The treatment of refractory cases with combination therapy is promising.

  13. Chromogranin A as Serum Marker for Gastroenteropancreatic Neuroendocrine Tumors: A Single Center Experience and Literature Review

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    Christoph J. Auernhammer

    2012-02-01

    Full Text Available The aim of this study was to assess the clinical sensitivities of the tumor markers chromogranin A (CgA, urinary 5-hydroxyindoleacetic acid (5-HIAA and alkaline phosphatase (AP in neuroendocrine tumors (NETs of the GastroEnteroPancreatic-(GEP- system depending on tumor primary location and metastatic spread. In a retrospective single-center series, sensitivities were evaluated in serum samples from 110 patients with midgut (n = 62 and pancreatic (n = 48 NETs. CgA levels were analyzed by a commercially-available immunoradiometric assay (CIS-bio during routine follow-up in the years 2000–2009. CgA showed a higher sensitivity for midgut (68% than pancreatic (54% NETs. A higher CgA sensitivity and significantly higher median CgA values were found in patients with liver metastases than in those without, and in patients with hepatic and additionally extra-hepatic metastases than in those with hepatic and nodal metastases alone, respectively. We found an overall sensitivity for elevated 5HIAA excretion of 69% for midgut NETs and a significant correlation between median CgA and 5-HIAA values. The sensitivity of AP and the correlations of AP/CgA-data-pairs were low in both midgut and pancreatic NETs, although highest for metastatic pancreatic NETs. The sensitivity of CgA measurement depends on the NET primary location and spread of disease. 5-HIAA and CgA showed comparable sensitivity in midgut NETs, while AP does not seem to be useful as a tumor marker in GEP-NETs.

  14. Rekanalisation von chronischen Koronarverschlüssen - Single-Center-Erfahrungen mit 75 Patienten

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    Schuler J

    2011-01-01

    Full Text Available Hintergrund: Chronische Koronarverschlüsse (chronic total occlusion, CTO werden in Salzburg bei 18,1 % der Patienten mit koronarer Herzerkrankung diagnostiziert. Die klinische Relevanz eines CTO ergibt sich aus der klinischen Symptomatik und einem validen Vitalitätsnachweis. 63,7 % der CTOs wurden im Jahr 2009 konservativ behandelt, 36,2 % einer Revaskularisation zugeführt: 18,8 % einer CABG und 17,4 % einer perkutanen Katheterintervention (PCI. Wir berichten über die Single-Center- Ergebnisse der CTO-PCI im Rahmen eines strukturierten CTO-Programms. Patienten: Insgesamt wurde über einen Zeitraum von 40 Monaten bei 75 Patienten (76 % männlich, mittleres Alter 62,4 Jahre ein CTO im Katheterlabor interveniert. 92 % wiesen eindeutige Symptome auf, ein Vitalitätsnachweis lag bei 82,3 % vor. 81,3 % der Patienten hatten eine Mehrgefäß-KHK, 42,6 % einen Infarkt und 58,6 % eine PCI in der Anamnese. Ergebnisse: Ein bilateraler Zugang wurde bei 36 % der Patienten gewählt, bei 20 % wurde zumindest ein retrograder Versuch unternommen. Die prozedurale Dauer betrug im Mittel 105 min, der mittlere Kontrastmittelverbrauch 319 ml, die mittlere Strahlendosis 3,23 gray. Die Erfolgsrate betrug insgesamt 73,3 %, die Komplikationsrate 13,3 %. Dabei handelte es sich überwiegend um keine lebensbedrohlichen Komplikationen. Sowohl bei Erfolg als auch bei Komplikationshäufigkeit war eine deutliche Lernkurve festzustellen. Schlussfolgerung: Die CTO-Rekanalisation ist bei sorgsamer Patientenauswahl eine rationale Therapieoption. Bei einem strukturierten Vorgehen und adäquater Materialauswahl kann bei einer akzeptablen Komplikationsrate bei 75 % der Patienten ein Erfolg erzielt werden. Als wesentliche Limitation des Eingriffes ist die hohe Strahlenbelastung für den Patienten anzusehen.

  15. Mycetoma: experience of 482 cases in a single center in Mexico.

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    Bonifaz, Alexandro; Tirado-Sánchez, Andrés; Calderón, Luz; Saúl, Amado; Araiza, Javier; Hernández, Marco; González, Gloria M; Ponce, Rosa María

    2014-08-01

    Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  16. Mycetoma: experience of 482 cases in a single center in Mexico.

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    Alexandro Bonifaz

    2014-08-01

    Full Text Available Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013. A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11% were actinomycetomas and 38 cases (7.88% were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years. The main affected localization was lower and upper limbs (70.74% and 14.52% respectively. Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported. The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%. Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21% and Actinomadura madurae (8.7%; meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  17. Relationship between renal function and extracorporeal membrane oxygenation use: a single-center experience.

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    Gupta, Punkaj; Carlson, Jacob; Wells, Dennis; Selakovich, Patrick; Robertson, Michael J; Gossett, Jeffrey M; Fontenot, Eudice E; Steiner, Matthew B

    2015-04-01

    The effects of extracorporeal membrane oxygenation (ECMO) support on renal function in children with critical illness are unknown. The objective of this study was to investigate the impact of ECMO on renal function among children in different age groups. We performed a single-center retrospective observational study in critically ill children ≤ 18 years supported on ECMO for refractory cardiac or pulmonary failure (2006-2012). The patient population was divided into four age groups for the purpose of comparisons. The Acute Kidney Injury Network's (AKIN's) validated, three-tiered staging system for acute kidney injury was used to categorize the degree of worsening renal function. Data on patient demographics, baseline characteristics, renal function parameters, dialysis, ultrafiltration, duration of mechanical cardiac support, and mortality were collected. Comparisons of baseline characteristics, duration of mechanical cardiac support, and renal function were made between the four age groups. During the study period, 311 patients qualified for inclusion, of whom 289 patients (94%) received venoarterial (VA) ECMO, 12 (4%) received venovenous (VV) ECMO, and 8 (3%) received both VV and VA ECMO. A total of 109 patients (36%) received ultrafiltration on ECMO, 58 (19%) received hemodialysis, and 51 (16%) received peritoneal dialysis. There was a steady and sustained improvement in renal function in all age groups during the ECMO run, with the maximum and longest-sustained improvement occurring in the oldest age group. Proportions of patients in different AKIN stages remained similar in the first 7 days after ECMO initiation. We demonstrate that renal dysfunction improves early after ECMO support. Irrespective of the underlying disease process or patient age, renal function improves in children with pulmonary or cardiac failure who are placed on ECMO.

  18. Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience

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    JIAO Li-qun; SONG Gang; LI Shen-mao; MIAO Zhong-rong; ZHU Feng-shui; JI Xun-ming; YIN Guo-yang

    2013-01-01

    Background Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies.This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.Postoperative 30-day complication rates were analyzed and compared with those of other studies.Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI),stroke,and death.Results The overall 30-day rate of MI,stroke,and death after CAS was 2.53%.In univariate analysis,patients who were symptomatic,had a neurological deficit (modified Rankin score (mRS) ≥3; P=0.001),and who were not taking statins experienced a significantly increased rate of MI,stroke,and death (P=-0.017).In multivariate Logistic regression analysis,the presence of symptoms (odds ratio (OR)=2.485; 95% confidence interval (CI)=1.267-4.876; P=0.008) and a neurological deficit (mRS ≥3) (OR=3.025; 95% CI=1.353-6.763; P=0.007) were independent risk factors for perioperative MI,stroke,and death.Conclusions According to this single-center experience,CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke.Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI,stroke,and death.

  19. External validation of the SEDAN score: The real world practice of a single center

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    Sombat Muengtaweepongsa

    2015-01-01

    Full Text Available Background and Purpose: Symptomatic intracranial hemorrhage (sICH is the most serious adverse event in stroke patients who received i.v. rt-PA and is usually associated with poor outcomes. The SEDAN score is built up to predict sICH. We aim to externally validate the SEDAN score in Thai patients from single center in the real world practice. Methods: The SEDAN score of stroke patients treated with intravenous rt-PA at Thammasat University Hospital from January 2010 to June 2012 was calculated. Patients were divided into three groups including symptomatic intracranial hemorrhage (sICH, asymptomatic intracranial hemorrhage (AsICH and no intracerebral hemorrhage (NoICH. The primary outcome of analyses was sICH. Each parameter of the SEDAN score and correlation between score and sICH were analyzed with univariate and multivariate model. Results: 295 patients (18.6% of stroke admission were treated with i.v. rt-PA. 13 patients (4.4% had sICH and 31 patients (10.4% had AsICH. Baseline blood sugar >12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10(SEDAN were associated with sICH by univariate analysis (P value = 0.018, 12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10 were 1.248, 2.503, 1.107, 1.532 and 1.263 respectively. Conclusions: The SEDAN score was practical to use and predictive in Thai population. Each parameter of the SEDAN score was an independent risk factor for sICH after treatment with i.v. rt-PA.

  20. Safety and retention rate of rufinamide in 300 patients: a single pediatric epilepsy center experience.

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    Thome-Souza, Sigride; Kadish, Navah E; Ramgopal, Sriram; Sánchez Fernández, Iván; Bergin, Ann M; Bolton, Jeffrey; Harini, Chellamani; Libenson, Mark; Olson, Heather; Peters, Jurriaan; Poduri, Annapurna; Rotenberg, Alexander; Takeoka, Masanori; Kothare, Sanjeev V; Kapur, Kush; Bourgeois, Blaise F D; Loddenkemper, Tobias

    2014-08-01

    Reports of studies evaluating rufinamide as an add-on therapy in children and adolescents with refractory epilepsy are restricted to a few publications. Prospective multicenter studies including children and adults have yielded important information about several types of epilepsies and syndromes. We evaluated the use of rufinamide in a single pediatric center with a large cohort and long-term follow-up period. We retrospectively included patients taking rufinamide from November 2008 to March 2013. Response was defined by a seizure reduction of ≥50% compared to baseline. Three hundred patients with a median age of 9.1 years (range 0.4-29.6 years) were reviewed. Median follow-up was 9 months (range 1-37 months). Epilepsy etiology was classified as genetic (23.7%), structural/metabolic (41%), and unknown cause (35.3%). Overall, rufinamide treatment led to a median seizure frequency reduction of 59.2% from responders to baseline. Seizure reduction was greater in patients with genetic etiology compared to structural/metabolic (66.2% vs. 45.5% responders, p = 0.005). Rufinamide was discontinued in 110 (36.7%) of 300 patients: 63 (21%) due to unsatisfactory response, 47 (15.7%) due to side effects, and in 18 (6%) of those due to both. Most common adverse effects were sleepiness, vomiting, mood changes, nausea, and loss of appetite. Median time to loss of efficacy was 11.6 months (range 3-28 months). Rufinamide provides satisfactory seizure reduction as an adjunctive treatment in refractory epilepsy. Results need to be interpreted in the setting of data acquisition, including inherent biases of retrospective studies. Patients with a known genetic etiology may have better responses than patients with structural/metabolic etiology. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  1. Multiple clinical presentations of lymphoproliferative disorders in pediatric liver transplant recipients: a single-center experience.

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    Pinho-Apezzato, M L; Tannuri, U; Tannuri, A C A; Mello, E S; Lima, F; Gibelli, N E; Santos, M M; Ayoub, A A; Maksoud-Filho, J G; Velhote, M C; Silva, M M; Andrade, W C; Miyatani, H T

    2010-06-01

    Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation that has been linked to Epstein-Barr virus (EBV) infection. The aim of this article was to describe a single-center experience with the multiplicity of clinical presentations of PTLD. Among 350 liver transplantations performed in 303 children, 13 survivor children displayed a histological diagnosis of PTLD (13/242 survivors; 5.4%). The age at diagnosis ranged from 12 to 258 months (median, 47), and the time from transplantation ranged from 1 to 84 months (median, 13). Ten of these children (76.9%) were EBV-naïve prior to transplantation. Fever was present in all cases. The clinical signs at presentation were anemia (92.3%), diarrhea and vomiting (69.2%), recurrent upper airway infections (38.4%), Waldeyer ring lymphoid tissue hypertrophy (23.0%), abdominal mass lesions (30.7%), massive cervical and mediastinal adenopathy (15.3%), or gastrointestinal and respiratory symptoms (30.7%). One child developed fulminant hepatic allograft failure secondary to graft involvement by PTLD. Polymorphic PTLD was diagnosed in 6 patients; 7 had the diagnosis of lymphoma. Treatment consisted of stopping immunosuppression as well as starting intravenous gancyclovir and anti-CD20 monoclonal antibody therapy. The mortality rate was 53.8%. The clinical presentation of PTLD varied from fever of unknown origin to fulminant hepatic failure. The other symptoms that may be linked to the diagnosis of PTLD are pancytopenia, tonsil and adenoid hypertrophy, cervical or mediastinal lymph node enlargement, as well as abdominal masses. Despite numerous advances, the optimal treatment approach for PTLD is not completely known and the mortality rate is still high.

  2. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

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    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  3. Profile of infective endocarditis observed from 2003 - 2010 in a single center in Italy.

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    Ferraris, Laurenzia; Milazzo, Laura; Ricaboni, Davide; Mazzali, Cristina; Orlando, Giovanna; Rizzardini, Giuliano; Cicardi, Marco; Raimondi, Ferdinando; Tocalli, Loredana; Cialfi, Alessandro; Vanelli, Paolo; Galli, Massimo; Antona, Carlo; Antinori, Spinello

    2013-11-15

    This study aimed to provide a contemporary picture of the epidemiologic, clinical, microbiologic characteristics and in-hospital outcome of infective endocarditis (IE) observed in a single center in Italy. We performed a retrospective study of patients with definite or probable IE observed at the "L. Sacco" Hospital in Milan, Italy, from January 1, 2003 through December 31, 2010. 189 episodes of IE in 166 patients were included. The mean number of incident IE in the study period was of 1.27 (range 0.59-1.76) cases per 1000 patients admitted. The median age of the cohort was 57 (interquartile range, 43-72) years, 63% were male and 62.5% had native valve IE. Twenty-six percent were active intravenous drug users (IVDU), 29% had a health care-associated IE and 5% chronic rheumatic disease. Twenty-nine percent of the cases occurred in patients affected by chronic liver disease and 19% in HIV positive subjects. Staphylococcus aureus was the most common pathogen (30%), followed by streptococci. The mitral (34%) and aortic (31%) valves were involved most frequently. The following complications were common: stroke (19%), non-stroke embolizations (25%), heart failure (26%) and intracardiac abscess (9%). Surgical treatment was frequently employed (52%) but in hospital mortality remained high (17%). Health care-associated IE and complications were independently associated with an increased risk of in-hospital death, while surgery was associated with decreased mortality. S. aureus emerged as the leading causative organism of IE in a University hospital in northern Italy. Our study confirmed the high in-hospital mortality of IE, particularly if health care associated, and the protective role of surgery.

  4. Predisposing Factors of Ischemic Colitis: Data from 14 Years of Experience in a Single Center

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    Hyun Il Seo

    2017-01-01

    Full Text Available Background and Aims. While several case reports on ischemic colitis (IC suggest the presence of predisposing causative factors, a few studies have investigated the predisposing factors in IC. This study aimed to identify the characteristics of patients with IC, particularly focusing on the predisposing factors. Methods. We conducted a single-center, retrospective analysis of 159 patients with IC. Clinical characteristics, laboratory data, endoscopic findings, and medical records were reviewed. Data were compared between groups of patients defined according to the predisposing factors. The predisposing factors are defined as temporary states or episodic events occurring within a week before the development of IC such as colonoscopy, enema, use of laxatives, heavy drinking, pancreatitis, shock, and burn. Results. Compared to the group of patients without predisposing factors of IC, the group of patients with predisposing factors was characterized by a relatively higher prevalence of male sex (56.9% versus 33.3%, p=0.005, younger age (60.9 ± 15.4 versus 67.2 ± 13.4 years, p=0.010, lower incidence of hypertension (43.1% versus 60.2%, p=0.044, and fewer risk factors (1.24 ± 1.18 versus 1.82 ± 1.22, p=0.005. Conclusions. Among men with predisposing factors, IC may develop even at a relatively younger age and in the absence of multiple risk factors, suggesting that predisposing factors may be involved in the pathogenesis of IC.

  5. Central nervous system involvement in T-cell lymphoma: A single center experience.

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    Gurion, Ronit; Mehta, Neha; Migliacci, Jocelyn C; Zelenetz, Andrew; Moskowitz, Alison; Lunning, Matthew; Moskowitz, Craig; Hamlin, Paul; Horwitz, Steven

    2016-05-01

    Background We characterized the incidence of central nervous system (CNS) involvement, risk factors and outcome in a large single institution dataset of peripheral T-cell lymphoma (PTCL). Methods Retrospective review of the PTCL database at Memorial Sloan Kettering Cancer Center. We identified 231 patients with any subtype of PTCL between 1994-2011 with a minimum six months of follow-up or an event defined as relapse or death. Results Histologies included peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) (31.6%), angioimmunoblastic (16.9%), anaplastic large cell lymphoma (ALCL), ALK- (12.1%), ALCL, ALK + (6.1%), extranodal NK/T-cell lymphoma (7.4%), adult T-cell leukemia/lymphoma (ATLL) (7.4%), and transformed mycosis fungoides (8.7%). Seventeen patients had CNS disease (7%). Fifteen had CNS involvement with PTCL and two had diffuse large B-cell lymphoma and glioblastoma. Median time to CNS involvement was 3.44 months (0.16-103.1). CNS prophylaxis was given to 24 patients (primarily intrathecal methotrexate). Rates of CNS involvement were not different in patients who received prophylaxis. Univariate analysis identified stage III-IV, bone marrow involvement, >1 extranodal site and ATLL as risk factors for CNS disease. On multivariate analysis, >1 extranodal site and international prognostic index (IPI) ≥ 3 were predictive for CNS involvement. The median survival of patients with CNS involvement was 2.63 months (0.10-75). Conclusions Despite high relapse rates, PTCL, except ATLL, carries a low risk of CNS involvement. Prognosis with CNS involvement is poor and risk factors include: >1 extra nodal site and IPI ≥3.

  6. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

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    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  7. Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

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    Elusta Ahmed

    2008-01-01

    Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

  8. Outcome results in children with IgA nephropathy: a single center experience

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    Bulut, Ipek Kaplan; Mir, Sevgi; Sozeri, Betul; Bulut, Mustafa Orhan; Sen, Sait; Dincel, Nida

    2012-01-01

    Background Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis. Patients manifest variable clinical symptoms (eg, microhematuria) with preserved or progressive deterioration of renal function resulting in end-stage renal disease. The aim of this study was to evaluate patients from a single center to describe the clinical features, treatments, and follow-up results of those with the disease. Methods This is a retrospective data study of all children with IgAN. Patients who had a histopathologically proven diagnosis of IgAN and were followed up for at least 5 years were included in the study. Renal biopsy, graded as Hass classification, was performed on all patients. A total of 39 patients were included in the study. Results The mean follow-up time (± standard deviation) was 10.4 ± 3.51 (range 5–16) years. Twenty-nine patients (74.4%) were male and ten (25.6%) were female. Nineteen (48.7%) patients presented with recurrent macroscopic hematuria, ten (25.6%) with microscopic hematuria ± proteinuria, six (15.4%) with nephritic syndrome, and four (10.3%) with nephrotic syndrome. All patients underwent a renal biopsy, which was graded according to the Hass classification. At the end of follow-up time, 18 (46.1%) patients were normal, 15 (38.5%) had minor urinary abnormalities, three (7.7%) had active renal disease, and three (7.7%) developed renal failure. Conclusion The results of the present study are better than those from most other series. The majority of children with IgAN in this study were admitted with recurrent macroscopic hematuria and found to have a good prognosis. We suggest that children with IgAN have a good prognosis in the first 5-year follow-up period. PMID:22334797

  9. Clinical profile of primary hyperparathyroidism from western India: A single center experience

    Directory of Open Access Journals (Sweden)

    Gopal R

    2010-01-01

    Full Text Available Background: Primary hyperparathyroidism (PHPT has a variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in India. Data from western India is lacking. Aim : To present the clinical profile of PHPT from western India. Settings and Design : This retrospective study was conducted at a tertiary care referral center. Materials and Methods : We analyzed the clinical presentation, biochemical, radiological features, and operative findings in adult patients with PHPT (1986-2008 and compared with our published data of children and adolescent patients with PHPT. Statistical Analysis : was done with SPSS 16 software. Results : Seventy-nine patients (F: M-2:1 with age ranging from 21 to 55 years (mean 33.5±8.82 were analyzed. Skeletal manifestations (75.5%, renal calculi (40.5% and proximal muscle weakness (45.5% were the most common symptoms of presentation with mean duration of symptoms being 33.70 (median: 24, range 1-120 months. Biochemical features included hypercalcemia (total corrected calcium 12.55±1.77 mg/dl, low inorganic phosphorus (1.81±0.682 mg/dl, elevated total alkaline phosphatase (mean: 762.2; median: 559; range: 50-4930IU/L and high parathyroid hormone (PTH (mean±SD: 866.61±799.15; median: 639.5; range: 52-3820 pg/ml. Preoperative localization was achieved in 74 patients and single adenoma was found during surgery in 72 patients. Hungry bone disease was seen in 30.3% and transient hypoparathyroidism developed in 62% patients. In comparison to PHPT in children there were no significant differences with regard to clinical, laboratory and radiological features. Conclusions : PHPT in western India is symptomatic disorder with skeletal and renal mani-festations at a much younger age. Clinical profile of PHPT in children is similar to that of adults.

  10. Predictors of pathologic complete response after preoperative concurrent chemoradiotherapy of rectal cancer: A single center experience

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    Choi, Eun Cheol [Proton Therapy Center, National Cancer Center, Goyang (Korea, Republic of); Kim, Jin Hee; Kim, Ok Bae; Kim, Mi Young; Oh, Young Ki; Baek, Sung Gyu [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    To identify possible predictors of pathologic complete response (pCR) of rectal cancer after preoperative concurrent chemoradiotherapy (CCRT). We conducted a retrospective review of 53 patients with rectal cancer who underwent preoperative CCRT followed by radical surgery at a single center between January 2007 and December 2012. The median radiotherapy dose to the pelvis was 54.0 Gy (range, 45.0 to 63.0 Gy). Five-fluorouracil-based chemotherapy was administered via continuous infusion with leucovorin. The pCR rate was 20.8%. The downstaging rate was 66%. In univariate analyses, poor and undifferentiated tumors (p = 0.020) and an interval of ≥7 weeks from finishing CCRT to surgery (p = 0.040) were significantly associated with pCR, while female gender (p = 0.070), initial carcinoembryonic antigen concentration of <5.0 ng/dL (p = 0.100), and clinical stage T2 (p = 0.100) were marginally significant factors. In multivariate analysis, an interval of ≥7 weeks from finishing CCRT to surgery (odds ratio, 0.139; 95% confidence interval, 0.022 to 0.877; p = 0.036) was significantly associated with pCR, while stage T2 (odds ratio, 5.363; 95% confidence interval, 0.963 to 29.877; p = 0.055) was a marginally significant risk factor. We suggest that the interval from finishing CCRT to surgery is a predictor of pCR after preoperative CCRT in patients with rectal cancer. Stage T2 cancer may also be an important predictive factor. We hope to perform a robust study by collecting data during treatment to obtain more advanced results.

  11. Peripherally inserted central venous catheter safety in burn care: a single-center retrospective cohort review.

    Science.gov (United States)

    Austin, Ryan E; Shahrokhi, Shahriar; Bolourani, Siavash; Jeschke, Marc G

    2015-01-01

    The use of peripherally inserted central catheter (PICC) line for central venous access in thermally injured patients has increased in recent years despite a lack of evidence regarding safety in this patient population. A recent survey of invasive catheter practices among 44 burn centers in the United States found that 37% of burn units use PICC lines as part of their treatment protocol. The goal of this study was to compare PICC-associated complication rates with the existing literature in both the critical care and burn settings. The methodology involved is a single institution retrospective cohort review of patients who received a PICC line during admission to a regional burn unit between 2008 and 2013. Fifty-three patients were identified with a total of seventy-three PICC lines. The primary outcome measurement for this study was indication for PICC line discontinuation. The most common reason for PICC line discontinuation was that the line was no longer indicated (45.2%). Four cases of symptomatic upper extremity deep vein thrombosis (5.5%) and three cases of central line-associated bloodstream infection (4.3%, 2.72 infections per 1000 line days) were identified. PICC lines were in situ an average of 15 days (range 1 to 49 days). We suggest that PICC line-associated complication rates are similar to those published in the critical care literature. Though these rates are higher than those published in the burn literature, they are similar to central venous catheter-associated complication rates. While PICC lines can be a useful resource in the treatment of the thermally injured patient, they are associated with significant and potentially fatal risks.

  12. Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

    Institute of Scientific and Technical Information of China (English)

    Wong Hoi She; Albert CY Chan; Tan To Cheung; Kenneth SH Chok; See Ching Chan; Ronnie TP Poon; Chung Mau Lo

    2016-01-01

    BACKGROUND: Acute pancreatitis is a relatively rare but po-tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS: A total of 1632 patients with hepatocellular car-cinoma who had undergone transarterial chemoembolization from January 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com-plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS: Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa-tients was 61 years. Most (79.6%) of the patients suffered from HBV-related hepatocellular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut-ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven (0.4%) patients suffered from acute pancre-atitis post-chemoembolization. Six patients had chemoembo-lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxorubicin eluting bead had a higher risk of acute pancreatitis [6/145 (4.1%) vs 1/1487 (0.1%), P CONCLUSIONS: Acute pancreatitis after transarterial chemo-embolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved.

  13. Vascular complications following 1500 consecutive living and cadaveric donor renal transplantations: A single center study

    Directory of Open Access Journals (Sweden)

    Salehipour Mehdi

    2009-01-01

    Full Text Available The aim of this study was to document vascular complications that occurred fol-lowing 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 allo-graft renal artery stenosis (n = 26; 1.7%, renal artery thrombosis (n = 9; 0.6%, and renal vein thrombosis (n = 7; 0.5%. Vascular complications were more frequent in recipients of cadaveric organs than recipients of allografts from living donors (12.5% vs. 7.97%; P= 0.017. The occurrence of vascular complications was significantly more frequent among recipients of renal allografts with multiple arteries when compared with recipients of kidneys with single artery (12.3% vs. 8.2%; P= 0.033. The same was true to venous complications as well (25.4% vs. 8.2%; P< 0.001. Our study shows that vascular complications were more frequent in allografts with multiple renal blood vessels. Also, the complications were much less frequent in recipients of living donor transplants.

  14. Outcomes of Kidney Transplantation Abroad: A Single-Center Canadian Cohort Study.

    Science.gov (United States)

    Quach, Kevin; Sultan, Heebah; Li, Yanhong; Famure, Olusegun; Kim, S Joseph

    2016-03-01

    An increasing demand for kidney transplantation has enticed some patients with end-stage renal disease (ESRD) to venture outside their country of residence, but their posttransplant outcomes may be suboptimal. We compared the risks and clinical outcomes among tourists, or patients who pursue a kidney transplant abroad, versus patients who received a transplant at the Toronto General Hospital (TGH). A single-center, 1:3 matched (based on age at transplant, time on dialysis, and year of transplant) cohort study was conducted. Forty-five tourists were matched with 135 domestic transplant recipients between January 1, 2000, and December 31, 2011. Multivariable Cox proportional hazards models were fitted to assess graft and patient outcomes. Among the 45 tourists, the majority (38 of 45) traveled to the Middle East or Far East Asia, and most received living donor kidney transplants (35 of 45). Multivariable Cox proportional hazards models showed that tourists had a higher risk for the composite outcome of acute rejection, death-censored graft failure, or death with graft function (DWGF; hazard ratio [HR] 2.08, 95% confidence interval [CI]: 1.06-4.07). Tourists also showed a higher risk for the individual end points of acute rejection, DWGF, and posttransplant hospitalizations. Patients going abroad for kidney transplantation may have inferior outcomes compared to domestic patients receiving kidney transplants. Patients who are contemplating an overseas transplant need to be aware of the increased risk of adverse posttransplant outcomes and should be appropriately counseled by transplant professionals during the pretransplant evaluation process. © 2016, NATCO.

  15. Mechanical Revascularization for Acute Ischemic Stroke: A Single-Center, Retrospective Analysis

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    Jeromel, Miran, E-mail: miran.jeromel@gmail.com; Milosevic, Z. V., E-mail: zoran.milosevic@guest.arnes.si; Kocijancic, I. J., E-mail: igor.kocijancic@gmail.com; Lovric, D., E-mail: dimitrijlavric@yahoo.com [University Medical Centre Ljubljana, Clinical Institute of Radiology, Department for Diagnostic and Interventional Neuroradiology (Slovenia); Svigelj, V., E-mail: viktor.svigelj@gmail.com; Zvan, B., E-mail: bojana.zvan@guest.arnes.si [University Medical Centre Ljubljana, Division Vascular and Intensive Neurology, Department of Neurology (Slovenia)

    2013-04-15

    BackgroundEndovascular mechanical revascularization (thrombectomy) is an increasingly used method for intracranial large vessel recanalization in acute stroke. The purpose of the study was to analyze the recanalization rate, clinical outcome, and complication rate in our stroke patients treated with mechanical revascularization. A total of 57 patients with large vessel stroke (within 3 h for anterior and 12 h for posterior circulation) were treated with mechanical revascularization at a single center during 24 months. The primary goal of endovascular treatment using different mechanical devices was recanalization of the occluded vessel. Recanalization rate (reported as thrombolysis in cerebral infarction [TICI] score), clinical outcome (reported as National Institutes of Health Stroke Scale [NIHSS] score and modified Rankin scale [mRS] score), as well as periprocedural complications were analyzed. The mean age of the patients was 63.1 {+-} 12.9 years, with baseline median NIHSS score of 14 (interquartile range, 9.5-19). Successful recanalization (TICI 2b or 3) was achieved in 41 (72 %) patients. Twenty patients (35 %) presented with favorable outcome (mRS {<=}2) 30 days after stroke. Overall, significant neurological improvement ({>=}4 NIHSS point reduction) occurred in 36 (63 %) patients. A clinically significant procedure-related adverse events (vessel disruption, peri/postprocedural intracranial bleeding) defined with decline in NIHSS of {>=}4 or death occurred in three (5 %) patients. The study showed a high recanalization rate with improved clinical outcome and a low rate of periprocedural complications in our stroke patients treated with mechanical revascularization. Therefore, we could conclude that endovascular revascularization (primary or in combination with a bridging thrombolysis) was an effective and safe procedure for intracranial large vessel recanalization in acute stroke.

  16. Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

    Institute of Scientific and Technical Information of China (English)

    LUO Nian-sang; YUAN Wo-liang; LIN Yong-qing; CHEN Yang-xin; MAO Xiao-qun; XIE Shuang-lun; KONG Min-yi; ZHOU Shu-xian; WANG Jing-feng

    2010-01-01

    Background Cardiac resynchronization therapy (CRT) could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure (HF) with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT(D) device, aged (57±11) years, with left ventricular ejection fraction of (32.1±9.8)%, of which 4 (7%) developed ventricular tachycardia/ventricular fibrillation (VT/VF) or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient's death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.

  17. Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study.

    Science.gov (United States)

    Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo

    2013-09-15

    to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.

  18. AT-09BEVACIZUMAB AND GLIOBASTOMA OF THE ELDERLY: A SINGLE-CENTER RETROSPECTIVE ANALYSIS

    Science.gov (United States)

    Barrascout, Eduardo; Lamuraglia, Michele; Gervais, Claire; Tiako, Manuela; Gaillard, Stephan; Aldea, Sorin; Mabro, May; Gachet, Julie; Theodore, Christine

    2014-01-01

    PURPOSE: The primary objective of this study was to determine any difference in progression free survival (PFS), overall survival (OS), clinical benefit and tolerability between elderly and non-elderly patients receiving bevacizumab at recurrence for glioblastoma in a single center. PATIENTS AND METHODS: We retrospectively analyzed 32 patients with recurrent glioblastoma receiving bevacizumab (10 mg/kg every 14 days) between January 2011 and December 2013 in second line. Bevacizumab was introduced for all patients at recurrence after a treatment of first line by temozolomide. A cohort of 14 patients was older than 70 years against 18 patients were under 70 years. RESULTS: No statistically significant difference was detected in terms of PFS and OS. PFS was 2.8 months for elderly patients against 2.9 for non-elderly patients (p >0.5). OS from recurrence in elderly and non-elderly patients was respectively 4.3 and 5.5 months (p >0,5). Clinical improvement in neurological symptoms was observed in 3 of 14 elderly patients (21.1%) and 11 of 18 young patients (61.1%). A more important improvement in performance status was observed in young patients. Regarding toxicity, 3 of the 14 elderly patients experienced grade II or III hypertension. In younger patients, 5 adverse events have been observed (2 proteinuria, 1 hypertension, 1 hemorrhage and 1 anal abscess). CONCLUSION: Despite small number of patients in this retrospective study, the efficacy and safety of bevacizumab in recurrent glioblastoma appears similar in elderly and non-elderly patients. However, clinical benefit seemed to be less important in elderly patients. A prospective multicentric study integrating geriatric assessment tools and quality of life would be interesting in this patient's population.

  19. SINGLE-PULSE RADIO OBSERVATIONS OF THE GALACTIC CENTER MAGNETAR PSR J1745–2900

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Zhen; Shen, Zhi-Qiang; Wu, Ya-Jun; Zhao, Rong-Bing; Fan, Qing-Yuan; Hong, Xiao-Yu; Jiang, Dong-Rong; Li, Bin; Liang, Shi-Guang; Ling, Quan-Bao; Liu, Qing-Hui; Qian, Zhi-Han; Zhang, Xiu-Zhong; Zhong, Wei-Ye; Ye, Shu-Hua [Shanghai Astronomical Observatory, Chinese Academy of Sciences, Shanghai 200030 (China); Wu, Xin-Ji [Department of Astronomy, Peking University, Beijing 100871 (China); Manchester, R. N. [CSIRO Astronomy and Space Science, P.O. Box 76, Epping, NSW 1710 (Australia); Weltevrede, P. [Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL (United Kingdom); Yuan, Jian-Ping [Key Laboratory of Radio Astronomy, Chinese Academy of Sciences (China); Lee, Ke-Jia, E-mail: yanzhen@shao.ac.cn [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China)

    2015-11-20

    In this paper, we report radio observations of the Galactic Center magnetar PSR J1745–2900 at six epochs between 2014 June and October. These observations were carried out using the new Shanghai Tian Ma Radio Telescope at a frequency of 8.6 GHz. Both the flux density and integrated profile of PSR J1745–2900 show dramatic changes from epoch to epoch, showing that the pulsar was in its “erratic” phase. On MJD 56836, the flux density of this magnetar was about 8.7 mJy, which was 10 times larger than that reported at the time of discovery, enabling a single-pulse analysis. The emission is dominated by narrow “spiky” pulses that follow a log-normal distribution in peak flux density. From 1913 pulses, we detected 53 pulses whose peak flux densities are 10 times greater than that of the integrated profile. They are concentrated in pulse phase at the peaks of the integrated profile. The pulse widths at the 50% level of these bright pulses were between 0.°2 and 0.°9, much narrower than that of the integrated profile (∼12°). The observed pulse widths may be limited by interstellar scattering. No clear correlation was found between the widths and peak flux density of these pulses and no evidence was found for subpulse drifting. Relatively strong spiky pulses are also detected in the other five epochs of observation, showing the same properties as those detected in MJD 56836. These strong spiky pulses cannot be classified as “giant” pulses but are more closely related to normal pulse emission.

  20. Outcome of Single Kidney Transplant From Pediatric Donors Younger Than 5 Years of Age After Cardiac Death in China: A Single Center Experience.

    Science.gov (United States)

    Wang, Yaomin; Lv, Junhao; Xie, Wenqing; Huang, Hongfeng; Peng, Wenhan; Wu, Jianyong; Chen, Jianghua

    2015-06-01

    This study was conducted to evaluate the outcomes of single kidney transplant from pediatric donors in China younger than 5 years old after cardiac death. We retrospectively reviewed single renal transplants from pediatric donors of cardiac death between January 2012 and June 2013 at the First Affiliated Hospital of Zhejiang University, China. Eleven recipients received single kidney transplant from 6 pediatric donors of cardiac death donors at our center (aged, transplant. No episodes of acute rejection occurred. No vascular thrombosis or stenosis after ureteroneocystostomy was seen. One patient had urine leakage on the eighth day after transplant, and was cured through a ureter reimplantation. The graft size increased significantly the first month after transplant compared with that recorded immediately after reperfusion (P = .011). The 1-year patient/graft survival was 100%. Use of single kidney from pediatric donors after cardiac death (aged, < 5 y) is a safe and effective procedure and can greatly expand the donor pool.

  1. [Evaluation of visual-motor integration functions in children between 6-15 years of age].

    Science.gov (United States)

    Tekok Kiliç, Ayda; Elmastas-Dikec, Banu; Can, Handan

    2010-01-01

    Visual-motor integration skills are considered an essential domain of clinical and psycho-educational assessment. The goal of the present investigation is to provide the Turkish norms for the Beery-Buktenica Developmental Visual-Motor Integration Test (VMI-4th) for children and adolescents between the ages of 6-15 years as part of a comprehensive neuropsychological test battery. A total of 1887 children from elementary and high schools in the city of Bursa were recruited for this study. From this sample 44 children were re-tested 3-4 weeks following the first administration for test-retest reliability. Findings showed clear developmental trajectories in visual-motor integration skills. Significant performance increments were observed in six month intervals for ages 6 and 7. Starting from age 8, norms were established for each age group separately. Girls and boys performed similarly on the VMI-4. Test- retest correlation was modest but within an acceptable range. The age-based norms established for the VMI-4 in this study can be used to assess children between the ages of 6-15 years as part of a clinical neuropsychological and a psycho-educational assessment. The mean VMI scores presented in this study represent performance of children in middle and middle-upper socio-economic status and may not represent the normal performance range of children from lower SES.

  2. Pulse Pressure magnifies the effect of COMTVal158Met on 15 Year Episodic Memory Trajectories

    Directory of Open Access Journals (Sweden)

    Ninni ePersson

    2016-03-01

    Full Text Available We investigated whether a physiological marker of cardiovascular health, pulse pres­sure (PP, and age magnified the effect of the functional COMT Val158Met (rs4680 pol­ymor­phism on 15-year cognitive trajectories (episodic memory [EM], visuospatial ability, and se­man­tic memory using data from 1585 non-demented adults from the Betula study. A mul­tiple-group growth model was specified to gauge individual differences in change. The allelic variants showed negligible differences across the cognitive markers in average trends. The older portion of the sample selectively age-magnified the effects of Val158Met on EM changes, resulting in greater decline in Val compared to homozygote Met carriers. This effect was attenuated by sta­tistical control for PP. Further, PP mod­erated the effects of COMT on 15-year EM trajectories, resulting in greater decline in Val carriers, even after accounting for the confounding effects of sex, education, cardiovascular diseases (dia­betes, stroke, and hypertension, and chronological age, controlled for practice gains. The effect was still present after excluding individuals with a history of cardiovascular diseases. The effects of cognitive change were not moderated by any other covariates. This report underscores the importance of addressing synergistic effects in nor­mal cognitive aging, as the addition thereof may even place healthy individuals at greater risk for memory decline.

  3. Evaluation of antimicrobial resistance of Helicobacter pylori in the last 15 years in West Poland.

    Science.gov (United States)

    Karpiński, Tomasz M; Andrzejewska, Ewa; Eder, Piotr; Linke, Krzysztof; Szkaradkiewicz, Andrzej

    2015-09-01

    Increasing resistance to drugs represents a serious problem in treatment of infections with Helicobacter pylori, providing cause of frequent therapeutic failures. Present study aimed at analysis of changes in resistance of H. pylori to antibiotics in West Poland within the recent 15 years. 108 strains of H. pylori were analysed, isolated from gastric mucosa of adult patients. Group 1 involved 66 strains isolated in years of 1998/1999. Group 2 comprised 42 isolates obtained in years of 2013/2014. Susceptibility to amoxicillin (AMX), clarithromycin (CL), tetracycline (TC) and metronidazole (MTZ) was determined by E-test (AB Biodisc). All strains on both studied groups were susceptible to AMX. In group 1 all strains proved to be susceptible to TC, while 9% and 36% of tested strains were resistant to CL and MTZ, respectively. By contrast, in group 2, 31% and 83% of strains were resistant to CL and MTZ, respectively. In parallel, 14% strains were found to be resistant to TC (according to EUCAST interpretations). In West Poland, within recent 15 years a dramatic increase was noted in H. pylori strains resistant to metronidazole. In parallel, a significant increase was noted in proportion of strains resistant to clarithromycin.

  4. The effects of birthweight and breastfeeding on asthma among children aged 1-5 years.

    Science.gov (United States)

    Xu, Xiaohui; Dailey, Amy B; Freeman, Natalie C; Curbow, Barbara A; Talbott, Evelyn O

    2009-11-01

    Asthma is a major cause of morbidity and mortality among children and has steadily increased in prevalence. The combined effect of birthweight and breastfeeding on childhood asthma remains unclear. In this study, we analysed a nationally representative sample of children aged 1-5 years from the National Health and Nutrition Examination Survey 1999-2002. Logistic regression was performed to examine the hypothesis whether birthweight and breastfeeding are independently associated with the prevalence of asthma after accounting for the complex sampling design. In addition, we sought to describe the relationship between birthweight and childhood asthma and to assess the potentially combined effect between birthweight and breastfeeding on asthma among children aged 1-5 years after considering the possible effects of social and environmental factors. We found that birthweight (measured continuously) was inversely and linearly associated with the prevalence of childhood asthma (odds ratio (OR) = 0.80 per 1 kg increase in birthweight, 95% confidence interval (CI): 0.65-0.98). Using a categorical variable, low birthweight (LBW) was positively associated with childhood asthma (OR = 1.28, 95% CI: 0.81-2.68). Furthermore, we detected an interaction between birthweight and breastfeeding on childhood asthma. Breastfeeding had a strong protective effect on asthma among children with high birthweight (OR = 0.14, 95% CI: 0.04-0.43) while it had no significant effect on asthma among children with normal birthweight or LBW. The mechanisms underlying these relationships remain uncertain and warrant further explanation.

  5. [Risk factors for dental fluorosis in children between 6 and 15 years old].

    Science.gov (United States)

    de Lourdes Azpeitia-Valadez, Ma; Sánchez-Hernández, Miguel Angel; Rodríguez-Frausto, Manuel

    2009-01-01

    To identify risk factors for dental fluorosis in children between 6 and 15 years. A cross-sectional survey in 1284 students between 6 and 15 years from four living areas. Presence and degree of dental fluorosis were investigated by using the classification of Dean, tooth decay and variables like source of water consumption, juices, prepared gaseous drinks, tea, types of dental paste used, and periodic applications of fluoride. Descriptive statistics and chi(2) test were applied. The prevalence of fluorosis was 52.6 %, (very slight 45.5 %, slight 40.0 %, moderate 11.8 %, and severe 2.6 %). Tooth decay appeared in 52.7 % of the total of cases studied. The variables with more significant differences were the presenting age (the greater fluorosis in children was from 8 to 14 years), tea, juice and prepared gaseous drink consumption, the periodic application of fluoride and the area of residence, varying from 45 to 61 % of fluorosis between the areas of residence. All of these had p fluorosis.

  6. High aerosol acidity despite declining atmospheric sulfate concentrations over the past 15 years

    Science.gov (United States)

    Weber, Rodney J.; Guo, Hongyu; Russell, Armistead G.; Nenes, Athanasios

    2016-04-01

    Particle acidity affects aerosol concentrations, chemical composition and toxicity. Sulfate is often the main acid component of aerosols, and largely determines the acidity of fine particles under 2.5 μm in diameter, PM2.5. Over the past 15 years, atmospheric sulfate concentrations in the southeastern United States have decreased by 70%, whereas ammonia concentrations have been steady. Similar trends are occurring in many regions globally. Aerosol ammonium nitrate concentrations were assumed to increase to compensate for decreasing sulfate, which would result from increasing neutrality. Here we use observed gas and aerosol composition, humidity, and temperature data collected at a rural southeastern US site in June and July 2013 (ref. ), and a thermodynamic model that predicts pH and the gas-particle equilibrium concentrations of inorganic species from the observations to show that PM2.5 at the site is acidic. pH buffering by partitioning of ammonia between the gas and particle phases produced a relatively constant particle pH of 0-2 throughout the 15 years of decreasing atmospheric sulfate concentrations, and little change in particle ammonium nitrate concentrations. We conclude that the reductions in aerosol acidity widely anticipated from sulfur reductions, and expected acidity-related health and climate benefits, are unlikely to occur until atmospheric sulfate concentrations reach near pre-anthropogenic levels.

  7. 200-BP-1 Prototype Hanford Barrier -- 15 Years of Performance Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Anderson L.; Draper, Kathryn E.; Link, Steven O.; Clayton, Ray E.

    2011-09-30

    Monitoring is an essential component of engineered barrier system design and operation. A composite capacitive cover, including a capillary break and an evapotranspiration (ET) barrier at the Hanford Site, is generating data that can be used to help resolve these issues. The prototype Hanford barrier was constructed over the 216-B-57 Crib in 1994 to evaluate surface-barrier constructability, construction costs, and physical and hydrologic performance at the field scale. The barrier has been routinely monitored between November 1994 and September 1998 as part of a Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) treatability test of barrier performance for the 200 BP 1 Operable Unit. Since FY 1998, monitoring has focused on a more limited set of key water balance, stability, and biotic parameters. In FY 2009, data collection was focused on: (1) water-balance monitoring, consisting of precipitation, runoff, soil moisture storage, and drainage measurements with evapotranspiration calculated by difference; (2) stability monitoring, consisting of asphalt-layer-settlement, basalt-side-slope-stability, and surface-elevation measurements; (3) vegetation dynamics; and (4) animal use. September 2009 marked 15 years since the start of monitoring and the collection of performance data. This report describes the results of monitoring activities during the period October 1, 2008, through September 30, 2009, and summarizes the 15 years of performance data collected from September 1994 through September 2009.

  8. EXPOSE-E: an ESA astrobiology mission 1.5 years in space.

    Science.gov (United States)

    Rabbow, Elke; Rettberg, Petra; Barczyk, Simon; Bohmeier, Maria; Parpart, André; Panitz, Corinna; Horneck, Gerda; von Heise-Rotenburg, Ralf; Hoppenbrouwers, Tom; Willnecker, Rainer; Baglioni, Pietro; Demets, René; Dettmann, Jan; Reitz, Guenther

    2012-05-01

    The multi-user facility EXPOSE-E was designed by the European Space Agency to enable astrobiology research in space (low-Earth orbit). On 7 February 2008, EXPOSE-E was carried to the International Space Station (ISS) on the European Technology Exposure Facility (EuTEF) platform in the cargo bay of Space Shuttle STS-122 Atlantis. The facility was installed at the starboard cone of the Columbus module by extravehicular activity, where it remained in space for 1.5 years. EXPOSE-E was returned to Earth with STS-128 Discovery on 12 September 2009 for subsequent sample analysis. EXPOSE-E provided accommodation in three exposure trays for a variety of astrobiological test samples that were exposed to selected space conditions: either to space vacuum, solar electromagnetic radiation at >110 nm and cosmic radiation (trays 1 and 3) or to simulated martian surface conditions (tray 2). Data on UV radiation, cosmic radiation, and temperature were measured every 10 s and downlinked by telemetry. A parallel mission ground reference (MGR) experiment was performed on ground with a parallel set of hardware and samples under simulated space conditions. EXPOSE-E performed a successful 1.5-year mission in space.

  9. DEVELOPMENT VARIABILITY OF LONGITUDINAL SPINE FEATURES IN CHILDREN AGING 7-15 YEARS OLD

    Directory of Open Access Journals (Sweden)

    Katarzyna Kochan

    2010-06-01

    Full Text Available Introduction. Increased body growth is connected with higher sensitivity to environmental influence and may be a cause of instability of body posture. This happens when trunk and lower limbs growth is more intense. Because body posture disorders are most often diagnosed in children and school adolescents, the sample chosen were subjects between 7 and 15 years old. Material and methods. The data was gathered in 2002 in the town of Polkowice. Examination concerned 2706 boys and girls aged 7 to 15 years old. The measurement included basic somatic features and for the body posture photogrammetric method was used. Results. It was indicated that the relative trunk length in both sexes was decreasing in early school period but in the three oldest groups of age there was a significant increase. The height of kyphosis was increasing significantly in both sexes with age. Most intensive growth of this parameter was observed between 12 and 13 years old subjects. In both sexes there could be seen significant increase of kyphosis depth between 12 and 14 years old and also the decrease of lumbar lordosis between 12 and 13 years old subjects. Conclusion. Significant increase of thoracical spine relative height and lumbar lordosis depth in adolescents in both sexes can be one of the causes of weakening spine stability and affect correct body posture development.

  10. Assessing the Efficacy of Tadalafil in Reducing Pulmonary Hypertension in Children and Adolescents Aged 5 Months-15 Years

    Directory of Open Access Journals (Sweden)

    MR Alipour

    2015-11-01

    Full Text Available Introduction: Pulmonary arterial hypertension in children has consequences such as right ventricular failure and even death. Recently, the use of phosphodiesterase 5 inhibitors has been taken into account in the treatment of pulmonary hypertension, among which tadalafil is more acceptable by parents and patients due to its single dose per day compared to sildenafil which should be taken 4 times a day. Therefore, this study aimed to investigate the effect of tadalafil on reducing pulmonary artery pressure in children and adolescents aged 5 months to 15 years old. Methods: This before and after type study entailed 20 patients of 5-month to 15-year with pulmonary arterial hypertension who had outpatient visits in Yazd Khatam-L-Anbiya clinic during 2013-2014. The participants were diagnosed by echocardiography, considering that they had not ever received any pulmonary arterial pressure lowering medicine up to now, whose congenital heart disease were inoperable. They were then treated using a single dose of oral tadalafil for 6 months. The collected data were analyzed using SPSS software via t-test and Chi-square tests. Results: Mean of pulmonary arterial pressure before and six months after taking tadalafil were 52.30 ± 7.948 mmHg and 33/55 ± 10/34 mmHg, respectively, which on average it was decreased by 18.75 mmHg(pv<0.0001. The mean of arterial oxygen saturation was reported %82.45 ± 7.14 and %86.25 ± 6.496 before and after taking tadalafil, respectively which was increased by 3.9% (pv<0.0001. The severity of tricuspid failure was reduced from moderate to mild level. No serious complication was observed leading to drug discontinuation in the patients’ follow-ups. Conclusion: The study findings revealed that tadalafil drug is effective on the treatment of pulmonary arterial hypertension within children and adolescents. Moreover, it can be used instead of sildenafil, due to its single dose per day.

  11. Classifying Pediatric Central Nervous System Tumors through near Optimal Feature Selection and Mutual Information: A Single Center Cohort

    Directory of Open Access Journals (Sweden)

    Mohammad Faranoush

    2013-10-01

    Full Text Available Background: Labeling, gathering mutual information, clustering and classificationof central nervous system tumors may assist in predicting not only distinct diagnosesbased on tumor-specific features but also prognosis. This study evaluates the epidemi-ological features of central nervous system tumors in children who referred to Mahak’sPediatric Cancer Treatment and Research Center in Tehran, Iran.Methods: This cohort (convenience sample study comprised 198 children (≤15years old with central nervous system tumors who referred to Mahak's PediatricCancer Treatment and Research Center from 2007 to 2010. In addition to the descriptiveanalyses on epidemiological features and mutual information, we used the LeastSquares Support Vector Machines method in MATLAB software to propose apreliminary predictive model of pediatric central nervous system tumor feature-labelanalysis. Results:Of patients, there were 63.1% males and 36.9% females. Patients' mean±SDage was 6.11±3.65 years. Tumor location was as follows: supra-tentorial (30.3%, infra-tentorial (67.7% and 2% (spinal. The most frequent tumors registered were: high-gradeglioma (supra-tentorial in 36 (59.99% patients and medulloblastoma (infra-tentorialin 65 (48.51% patients. The most prevalent clinical findings included vomiting,headache and impaired vision. Gender, age, ethnicity, tumor stage and the presence ofmetastasis were the features predictive of supra-tentorial tumor histology.Conclusion: Our data agreed with previous reports on the epidemiology of centralnervous system tumors. Our feature-label analysis has shown how presenting features maypartially predict diagnosis. Timely diagnosis and management of central nervous systemtumors can lead to decreased disease burden and improved survival. This may be furtherfacilitated through development of partitioning, risk prediction and prognostic models.

  12. The effect of aqueous Elaeagnus angustifolia extract on acute non-inflammatory diarrhea in 1-5 year old children

    Directory of Open Access Journals (Sweden)

    Khoshdel Abofazl

    2014-01-01

    Full Text Available Introduction: Acute diarrhea is one of the most important causes of global childhood mortality and morbidity. The most common complication of acute diarrhea is dehydration. The aim of this study was to evaluate the use of aqueous Elaeagnus angustifolia extract in controlling non-inflammatory diarrhea in a hospital setting. Methods: In this case–controlled randomized double blind clinical trial 80 children in age range of 1-5 years were admitted in pediatric ward with diagnosis of non-inflammatory diarrhea. The patients were randomly divided into two equal groups of 40 cases. The subject in the first group received aqueous Elaeagnus angustifolia extract, 1.2 ml/Kg single dose for 4 days duration and the second group (control group 1.2 cm/Kg distilled water single dose for 4 days duration. Data analysis were performed by Chi-square and t-tests, using SPSS software. Results: The groups were similar regarding gender, mean age, and frequency, and consistency of defecation (p> 0.05. Although the children seemed better in regard to frequency and consistency of defecation, however the results showed that aqueous extract of Elaeagnus angustifolia was not significantly effective in the treatment of non-inflammatory diarrhea. Conclusion: The results of this study demonstrated that the use of aqueous extract of Elaeagnus angustifolia was not effective in the treatment of non-inflammatory diarrhea in children.

  13. Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

    DEFF Research Database (Denmark)

    Kumar, Shailesh; Lausen, Jens L.; Garcia-Ortiz, Cesar E.

    2016-01-01

    Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum- information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are e...

  14. Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

    DEFF Research Database (Denmark)

    Kumar, Shailesh; Larsen Lausen, Jens; García Ortíz, César Eduardo;

    2016-01-01

    Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs...

  15. Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

    CERN Document Server

    Kumar, Shailesh; Garcia-Ortiz, Cesar E; Andersen, Sebastian K H; Roberts, Alexander S; Radko, Ilya P; Smith, Cameron L C; Kristensen, Anders; Bozhevolnyi, Sergey I

    2016-01-01

    Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are especially useful as biological fluorophores due to their chemical neutrality, brightness and room-temperature photostability. Furthermore, NDs containing multiple NV centers also have potential in high-precision magnetic field and temperature sensing. Coupling NV centers to propagating surface plasmon polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the fir...

  16. Hypertensive crisis in children: an experience in a single tertiary care center in Korea.

    Science.gov (United States)

    Lee, Geum Hwa; Lee, I Re; Park, Se Jin; Kim, Ji Hong; Oh, Ji Young; Shin, Jae Il

    2015-01-01

    Hypertensive crisis is a medical emergency that can cause acute damage to multiple end-organs. However, relatively little is known on the etiology, treatment, and outcomes of hypertensive crisis in Korean children. The aim of this study was to determine the etiologies and efficacy of drugs for hypertensive crisis in children during the past 5 years at a single center in Korea. We analyzed data from 51 children with hypertensive crisis during the period between January 1, 2010 and April 1, 2014. The patients were divided into two groups: those diagnosed with a hypertensive emergency (hypertension with organ injury, n = 31) and those diagnosed with a hypertensive urgency (hypertension without organ injury, n = 20). Baseline etiologies and risk factors were compared between the two groups. In addition, systolic and diastolic blood pressures were evaluated at 1, 2, 4, and 5 hours after the administration of intravenous antihypertensive drugs. Kidney injury and cancer were the common causes in patients with hypertensive crisis. Cardiovascular complications (cardiac hypertrophy) (p = 0.002), central nervous system complications (p = 0.004), and retinopathy (p = 0.034) were more frequently observed in children with hypertensive emergency than those with hypertensive urgency. However, the proportion of renal complications was similar in both groups. Hydralazine was most commonly used in both groups to control acute increasing blood pressure at first. However, it was often ineffective for controlling abrupt elevated blood pressure. Therefore, intravenous antihypertensive drugs were changed from hydralazine to nicardipine, labetalol, or nitroprusside to control the high blood pressure in 45.1 % of the patients. Particularly, in patients with hypertensive crisis, there was no significant difference in reduction of systolic and diastolic blood pressure and in improvement of clinical outcomes between nicardipine and labetalol administration. Close blood

  17. Design and prototyping of self-centering optical single-mode fiber alignment structures

    Science.gov (United States)

    Ebraert, Evert; Gao, Fei; Beri, Stefano; Watté, Jan; Thienpont, Hugo; Van Erps, Jürgen

    2016-06-01

    The European Commission’s goal of providing each European household with at least a 30 Mb s-1 Internet connection by 2020 would be facilitated by a widespread deployment of fibre-to-the-home, which would in turn be sped up by the development of connector essential components, such as high-precision alignment features. Currently, the performance of state-of-the-art physical contact optical fiber connectors is limited by the tolerance on the cladding of standard telecom-grade single-mode fiber (SMF), which is typically smaller than  ±1 μm. We propose to overcome this limit by developing micro-spring-based self-centering alignment structures (SCAS) for SMF-connectors. We design these alignment structures with robustness and low-cost replication in mind, allowing for large-scale deployment. Both theoretical and finite element analysis (FEA) models are used to determine the optimal dimensions of the beams of which the micro-springs of the SCAS are comprised. Two topologies of the SCAS, consisting of three and four micro-springs respectively, are investigated for two materials: polysulfone (PSU) and polyetherimide (PEI). These materials hold great potential for high-performance fiber connectors while being compatible with low-cost production and with the harsh environmental operation conditions of those connectors. The theory and FEA agree well (account in our theoretical model. Prototypes are successfully fabricated using deep proton writing and subsequently characterized. The controlled insertion of an SMF in the SCAS is investigated and we determine that a force of 0.11 N is required. The fiber insertion also causes an out-of-plane deformation of the micro-springs in the SCAS of about 7 μm, which is no problem for robustness according to the FEA model. Finally connector-assemblies are made with the alignment system and we show that an insertion loss down to 0.1 dB is achievable. The prototypes are subsequently used as a sacrificial master for mould

  18. Congenital heart anomaly in newborns with congenital diaphragmatic hernia: a single-center experience.

    Science.gov (United States)

    Ruano, R; Javadian, P; Kailin, J A; Maskatia, S A; Shamshirsaz, A A; Cass, D L; Zamora, I J; Sangi-Haghpeykar, H; Lee, T C; Ayres, N A; Mehollin-Ray, A; Cassady, C I; Fernandes, C; Welty, S; Belfort, M A; Olutoye, O O

    2015-06-01

    To evaluate the impact of the presence of a congenital heart anomaly (CHA) and its potential contribution to morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). In this retrospective cohort study, prenatal and postnatal data of all newborns diagnosed with CDH between January 2004 and December 2012 in a single center were reviewed. Cases were classified into two groups: those with 'isolated' CDH and those with both CDH and CHA. Patients with CHA were further subclassified into those with a major or minor CHA based on the Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1), and the Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery (STS-EACTS) scoring systems. Patients with associated non-cardiac anomalies, including 'syndromic cases', were excluded from the analysis. Primary and secondary outcomes were survival up to 1 year of age and a need for extracorporeal membrane oxygenation (ECMO), respectively. Of the 180 infants with CDH, 41 were excluded because of the presence of non-cardiac associated anomalies, 118 had isolated CDH and 21 had CDH with CHA (16 with minor and five with major CHA). Receiver-operating characteristics curve analysis demonstrated that the best cut-off for survival was when the score for CHA was ≤ 2 for both RACHS-1 (area under the curve (AUC), 0.74 (P = 0.04); sensitivity, 80.0%; specificity, 87.5%) and STS-EACTS (AUC, 0.83 (P = 0.03); sensitivity, 100%; specificity, 87.5%). Survival rate at 1 year was significantly lower in those with CHD and a major CHA (40.0%; P = 0.04) than in those with isolated CDH (77.1%) and those with CDH and a minor CHA (81.3%). We found no significant differences among the groups with regard to the need for ECMO. In general, a milder form of CHA does not appear to have a negative impact on the survival of infants with CDH. However, mortality appears to be significantly higher in infants with CDH and a major form of CHA. The scoring systems

  19. Fulminant limb and retroperitoneal necrotizing fasciitis in a 15-year-old girl with Fanconi anaemia

    Energy Technology Data Exchange (ETDEWEB)

    O' Regan, Kevin; Maher, Michael M. [Mercy University Hospital, Department of Radiology, Cork (Ireland); Cork University Hospital, Department of Radiology, Cork (Ireland); O' Mahony, Edward; MacEneaney, Peter; Fitzgerald, Edward [Mercy University Hospital, Department of Radiology, Cork (Ireland)

    2009-10-15

    Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management. (orig.)

  20. Mild phenotype in a 15-year-old boy with Pallister-Killian syndrome.

    Science.gov (United States)

    Genevieve, D; Cormier-Daire, V; Sanlaville, D; Faivre, L; Gosset, P; Allart, L; Picq, M; Munnich, A; Romana, S; de Blois, Mc; Vekemans, M

    2003-01-01

    Pallister-Killian syndrome is a rare disorder characterized by multiple congenital anomalies, coarse face, pigmentary skin changes, seizures, severe mental retardation, and the presence of an extra metacentric chromosome i(12p) confined to skin fibroblasts only. Here, we report on an unusual case of i(12p) in a 15-year-old boy presenting with mild mental retardation, minor facial features (long face, prognathism, short neck), normal weight, length, and OFC parameters as well as hyperpigmented streaks. The boy attended normal school until the age of 14 years. Because of hyperpigmented stripes, chromosome analysis was performed on skin fibroblasts. This study showed that 37% of the cells had an additional isochromosome for the short arm of chromosome 12. This observation illustrates the phenotypic variability of i(12p) and emphasizes the importance of skin fibroblasts chromosome analysis in patients with pigmentary skin changes.

  1. Self-reported recurrent pain and medicine use behaviours among 15-year olds

    DEFF Research Database (Denmark)

    Gobina, I; Villberg, J; Villerusa, A

    2015-01-01

    recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. RESULTS: More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were......BACKGROUND: There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year......-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries. METHODS: The World Health Organization (WHO) collaborative international Health Behaviour...

  2. Vertebral Column Metastases from an Esthesioneuroblastoma: Chemotherapy, Radiation, and Resection for Recurrence with 15-Year Followup

    Directory of Open Access Journals (Sweden)

    Ali S. Shirzadi

    2013-01-01

    Full Text Available Esthesioneuroblastoma (ENB is an uncommon aggressive malignant intranasal neoplasm that originates from neural crest cells of the olfactory epithelium. Although local invasion to the sinuses is common, spinal metastasis of ENB is rare with only 28 documented cases involving the spine spinal cord, or leptomeninges. We report a case of ENB with multiple drop metastases to the cervical and thoracic spine, and review the patient’s disease, medical history, and multiple interventions during a span of 15 years following the initial cranial resection. Despite aggressive multiple surgical resections, radiation, and chemotherapy, the tumor had significant progression and recurrence. The literature is reviewed, followed by a discussion of the natural progression of the disease and various reported interventions. Although a combination of surgery with chemotherapy and radiation therapy has been recommended, no definitive management has been established for ENB. Further research is needed to determine decisive treatment for metastatic ENB to the spine.

  3. Fulminant limb and retroperitoneal necrotizing fasciitis in a 15-year-old girl with Fanconi anaemia.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2012-01-31

    Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.

  4. Fulminant limb and retroperitoneal necrotizing fasciitis in a 15-year-old girl with Fanconi anaemia.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2009-10-01

    Necrotizing fasciitis (NF) is an uncommon soft-tissue infection in children that carries a high mortality rate. We present a 15-year-old girl with chronic pancytopenia secondary to Fanconi anaemia who developed extensive NF of the lower limb, which unfortunately resulted in a fatal outcome. Immunodeficiency is a known risk factor for the development of this condition. The findings in this case demonstrate that patients with Fanconi anaemia may be susceptible to NF and that the clinical course may be more aggressive due to underlying immunosuppression. Prompt diagnosis of NF is vital in order to initiate appropriate treatment and to optimize patient outcome. Radiological investigation demonstrated extensive soft-tissue gas and destruction affecting the entire lower limb, abdominal wall and retroperitoneum, which led to timely definitive diagnosis and management.

  5. UNOSAT at CERN – 15 years of satellite imagery support to the humanitarian and development community

    CERN Document Server

    CERN. Geneva

    2017-01-01

    Abstract: UNOSAT is part of the United Nations Institute for Training and Research (UNITAR) and has been hosted at CERN since 2001. This partnership allows UNOSAT to benefit from CERN's IT infrastructure whenever the situation requires, allowing the UN to be at the forefront of satellite-analysis technology. Specialists in geographic information systems (GIS) and in the analysis of satellite data, supported by IT engineers and policy experts, ensure a dedicated service to the international humanitarian and development communities 24 hours a day, seven days a week. The presentation will give an overview of the variety of activities carried out by UNOSAT over the last 15 years including support to humanitarian assistance and protection of cultural heritage, sustainable water management in Chad and training & capacity development in East Africa and Asia. The talk will be followed at 12:00 by the inauguration of the UNOSAT exhibition, in front of the Users' office. Speaker: Einar Bjor...

  6. Lessons learned from 15 years of KIMS and 5 years of ACROSTUDY

    DEFF Research Database (Denmark)

    Luger, Anton; Feldt-Rasmussen, Ulla; Abs, Roger

    2011-01-01

    BACKGROUND: Pharmacoepidemiological surveys provide a valuable contribution to the continued monitoring of drug-related effects in patients with rare disorders. One of the earliest examples of this type of survey is KIGS (Pfizer International Growth Study Database), which has monitored the safety......, pharmacoepidemiological surveys such as KIMS and ACROSTUDY provide valuable information on the safety and effectiveness of treatment with GH replacement and pegvisomant in the real world.......-deficient adults for 15 years. Approximately 5 years ago, the ACROSTUDY database was established to monitor the long-term safety and effectiveness of pegvisomant in patients with acromegaly. CONCLUSIONS: By collecting data on the treatment of relatively rare conditions in routine clinical practice...

  7. 15 years of protest and media technologies scholarship: A sociotechnical timeline

    DEFF Research Database (Denmark)

    Neumayer, Christina; Rossi, Luca

    2016-01-01

    This article investigates the relationship between the invention of new media technologies and scholarship concerning protest and political engagement. Building on an innovative approach that moves beyond a systematic literature review, this article contributes to our understanding of scholarship...... concerning digital communication technologies and how they may have been adopted and shaped protest movements and political engagement. Based on visualisations, we draw a sociotechnical timeline of protest and media technology scholarship within three dimensions: Technological development, methods...... and techniques, and the social phenomena under investigation. The article concludes by identifying major trends in protest and media technologies scholarship over the past 15 years. The sociotechnical timeline enhances our understanding of academic discourse at the intersection of protest and media technologies...

  8. The American Oystercatcher (Haematopus palliatus) Working Group: 15 years of collaborative focal species research and management

    Science.gov (United States)

    Simons, Theodore R.

    2017-01-01

    The American Oystercatcher (Haematopus palliatus) Working Group formed spontaneously in 2001 as coastal waterbird biologists recognized the potential for American Oystercatchers to serve as focal species for collaborative research and management. Accomplishments over the past 15 years include the establishment of rangewide surveys, color-banding protocols, mark-resight studies, a revision of the Birds of North America species account, and new mechanisms for sharing ideas and data. Collaborations among State, Federal, and private sector scientists, natural resource managers, and dedicated volunteers have provided insights into the biology and conservation of American Oystercatchers in the United States and abroad that would not have been possible without the relationships formed through the Working Group. These accomplishments illustrate how broad collaborative approaches and the engagement of the public are key elements of effective shorebird conservation programs.

  9. LEGO-based Robotics in Higher Education: 15 Years of Student Creativity

    Directory of Open Access Journals (Sweden)

    Ethan Danahy

    2014-02-01

    Full Text Available Our goal in this article is to reflect on the role LEGO robotics has played in college engineering education over the last 15 years, starting with the introduction of the RCX in 1998 and ending with the introduction of the EV3 in 2013. By combining a modular computer programming language with a modular building platform, LEGO Education has allowed students (of all ages to become active leaders in their own education as they build everything from animals for a robotic zoo to robots that play children’s games. Most importantly, it allows all students to develop different solutions to the same problem to provide a learning community. We look first at how the recent developments in the learning sciences can help in promoting student learning in robotics. We then share four case studies of successful college-level implementations that build on these developments.

  10. Overweight, body image and bullying--an epidemiological study of 11- to 15-years olds

    DEFF Research Database (Denmark)

    Brixval, Carina S; Rayce, Signe L B; Rasmussen, Mette

    2012-01-01

    ORs were 1.89 (1.25-2.85) in overweight and 2.74 (0.96-7.82) in obese girls. The mediation analyses showed that body image fully mediated the associations between weight status and exposure to bullying in both boys and girls. CONCLUSIONS: This study shows that overweight and obese boys and girls......BACKGROUND: The purpose of this study was to examine the association between weight status and exposure to bullying among 11-, 13- and 15-year-old Danish school children. Furthermore, the purpose was to investigate the potentially mediating effect of body image. METHODS: Data from the Danish...... are of higher odds of being exposed to bullying than their normal weight peers. Moreover, this study finds that body image may statistically explain this association between overweight and exposure to bullying. However, the study is cross-sectional, and hypotheses of possibilities for opposite causality...

  11. LEGO-based Robotics in Higher Education: 15 Years of Student Creativity

    Directory of Open Access Journals (Sweden)

    Ethan Danahy

    2014-02-01

    Full Text Available Our goal in this article is to reflect on the role LEGO robotics has played in college engineering education over the last 15 years, starting with the introduction of the RCX in 1998 and ending with the introduction of the EV3 in 2013. By combining a modular computer programming language with a modular building platform, LEGO Education has allowed students (of all ages to become active leaders in their own education as they build everything from animals for a robotic zoo to robots that play children's games. Most importantly, it allows all students to develop different solutions to the same problem to provide a learning community. We look first at how the recent developments in the learning sciences can help in promoting student learning in robotics. We then share four case studies of successful college-level implementations that build on these developments.

  12. Pelvic osteomyelitis in a 15-year-old girl: case report.

    Science.gov (United States)

    Tural Kara, Tugce; Ozdemir, Halil; Fitoz, Suat; Ciftci, Ergin; Ince, Erdal

    2016-10-01

    Pelvic osteomyelitis is a rare infection. Ilium, ischium, pubis and acetabulum are commonly affected sites. Pelvic radiography, pelvic magnetic resonance and scintigraphy are useful imaging techniques for diagnosis. However, diagnoses should be confirmed with bone biopsy from the lesion. Sometimes diagnosis is delayed because of deep localization of infection site. Here in, we report a 15-year-old girl with left groin pain who was diagnosed as pelvic osteomyelitis one month after initial symptoms. Patient was successfully treated with antibiotics for 8 weeks. In conclusion, although pelvic osteomyelitis is an unusual infection in childhood, it should be considered as differential diagnoses of pain in groin, hips, thigh, abdomen and spine. If diagnosis is suspicious, empiric treatment should be started quickly, because it will be possible to achieve satisfactory clinical results with effective treatment.

  13. How to achieve and prove performance improvement - 15 years of experience in German wastewater benchmarking.

    Science.gov (United States)

    Bertzbach, F; Franz, T; Möller, K

    2012-01-01

    This paper shows the results of performance improvement, which have been achieved in benchmarking projects in the wastewater industry in Germany over the last 15 years. A huge number of changes in operational practice and also in achieved annual savings can be shown, induced in particular by benchmarking at process level. Investigation of this question produces some general findings for the inclusion of performance improvement in a benchmarking project and for the communication of its results. Thus, we elaborate on the concept of benchmarking at both utility and process level, which is still a necessary distinction for the integration of performance improvement into our benchmarking approach. To achieve performance improvement via benchmarking it should be made quite clear that this outcome depends, on one hand, on a well conducted benchmarking programme and, on the other, on the individual situation within each participating utility.

  14. A COMPARISON OF AUTOREFRACTOMETER WITH CYCLOPLEGIC RETINOSCOPY IN CHILDREN AGED 3 TO 15 YEARS

    Directory of Open Access Journals (Sweden)

    Jaishree

    2015-09-01

    Full Text Available AIM: To compare the accuracy of the autorefractometer with traditional retinoscopy as a means of determining the approximate subjective refraction in children after cycloplegia. MATERIAL AND METHODS: Prospective observation study carried out in 72 eyes of 72 patients aged 3 to 15 years in upgraded department of Ophthalmology, LLRM Medical College, Meerut between April 2013 to June 2013. The negative spherical power of autorefracto meter was higher than retinoscopic group. The positive spherical power was lower in autorefractometer. DISCUSSION: Our observations in this younger age group amply that the inbuilt automatic fogging system of the autorefractometer fails to neutralize adequ ately the patient's accommodative efforts during manifest refraction. CONCLUSION: Manual retinoscopy is still the most accurate technique to estimate refractive status in children.

  15. The price of a 15-year delay in diagnosis of Sheehan's syndrome.

    Science.gov (United States)

    Parikh, Rohan; Buch, Varun; Makwana, Mitesh; Buch, Harit N

    2016-04-01

    We describe a case of a 48-year-old woman who presented with a 15-year history of recurrent episodes of hypoglycemia and hyponatremia leading to altered behavior and generalized seizures. She underwent full clinical assessment, endocrine tests, and a pituitary magnetic resonance scan that showed pananterior hypopituitarism secondary to postpartum pituitary necrosis (Sheehan's syndrome). She was commenced on appropriate hormone replacement therapy, which led to significant improvement in lethargy, anorexia, muscle weakness, and episodes of hypoglycemia. In addition to the alleviation of her physical symptoms, she experienced a significant improvement in her psychological well-being and reduction in hospital visits. This case illustrates the impact of delay in diagnosis of an easily treatable medical condition and its socioeconomic implications, especially for the population of a developing country like India.

  16. The price of a 15-year delay in diagnosis of Sheehan's syndrome

    Science.gov (United States)

    Parikh, Rohan; Buch, Varun; Makwana, Mitesh

    2016-01-01

    We describe a case of a 48-year-old woman who presented with a 15-year history of recurrent episodes of hypoglycemia and hyponatremia leading to altered behavior and generalized seizures. She underwent full clinical assessment, endocrine tests, and a pituitary magnetic resonance scan that showed pananterior hypopituitarism secondary to postpartum pituitary necrosis (Sheehan's syndrome). She was commenced on appropriate hormone replacement therapy, which led to significant improvement in lethargy, anorexia, muscle weakness, and episodes of hypoglycemia. In addition to the alleviation of her physical symptoms, she experienced a significant improvement in her psychological well-being and reduction in hospital visits. This case illustrates the impact of delay in diagnosis of an easily treatable medical condition and its socioeconomic implications, especially for the population of a developing country like India. PMID:27034575

  17. Patch-test results in children and adolescents: systematic review of a 15-year period.

    Science.gov (United States)

    Rodrigues, Dulcilea Ferraz; Goulart, Eugênio Marcos Andrade

    2016-01-01

    The number of studies on patch-test results in children and adolescents has gradually increased in recent years, thus stimulating reviews. This paper is a systematic review of a 15-year period devoted to studying the issue. Variations pertaining to the number and age groups of tested children and/or adolescents, the number of subjects with atopy/atopic dermatitis history, the quantity, type and concentrations of the tested substances, the test technique and type of data regarding clinical relevance, must all be considered in evaluating these studies, as they make it harder to formulate conclusions. The most common allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance, potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids health professionals in planning preventive programs aimed at improving children's quality of life and ensuring that their future prospects are not undermined.

  18. Hemosuccus Pancreaticus: 15-Year Experience from a Tertiary Care GI Bleed Centre

    Science.gov (United States)

    Palaniappan, Ravichandran; Ramaswami, Sukumar; Perumal, Senthil Kumar; Lakshmanan, Anand; Srinivasan, U. P.; Ramasamy, Ravi; Sathyanesan, Jeswanth

    2013-01-01

    Background. Hemosuccus pancreaticus (HP) is a very rare and obscure cause of upper gastrointestinal bleeding. Due to its rarity, the diagnostic and therapeutic strategy for the management of this potentially life threatening problem remains undefined. The objective of our study is to highlight the challenges in the diagnosis and management of HP and to formulate a protocol to effectively and safely manage this condition. Methods. We retrospectively reviewed the records of all patients who presented with HP over the last 15 years at our institution between January 1997 and December 2011. Results. There were a total of 51 patients with a mean age of 32 years. Nineteen patients had chronic alcoholic pancreatitis; twenty-six, five, and one patient had tropical pancreatitis, acute pancreatitis, and idiopathic pancreatitis, respectively. Six patients were managed conservatively. Selective arterial embolization was attempted in 40 of 45 (89%) patients and was successful in 29 of the 40 (72.5%). 16 of 51 (31.4%) patients required surgery. Overall mortality was 7.8%. Length of followup ranged from 6 months to 15 years. Conclusions. Upper gastrointestinal bleeding in a patient with a history of chronic pancreatitis could be caused by HP. All hemodynamically stable patients with HP should undergo prompt initial angiographic evaluation, and if possible, embolization. Hemodynamically unstable patients and those following unsuccessful embolization should undergo emergency haemostatic surgery. Centralization of GI bleed services along with a multidisciplinary team approach and a well-defined management protocol is essential to reduce the mortality and morbidity of this condition. PMID:24959558

  19. Energy Budget of the Thermosphere and Mesosphere from 15 Years of SABER Observations

    Science.gov (United States)

    Hunt, L. A.; Mlynczak, M. G.; Marshall, B. T.; Russell, J. M., III

    2016-12-01

    The Sounding of the Atmosphere using Broadband Emission Radiometry (SABER) instrument on the Thermosphere-Ionosphere-Mesosphere Energetics and Dynamics (TIMED) satellite has provided nearly 15 years of continuous measurements in the mesosphere and thermosphere and operations are ongoing. The SABER instrument has performed exceptionally well since its launch in December 2001, and several more years of observations are eagerly anticipated. SABER is a limb-scanning instrument that makes vertical profile measurements of infrared radiance in ten channels chosen to permit retrieval or derivation of a variety of data products. These include radiative emission of NO at 5.3 μm and CO2 at 15 μm, two key components that govern radiative cooling of the atmosphere above 100 km. Other channels provide information about the thermal structure and elements of the energy budget of the upper mesosphere. From SABER radiances, we determine amounts of atomic oxygen and hydrogen, radiative cooling by CO2, solar heating by O3 and O2, and chemical heating from a suite of exothermic reactions over the vertical range of 65-100 km. We have observed changes in the energy budgets of these regions from mid-solar cycle 23 to the current downturn in solar cycle 24, encompassing portions of two very different solar cycles and the unusually long solar minimum between them. This talk focuses on the natural variability in the composition and energy budget of the mesosphere and lower thermosphere imposed by the variability of the Sun over the past 15 years.

  20. Development Process and Technical Aspects of Laparoscopic Hepatectomy: Learning Curve Based on 15 Years of Experience.

    Science.gov (United States)

    Komatsu, Shohei; Scatton, Olivier; Goumard, Claire; Sepulveda, Ailton; Brustia, Raffaele; Perdigao, Fabiano; Soubrane, Olivier

    2017-05-01

    Laparoscopic hepatectomy continues to be a challenging operation associated with a steep learning curve. This study aimed to evaluate the learning process during 15 years of experience with laparoscopic hepatectomy and to identify approaches to standardization of this procedure. Prospectively collected data of 317 consecutive laparoscopic hepatectomies performed from January 2000 to December 2014 were reviewed retrospectively. The operative procedures were classified into 4 categories (minor hepatectomy, left lateral sectionectomy [LLS], left hepatectomy, and right hepatectomy), and indications were classified into 5 categories (benign-borderline tumor, living donor, metastatic liver tumor, biliary malignancy, and hepatocellular carcinoma). During the first 10 years, the procedures were limited mainly to minor hepatectomy and LLS, and the indications were limited to benign-borderline tumor and living donor. Implementation of major hepatectomy rapidly increased the proportion of malignant tumors, especially hepatocellular carcinoma, starting from 2011. Conversion rates decreased with experience for LLS (13.3% vs 3.4%; p = 0.054) and left hepatectomy (50.0% vs 15.0%; p = 0.012), but not for right hepatectomy (41.4% vs 35.7%; p = 0.661). Our 15-year experience clearly demonstrates the stepwise procedural evolution from LLS through left hepatectomy to right hepatectomy, as well as the trend in indications from benign-borderline tumor/living donor to malignant tumors. In contrast to LLS and left hepatectomy, a learning curve was not observed for right hepatectomy. The ongoing development process can contribute to faster standardization necessary for future advances in laparoscopic hepatectomy. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Craniomaxillofacial trauma: synopsis of 14,654 cases with 35,129 injuries in 15 years.

    Science.gov (United States)

    Kraft, Anna; Abermann, Elisabeth; Stigler, Robert; Zsifkovits, Clemens; Pedross, Florian; Kloss, Frank; Gassner, Robert

    2012-03-01

    Craniomaxillofacial (CMF) trauma occurs in isolation or in combination with other serious injuries, including intracranial, spinal, and upper- and lower-body injuries. It is a major cause of expensive treatment and rehabilitation requirements, temporary or lifelong morbidity, and loss of human productivity. The aim of this study was to evaluate patterns of CMF trauma in a large patient sample within a 15-year time frame. Between 1991 and 2005, CMF trauma data were collected from 14,654 patients with 35,129 injuries at the Department of Cranio-Maxillofacial and Oral Surgery in Innsbruck, assessing a plethora of parameters such as injury type and mechanism as well as age and gender distribution over time. Three main groups of CMF trauma were evaluated: facial bone fractures, dentoalveolar trauma, and soft tissue injuries. Statistical comparisons were carried out using a chi-square test. This was followed by a logistic regression analysis to determine the impact of the five main causes for CMF injury. Older people were more prone to soft tissue lesions with a rising risk of 2.1% per year older, showing no significant difference between male and female patients. Younger patients were at higher risk of suffering from dentoalveolar trauma with an increase of 4.4% per year younger. This number was even higher (by 19.6%) for female patients. The risk of sustaining facial bone fractures increased each year by 4.6%. Male patients had a 66.4% times higher risk of suffering from this type of injury. In addition, 2550 patients (17.4%) suffered from 3834 concomitant injuries of other body parts. In summary, we observed changing patterns of CMF trauma over the last 15 years, paralleled by advances in refined treatment and management options for rehabilitation and reconstruction of patients suffering from CMF trauma.

  2. Vitamin supplementation and related nutritional status in Thai children, aged 1-5 years.

    Science.gov (United States)

    Ratanachu-ek, Suntaree

    2014-06-01

    To evaluate the prevalence of vitamin supplementation in Thai children aged 1-5 years at Queen Sirikit National Institute of Child Health (QSNICH), parental knowledge of vitamins, practices, and related factors such as nutritional status in vitamin supplementation. A cross-sectional study was performed at the Well Child Clinic, QSNICH, from 1-31 May 2005. Five hundred parents of young children, aged 1-5 years were interviewed by using the questionnaire to obtain information regarding knowledge and practices of vitamin supplementation. Weight and length/height were measured and nutritional status was assessed using the Thai growth reference. The relationships among vitamin supplement, nutritional status, and other related factors were analyzed using Chi-square test. The p-value vitamin supplementation was 76%, including vitamin C 62%, multi-vitamin (MTV) 35%, and cod-liver oil 20%. Regarding parental knowledge of vitamins, 57% of them knew the health benefits but 74% did not know the toxic effects of vitamins. The reasons for vitamin supplementation were poor feeding 63%, under-weight 23% and unhealthy status 14%. Vitamins were obtained from over-the-counter 59%, health services 40%, and friends 1%. Vitamin supplementation was significantly higher in children over 2 years of age, whose parents knew the benefits of vitamins, and in those children with malnutrition. The prevalence of vitamin supplementation was high in malnourished children, over 2 years of age whose parents had knowledge about benefits of vitamins. Parents should be warned about the dangers of high dose of vitamin consumption.

  3. Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience

    Directory of Open Access Journals (Sweden)

    Mesut Aydın

    2014-12-01

    Full Text Available Objectives: Atrial fibrillation (AF, the most common arrhythmia in clinical practice, is a major cause of stroke. Atrial fibrillation increases morbidity and mortality. Nowadays cryoablation therapy is being performed efficiently and safely worldwide. In this paper the clinical outcomes of the patients whom were treated with cryoablation were discussed. Methods: Between June 2012 and March 2014, patients with paroxysmal AF who were treated with cryoablation were included in the study. The medical records of the patients were retrospectively reviewed. Patients were called to receive information about the symptom recurrence. Results: Twelve patients were included in the study. Half of the patients were female. The mean age was 48 ± 15 years. Acute procedural success rate of cryoablation was 100%. In one patient transient right phrenic nerve injury occurred which was returned to normal after discontinuation of cryoablation therapy. One patient developed AF episode for 10 minutes in the 4th month of follow-up period. Conclusion: In patients with paroxysmal atrial fibrillation cryoablation effectively decrease symptoms consistent with the literature. J Clin Exp Invest 2014; 5 (4: 599-603

  4. Ageing implementation and refurbishment development at the IEA-R1 nuclear research reactor: a 15 years experience

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas, Jose Patricio N.; Ricci Filho, Walter; Carvalho, Marcos R. de; Berretta, Jose Roberto; Marra Neto, Adolfo, E-mail: ahiru@ipen.b, E-mail: wricci@ipen.b, E-mail: carvalho@ipen.b, E-mail: jrretta@ipen.b, E-mail: amneto@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    last 15 years. (author)

  5. Deterministic coupling of a single silicon-vacancy color center to a photonic crystal cavity in diamond

    CERN Document Server

    Riedrich-Möller, Janine; Pauly, Christoph; Mücklich, Frank; Fischer, Martin; Gsell, Stefan; Schreck, Matthias; Becher, Christoph

    2014-01-01

    Deterministic coupling of single solid-state emitters to nanocavities is the key for integrated quantum information devices. We here fabricate a photonic crystal cavity around a preselected single silicon-vacancy color center in diamond and demonstrate modification of the emitters internal population dynamics and radiative quantum efficiency. The controlled, room-temperature cavity coupling gives rise to a resonant Purcell enhancement of the zero-phonon transition by a factor of 19, coming along with a 2.5-fold reduction of the emitter's lifetime.

  6. Controling the single-diamond nitrogen-vacancy color center photoluminescence spectrum with a Fabry-Perot microcavity

    Energy Technology Data Exchange (ETDEWEB)

    Dumeige, Yannick [Universite Europeenne de Bretagne, Laboratoire Foton, CNRS UMR 6082 Foton, Enssat, 6 rue de Kerampont, 22305 Lannion Cedex (France); Alleaume, Romain [Institut Telecom/Telecom ParisTech, Laboratoire Traitement et Communication de l' Information, CNRS UMR 5141, 46 rue Barrault, 75634 Paris Cedex (France); Grangier, Philippe [Laboratoire Charles Fabry de l' Institut d' Optique, CNRS UMR 8501, Institut d' Optique Graduate School, Campus Polytechnique-RD 128, 2 avenue Augustin Fresnel 91127 Palaiseau Cedex (France); Treussart, Francois; Roch, Jean-Francois, E-mail: yannick.dumeige@univ-rennes1.fr [Laboratoire de Photonique Quantique et Moleculaire, CNRS UMR 8537, Ecole Normale Superieure de Cachan, 61 avenue du President Wilson, 94235 Cachan Cedex (France)

    2011-02-15

    We present here both theoretical and experimental results on the fluorescence of single defect centers in diamond nanocrystals embedded in a planar dielectric microcavity. From a theoretical point of view, we show that the overall fluorescence collection efficiency using a moderate numerical aperture microscope objective can be enhanced by using a low-quality-factor microcavity. This could be used in particular for low-temperature applications, where the numerical aperture of collection microscope objectives is limited due to the experimental constraints. We experimentally investigate the control of the fluorescence spectrum of the emitted light from a single center. We show the simultaneous narrowing of the room temperature broadband emission spectrum and the increase in the fluorescence spectral density.

  7. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    OpenAIRE

    Silviu Grisaru; Morgunov, Melissa A.; Samuel, Susan M.; Julian P Midgley; Wade, Andrew W; Tee, James B.; Hamiwka, Lorraine A.

    2011-01-01

    Acute kidney injury (AKI) is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS) remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT) and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 5...

  8. Radiotherapy of Painful Vertebral Hemangiomas: The Single Center Retrospective Analysis of 137 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Miszczyk, Leszek, E-mail: leszek@io.gliwice.pl [Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice (Poland); Tukiendorf, Andrzej [Cardiff Research Consortium, The MediCentre Eastgate House, Cardiff, South Glamorgan (United Kingdom)

    2012-02-01

    Purpose: An evaluation of dose-response relationship and an attempt to define predictive factors. Methods and Materials: A total of 137 cases of painful vertebral hemangioma irradiations (101 patients). Fraction dose (fd) varied from 2 to 15 Gy (123 fractionated and 14 radiosurgical treatments), and total dose (TD) from 8 to 30 Gy (111 cases irradiated with fd of 2 GY to TD of 24 Gy). We evaluated pain relief, changes in analgesic requirements, and reossification. Results: Means of pain relief 1, 6, 12, and 18 months after radiotherapy (defined as a decrease of primary pain level expressed in percent) were 60.5%, 65.4%, 68.3%, and 78.4%, respectively. Proportion of patients with no need for analgesics and patients using tramadol were 39%, 40%, 44%, 57%, and 20%, 17%, 22%, and 11% in these times. The proportion of patients experiencing complete/partial pain relief changed from 36/48% 1 month, to 64/22% 1.5 years after radiotherapy. No impact of radiotherapy on reossification was found. The positive impact of fd and TD increase for analgesics uptake reduction and pain relief was found. An increase of the fd by 1 Gy results in 27% chance of analgesics uptake reduction and 3.8% reduction of pain, whereas 14% analgesics uptake reduction and 2.2% of pain reduction in case of the TD. The predictive factors improving results were found: female gender, older age, better performance states (the chance of the lower analgesic treatment decreases over 2.5 times in comparison to the higher Zubrod degree), bigger Hb concentration, shorter symptoms duration and lower analgesics uptake before radiotherapy. Conclusions: The obtained data support the efficacy of radiotherapy in improving pain secondary to vertebral hemangioma, with the degree of pain amelioration being related to increasing fd and TD. The positive predictive factors were defined: female gender, older age, better performance status, increased Hb concentration, shorter symptoms duration, and lower analgesics uptake before radiotherapy.

  9. Cystic fibrosis-related liver disease: a single-center experience

    Directory of Open Access Journals (Sweden)

    Paula Catarino Costa

    2011-10-01

    Full Text Available Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases. All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years, revealed by hepatomegaly or hepatosplenomegaly (3 cases and/ or abnormalities of liver function tests (3 cases changes of liver ultrasound (7 cases with evidence of portal hypertension (2 cases. Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis, progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.

  10. Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

    Science.gov (United States)

    Kumar, Shailesh; Lausen, Jens L.; Garcia-Ortiz, Cesar E.; Andersen, Sebastian K. H.; Roberts, Alexander S.; Radko, Ilya P.; Smith, Cameron L. C.; Kristensen, Anders; Bozhevolnyi, Sergey I.

    2016-02-01

    Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are especially useful as biological fluorophores due to their chemical neutrality, brightness and room-temperature photostability. Furthermore, NDs containing multiple NV centers also have potential in high-precision magnetic field and temperature sensing. Coupling NV centers to propagating surface plasmon polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the first case, we concentrate on monitoring differences in fluorescence spectra obtained from a source ND, which is illuminated by a pump laser, and from a scattering ND illuminated only by the fluorescence-excited SPP radiation. In the second case, we observe changes in the average NV lifetime when the same ND is characterized outside and inside a VG. Fluorescence emission from the VG terminations is also observed, which confirms the NV coupling to the VG-supported SPP modes.

  11. Single-patient (n-of-1) trials: a pragmatic clinical decision methodology for patient-centered comparative effectiveness research.

    Science.gov (United States)

    Duan, Naihua; Kravitz, Richard L; Schmid, Christopher H

    2013-08-01

    To raise awareness among clinicians and epidemiologists that single-patient (n-of-1) trials are potentially useful for informing personalized treatment decisions for patients with chronic conditions. We reviewed the clinical and statistical literature on methods and applications of single-patient trials and then critically evaluated the needs for further methodological developments. Existing literature reports application of 2,154 single-patient trials in 108 studies for diverse clinical conditions; various recent commentaries advocate for wider application of such trials in clinical decision making. Preliminary evidence from several recent pilot acceptability studies suggests that single-patient trials have the potential for widespread acceptance by patients and clinicians as an effective modality for increasing the therapeutic precision. Bayesian and adaptive statistical methods hold promise for increasing the informational yield of single-patient trials while reducing participant burden, but are not widely used. Personalized applications of single-patient trials can be enhanced through further development and application of methodologies on adaptive trial design, stopping rules, network meta-analysis, washout methods, and methods for communicating trial findings to patients and clinicians. Single-patient trials may be poised to emerge as an important part of the methodological armamentarium for comparative effectiveness research and patient-centered outcomes research. By permitting direct estimation of individual treatment effects, they can facilitate finely graded individualized care, enhance therapeutic precision, improve patient outcomes, and reduce costs. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Purcell-Enhanced Single-Photon Emission from Nitrogen-Vacancy Centers Coupled to a Tunable Microcavity

    Science.gov (United States)

    Kaupp, Hanno; Hümmer, Thomas; Mader, Matthias; Schlederer, Benedikt; Benedikter, Julia; Haeusser, Philip; Chang, Huan-Cheng; Fedder, Helmut; Hänsch, Theodor W.; Hunger, David

    2016-11-01

    Optical microcavities are a powerful tool for enhancing the fluorescence of individual quantum emitters. However, the broad emission spectra encountered in the solid state at room temperature limit the influence of a cavity, calling for an ultrasmall mode volume. We demonstrate Purcell-enhanced single-photon emission from nitrogen-vacancy centers in nanodiamonds coupled to a tunable fiber-based microcavity with a mode volume down to 1.0 λ3. We record cavity-enhanced fluorescence images and study several single emitters with one cavity. The Purcell effect is evidenced by enhanced fluorescence collection and tunable lifetime modification, and we infer an effective Purcell factor of up to 2. Furthermore, we show an alternative regime for light confinement, where a Fabry-Perot mode is combined with additional mode confinement by the nanocrystal itself. Simulations predict effective Purcell factors of up to 11 for nitrogen-vacancy centers and 63 for silicon-vacancy centers, holding promise for bright single-photon sources and efficient spin readout under ambient conditions.

  13. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years

    Science.gov (United States)

    Bıçakcı, Ünal; Genç, Gürkan; Tander, Burak; Günaydın, Mithat; Demirel, Dilek; Özkaya, Ozan; Rızalar, Rıza; Arıtürk, Ender; Bernay, Ferit

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared. MATERIALS AND METHODS: We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. RESULTS: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 vs n = 25) (P V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. CONCLUSION: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method. PMID:27073310

  14. Relationship between salivary fluor concentration and caries index in 12–15 years old children

    Directory of Open Access Journals (Sweden)

    Vidyana Pratiwi

    2012-03-01

    Full Text Available Background: Dental caries is a bacterial infection leading to dissolution and localized damage of hard tissues. The assessment of caries risk is based on several caries indicators including clinical conditions (DMF-T index, environment (fluor, and general health. Purpose: The objective of this study was to assess the relationship between salivary fluor concentration and caries index in children aging 12–15 years old at SMP Negeri 2 PTPN VIII Pangalengan. Methods: This study is an observational analytical study using crosssectional approach and is conducted in a field trial manner. The study sample consists of 80 students in the age of 12 to 15 years old at SMP Negeri 2 PTPN VIII selected through Probability Sampling manner using simple random sampling method. Results: The result of this study shows a DMF-T index of 4.32 and salivary fluor concentration mean of 0.018. Pearson Product Moment correlation test shows that there is a weak correlation between salivary fluor concentration and DMF-T index. Conclusion: It is concluded that the salivary fluor concentration has an insignificant correlation with the DMF-T index since the fluor concentration in saliva is very low.Latar belakang: Karies gigi adalah penyakit infeksi bakteri yang berakibat pada disolusi dan kerusakan terlokalisasi jaringan keras. Penilaian risiko karies berdasarkan atas beberapa indikator karies yaitu kondisi klinis (indeks DMF-T, lingkungan (fluor, dan kesehatan umum. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan konsentrasi fluor yang terdapat dalam saliva dengan indeks karies pada anak usia 12-15 tahun di SMP Negeri 2 PTPN VIII Pangalengan. Metode: Jenis penelitian ini adalah penelitian analitik observasional dengan pendekatan cross sectional yang dilakukan di lapangan. Sampel penelitian sebanyak 80 orang siswasiswi usia 12–15 tahun di SMP Negeri 2 PTPN VIII Pangalengan yang dipilih secara Probability Sampling dengan metode simple random sampling. Hasil

  15. Iron status of schoolchildren (6–15 years and associated factors in rural Nigeria

    Directory of Open Access Journals (Sweden)

    Rufina N. B. Ayogu

    2015-05-01

    Full Text Available Background: Schoolchildren are vulnerable to anaemia because of their higher iron need to meet the demands of puberty and adolescence. Objective: The survey determined the haemoglobin levels of schoolchildren aged 6–15 years and the factors affecting their haemoglobin status. Design: Data were obtained through a cross sectional survey of 450 randomly selected schoolchildren in Ede-Oballa, Nsukka, Enugu State, Nigeria. Ninety were selected for clinical examination, biochemical tests, and nutrient intake study. Haemoglobin, malaria, and stool analysis were carried out by the cyanmethaemoglobin, thin blood film, and wet mount direct methods, respectively. Iron intake was determined by a three-day weighed food intake. Results: Results showed that the schoolchildren had pallor (35.6%, brittle hair (31.1%, koilonychia (2.2%, oedema (4.4% and sore/smooth tongue (7.8%. The children also had malaria (58.9% and Entamoeba histolytica (42.2%, hookworm (36.7%, tapeworm (35.6%, whipworm (34.5%, and roundworm (27.9% infestations. Iron intake was inadequate (<100% of recommended nutrient intake for most of the children. The mean haemoglobin levels of the schoolchildren were low. The 6–9, 10–12, and 13–15 year olds had 9.0, 9.1, and 9.3 g/dl, respectively. Most (85.5% of them had anaemia. Moderate anaemia was prevalent in 62.2%. Severe anaemia affected the 6–9 year olds more. Malaria (P<0.001, Entamoeba histolytica (P<0.01, hookworm (P<0.05, tapeworm (P<0.01, and whipworm (P<0.001 caused significant reduction in haemoglobin level. Age (b=1.284, P<0.05, birth order (b=−0.629, P<0.01, frequency of illness attack (b=−1.372, P<0.01, household size (b=−0.526, P<0.05, and frequency of skipping breakfast (b=−1.542, P<0.001 were factors that influenced the haemoglobin status of the children. Conclusion: The schoolchildren had poor iron status as a result of consumption of plant sources of iron with low bioavailability, parasitic infections, birth order

  16. Iron status of schoolchildren (6–15 years) and associated factors in rural Nigeria

    Science.gov (United States)

    Ayogu, Rufina N. B.; Okafor, Adaobi M.; Ene-Obong, Henrietta N.

    2015-01-01

    Background Schoolchildren are vulnerable to anaemia because of their higher iron need to meet the demands of puberty and adolescence. Objective The survey determined the haemoglobin levels of schoolchildren aged 6–15 years and the factors affecting their haemoglobin status. Design Data were obtained through a cross sectional survey of 450 randomly selected schoolchildren in Ede-Oballa, Nsukka, Enugu State, Nigeria. Ninety were selected for clinical examination, biochemical tests, and nutrient intake study. Haemoglobin, malaria, and stool analysis were carried out by the cyanmethaemoglobin, thin blood film, and wet mount direct methods, respectively. Iron intake was determined by a three-day weighed food intake. Results Results showed that the schoolchildren had pallor (35.6%), brittle hair (31.1%), koilonychia (2.2%), oedema (4.4%) and sore/smooth tongue (7.8%). The children also had malaria (58.9%) and Entamoeba histolytica (42.2%), hookworm (36.7%), tapeworm (35.6%), whipworm (34.5%), and roundworm (27.9%) infestations. Iron intake was inadequate (<100% of recommended nutrient intake) for most of the children. The mean haemoglobin levels of the schoolchildren were low. The 6–9, 10–12, and 13–15 year olds had 9.0, 9.1, and 9.3 g/dl, respectively. Most (85.5%) of them had anaemia. Moderate anaemia was prevalent in 62.2%. Severe anaemia affected the 6–9 year olds more. Malaria (P<0.001), Entamoeba histolytica (P<0.01), hookworm (P<0.05), tapeworm (P<0.01), and whipworm (P<0.001) caused significant reduction in haemoglobin level. Age (b=1.284, P<0.05), birth order (b=−0.629, P<0.01), frequency of illness attack (b=−1.372, P<0.01), household size (b=−0.526, P<0.05), and frequency of skipping breakfast (b=−1.542, P<0.001) were factors that influenced the haemoglobin status of the children. Conclusion The schoolchildren had poor iron status as a result of consumption of plant sources of iron with low bioavailability, parasitic infections, birth order

  17. Tuberculous Lymphadenitis in South-Eastern Nigeria; A 15 Years Histopathologic Review (2000-2014)

    Science.gov (United States)

    Ukekwe, FI; Olusina, DB; Banjo, AAF; Akinde, OR; Nzegwu, MA; Okafor, OC; Ocheni, S

    2016-01-01

    Background: The human immunodeficiency virus (HIV) pandemic has brought about a resurgence in tuberculosis (TB), especially in developing countries. Previous studies on TB lymphadenitis (TBLN) in South-Eastern Nigeria were done before the advent of the HIV pandemic making a review pertinent. Aim: To evaluate the role of TBLN as a cause of superficial lymphadenopathy in the post-HIV/acquired immune deficiency syndrome (AIDS) era of South-Eastern Nigeria. Materials and Methods: This is a 15 years (2000-2014) retrospective review of all superficial lymph node biopsies (SLNBs) received at the Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria. Results: One hundred and seventy-two cases of TBLN were identified in this study constituting 14.6% (172/1,180) of SLNBs received at our Hospital's Morbid Anatomy Department during the 15 years period under review. Twenty-eight cases of TBLN were clinically screened for HIV, 23 of which tested positive, representing 82.1% (23/28) of clinically screened cases. Acid fast bacilli demonstration was positive in 15.1% (26/172) of cases using Ziehl-Neelsen stain. 48.8% (84/172) of TBLN cases were males, and 51.2% (88/172) were females with most (22) cases received in 2012 and least (5) cases in 2000. Most TBLN occurred in the 21-25 years age group with a total of 21.5% (37/172) of cases and a male to female ratio of 1:1.5 The most common biopsy site for TBLN was the cervical group followed by the axillary and inguinal groups with 73.8% (127/172), 14% (24/172), and 4.7% (8/172) of cases, respectively. Conclusions: There is a remarkable decline in the prevalence of TB lymphadenitis in South-Eastern Nigeria indicating a change in trend from the pre- to the post-HIV/AIDS era with slightly more females now presenting with TBLN and most TB lymphadenitis patients now presenting with associated HIV/AIDS disease. There is an urgent need to provide modern diagnostic facilities in our medical

  18. Persistence of artificial sweeteners in a 15-year-old septic system plume

    Science.gov (United States)

    Robertson, W. D.; Van Stempvoort, D. R.; Solomon, D. K.; Homewood, J.; Brown, S. J.; Spoelstra, J.; Schiff, S. L.

    2013-01-01

    SummaryGroundwater contamination from constituents such as NO3-, often occurs where multiple sources are present making source identification difficult. This study examines a suite of major ions and trace organic constituents within a well defined septic system plume in southern Ontario, Canada (Long Point site) for their potential use as wastewater tracers. The septic system has been operating for 20 years servicing a large, seasonal-use campground and tritium/helium age dating indicates that the 200 m long monitored section of the plume is about 15 years old. Four parameters are elevated along the entire length of the plume as follows; the mean electrical conductivity value (EC) in the distal plume zone is 926 μS/cm which is 74% of the mean value below the tile bed, Na+ (14.7 mg/L) is 43%, an artificial sweetener, acesulfame (12.1 μg/L) is 23% and Cl- (71.5 mg/L) is 137%. EC and Cl- appear to be affected by dispersive dilution with overlying background groundwater that has lower EC but has locally higher Cl- as result of the use of a dust suppressant (CaCl2) in the campground. Na+, in addition to advective dilution, could be depleted by weak adsorption. Acesulfame, in addition to the above processes could be influenced by increasing consumer use in recent years. Nonetheless, both Na+ and acesulfame remain elevated throughout the plume by factors of more than 100 and 1000 respectively compared to background levels, and are strong indicators of wastewater impact at this site. EC and Cl- are less useful because their contrast with background values is much less (EC) or because other sources are present (Cl-). Nutrients (NO3-, NH4+, PO43-, K+) and pathogens (Escherichia coli) do not persist in the distal plume zone and are less useful as wastewater indicators here. The artificial sweetener, acesulfame, has persisted at high concentrations in the Long Point plume for at least 15 years (and this timing agrees with tritium/helium-3 dating) and this compound likely

  19. Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality--a single-center experience

    DEFF Research Database (Denmark)

    Schmidt, Palle Nordblad; Novovic, Srdan; Roug, Stine

    2015-01-01

    OBJECTIVE: Endoscopic transmural drainage and necrosectomy (ETDN) is a promising alternative to percutaneous drainage and surgical intervention in the treatment of walled-off pancreatic and peripancreatic necroses (WONs). We assessed the outcome and safety profile of ETDN in a single-center patie...... in a single, high-volume center has an acceptable safety profile and is associated with a low mortality....

  20. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years

    Directory of Open Access Journals (Sweden)

    Ünal Biçakci

    2016-01-01

    Full Text Available Introduction: The aim of this study was to evaluate patients with end stage renal failure (ESRD who underwent chronic peritoneal dialysis (CPD. The clinical outcomes of laparoscopic and open placements of catheters were compared. Materials and Methods: We reviewed 49 (18 male and 31 female children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. Results: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 v sn = 25 (P<0.01. Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years vs 13.4 ± 0.85 years. According to the development of complications, significant difference has not been found between the open (n = 9 and laparoscopic (n = 3 approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. Conclusion: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method.

  1. Immediate procedural outcomes in 35 consecutive pipeline embolization cases: a single-center, single-user experience.

    Science.gov (United States)

    Colby, Geoffrey P; Lin, Li-Mei; Gomez, Juan F; Paul, Alexandra R; Huang, Judy; Tamargo, Rafael J; Coon, Alexander L

    2013-05-01

    Flow diverters are an exciting new class of endovascular devices that treat aneurysms by curative reconstruction of the parent artery. The Pipeline embolization device (PED) is the first FDA-approved intracranial flow diverting device available in the USA. This paper presents periprocedural results with the device in a series of 35 consecutive cases. All patients who underwent PED treatment of an intracranial aneurysm at our institution following FDA approval of the device in April 2011 were included in the series. Patient demographics, aneurysm characteristics, procedural details and technical and clinical outcomes were analyzed. Thirty-four patients (age range 23-78 years, mean 56.4 years) with 41 unruptured aneurysms (37 anterior circulation, four posterior circulation, mean size 11.4 mm, 20/21 large or giant) were treated with the PED in 35 cases (one patient had bilateral aneurysms treated on 2 separate occasions). Thirty-four of 35 cases (97%) were successfully completed. A total of 64 PEDs were implanted, with a mean number of 1.2 PEDs implanted per anterior circulation cases and 6.5 per posterior circulation cases. A single PED was implanted in 73% of cases. Immediate flow disruption occurred in 97% of the cases. The overall rate of major stroke or mortality was 3% (1/35 patients). Minor stroke, cranial nerve palsy, transient neurological deficit and groin complication occurred in one patient each (3% each, 12% total). Treatment of cerebral aneurysms with the PED carries an acceptable risk profile when a rigorous and uniform technique is used. Although the long-term results will need to be analyzed, the immediate procedural outcomes in the study series using this technique appear quite promising.

  2. One-year experience with single incision laparoscopic cholecystectomy in a single center: without the use of inverse triangulation.

    Science.gov (United States)

    Ryu, Yun Beom; Lee, Jung Woo; Park, Yo Han; Lim, Man Sup; Cho, Ji Woong; Jeon, Jang Yong

    2016-02-01

    Single incision laparoscopic cholecystectomy (SILC) is generally performed with the use of inverse triangulation. In this study, we performed 3-channel or 4-channel SILC without the use of inverse triangulation. We evaluated the adequacy and feasibility of SILC using our surgical method. We retrospectively reviewed our series of 309 SILCs performed between March 2014 and February 2015. Among 309 SILCs, male were 148 and female were 161 patients, mean age was 48.7 ± 15.3 years old and mean body mass index was 24.8 ± 3.8 kg/m(2). Forty patients had previously undergone abdominal surgery including 6 cases of upper abdominal surgery. SILC after percutaneous transhepatic gallbladder (GB) drainage was completed in 8.7% of cases. There were 10 cases of emergency SILC. SILC was performed for noncomplicated GB including symptomatic GB stone and polyp in 66.7% of cases, acute cholecystitis in 33.3%. Overall, 96.8% of procedures were successfully completed without additional port. The reason for addition of an extra port or open conversion included technical difficulties due to severe adhesion and bleeding. The mean operating time was 60.7 ± 22.3 minutes. The overall complication rate was 4.8%: 9 patients of wound seroma, 1 case of bile leakage from GB bed, 4 cases of intra-abdominal abscess or fluid collection, and 1 case of incisional hernia were developed. There was no case of common bile duct injury. Our surgical method of SILC without the use of inverse triangulation is safe, feasible and effective technique.

  3. 77 FR 59931 - Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program...

    Science.gov (United States)

    2012-10-01

    ... HUMAN SERVICES Health Resources and Services Administration Single Source Program Expansion Supplement... baccalaureate nursing education program in the Pacific. Its focus is on health careers training and development..., program resource purchases, and faculty development. FOR FURTHER INFORMATION CONTACT: Meseret Bezuneh...

  4. Efficient Extraction of Zero-Phonon-Line Photons from Single Nitrogen-Vacancy Centers in an Integrated GaP-on-Diamond Platform

    Science.gov (United States)

    Gould, Michael; Schmidgall, Emma R.; Dadgostar, Shabnam; Hatami, Fariba; Fu, Kai-Mei C.

    2016-07-01

    Scaling beyond two-node quantum networks using nitrogen-vacancy (NV) centers in diamond is limited by the low probability of collecting zero-phonon-line (ZPL) photons from single centers. Here, we demonstrate GaP-on-diamond disk resonators which resonantly couple ZPL photons from single NV centers to single-mode waveguides. In these devices, the probability of a single NV center emitting a ZPL photon into the waveguide mode after optical excitation can reach 9%, due to a combination of resonant enhancement of the ZPL emission and efficient coupling between the resonator and waveguide. We verify the single-photon nature of the emission and experimentally demonstrate both high in-waveguide photon numbers and substantial Purcell enhancement for a set of devices. These devices may enable scalable integrated quantum networks based on NV centers.

  5. Efficient extraction of zero-phonon-line photons from single nitrogen-vacancy centers in an integrated GaP-on-diamond platform

    CERN Document Server

    Gould, Michael; Dadgostar, Shabnam; Hatami, Fariba; Fu, Kai-Mei C

    2016-01-01

    Scaling beyond two-node quantum networks using nitrogen vacancy (NV) centers in diamond is limited by the low probability of collecting zero phonon line (ZPL) photons from single centers. Here, we demonstrate GaP-on-diamond disk resonators which resonantly couple ZPL photons from single NV centers to single-mode waveguides. In these devices, the probability of a single NV center emitting a ZPL photon into the guided waveguide mode after optical excitation can reach 9%, due to a combination of resonant enhancement of the ZPL emission and efficient coupling between the resonator and waveguide. We verify the single-photon nature of the emission and experimentally demonstrate both high in-waveguide photon numbers and substantial Purcell enhancement for a set of devices. These devices may enable scalable integrated quantum networks based on NV centers.

  6. Outcome of Cushing's disease following transsphenoidal surgery in a single center over 20 years.

    LENUS (Irish Health Repository)

    Hassan-Smith, Zaki K

    2012-04-01

    Historically, Cushing\\'s disease (CD) was associated with a 5-yr survival of just 50%. Although advances in CD management have seen mortality rates improve, outcome from transsphenoidal surgery (TSS), the current first-line treatment, varies significantly between centers.

  7. Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

    Directory of Open Access Journals (Sweden)

    Gherasim Dorin Nicolae

    2017-03-01

    Full Text Available Objective: This study presents the experience of one neurosurgical center in the treatment of 18 consecutive patients with distal anterior cerebral artery (DACA aneurysms during a 10 years period. Our aim was to compare treatment outcomes of these lesions with intracranial aneurysms in general, and to present technical nuances in surgical treatment.

  8. Guillain Barré syndrome in a population less than 15 years old in Brazil

    Directory of Open Access Journals (Sweden)

    Dias-Tosta Elza

    2002-01-01

    Full Text Available To know the impact of the Guillain Barré syndrome (GBS in the population less than 15 years old, after the eradication of poliomyelitis. Data bank from the program of epidemiological surveillance of acute flaccid palsies (AFP from the Fundação Nacional de Saúde were analyzed between 1990 -- 1996. From 3619 notifications of AFP there were 1678 GBS. GBS yearly incidence rates is 0.39-0.63 cases/100,000. No consistent seasonal variation existed or relationship to vaccines. Weakness at inclusion were, moderate 52.1%, severe in 47.9%, sixty days after 57.1% normal, 7.4% mild, 15.7% moderate, 10.4% with severe deficits, death in 5.4%. 67 (4.0% cases unknown. Death rates varies from 2.8% in southeast to 7.9% in the northeast. GBS was the most frequent cause of AFP. In spite of the severity of this disease being similar in the different regions, the outcome varies according to origin of the cases, possibly reflecting the economical conditions in those places.

  9. University of the seas, 15 years of oceanographic schools on board of the Marion Dufresne

    Science.gov (United States)

    Malaize, Bruno; Deverchere, Jacques; Leau, Hélène; Graindorge, David

    2015-04-01

    Since the first University at Sea, proposed by two French Universities (Brest and Bordeaux) in 1999, the R/V Marion Dufresne, in collaboration with the French Polar institute (IPEV), has welcome 12 oceanographic schools. The main objective of this educational and scientific program is to stimulate the potential interest of highly graduated students in scientific fields dealing with oceanography, and to broaden exchanges with foreign universities, strengthening a pool of excellence at a high international scientific level. It is a unique opportunity for the students to discover and to be involved in the work in progress of collecting scientific data on board of a ship, and to attend international research courses given by scientists involved in the cruise program. They also experience the final task of the scientific work by presenting their own training results, making posters on board, and writing a cruise report. For some University at Sea, students had also updated a daily journal, available on internet, hosted by the main institutions involved (as IPEV or EPOC, Bordeaux University). All this work is done in English, a common language to all the participants. An overview of these 15 years background experience will be presented, underlying the financial supports used, the logistic on board, as well as all the benefits acquiered by all former students, now in permanent positions in different international institutions.

  10. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, A.E.; Reyes, F.I.; Faiman, C.

    1987-07-01

    Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

  11. Gustilo IIIC fractures in the lower limb: our 15-year experience.

    Science.gov (United States)

    Soni, A; Tzafetta, K; Knight, S; Giannoudis, P V

    2012-05-01

    Controversy continues to surround the management of patients with an open fracture of the lower limb and an associated vascular injury (Gustilo type IIIC). This study reports our 15-year experience with these fractures and their outcome in 18 patients (15 male and three female). Their mean age was 30.7 years (8 to 54) and mean Mangled Extremity Severity Score (MESS) at presentation was 6.9 (3 to 10). A total of 15 lower limbs were salvaged and three underwent amputation (two immediate and one delayed). Four patients underwent stabilisation of the fracture by external fixation and 12 with an internal device. A total of 11 patients had damage to multiple arteries and eight had a vein graft. Wound cover was achieved with a pedicled flap in three and a free flap in six. Seven patients developed a wound infection and four developed nonunion requiring further surgery. At a mean follow-up of five years (4.1 to 6.6) the mean visual analogue scale for pain was 64 (10 to 90). Depression and anxiety were common. Activities were limited mainly because of pain, and the MESS was a valid predictor of the functional outcome. Distal tibial fractures had an increased rate of nonunion when associated with posterior tibial artery damage, and seven patients (39%) were not able to return to their previous occupation.

  12. Leprosy in children and adolescents under 15 years old in an urban centre in Brazil

    Science.gov (United States)

    Santos, Selton Diniz; Penna, Gerson Oliveira; Costa, Maria da Conceição Nascimento; Natividade, Marcio Santos; Teixeira, Maria Glória

    2016-01-01

    This original study describes the intra-urban distribution of cases of leprosy in residents under 15 years old in Salvador, Bahia, Brazil; the study also identifies the environment in which Mycobacterium leprae is being transmitted. The cases were distributed by operational classification, clinical forms, type of contact and the addresses were geo-referenced by neighborhood. Between 2007 and 2011, were reported 145 cases of leprosy in target population living in Salvador, corresponding to detection rates of 6.21, 6.14, 5.58, 5.41 and 6.88/100,000 inhabitants, respectively. The spatial distribution of the disease was focal. Of the 157 neighborhoods of Salvador, 44 (28.6%) notified cases of leprosy and in 22 (50%) of these were detected more than 10 cases per 100,000 inhabitants. The infectious forms were found in 40% of cases. Over 90% of cases had been living in Salvador for more than five years. Overall, 52.6% reported having had contact with another infected individual inside the household and 25% in their social circle. In Salvador, M. leprae transmission is established. The situation is a major concern, since transmission is intense at an early age, indicating that this endemic disease is expanding and contacts extend beyond individual households. PMID:27223655

  13. Revegetation dynamics after 15 years of rewetting in two extracted peatlands in Sweden

    Directory of Open Access Journals (Sweden)

    S.A. Kozlov

    2016-02-01

    Full Text Available The restoration of extracted peatlands poses challenges with regard to their recolonisation by vegetation. The most significant problems are unstable water levels, destroyed propagule bank, and temperature fluctuations on bare peat surfaces. Rewetting is considered necessary for the re-establishment of peat-forming vegetation. Revegetation was investigated in a long-term field study at two rewetted extracted peatland sites in south-central Sweden, namely Västkärr (originally a lagg fen and Porla (originally a bog. Both sites were expanses of bare peat before rewetting. Rewetting procedures were applied in 1999 and strongly promoted plant colonisation. At Västkärr, colonisation started in the first year after rewetting, mostly by species that were not found during repeat vegetation surveys 15 years later. By 2014, Västkärr was a shallow lake surrounded by mesotrophic and eutrophic vegetation with species such as Carex rostrata, Lemna minor, Typha latifolia, Phalaris arundinacea and Phragmites australis. Revegetation of the Porla site was slower and started with Eriophorum vaginatum and Polytrichum spp. Sphagnum mosses appeared after six years and had established quite well after 13 years. A residual Sphagnum peat layer, inflowing surface water and groundwater provided spatially variable nutrient conditions. Sphagnum species and E. vaginatum established in nutrient-poor areas, while C. rostrata, P. australis and Eriophorum angustifolium colonised more nutrient-rich locations.

  14. Facial emotion and identity processing development in 5- to 15-year-old children.

    Science.gov (United States)

    Johnston, Patrick J; Kaufman, Jordy; Bajic, Julie; Sercombe, Alicia; Michie, Patricia T; Karayanidis, Frini

    2011-01-01

    Most developmental studies of emotional face processing to date have focused on infants and very young children. Additionally, studies that examine emotional face processing in older children do not distinguish development in emotion and identity face processing from more generic age-related cognitive improvement. In this study, we developed a paradigm that measures processing of facial expression in comparison to facial identity and complex visual stimuli. The three matching tasks were developed (i.e., facial emotion matching, facial identity matching, and butterfly wing matching) to include stimuli of similar level of discriminability and to be equated for task difficulty in earlier samples of young adults. Ninety-two children aged 5-15 years and a new group of 24 young adults completed these three matching tasks. Young children were highly adept at the butterfly wing task relative to their performance on both face-related tasks. More importantly, in older children, development of facial emotion discrimination ability lagged behind that of facial identity discrimination.

  15. Relationship between serum cholesterol and body mass index in Nigeria schoolchildren aged 2-15 years.

    Science.gov (United States)

    Nwaiwu, Obiyo; Ibe, Bede C

    2015-04-01

    Non-communicable disease is becoming a public health problem that it is already present in more affluent countries. The aim of this study was to determine the relationship between body mass index (BMI) and total serum cholesterol with its lipoprotein fractions in children aged 2-15 years. Serum cholesterol was estimated using the enzymatic spectrophotometer cholesterol oxidase/peroxidase method. BMI was calculated as weight (kg)/height (m(2)). Total cholesterol and low-density lipoprotein were positively co-related with BMI (p < 0.05). Using linear regression, equations that can be used to predict serum total cholesterol from known BMI values were developed. There is a positive correlation between BMI and serum cholesterol. BMI which is non-invasive is recommended as a screening tool for cardiovascular risk in settings where serum cholesterol cannot be routinely estimated. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Complications Related to Pectus Carinatum Correction: Lessons Learned from 15 Years' Experience. Management and Literature Review.

    Science.gov (United States)

    Del Frari, Barbara; Sigl, Stephan; Schwabegger, Anton H

    2016-08-01

    Various methods of corrective thoracoplasty for pectus carinatum deformity have been described, but to date no studies describe a review of complications and how to manage them. Complications are dependent not only on the technique used and the patient's age, but also on the experience of the treating surgeon. The authors present their 15 years' experience with surgical correction of pectus carinatum and the complications that have occurred. A literature review regarding complications with pectus carinatum surgery is performed. A retrospective review of 95 patients (mean age, 19 years) was performed. One hundred four surgical procedures for repair of pectus carinatum were performed from July of 2000 to July of 2015 using a modified Ravitch technique, bioabsorbable material, postoperative bracing, and in some cases a diced rib cartilage graft technique. Intraoperative and postoperative complications were evaluated. The mean patient follow-up was 13.6 months (range, 4 months to 9.75 years). Intraoperative complications were pleura lesion and laceration of the internal mammary vein. Postoperative complications were recurrent mild protrusion, persistent protrusion of one or two costal cartilages, minor wound healing delay, skin ulcer, hypertrophic scar, transient intercostal dysesthesia, marginal pneumothorax, seroma, meningitis, and epidural hematoma. In our reported series of pectus carinatum repair, increasing experience and progressively less extensive techniques have resulted in fewer complications, low morbidity, and early return to activity. Complications were observed in the early period of application, predominantly because of a lack of experience, and usually subsided with increasing numbers of patients and frequency of surgery. Therapeutic, IV.

  17. Antarctic station life: The first 15 years of mixed expeditions to the Antarctic

    Science.gov (United States)

    Sarris, Aspa

    2017-02-01

    This study examined the experiences of women who lived and worked on remote and isolated Antarctic stations for up to 15 months at a time. The study employed purposeful sampling and a longitudinal - processual approach to study women's experiences over the first 15 years of mixed gender Antarctic expeditions. The retrospective analysis was based on a semi-structured interview administered to 14 women upon their return to Australia. The results showed that women referred to the natural physical Antarctic environment as one of the best aspects of their experience and the reason they would recommend the Antarctic to their friends as a good place to work. In describing the worst aspect of their experience, women referred to aspects of Antarctic station life, including: (i) the male dominated nature of station culture; (ii) the impact of interpersonal conflict, including gender based conflict and friction between scientists and trades workers; and (iii) the lack of anonymity associated with living and working with the same group of individuals, mainly men, for up to 12 months or more. The results are discussed within the context of the evolution of Antarctic station culture and recommendations are made in terms of the demography of expeditions, expeditioner selection and recruitment and the ongoing monitoring of Antarctic station culture. The study presents a framework that can be applied to groups and teams living and working in analogous isolated, confined and extreme work environments, including outer space missions.

  18. Gout in a 15-year-old boy with juvenile idiopathic arthritis: a case study.

    Science.gov (United States)

    Morris, Hallie; Grant, Kristen; Khanna, Geetika; White, Andrew J

    2014-01-06

    Joint pain is a common complaint in pediatrics and is most often attributed to overuse or injury. In the face of persistent, severe, or recurrent symptoms, the differential typically expands to include bony or structural causes versus rheumatologic conditions. Rarely, a child has two distinct causes for joint pain. In this case, an obese 15-year-old male was diagnosed with gout, a disease common in adults but virtually ignored in the field of pediatrics. The presence of juvenile idiopathic arthritis (JIA) complicated and delayed the consideration of this second diagnosis. Indeed, the absence of gout from this patient's differential diagnosis resulted in a greater than two-year delay in receiving treatment. The patients' BMI was 47.4, and he was also mis-diagnosed with osteochondritis dissecans and underwent medical treatment for JIA, assorted imaging studies, and multiple surgical procedures before the key history of increased pain with red meat ingestion, noticed by the patient, and a subsequent elevated uric acid confirmed his ultimate diagnosis. With the increased prevalence of obesity in the adolescent population, the diagnosis of gout should be an important consideration in the differential diagnosis for an arthritic joint in an overweight patient, regardless of age.

  19. Changes of Species Richness in Heathland Communities over 15 Years following Disturbances

    Directory of Open Access Journals (Sweden)

    L. Calvo

    2012-01-01

    Full Text Available The aim of this study was to define the species richness patterns over a period of 15 years during the vegetation recovery process after disturbances (burning, cutting and ploughing in heathlands. Three communities were selected: two dominated by Erica australis and one dominated by Calluna vulgaris. The alpha and gamma diversity patterns were site specific and influenced by the ecological traits of dominant shrub species. The shrubland dominated by Erica australis, typical resprouters with a fast regeneration, showed the highest values of alpha and gamma diversity during the first 7 years of regeneration. The heathland dominated by Calluna vulgaris, an obligate seeder, had a contrasting pattern of alpha and gamma diversity, as the highest values appeared from year 7 until year 14. Thus, the speed of regeneration of the dominant shrub species could be the main factor affecting structural parameters in these communities. Species richness patterns did not vary in relation to the different types of perturbation. Cutting and burning would be the most suitable forestry management strategies to conserve Erica australis heathlands, but burning is more appropriate in Calluna vulgaris ones because cutting modified this community.

  20. Choledochoduodenostomy. Analysis of 71 cases followed for 5 to 15 years.

    Science.gov (United States)

    Escudero-Fabre, A; Escallon, A; Sack, J; Halpern, N B; Aldrete, J S

    1991-01-01

    To investigate the long-term effectiveness of choledochoduodenostomy (CDD), the experience with 71 patients followed for 5 or more years after CDD was analyzed retrospectively. From 1968 to 1984, 134 patients underwent CDD. Eight patients (6%) died in the immediate postoperative period, 55 left the hospital, 8 of them were lost to follow-up, and 47 were followed but died before 5 years elapsed after CDD. The remaining 71 patients form the data base for this analysis: 38 were followed for more than 5 years, 25 were followed for more than 10 years, and 8 were followed for more than 15 years (mean 12.1 years +/- 1.3 SEM). Choledocholithiasis, chronic pancreatitis, and postoperative stricture were the indications for CDD. Cholangitis was observed in only three patients. The diameter of the common bile duct (CBD) was large in most patients (mean 18 mm +/- 0.9 SEM). These results infer that CDD is effective to treat non-neoplastic obstructing lesions of the distal CBD on a long-term basis and that the presence of a dilated CBD (more than 16 mm) that allows the construction of a CDD more than 14 mm is essential to obtain good results. PMID:2039295

  1. Sir Karl Popper (1902-1994): in memoriam, 15 years later.

    Science.gov (United States)

    Notturno, Mark Amadeus

    2009-12-01

    September 17th, 2009 marks the 15th anniversary of Sir Karl Popper's death. Popper was an outspoken champion of critical rationalism, and a constant critic of authoritarian tendencies in science and society. He was also one of the spiritual founders of this journal and served on its first editorial advisory board. Popper was recognized around the world as one of the 20th century's greatest philosophers of science and one of its most articulate and influential critics of Marxism and closed society. When he died, the contemporary wisdom among professional philosophers was that his philosophy was generally right-but somehow obsolete. Some commentators said that it was now obvious that scientific theories cannot be shown to be true. Others said that we had witnessed the end of history and that his critique of closed societies, while no doubt important in its day, had been fully assimilated into Western thinking and still had meaning, if at all, only for the democracies in transition that were trying to emerge from the former Soviet Union. But 15 years after his death, a look at science and society around the world gives us good reason to remember his philosophy.

  2. Facial Emotion and Identity Processing Development in 5- to 15-Year-Old Children

    Directory of Open Access Journals (Sweden)

    Patrick eJohnston

    2011-02-01

    Full Text Available Most developmental studies of emotional face processing to date have focussed on infants and very young children. Additionally, studies that examine emotional face processing in older children do not distinguish development in emotion and identity face processing from more generic age-related cognitive improvement. In this study, we developed a paradigm that measures processing of facial expression in comparison to facial identity and complex visual stimuli. The three matching tasks were developed (i.e., facial emotion matching, facial identity matching and butterfly wing matching to include stimuli of similar level of discriminability and to be equated for task difficulty in earlier samples of young adults. Ninety two children aged 5 to 15 years and a new group of 24 young adults completed these three matching tasks. Young children were highly adept at the butterfly wing task relative to their performance on both face-related tasks. More importantly, in older children, development of facial emotion discrimination ability lagged behind that of facial identity discrimination.

  3. Sarcoidosis with arteriovenous malformation in a 15 year old girl—the rarest of the rare

    Directory of Open Access Journals (Sweden)

    Iman eQaiser

    2015-09-01

    Full Text Available Introduction: Sarcoidosis is an uncommon multi-system disorder with many possible complications. Arteriovenous malformations are a rare vascular complication of sarcoidosis.Case Description: A 15 year old girl presented to the Pediatric Clinic at AKUH with pulmonary, hepatic, joint and skin manifestations. Physical examination and investigations pointed towards sarcoidosis, including raised ESR, ACE and ALT. An incidental finding of pulmonary arteriovenous malformation (PAVM was noticed on echocardiography. She responded to oral corticosteroids, her ACE and ALT levels improved. There was lack of indication for pulmonary angio-embolization for her PAVM. On 4-year follow up, her condition improved and she is clinically well.Discussion: PAVM is an extremely rare complication of sarcoidosis, especially among the pediatric population. Hence, this is the first reported case of its kind. The relation between sarcoidosis and PAVM is difficult to establish, however, there are some theories. This condition may be treated depending on the symptoms. Since our patient did not have any significant symptoms of PAVM, she was treated for the underlying disease, i.e. sarcoidosis.Conclusion: While dealing with patients having multi-system disorders like sarcoidosis, one must be very vigilant so as not to miss out on any complication. Regular follow-up visits should be scheduled to rule out new complications and to monitor the past ones.

  4. 15 Years of Oceanography in the Azores: From Oceanographic Cruises to an Integrated Approach

    Science.gov (United States)

    Juliano, M. F.; Alves, M.; Simões, A.; Rodeia, J.

    2006-07-01

    Oceanographic research in the Azores has only started 15 years ago. Nevertheless, it has been possible to evolve from the typical "research cruise approach" to a more versatile and integrated approach, that has proofed to be further rewarding and adequate for the size and resources of the group. The Azorean Oceanographers have participated and conducted several research cruises since 1990, and anticipating the importance of correlating in situ data with satellite data has lead us to plan the last of these, so that there was a coincidence of transects, moorings and satellite ground tracks. On the other hand, the group has invested in data processing and merging hydrological historical data with the results from the above mentioned oceanographic cruises, creating a hydrological database for the whole Atlantic Ocean. Also, through the application of a novel methodology and approach, the group has contributed to a new vision of the currents systems in the South Atlantic Ocean, namely with the newly found St. Helena Current, the congener of the Azores Current. As a result of this continued shift in methodology, the group is now using an integrated approach where field data, model output and processed altimeter data are merged to produce operational oceanography products, such as sea state charts and daily oceanic current charts.

  5. CERN openlab ‘open day’ marks 15 years of fruitful collaboration

    CERN Multimedia

    Andrew Purcell

    2016-01-01

    CERN openlab (see here) is organising an ‘open day’ event on 8-9 June 2016. The event will provide an opportunity to learn about CERN openlab’s work: collaborating with leading ICT companies and research institutes to accelerate the development of cutting-edge solutions for the worldwide LHC community, as well as for wider scientific research.   The event will take place at CERN in the main auditorium, as well as in the upstairs mezzanine area of the main building. It will feature both talks and posters on the achievements of diverse CERN openlab projects over the last year. There will also be hands-on technology demonstrations from companies working with CERN openlab, so that you too can discover the latest ICT innovations. The event marks 15 years since CERN openlab was established. “Since 2001, this unique public-private partnership has worked to ensure that members of CERN’s scientific community have access to the v...

  6. Teacher training workshops in education: summary of 15 years' personal experience.

    Science.gov (United States)

    Guilbert, J J

    1985-09-01

    Teachers of doctors and other health personnel have become increasingly aware of the potential usefulness of applying to their programmes the principles and methods elaborated by educational scientists. Teacher training took many forms, but the workshop was by far the most common. This report is a summary account of the personal experience of the author over 15 years, from 1968 to 1983, as organizer and leader of more than 100 workshops for eleven categories of health professions, in sixteen working languages for over 2000 participants in thirty countries. It shows the way the organization of the workshops was modified from a teacher-centred to a learner-centred approach. The report goes on to describe the first implementation phase (1972-1975), which showed the need for efficient learning materials such as a semi-programmed text providing guidance during the learner's progression through the whole educational cycle. It also became clear that the working language used during a workshop was as important factor in the determination of its success. The report describes further how leaders were selected and trained through 'learning by doing' and how the second implementation phase (1976-1983) developed so that the programme of each workshop was prepared after (and not before) the beginning of the workshop on the basis of independent choices made by each participant.

  7. [Prevalence of dental fluorosis in children between 6 to 15 years old].

    Science.gov (United States)

    Azpeitia-Valadez, María de Lourdes; Rodríguez-Frausto, Manuel; Sánchez-Hernández, Miguel Angel

    2008-01-01

    dental fluorosis is a defect in the formation of the enamel by high fluoride concentrations during tooth development. It produces hypomineralization of the enamel by increasing the porosity, thus exposing the tooth to decay. to determine the prevalence and severity of fluorosis in children aged 6 to 15 years. a sample of 456 children was evaluated. The diagnosis of fluorosis was made through physical examination and the severity of the damage was described by using a modified version of Dean's scale. 270 children presented fluorosis (59.2 %). The most affected were children of 8 to 12 years, students of first to fifth year of primary school. The severity was mild and very mild in 90 % of cases. Tooth decay appeared in 55 % of children with fluorosis and in 43 % of children without fluorosis. the prevalence of dental fluorosis is rapidly increasing. Tooth decay affected more often children with fluorosis. Assuming that the prevalence of fluorosis is due to excessive fluoride application rather than to environmental exposure is possible.

  8. Nonossifying fibroma (metaphyseal fibrous defect) of the mandible in a 15-year-old boy.

    Science.gov (United States)

    Mannan, Abul Ala; Singh, N Gopendro; Al-Waheeb, Salah; Taher, Taher N; Mohammed, Emad El Din El Din

    2015-06-01

    We describe a rare case of nonossifying fibroma of the mandible in a 15-year-old boy who presented with a left mandibular swelling. Conventional imaging showed an expansile radiolucent lesion involving the angle and the body of the left mandible. The lesion was curetted, and a miniplate was implanted at the excision site. Microscopic examination of the removed specimen revealed a cellular lesion characterized by a proliferation of uniform spindle-shaped cells in a vague but prominent storiform pattern, which represented the classic appearance of nonossifying fibroma. Three months later, radiography detected a fracture of the implantation plate. The area was re-explored with curettage of the soft tissue, which on microscopy demonstrated findings similar to the initial curettage findings. Follow-up radiology revealed satisfactory healing of the jaw, and no further recurrence was seen 2 years after the initial surgery. We present this case to highlight the importance of recognizing nonossifying fibroma in the mandible, which can be easily confused with more common mandibular lesions.

  9. Results of proximal gastric vagotomy over 1-5 years in a district general hospital.

    Science.gov (United States)

    Makey, D A; Tovey, F I; Heald, R J

    1979-01-01

    One hundred and seventy-three underwent proximal gastric vagotomy for duodenal ulceration over a 6-year period. One hundred and fifteen of these have been followed up for 1-5 years. The operative mortality was nil and the result was satisfactory in 91 per cent. The incidence of side effects was small, notably that of dumping being 2.4 per cent and of diarrhoea, 3.6 per cent. Incidence of postoperative heartburn was reduced from 13 per cent to 4 per cent by the introduction of hepatic interposition. The incidence of recurrent ulceration was 5.1 per cent after an average interval of 2 years and that of new gastric ulceration 2.6 per cent after an average of 4 years. There were no recurrent ulcers in those who had peroperative Burge tests, although secretory studies showed no difference between those tested and those not tested. Most recurrences occurred in the earliest cases operated on before Burge testing was introduced and when only 2 cm of the lower oesophagus were exposed.

  10. Excimer ultraviolet sources for thin film deposition: a 15 year perspective

    Science.gov (United States)

    Boyd, Ian W.; Liaw, Irving I.

    2010-02-01

    High intensity intensity ultraviolet (UV) and vacuum ultraviolet (VUV) radiation provide a singular dominant narrow-band emission at various wavelengths(λ) between 108 - 351 nm. The use of dielectric-barrier discharges in its embodiment of an excimer lamp as a photon-source provides a novel method to induce surface modification. From its in relatively humble beginnings in ozone generation, the excimer lamp has found new applications in the field of low-temperature processing of surfaces. Herein, a 15 year perspective of work done at the Materials & Devices Group at University College London between 1992 and 2007 is presented. The excimer lamps' application to the modification of surfaces for materials processing include: photo-induced formation of high-κ dielectric thin films and more recently the UV-induced photo-doping of silicon substrates, amongst others. With its robust yet inexpensive setup and flexibility of geometric configurations, they are easily coupled in parallel resulting in the provision of high photon fluxes over large areas. These sources also have an incoherent and almost monochromatic selectivity for application to process chemical pathway specific tasks by simple variation of the discharge gas mixture. These sources are an interesting addition to and an alternative to lasers for scalable industrial applications and have potential for a myriad of applications across different fields.

  11. Hearing and loud music exposure in 14-15 years old adolescents

    Directory of Open Access Journals (Sweden)

    Mario R Serra

    2014-01-01

    The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs were classified as: normal (Group 1, slightly shifted (Group 2, and significantly shifted (Group 3. The musical general exposure (MGE, from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01, in Group 3 compared with Group 2 (P < 0.05 only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01. Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05 and in Group 3 compared with Group 1 (P < 0.05. A significant difference (P < 0.05 was found in Group 1′s HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2 dBA and PMPs (82.9-104.6 dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

  12. A 15 year record of frontal glacier ablation rates estimated from seismic data

    Science.gov (United States)

    Köhler, Andreas; Nuth, Christopher; Kohler, Jack; Berthier, Etienne; Weidle, Christian; Schweitzer, Johannes

    2016-12-01

    We present a unique time series of continuous glacier frontal ablation rates with weekly resolution over 15 years estimated from seismic calving observations at Kronebreen, Svalbard. Using linear statistical models, we calibrate the seismic record with 7 years of satellite-derived frontal ablation measurements. The two basic input parameters required for our models are the cumulative duration of individual seismic calving events and the incompleteness of the seismic record to correct for the effect of seismic background noise. Frontal ablation follows the seasonal glacier speedup, peaking 1-2 months after the melt season maximum. Short-lived peaks are associated with melt and rain events. Cumulative frontal ablation of Kronebreen between 2001 and 2015 is about 4.0 km3 (3.7 Gt), with the greatest annual loss (0.45 km3) between 2013 and 2014 at the onset of the recent accelerated retreat of the glacier. Our approach provides a potential method for monitoring tidewater glaciers worldwide that have sufficiently close seismic instrumentation.

  13. [Pseudotumoral pelvic actinomycosis in a woman who had been using an IUD for 15 years].

    Science.gov (United States)

    Ben Nasr, R; Ben Othman, M; Cammoun, M

    1989-01-01

    A 56-year-old woman was referred to a hospital in Tunis for a tumor of the right ovary. The patient had had 11 term pregnancies and had been using an IUD with no medical supervision for 15 years. She complained of recent constipation and weight loss. The uterus was of normal size but of hard consistency and fixed to the sacrum. A cervical smear was normal. The patient was found to be anemic and the sedimentation rate was accelerated. A diagnosis of probably malignant tumor of the right ovary was made and a hysterectomy with bilateral ovarectomy was performed after laparotomy. The patient left the hospital after receiving a prescription for ampicillin and was lost to follow-up. Histological examination showed the mass to be comprised of inflammatory fibrous and granulomatous tissue with numerous abscesses of a filamentous, strongly eosinophilic character suggesting actinomycosis. Pelvic actinomycosis is a rare chronic infection caused by a gram positive anaerobic bacteria, Actinomyces Israeli. The clinical signs usually include anemia, weight loss, and pelvic mass. Clinical diagnosis is difficult, and diagnosis is usually based on histological and bacteriologic examination. Observation of the symptoms in association with IUD use suggests actinomycosis. The treatment of choice combines surgery with antibiotic therapy for 2 months. Cervical smears should be regularly scheduled for IUD users not only to screen for prenoplastic and neoplastic lesions but to indicate actinomycosis at an early stage when treatment will allow serious complications to be avoided.

  14. Social background, bullying, and physical inactivity: National study of 11- to 15-year-olds.

    Science.gov (United States)

    Henriksen, P W; Rayce, S B; Melkevik, O; Due, P; Holstein, B E

    2016-10-01

    More children from lower social backgrounds are physically inactive than those from higher ones. We studied whether bullying was a mediating factor between lower social background and physical inactivity. We also examined the combined effect of low social class and exposure to bullying on physical inactivity. The Danish sample of the Health Behaviour in School-aged Children (HBSC) study 2006 included 6269 schoolchildren in three age groups: 11-, 13-, and 15-year-olds from a random sample of 80 schools. The students answered the internationally standardized HBSC questionnaire. The applied definition leaves 4.0% in the category physically inactive. The sex and age-adjusted OR (95% CI) for physical inactivity was 2.10 (1.39-3.18) among students with low social class and unclassifiable 3.53 (2.26-5.53). Exposure to bullying was associated with physical inactivity, sex and age-adjusted OR = 2.39 (1.67-3.41). Exposure to bullying did not explain the association between social class and physical inactivity. The association between social class and physical inactivity was more pronounced among participants also exposed to bullying. In conclusion, there was a significantly increased odds ratio for physical inactivity among students from lower social classes and for students exposed to bullying. There was a combined effect of low social class and bullying on physical inactivity. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. TEN DAYS TRAINING EFECTIVITY ON MEASURED SPECIFIC MOTOR ABILITIES OF BASKETBALL PLAYERS 15 YEARS OF AGE

    Directory of Open Access Journals (Sweden)

    Pavle Rubin

    2009-11-01

    Full Text Available Research took place in the basketball camp “Kikinda 07”. The sample consisted of 20 basketball players, 15 years of age (cadets, from Kikindas basketball clubs. On the inicial (9.VIII 2007. year and final (19.VIII 2007. year measurement, 9 tests spe- cific motor abilities (SMA were done: Player movement with the ball, Ball manipulation and Player movement without the ball. The aim was to prove 10 days training efektivity (15 trainings at 90 min. on specific motor abilities (SMA at cadets. Basketball players (cadets were trained under programme made by author of this research. The differences between two measurements (initial and final were proven using multivariate analysis of variance (MANOVA. Using this results the significant statistical difference appeared between two measuremeents (on .00 level. Univariate analysis of variance (ANOVA proved a statistical significant better results after training (in final measurement in 4 tests (variable: “Kamikaze” (shorted with driving (on .05 level; Driving the ball aro- und central circle (on .00 level (for SMA measurement movement player with a ball; and for SMA ball manipulation: Driblling with variations and Circling with ball around a body (on .00 level.

  16. [FREQUENCIES OF FETAL CHROMOSOMAL ABERRATIONS DETECTED BY AMNIOCENTESIS: OUR 15-YEARS EXPERIENCE].

    Science.gov (United States)

    Stoyanova, V; Ivanov, H; Linev, A; Vachev, T

    2015-01-01

    Amniocentesis is the most common and reliable prenatal diagnostic method for chromosomopathies. The purpose of the present study is to retrospectively evaluate our 15-year experience with prenatal cytogenetic diagnosis by amniocentesis, focusing on the indications and rates of chromosome abnormalities. The current study involve prenatal cytogenetic analysis from 564 amniocentesis performed at the Department of Medical Genetics, St. George University Hospital, Plovdiv between January 2000 and December 2014. Among clinical indications, abnormal maternal serum screening results (54.96%; 310/564) have been the most common indication for amniocentesis. Chromosomal abnormalities were detected in 5.5% (31/546) of cases. Structural rearrangements were the most common abnormality found (16/3 1;51,61%) with prevalence of balanced aberrations--11 cases. The highest detection rate of chromosome aberrations was in cases undergoing amniocentesis due to known family history of chromosomal abnormality (15.1%), followed by abnormal fetal ultrasound finding group (7.69%), increasing-risk maternal prenatal screening results (4.52%), and advanced maternal age (3.28%). This study provides important information for prenatal genetic counseling of families at risk with aim of prenatal care and prevention during pregnancies.

  17. Invasive fungal sinusitis in patients with hematological malignancy: 15 years experience in a single university hospital in Taiwan

    Science.gov (United States)

    2011-01-01

    Background Risk factors and outcomes in hematological patients who acquire invasive fungal sinusitis (IFS) are infrequently reported in the modern medical era. Method A retrospective study of hospitalized patients with hematological disease was conducted at National Taiwan University Hospital between January 1995 and December 2009. Results Clinical characteristics and outcomes with their associated radiographic and microbiological findings were analyzed. Forty-six patients with IFS and 64 patients with chronic non-invasive sinusitis were enrolled as comparsion. IFS developed more commonly in patients with acute myeloid leukemia (AML) and with prolonged neutropenia (absolute neutrophil count less than 500/mm3 for more than 10 days) (p sinus infiltration was found in 15 of 46 (33%) patients on imaging. Overall, 19 of 46 patients (41.3%) died within 6 weeks. Patients with disease subtype of AML (p = 0.044; Odds Ratio [OR], 5.84; 95% confidence interval [95% CI], 1.02-30.56) and refractory leukemia status (p = 0.05; OR, 4.27; 95% CI, 1.003-18.15) had worse prognosis. Multivariate analysis identified surgical debridement as an independent good prognostic factor (p = 0.047) in patients with IFS. Conclusions Patients of AML with prolonged neutropenia (> 10 days) had significantly higher risk of IFS. Early introduction of anti-fungal agent and aggressive surgical debridement potentially decrease morbidity and mortality in high risk patients with IFS. PMID:21939544

  18. Within-person reproducibility of red blood cell mercury over a 10- to 15-year period among women in the Nurses' Health Study II

    DEFF Research Database (Denmark)

    Kioumourtzoglou, Marianthi-Anna; Roberts, Andrea L; Nielsen, Flemming;

    2016-01-01

    assessed within-person reproducibility of red blood cell (RBC) mercury (Hg), a marker of methyl-mercury, over 10-15 years in a sample of 57 women. Fifty-seven women from the Nurses' Health Study II provided two blood samples 10-15-years apart (median: 12 years), which were analyzed for mercury levels...... in the red blood cells (B-Hg*). To characterize within-person reproducibility, we estimated correlation and intraclass correlation coefficients (r and ICC) across the two samples. Further, we compared different prediction models, including variables on fish and seafood consumption, for B-Hg* at the first.......8% of the variability in that B-Hg*, giving a correlation of r=0.52. Despite decreasing B-Hg* levels over time, we observed strong correlations and high ICC estimates across B-Hg* measured 10-15 years apart, suggesting good relative within-person stability over time. Our results indicate that a single measurement of B...

  19. Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience.

    Science.gov (United States)

    Rampelli, S K; Rajesh, N G; Srinivas, B H; Harichandra Kumar, K T; Swaminathan, R P; Priyamvada, P S

    2016-01-01

    There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN) in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 31; 77.5%) followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20%) and anti-glomerular basement membrane disease (n = 1; 2.5%). The most common etiology of ICGN was IgA nephropathy (n = 11; 27.5%) followed by lupus nephritis (n = 7; 17.5%) and post-infectious glomerulonephritis (PIGN) (n = 7; 17.5%). The patients with PauciGN were significantly older compared to those with ICGN (44.5 ± 15 years vs. 31.8 ± 11 years; P = 0.01). The patients with PauciGN presented with significantly higher serum creatinine (9.7 ± 4.4 vs. 6.6 ± 3.3 mg/dl; P = 0.03). The histopathologic parameters of ICGN and PauciGN were comparable except for a higher proportion of sclerosed glomeruli in ICGN. At the end of 3 months follow-up, only two patients went into complete remission (5.4%). Majority of the patients had end-stage renal failure (48.6%) and were dialysis dependent and seven patients (18.9%) expired. There was no signifi difference in the renal survival (10.9 ± 1.9 vs. 9.6 ± 3.3 months) or patient survival (17.5 ± 2.1 vs. 17.3 ± 4.3 months). The parameters associated with adverse outcomes at 3 months were hypertension (odds ratio [OR]: 0.58; confidence interval [CI]: 0.36-0.94), need for renal replacement therapy (OR: 0.19; CI: 0.04-0.9), serum creatinine at admission (P = 0.019), estimated glomerular filtration rate (P = 0.022) and percentage of fibrocellular crescents (P = 0.022).

  20. Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience

    Directory of Open Access Journals (Sweden)

    S K Rampelli

    2016-01-01

    Full Text Available There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN was the most common etiology (n = 31; 77.5% followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20% and anti-glomerular basement membrane disease (n = 1; 2.5%. The most common etiology of ICGN was IgA nephropathy (n = 11; 27.5% followed by lupus nephritis (n = 7; 17.5% and post-infectious glomerulonephritis (PIGN (n = 7; 17.5%. The patients with PauciGN were significantly older compared to those with ICGN (44.5 ± 15 years vs. 31.8 ± 11 years; P = 0.01. The patients with PauciGN presented with significantly higher serum creatinine (9.7 ± 4.4 vs. 6.6 ± 3.3 mg/dl; P = 0.03. The histopathologic parameters of ICGN and PauciGN were comparable except for a higher proportion of sclerosed glomeruli in ICGN. At the end of 3 months follow-up, only two patients went into complete remission (5.4%. Majority of the patients had end-stage renal failure (48.6% and were dialysis dependent and seven patients (18.9% expired. There was no signifi difference in the renal survival (10.9 ± 1.9 vs. 9.6 ± 3.3 months or patient survival (17.5 ± 2.1 vs. 17.3 ± 4.3 months. The parameters associated with adverse outcomes at 3 months were hypertension (odds ratio [OR]: 0.58; confidence interval [CI]: 0.36–0.94, need for renal replacement therapy (OR: 0.19; CI: 0.04–0.9, serum creatinine at admission (P = 0.019, estimated glomerular filtration rate (P = 0.022 and percentage of fibrocellular crescents (P = 0.022.

  1. Prevalence and self perception of Dental Fluorosis among 15 year old school children in Prakasham district of south India

    OpenAIRE

    Naidu, Guntipalli. M; Rahamthullah, S. A. K. Uroof; Kopuri, Raj Kumar Chowdary; Kumar, Y Anil; Suman, S V; Balaga, Ramesh Naidu

    2013-01-01

    Background: To assess the Prevalence and self perception of dental fluorosis among 15 - year old school children. Materials & Methods: A cross sectional study was conducted on 840, 15 - year old school children from 12 schools of Prakasam district. After taking informed consent from their parents or legal representatives, an interview was conducted using a pretested questionnaire to collect the data regarding self perception of dental fluorosis, dental behaviour, and source of water ...

  2. Arterial pseudoaneurysms following hepato-pancreato-biliary surgery: a single center experience.

    Science.gov (United States)

    Ielpo, Benedetto; Caruso, Riccardo; Prestera, Antonio; De Luca, Giuseppe Massimiano; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Olivares, Sergio; Quijano, Yolanda; Vicente, Emilio

    2015-01-31

    Arterial pseudoaneurysm is an uncommon lethal complication following hepato-pancreato-biliary surgery. Aim of this study is to present and discuss the experience of a high volume oncological center. Since 2007 all major surgeries performed at Sanchinarro Oncological Center have been included in a prospective database looking for postoperative arterial pseudonaurysm. Until June 2014, among 559 hepato-pancreato-biliary procedures, a total of 14 arterial pseudoaneurysms have been identified (2.5%). Sentinel bleeding was in 57% of cases. Failed arterial embolization occurred in 2 cases. Overall mortality rate was 28.5%. We also identified 3 asymptomatic pseudoaneurysms, one of them managed without embolization, developing a sudden bleeding and died after surgery. According to our experience, pseudoaneurysm incidence is higher than reported in current literature and it can be successfully managed through arterial embolization. Furthermore, we found 3 asymptomatic pseudoaneurysms, whose management is still controversial.

  3. Causes of amenorrhea in Korea: Experience of a single large center

    OpenAIRE

    2014-01-01

    Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea wer...

  4. Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Holme Hansen, Ebba; Due, Pernille;

    2003-01-01

    difficulties. CONCLUSION: A high proportion of 11-15-year-old girls and boys reported medicine use in relation to common health complaints. The proportion of users increased during the past decade. It is suggested that more information about medicine be built into health education programs in the future.......AIMS: To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep. METHODS: Four cross......: A large proportion of 11-15-year-olds reported medicine use during the past month. It was most common to take medicines for headache (used by 55% of 15-year-old girls and 36% of 15-year-old boys in 1998) and stomach ache (33% among 15-year-old girls in 1998). Pain reliever use was higher among girls than...

  5. Single plus one port laparoscopic radical prostatectomy:a report of 8 cases in one center

    Institute of Scientific and Technical Information of China (English)

    GAO Yi; XU Dan-feng; LIU Yu-shan; CUI Xin-gang; CHE Jian-ping; YAO Ya-cheng; YIN Lei

    2011-01-01

    Laparoscopic radical prostatectomy is considered the first treatment of choice for local prostate cancer due to its minimal invasion advantage. To further achieve the goal of minimal invasion, single port laparoscopic radical prostatectomy has been developed to minimize the complications associated with puncture tracks. The aim of this study was to illustrate the technique for single port laparoscopic radical prostatectomy and evaluate its efficacy and safety. We reported 8 cases of radical prostatectomy with excellent early outcome carried out in Shanghai Changzheng Hospital from June 2009 to August 2009 using a home-made multiple instrument access port and adding an additional small incision at McBumey point.

  6. ALH84001: The Key to Unlocking Secrets About Mars-15 Years and Counting

    Science.gov (United States)

    Gibson, Everett K.

    2011-01-01

    From the December 27, 1984 discovery of ALH84001, and its subsequent identification as a sample of Mars in 1993, mystery and debate has surrounded the meteorite. With the realization that the ALH84001 sample was a orthopyroxenite and one of the oldest SNC meteorites (4.09 Ga) available to study, important and critical information about the Martian hydrosphere and atmosphere along with the early history and evolution of the planet could be obtained by studying the unique carbonate globules (3.9 Ga) in the sample. The initial work showed the carbonate globules were deposited within fractures and cracks in the host-orthopyroxene by low-temperature aqueous fluids. Ideas that the carbonates were formed at temperatures approaching 800oC were ruled out by later experiments. The 1996 announcement by McKay et al. that ALH84001 contained features which could be interpreted as having a biogenic origin generated considerable excitement and criticism. The NASA Administrator Dan Golden said the 1996 ALH84001 announcement saved NASA s Mars planetary exploration program and injected $6 billion dollars over five years into the scientific research and analysis efforts. All of the original four lines of evidence for possible biogenic features within ALH84001 offered by McKay et al. have withstood the test of time. Criticism has been directed at the interpretation of the 1996 analytical data. Research has expanded to other SNC meteorites. Despite the numerous attacks on the ideas, the debate continues after 15 years. The 2009 paper by Thomas-Keprta et al. on the origins of a suite of magnetites within the ALH84001 has offered strong arguments that some of the magnetites can only be formed by biogenic processes and not from thermal decomposition or shock events which happened to the meteorite. NASA s Astrobiology Institute was formed from the foundation laid by the ALH84001 hypothesis of finding life beyond the Earth. The strong astrobiology outreach programs have expanded because of

  7. A 15 year legacy of cloud and atmosphere observations in Barrow, Alaska

    Science.gov (United States)

    Shupe, M.

    2012-12-01

    For the past 15 years, the U.S. Department of Energy Atmospheric Radiation Measurement (ARM) Program has operated the North Slope of Alaska (NSA) atmospheric observatory in Barrow, Alaska. Barrow offers many valuable perspectives on the Arctic environment that complement observations at lower latitudes. Unique features of the Arctic region include cold and dry atmospheric conditions, strong annual variability in sun light, a seasonally high-reflective surface, and persistent clouds that involve mixed-phase processes. ARM's ultimate objective with its flagship observatory at the northernmost point in U.S. territory is to provide measurements that can be used to improve the understanding of these atmospheric physical and radiative properties and processes such that they can be better represented in climate models. The NSA is the most detailed and long-lasting cloud-radiation-atmosphere observatory in the Arctic, providing continuous, sophisticated measurements of climate-relevant parameters. Instrument suites include active radars and lidars at various frequencies, passive radiometers monitoring radiation in microwave, infrared, visible and ultraviolet wavelengths, meteorological towers, and sounding systems. Together these measurements are used to characterize many of the important properties of clouds, aerosols, atmospheric radiation, dynamics, thermodynamics, and the surface. The coordinated nature of these measurements offers important multi-dimensional insight into many fundamental processes linking these different elements of the climate system. Moreover, the continuous operations of the facility support these observations over the full diurnal cycle and in all seasons of the year. This presentation will highlight a number of important studies and key findings that have been facilitated by the NSA observations during the first 15 years in operation. Some of these include: a thorough documentation of clouds, their occurrence frequency, phase, microphysical

  8. Contribution of Health Researches in National Knowledge Production: A Scientometrics Study on 15-Year Research Products of Iran.

    Science.gov (United States)

    Djalalinia, Shirin; Peykari, Niloofar; Eftekhari, Monir Baradaran; Sobhani, Zahra; Laali, Reza; Qorbani, Omid Ali; Akhondzadeh, Shahin; Malekzadeh, Reza; Ebadifar, Asghar

    2017-01-01

    Researchers, practitioners, and policymakers call for updated valid evidence to monitor, prevent, and control of alarming trends of health problems. To respond to these needs, health researches provide the vast multidisciplinary scientific fields. We quantify the national trends of health research outputs and its contribution in total science products. We systematically searched Scopus database with the most coverage in health and biomedicine discipline as the only sources for multidisciplinary citation reports, for all total and health-related publications, from 2000 to 2014. These scientometrics analyses covered the trends of main index of scientific products, citations, and collaborative papers. We also provided information on top institutions, journals, and collaborative research centers in the fields of health researches. In Iran, over a 15-year period, 237,056 scientific papers have been published, of which 81,867 (34.53%) were assigned to health-related fields. Pearson's Chi-square test showed significant time trends between published papers and their citations. Tehran University of Medical Sciences was responsible for 21.87% of knowledge productions share. The second and the third ranks with 11.15% and 7.28% belonged to Azad University and Shahid Beheshti University of Medical Sciences, respectively. In total fields, Iran had the most collaborative papers with the USA (4.17%), the UK (2.41%), and Canada (0.02%). In health-related papers, similar patterns of collaboration followed by 4.75%, 2.77%, and 1.93% of papers. Despite the ascending trends in health research outputs, more efforts required for the promotion of collaborative outputs that cause synergy of resources and the use of practical results. These analyses also could be useful for better planning and management of planning and conducting studies in these fields.

  9. Contribution of health researches in national knowledge production: A scientometrics study on 15-year research products of Iran

    Directory of Open Access Journals (Sweden)

    Shirin Djalalinia

    2017-01-01

    Full Text Available Background: Researchers, practitioners, and policymakers call for updated valid evidence to monitor, prevent, and control of alarming trends of health problems. To respond to these needs, health researches provide the vast multidisciplinary scientific fields. We quantify the national trends of health research outputs and its contribution in total science products. Methods: We systematically searched Scopus database with the most coverage in health and biomedicine discipline as the only sources for multidisciplinary citation reports, for all total and health-related publications, from 2000 to 2014. These scientometrics analyses covered the trends of main index of scientific products, citations, and collaborative papers. We also provided information on top institutions, journals, and collaborative research centers in the fields of health researches. Results: In Iran, over a 15-year period, 237,056 scientific papers have been published, of which 81,867 (34.53% were assigned to health-related fields. Pearson's Chi-square test showed significant time trends between published papers and their citations. Tehran University of Medical Sciences was responsible for 21.87% of knowledge productions share. The second and the third ranks with 11.15% and 7.28% belonged to Azad University and Shahid Beheshti University of Medical Sciences, respectively. In total fields, Iran had the most collaborative papers with the USA (4.17%, the UK (2.41%, and Canada (0.02%. In health-related papers, similar patterns of collaboration followed by 4.75%, 2.77%, and 1.93% of papers. Conclusions: Despite the ascending trends in health research outputs, more efforts required for the promotion of collaborative outputs that cause synergy of resources and the use of practical results. These analyses also could be useful for better planning and management of planning and conducting studies in these fields.

  10. 15 years of research on Oral-Facial-Digital syndromes: from 1 to 16 causal genes

    Science.gov (United States)

    Bruel, Ange-Line; Franco, Brunella; Duffourd, Yannis; Thevenon, Julien; Jego, Laurence; Lopez, Estelle; Deleuze, Jean-François; Doummar, Diane; Giles, Rachel H.; Johnson, Colin A.; Huynen, Martijn A.; Chevrier, Véronique; Burglen, Lydie; Morleo, Manuela; Desguerres, Isabelle; Pierquin, Geneviève; Doray, Bérénice; Gilbert-Dussardier, Brigitte; Reversade, Bruno; Steichen-Gersdorf, Elisabeth; Baumann, Clarisse; Panigrahi, Inusha; Fargeot-Espaliat, Anne; Dieux, Anne; David, Albert; Goldenberg, Alice; Bongers, Ernie; Gaillard, Dominique; Argente, Jesús; Aral, Bernard; Gigot, Nadège; St-Onge, Judith; Birnbaum, Daniel; Phadke, Shubha R.; Cormier-Daire, Valérie; Eguether, Thibaut; Pazour, Gregory J.; Herranz-Pérez, Vicente; Lee, Jaclyn S.; Pasquier, Laurent; Loget, Philippe; Saunier, Sophie; Mégarbané, André; Rosnet, Olivier; Leroux, Michel R.; Wallingford, John B.; Blacque, Oliver E.; Nachury, Maxence V.; Attie-Bitach, Tania; Rivière, Jean-Baptiste; Faivre, Laurence; Thauvin-Robinet, Christel

    2017-01-01

    Oral-facial-digital syndromes (OFDS) gather rare genetic disorders characterized by facial, oral and digital abnormalities associated with a wide range of additional features (polycystic kidney disease, cerebral malformations and several others) to delineate a growing list of OFD subtypes. The most frequent, OFD type I, is caused by a heterozygous mutation in the OFD1 gene encoding a centrosomal protein. The wide clinical heterogeneity of OFDS suggests the involvement of other ciliary genes. For 15 years, we have aimed to identify the molecular bases of OFDS. This effort has been greatly helped by the recent development of whole exome sequencing (WES). Here, we present all our published and unpublished results for WES in 24 OFDS cases. We identified causal variants in five new genes (C2CD3, TMEM107, INTU, KIAA0753, IFT57) and related the clinical spectrum of four genes in other ciliopathies (C5orf42, TMEM138, TMEM231, WDPCP) to OFDS. Mutations were also detected in two genes previously implicated in OFDS. Functional studies revealed the involvement of centriole elongation, transition zone and intraflagellar transport defects in OFDS, thus characterizing three ciliary protein modules: the complex KIAA0753-FOPNL-OFD1, a regulator of centriole elongation; the MKS module, a major component of the transition zone; and the CPLANE complex necessary for IFT-A assembly. OFDS now appear to be a distinct subgroup of ciliopathies with wide heterogeneity, which makes the initial classification obsolete. A clinical classification restricted to the three frequent/well-delineated subtypes could be proposed, and for patients who do not fit one of these 3 main subtypes, a further classification could be based on the genotype. PMID:28289185

  11. Body image and weight control in South Africans 15 years or older: SANHANES-1.

    Science.gov (United States)

    Mchiza, Zandile J; Parker, Whadi-Ah; Makoae, Mokhantso; Sewpaul, Ronel; Kupamupindi, Takura; Labadarios, Demetre

    2015-09-30

    South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap. Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity. Body mass index appears to influence body image and weight adjustment in South Africa. South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.

  12. Adherence to osteoporosis medicines in Estonia-a comprehensive 15-year retrospective prescriptions database study.

    Science.gov (United States)

    Laius, Ott; Pisarev, Heti; Maasalu, Katre; Kõks, Sulev; Märtson, Aare

    2017-12-01

    Some patients do not take medicines as they are supposed to. Our research showed that in Estonia, one fifth of patients did not start treatment with osteoporosis medicines and only 20% used the medicines for at least 3 years as they should. This induces unnecessary costs to the healthcare system. Medication non-adherence is the number one reason for not obtaining the expected clinical effect of medicines. With osteoporosis treatment, it has been shown that both implementation of treatment and persistence influence the risk of fractures significantly. Long-term adherence to medication in Estonia is to be determined with this study. A 15-year retrospective study was carried out in order to establish initiation, implementation, and persistence of Estonian patients. All new users of osteoporosis medicines were analyzed for all prescriptions they received during the study period. Sufficient adherence to treatment was defined as a patient being dispensed 80% or more prescribed doses for at least 1 year. The study period was from 2001 to 2015. Patients (24,652) were included in the study. Of the patients, 93.7% (n = 23,091) were women and 6.3% (n = 1564) were men. Eighteen percent (4636) were dispensed only one prescription. Of the patients, 44.2% included in the study had medication possession ratio (MPR) ≥80% over follow-up period; 8922 (36.2%) who were prescribed from 2001 to 2015 persisted for 1 year with MPR ≥80% and 19.8% persisted for 3 years. Forty percent of expenditure on osteoporosis medication was made for treatment courses with insufficient adherence. There is room for improvement in Estonia with medication adherence relating to all three aspects that determine adherence-initiation, implementation, and persistence. This means further efforts are to be made to educate patients and healthcare professionals on realizing the importance of good adherence.

  13. [Social stratification and nutritional anthropometry in children under 15 years old La Escalera, Lara State, Venezuela].

    Science.gov (United States)

    Torres-Villanueva, Mario; Dellán-Rodríguez, Graciela; Papale-Centofanti, Jham; Rodríguez, Dioslibeth; Mendoza, Norelis; Berné, Yelitza

    2007-09-01

    Malnutrition is a public health problem for underdeveloped countries. From the 852 million of undernourished estimated by FAO between 2000 and 2002, 815 million belonged to underdeveloped countries, 28 million to countries in transition and 9 million to developed countries. Malnutrition in Venezuela had a 6% raise between 2000 and 2002, when it went from 11% to 17%. This work was done with children under 15 years old from La Escalera, using classic indicators and their combination, relating them with socioeconomic conditions, through the NBI and Graffar Méndez Castellano methods, as to consider the population nutritional profile. The higher prevalence corresponded to normal nutritional values, which oscillated between 55,7% and 80,7% in the 7-14 years old group and the 2-6 years old group, respectively. Malnutrition was found in the under 2 years old group and 7-14 years old group, with values ranging between 12,5 and 41,0% respectively. The least prevalence was found for excess malnutrition. 100% of the families in this study are poor, according to NBI; although the Graffar Mendez Castellano method established that poverty was about 60%, while 40% belonged to a medium-low status. Relating nutritional diagnosis with social stratification and the mother's educational level, three patterns were observed: III, IV and V, prevailing normal diagnosis, followed by malnutrition by deficit and malnutrition by excess, respectively. The predominating mother's educational level corresponded to incomplete high school, followed by analphabetism and the least prevalent has complete basic elementary education. It should be noted that the nutrition deficit was inversely related to the socioeconomic stratification and the mother's educational level.

  14. The Bender Gestalt test for 5- to 15-year old Brazilian children: norms and validity.

    Science.gov (United States)

    Brito, G N; Santos, T R

    1996-11-01

    Norms for two modalities (normal and stress) of the Bender Gestalt test were developed for the neuropsychological assessment of children in the greater Rio de Janeiro area. For each modality, a measure of performance, a measure of speed and a measure of emotional disturbance were obtained. A total of 398 children (199 males and 199 females), 5 to 15 years old, who were attending a public school in Niterói were the subjects of this study. Analysis of the data revealed that age, but not sex, had a significant effect on performance, but not on speed, in both modalities such that older children made fewer errors than younger children. Also, the number of emotional indicators significantly decreased with age. Additionally, boys needed more time to complete the normal modality than girls, and showed a higher number of emotional indicators in both modalities. The Bender test was found to be valid in the sense that children who had failed at least one grade in school performed worse than those who had not. The number of emotional indicators was shown to be valid since it was significantly correlated with factors such as hyperactivity-conduct problem, and independent functioning, and inattention of the Composite Teacher Rating Scale (Brito GNO and Pinto RCA (1991). Journal of Clinical and Experimental Neuropsychology, 13: 417-418). We conclude that the Bender test is valid for use in schoolchildren, and the number of emotional indicators is valid as an index of psychopathology, but sex and age should be considered when using the norms in Brazil.

  15. Association between earthquake events and cholera outbreaks: a cross-country 15-year longitudinal analysis.

    Science.gov (United States)

    Sumner, Steven A; Turner, Elizabeth L; Thielman, Nathan M

    2013-12-01

    Large earthquakes can cause population displacement, critical sanitation infrastructure damage, and increased threats to water resources, potentially predisposing populations to waterborne disease epidemics such as cholera. Problem The risk of cholera outbreaks after earthquake disasters remains uncertain. A cross-country analysis of World Health Organization (WHO) cholera data that would contribute to this discussion has yet to be published. A cross-country longitudinal analysis was conducted among 63 low- and middle-income countries from 1995-2009. The association between earthquake disasters of various effect sizes and a relative spike in cholera rates for a given country was assessed utilizing fixed-effects logistic regression and adjusting for gross domestic product per capita, water and sanitation level, flooding events, percent urbanization, and under-five child mortality. Also, the association between large earthquakes and cholera rate increases of various degrees was assessed. Forty-eight of the 63 countries had at least one year with reported cholera infections during the 15-year study period. Thirty-six of these 48 countries had at least one earthquake disaster. In adjusted analyses, country-years with ≥10,000 persons affected by an earthquake had 2.26 times increased odds (95 CI, 0.89-5.72, P = .08) of having a greater than average cholera rate that year compared to country-years having cholera infections appeared to weaken as higher levels of cholera rate increases were tested. A trend of increased risk of greater than average cholera rates when more people were affected by an earthquake in a country-year was noted. However these findings did not reach statistical significance at traditional levels and may be due to chance. Frequent large-scale cholera outbreaks after earthquake disasters appeared to be relatively uncommon.

  16. Systolic blood pressure and (cardiac) mortality over 15 years after venous coronary bypass surgery.

    Science.gov (United States)

    Voors, A A; van Brussel, B L; Kelder, J C; Plokker, H W

    1997-10-01

    The aim of the present study was to determine the influence of pre-operative systolic blood pressure and systolic blood pressure 1 and 5 years after venous coronary bypass surgery on subsequent cardiac and non-cardiac mortality. A prospective 15 years follow-up study. A series of 446 consecutive coronary bypass surgery patients, operated on between April 1976 and April 1977. According to their systolic blood pressure, patients were divided into five groups. Systolic blood pressure 5 years after surgery, but not pre-operative systolic blood pressure, was an independent predictor of cardiac mortality. Multivariate Cox proportional hazards analysis revealed that pre-operative systolic blood pressure was not associated with cardiac mortality, while higher systolic blood pressure 1 year after surgery showed a trend towards increased cardiac mortality. Systolic blood pressure 5 years after surgery appeared to be a strong independent predictor of cardiac mortality during the subsequent follow-up period. Patients with a systolic blood pressure of 130-139 mmHg had the lowest risk. Compared to this group, the cardiac mortality risk in patients with a systolic blood pressure 5 years after surgery of 140-149 mmHg, 150-159 mmHg and > or = 160 mmHg, was 2.3 (1.2 to 4.6), 3.4 (1.6 to 7.1) and 3.1 (1.4 to 6.5) times higher. Systolic blood pressure < 130 mmHg 5 years after surgery was also associated with a 2.3 times (1.1 to 4.7) times increased risk for cardiac mortality, compared to patients with a systolic blood pressure of 130-139 mmHg. These findings underline the importance of systolic blood pressure control in the initial years after coronary bypass surgery.

  17. A 15-Year-Old Male Baseball Player With a Mass in the Brachialis Muscle.

    Science.gov (United States)

    Golub, Ivan J; Garcia, Roberto A; Wittig, James C

    2016-05-01

    A 15-year-old boy presented with a mass in his right arm after suffering a minor injury playing baseball. He had been diagnosed with a hematoma. There was no other outstanding medical/surgical history. Magnetic resonance images showed a heterogeneous mass arising from the brachialis muscle that mainly enhanced peripherally with extremely scant internal nodular enhancement. Core needle biopsy cells were positive for CD31 and CD34, markers for atypical endothelial cells, as well as MIB-1 and p53. The final diagnosis was an angiosarcoma of the brachialis muscle. Pediatric angiosarcoma, particularly within deep tissue, is exceedingly rare. Histological and immunohistochemical modalities led to the diagnosis. Magnetic resonance images suggested a mass with a large cystic/hemorrhagic space that could have been misconstrued as a hematoma had there been absolutely no nodular or septal enhancement. The patient underwent neoadjuvant chemotherapy and radiation before undergoing limb-sparing surgery that included resection of the mass with the brachialis muscle and short head of the biceps muscle. Neoadjuvant treatment was deemed successful due to a drastic reduction in the size of the tumor and 95% tumor necrosis. The patient was disease free 2 years postoperatively. There had been no local/systemic recurrences. He was pain free, had normal elbow function, and had returned to playing baseball. It is important to be extremely suspicious when a patient presents with a hemorrhagic, painless, enlarging mass after sustaining minor trauma. A careful and meticulous biopsy must be completed to achieve the correct diagnosis. Magnetic resonance imaging with gadolinium is recommended for evaluation because these masses can be often misinterpreted as hematomas. [Orthopedics. 2016; 39(3):e545-e548.].

  18. Characteristics of immune memory 10-15 years after primary hepatitis B vaccination.

    Science.gov (United States)

    Brunskole Hummel, Irena; Zitzmann, Anita; Erl, Monika; Wenzel, Jürgen J; Jilg, Wolfgang

    2016-01-27

    The definition of immune memory after hepatitis B vaccination is still under debate. Therefore, we analysed hepatitis B surface antigen (HBsAg)-specific memory in more detail by investigating the kinetics of humoral and cellular responses after hepatitis B booster vaccination. The anti-HBs kinetics of 23 individuals with anti-HBs titres below 10 IU/l, who had been vaccinated 10-15 years ago, was monitored at day 0, 3, 7, 14 and 28 after booster vaccination. HBsAg-specific IFNγ- and IL5-secreting cells in enriched CD4(+) fraction were measured at day 0, 7 and 28 post-booster by enzyme-linked immunospot assay (ELISpot). 22 of 23 subjects showed similar anti-HBs kinetic curves, including 3 of 4 subjects who did not reach anti-HBs titres of 10 IU/l. The steep anti-HBs increase started between day 3 and 7 and peaked around day 14. A plateau or only minimal changes were visible between day 14 and 28. 17.4% of subjects showed pre-booster cellular responses, and this rate had increased to 47.8% and 56.5% after 7 and 28 days, respectively. The kinetic patterns of T cell responses differed considerably among subjects. A dominance of Th2 responses (IL5 secretion) over Th1 responses (IFNγ secretion) could be observed. The presence of B cell memory could be shown by a typical anamnestic anti-HBs response curve after a booster dose in all but one individual. In contrast, T cell responses to booster vaccination, which occurred in approximately 50% of participants, were rather heterogeneous. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Behavioural early-life exposures and body composition at age 15 years.

    Science.gov (United States)

    Leary, S D; Lawlor, D A; Davey Smith, G; Brion, M J; Ness, A R

    2015-02-09

    Previous studies have demonstrated associations between some early-life exposures and later obesity, but most have used body mass index in childhood or adulthood as the outcome. The objective of this study was to investigate whether early-life exposures were associated with directly measured fat and lean mass in adolescence. This study used data on 4750 mother-offspring pairs, collected as a part of the Avon Longitudinal Study of Parents and Children, Bristol, UK between 1991 and 1992; associations between behavioural exposures occurring from conception up to 5 years of age (maternal and paternal smoking during pregnancy, breastfeeding, age at introduction to solids, dietary patterns and physical inactivity during early childhood) and offspring body composition measured by dual-energy X-ray absorptiometry at ~15 years were assessed. After full adjustment for potential confounders, maternal smoking during pregnancy, having a junk food diet and spending more time watching television in early childhood were all associated with higher fat mass at age 15, whereas maternal smoking, having a healthy diet and playing computer games more frequently in early childhood were all associated with a higher lean mass at age 15. Associations with paternal smoking were generally weaker for both fat and lean mass, but as there was no strong statistical evidence for maternal vs paternal differences, confounding by social factors rather than a direct effect of maternal smoking cannot be ruled out. Early feeding was not associated with fat or lean mass at age 15. This study does not provide compelling evidence for associations between most early-life factors and body composition in adolescence. However, possible associations with dietary patterns and physical inactivity in early childhood require further investigation in other cohorts that have direct measurements of adolescent body composition.

  20. Selected atherosclerosis risk factors in youth aged 13–15 years 

    Directory of Open Access Journals (Sweden)

    Agnieszka Michalska

    2012-09-01

    Full Text Available Introduction:The high frequency of cases of circulatory system conditions in Europe and other countries around the world requires scientific research to define risk factors of early atherosclerotic changes. The aim of the present study was to define which students are at danger of developing atherosclerosis by means of measuring cholesterol and triglyceride levels in blood as well as defining the correlation between atherosclerosis risk factors and arterial blood pressure, physical fitness and efficiency of the subjects.Material/Methods:The research covered 167 students of Public Junior High School ¹1 in Biala Podlaska aged 13–15 years. Accutrend GCT was employed to define the levels of total cholesterol and triglycerides in the screen test. Those students who were found to have increased values of biochemical parameters of capillary blood were subjected to additional blood tests aiming to define complete lipid profile of venous blood. The blood pressure in subjects was tested three times. The Moderate-to-Vigorous Physical Activity (MVPA test, suggested by American authors, was employed to define physical activity in subjects. EUROFIT was employed to define physical efficiency.Results:Among the 167 subjects there were found 42 students (25.1�20whose lipid level in capillary blood proved to be increased. Full lipid profile tests proved that 16 students (9.6�20had increased blood lipid levels; those subjects constituted the risk group. Subjects in the risk group were characterized by lower levels of physical activity and physical efficiency compared to subjects with normal blood lipid level. Moreover, the frequency of hypertension was greater in risk group subjects compared to subjects with normal blood lipid levels.Inferences:Students diagnosed with atherosclerosis risk factors require observation and early prophylactics by adopting habits of healthy physical activity.

  1. ADHD symptoms in children aged 5 to 15 years in Zhabei District, Shanghai

    Directory of Open Access Journals (Sweden)

    Wen-Lan Jin

    Full Text Available Background and Objectives: The prevalence of attention deficit hyperactivity disorder (ADHD and its related factors remains unclear in Shanghai.The aim of this study was to investigate the positive rates of ADHD symptoms and the associated factors in a sample of children aged 5 to 15 years in Zhabei District, Shanghai. Methods: The participants were selected by cluster-stratified sampling of the general information and responses gathered from questionnaires on ADHD symptoms. The questionnaires examined summed up to 9,627. The positive rates of inattention and hyperactivity-impulsivity symptoms and the socio-demographic factors were compared. Results: The positive rates of most ADHD symptoms decreased with age. Children between 5 and 7 years and between 7 and 9 years exhibited the highest ADHD positive rates. Boys showed a higher positive rate of ADHD symptoms compared to girls. Children who were local residents showed a higher rate than nonlocal residents and those of other nationalities. This might be related to the integration of immigrants and those belonging to lower socioeconomic classes. The positive rates of ADHD symptoms decreased with the educational level of the parents, while the parents'; level of education was associated with the severity of the ADHD symptoms. Problems of inattention were more common than problems of hyperactivity, as indicated by the positive rates. Conclusions: The improper educational guidance of ineffective parents, as well as simple and crude attitudes to education, may place children in such a conflicting state, gradually creating psychological problems and resulting in a lack of self-confidence and ADHD.

  2. [Pneumococcal meningitis in children under 15 years of age in Misiones (Argentina). Sixteen year's epidemiological surveillance].

    Science.gov (United States)

    Grenón, Sandra L; Salvi Grabulosa, Marcelo C; Regueira, Mabel M; Fossati, María S; von Specht, Martha H

    2014-01-01

    We report the results of pneumococcal meningitis surveillance conducted at the Provincial Pediatric Hospital of Posadas, Misiones (Argentina), before the conjugate vaccine was introduced into the national vaccination schedule. Between January 1994 and December 2009, 167 cases of Streptococcus pneumoniae meningitis were diagnosed in children aged 1 month to 15 years. The attack rate/100,000 children ranged from 19.2 (1997) to 4.3 (2009), with a mean of 10.6 and a tendency to decrease (y=-0.689x+16.52). The number of cases per 100,000 children decreased from 146.6 to 34.8 and particularly involved the group of children aged 1 to 11 months (94/167, 56%). Thirty point seven percent (30.7%) (46/150) of the isolates were resistant to penicillin whereas 16.7% (25/150) were non-susceptible to cefotaxime. β-lactam resistance increased as from 1997 and began to decline in 2005. Nineteen serotypes were detected; type 14 was predominant and accounted for 32% (40/125). Eighty four point eight percent (84.8%) of the isolates were circumscribed to nine serotypes: 14, 5, 1, 7F, 18C, 6B, 9N, 9V and 4. Theoretical coverage for patients aged 2 years was 84.1% (74/88) and 83.8% (31/37) for the 10-valent vaccine and 89.8 % (79/88) and 83.8% (31/37) for the 13-valent vaccine respectively. Penicillin resistance was restricted to 8 serotypes (14, 6B, 6A, 9V, 4, 23B, 19A1) and nonsusceptibility to cefotaxime was circumscribed to 3 serotypes (14, 9V and 1). This study will allow to evaluate the impact of the implementation of conjugate vaccines on our area.

  3. Ozone pollution during heat wave periods over last 15 years in Central Europe

    Science.gov (United States)

    Struzewska, J.; Kaminski, J. W.; Jefimow, M.

    2012-04-01

    Periods characterized with the high ozone concentrations are usually associated with very high air temperature and antycyclonic conditions or meridional circulation. A 15-year (1997 - 2011) maximum daily temperature records from GSOD NOAA archive was analyzed for 20 stations in Central Europe. For each year the number of days with the maximum temperature exceeding 25oC and 30oC was calculated. For years with a positive anomaly of the number of the hot days the data were analyzed to identify exact dates and the duration of such events. This allows classification of the high temperature period as "heat waves" (periods with maximum temperature exceeding 30oC lasting at least 3 consecutive days) and hot weather periods (periods with maximum temperature exceeding 25oC and high daily average temperature). These two types of high temperature are usually associated with different air masses inflow - subtropical from the south or transformed polar from westerly directions. This indicates also the differences in contribution of transboundary transport of ozone and its precursors. For selected high temperature episodes the ozone pollution was assessed based on AirBase (1997-2009) and national database (2010-2011). The analysis covered the 8-hour running average and daily maximum concentration of ozone near the surface. Also, the contribution to the SOMO35 index during selected episodes will be calculated as a diagnostic for adverse health effects. Since the two analyzed types of hot weather periods have different origin in terms of synoptic scale situation, an attempt will be made to answer whether there are differences in the intensity of ozone episodes during selected hot weather periods. The outcome from the study will be useful for the interpretation of modelling results for air quality in future climate.

  4. Skin and nipple-areola complex sparing mastectomy in breast cancer patients: 15-year experience.

    Science.gov (United States)

    Stanec, Zdenko; Žic, Rado; Budi, Srećko; Stanec, Sanda; Milanović, Rudolf; Vlajčić, Zlatko; Roje, Zeljka; Rudman, Franjo; Martić, Krešimir; Held, Rebeka; Božo, Gorjanc

    2014-11-01

    Skin and nipple-areola complex sparing mastectomy (SNSM) and primary reconstruction have been popular for breast cancer treatment in the last decade. An advantage of the SNSM technique is the removal of all breast tissue as a radical surgical procedure while preserving native breast integrity, nipple-areola complex (NAC), and submammary fold. This retrospective 15-year clinical study analyzes medical records from our breast surgery database collected at our department between 1997 and 2012. A total number of 3757 patients were treated for breast cancer; 411 (10.9%) patients had a skin-sparing mastectomy with the median (range) length follow-up of 63 months. This is the longest follow-up for SNSM in breast cancer patients; 3.7% of patients who underwent SNSM developed disease local recurrence, whereas occult NAC involvement with cancer occurred in 7.7% and local recurrence in the NAC in 1.2%. Partial necrosis of the NAC developed in 9.4% and total necrosis in 0.7% of operated breasts. All disease recurrences occurred in the first 10 years of the follow-up period. Local recurrence developed as first recurrence event has longer median cancer-specific survival time of 70 months than those with only distant metastases with 50 months and locoregional plus distant metastases with 35.5 months. The "Omega" pattern incision combines an oncological radical procedure with a lower incidence of skin flap necrosis. Patients reconstructed with autologous tissue were the group most satisfied. SNSM is an oncological safe procedure for breast cancer treatment with low recurrence in properly selected patients.

  5. Patients With Chronic Three-Vessel Disease in a 15-Year Follow-Up Study

    Science.gov (United States)

    Máchal, Jan; Pávková-Goldbergová, Monika; Hlinomaz, Ota; Groch, Ladislav; Vašků, Anna

    2014-01-01

    Abstract Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin–angiotensin–aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were obtained from the national insurance registry. All data were available in the case of 150 patients with 3VD. Statistical analysis used stepwise Cox regression with dominant, recessive, or additive mode of genetic expression. Involved variables included age, sex, BMI, blood pressure, diabetes, ejection fraction, left main stenosis, previously diagnosed coronary stenosis, myocardial infarction in personal history, and coronary bypass along with polymorphisms pre-selected by log-rank tests. Out of the 23 polymorphisms, four were included in the model construction. SNP in the IL-6 gene rs1800795 (−174 G/C) has been found to be a significant predictor of survival. This SNP was in a linkage disequilibrium with rs1800797 (−597 G/A) in the same gene (D′ = 1.0), which was also found to constitute a significant predictor of survival when rs1800795 was not included in the model construction. Age, increased BMI, diabetes, low EF, and left main stenosis were also significant predictors in all models. Age, increased BMI, diabetes, low ejection fraction, left main stenosis, and genetic variation in the IL-6 promoter were established as significant independent risk factors for the survival of patients with three-vessel disease. PMID:25526459

  6. Citation analysis of the Croatian Medical Journal: the first 15 years.

    Science.gov (United States)

    Kovacić, Natasa; Huić, Mirjana; Ivanis, Ana

    2008-02-01

    The Croatian Medical Journal (CMJ) is a bimonthly scientific journal, that publishes mostly original articles. It is indexed in the Index Medicus/MEDLINE, Current Contents/Clinical Medicine, and the Science Citation Index Expanded. Since the CMJ's 15th anniversary in 2007, our aim has been to assess the importance of the Journal through its impact factor (IF) and immediacy index, with a particular focus placed on the proportion of self-citations. According the Web of Knowledge database, the current official IF for the CMJ is 0.825, ranking it 62nd out of 103 journals within the Thomson Scientific category "Medicine - General and Internal." The exclusion of self-citations resulted in a small decrease in the journal's rank - to 66th place. According to the Web of Science database, the predicted CMJ IF in 2007 is between 1.024 and 1.125, showing a clear increase. The immediacy index of the CMJ is continuously low, with a high contribution of self-citations, implying that articles published in the CMJ require more time to be cited, and that their topics are of particular interest to the journal's readers and contributors. Self-citations contributed significantly to the IF in the first few years after the journal was established. The proportion of independent citations progressively increased, and of all the citations included in the IF in 2007, almost 70% were fully independent. Some of these citations were from articles published in journals with IF higher than 5. Taken together, our data suggest that the CMJ has significantly improved its citation ratings during the last 15 years, confirming that a quality-oriented editorial policy in a small peripheral journal may result in a truly increased international visibility.

  7. Seasonal variations in dermatologic and dermatopathologic diagnoses: a retrospective 15-year analysis of dermatopathologic data.

    Science.gov (United States)

    Harvell, Jeff D; Selig, Daniel J

    2016-10-01

    Certain dermatologic conditions are known to show seasonal variations in frequency, the reasons for which are unclear but in some cases may be attributable to changes in ambient weather conditions. The current study was conducted to determine whether seasonal trends might exist for dermatologic conditions including erythema multiforme, guttate psoriasis, erythema dyschromicum perstans (ashy dermatosis), pityriasis lichenoides, and pityriasis rosea. Data were derived from a 15-year retrospective review of electronic records from a large dermatopathology laboratory located in the mid-Atlantic region of the USA. Numbers of diagnoses per month and "per season" were determined. Pairwise comparisons of seasonal data were made using two-sample t-tests with significance set at P ≤ 0.05. Perniosis (chilblains) was significantly more common in winter and spring (P = 0.001). Hand, foot, and mouth disease was statistically more prevalent in summer and autumn (P = 0.028). Erythema multiforme was most common in spring and summer (P = 0.004). Grover's disease was most common in winter and spring (P = 0.000039). Guttate psoriasis was non-significantly more common in winter and spring (P = 0.076). No statistically significant seasonal variation was found for erythema dyschromicum perstans (P = 0.899), pityriasis rosea (P = 0.727), or pityriasis lichenoides (P = 0.366). This study found statistically significant seasonal trends for several dermatologic conditions. The study was primarily epidemiologic and was not intended to address histopathologic differences that might underlie the seasonal variations observed. However, further investigation of seasonal differences in the histopathology of erythema multiforme may prove interesting. © 2016 The International Society of Dermatology.

  8. Marine mammal strandings and environmental changes: a 15-year study in the St. Lawrence ecosystem.

    Science.gov (United States)

    Truchon, Marie-Hélène; Measures, Lena; L'Hérault, Vincent; Brêthes, Jean-Claude; Galbraith, Peter S; Harvey, Michel; Lessard, Sylvie; Starr, Michel; Lecomte, Nicolas

    2013-01-01

    Understanding the effects of climatic variability on marine mammals is challenging due to the complexity of ecological interactions. We used general linear models to analyze a 15-year database documenting marine mammal strandings (1994-2008; n = 1,193) and nine environmental parameters known to affect marine mammal survival, from regional (sea ice) to continental scales (North Atlantic Oscillation, NAO). Stranding events were more frequent during summer and fall than other seasons, and have increased since 1994. Poor ice conditions observed during the same period may have affected marine mammals either directly, by modulating the availability of habitat for feeding and breeding activities, or indirectly, through changes in water conditions and marine productivity (krill abundance). For most species (75%, n = 6 species), a low volume of ice was correlated with increasing frequency of stranding events (e.g. R(2)adj = 0.59, hooded seal, Cystophora cristata). This likely led to an increase in seal mortality during the breeding period, but also to increase habitat availability for seasonal migratory cetaceans using ice-free areas during winter. We also detected a high frequency of stranding events for mysticete species (minke whale, Balaenoptera acutorostrata) and resident species (beluga, Delphinapterus leucas), correlated with low krill abundance since 1994. Positive NAO indices were positively correlated with high frequencies of stranding events for resident and seasonal migratory cetaceans, as well as rare species (R(2)adj = 0.53, 0.81 and 0.34, respectively). This contrasts with seal mass stranding numbers, which were negatively correlated with a positive NAO index. In addition, an unusual multiple species mortality event (n = 114, 62% of total annual mortality) in 2008 was caused by a harmful algal bloom. Our findings provide an empirical baseline in understanding marine mammal survival when faced with climatic variability. This is a promising

  9. [Lymphadenitis due to non-tuberculous mycobacteria: Experience over 15 years].

    Science.gov (United States)

    Ruiz Del Olmo Izuzquiza, Ignacio; Bustillo Alonso, Matilde; Monforte Cirac, María Luisa; Burgués Prades, Pedro; Guerrero Laleona, Carmelo

    2017-03-01

    To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain). A retrospective study was conducted on patients under 15 years-old diagnosed with non-tuberculous mycobacterial lymphadenitis between the years 2000 and 2015. patients with lymphadenitis and positive culture. Quantitative values are shown as mean, rank, and standard deviation, and qualitative data as frequencies. Twenty-seven cases were registered, with a mean age of presentation of 39.9 months (range 10 months-8 years). The mean time between the symptoms onset and first consultation was 1.7±1.1 months. The most frequent location was sub-maxilar in 17/27 cases (63%), on the right side in 59.3%, and size 2.96±1.26cm. Fistulae were observed in 16/27 cases. Tuberculin test was greater than 10mm in 7/24 (29.1%). Microbiological cultures were positive for Mycobacterium avium in 14/27 (51.9%), Mycobacterium intracellulare 3/27 (11.1%), and Mycobacterium lentiflavum 3/27 (11.1%). Combined treatment of antibiotics and surgery was given in 16/27 cases (59.8%), medical treatment only in7/27 (25.9%), and surgical exeresis alone in 4/27 (14.8%). Two patients required a new surgery, and one showed severe neutropenia secondary to rifabutin. Only one case (3.7%) suffered from temporary facial palsy as sequel. The most frequent treatment was the combination of antibiotics and surgery. Delay in diagnosis seemed to be responsible for the limited number of exeresis as first option, only one for every seven patients. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Rheumatic heart disease: 15 years of clinical and immunological follow-up

    Directory of Open Access Journals (Sweden)

    Roney O Sampaio

    2008-01-01

    Full Text Available Roney O Sampaio, Kellen C Fae, Lea MF Demarchi, Pablo MA Pomerantzeff, Vera D Aiello, Guilherme S Spina, Ana C Tanaka, Sandra E Oshiro, Max Grinberg, Jorge Kalil, Luiza GuilhermeHeart Institute (InCor, University of São Paulo, BrazilAbstract: Rheumatic fever (RF is a sequel of group A streptococcal throat infection and occurs in untreated susceptible children. Rheumatic heart disease (RHD, the major sequel of RF, occurs in 30%–45% of RF patients. RF is still considered endemic in some regions of Brazil and is responsible for approximately 90% of early childhood valvular surgery in the country. In this study, we present a 15-year clinical follow-up of 25 children who underwent surgical valvular repair. Histopathological and immunological features of heart tissue lesions of RHD patients were also evaluated. The patients presented severe forms of RHD with congestive symptoms at a very young age. Many of them had surgery at the acute phase of RF. Histological analysis showed the presence of dense valvular inflammatory infiltrates and Aschoff nodules in the myocardium of 21% of acute RHD patients. Infiltrating T-cells were mainly CD4+ in heart tissue biopsies of patients with rheumatic activity. In addition, CD4+ and CD8+ infiltrating T-cell clones recognized streptococcal M peptides and cardiac tissue proteins. These findings may open the possibilities of new ways of immunotherapy. In addition, we demonstrated that the surgical procedure during acute phase of the disease improved the quality of life of young RHD patients.Keywords: rheumatic heart disease, Streptococcus pyogenes, heart failure, inflammatory infiltrate, T lymphocytes, molecular mimicry

  11. Sociodemographic correlates of food habits among school adolescents (12–15 year in north Gaza Strip

    Directory of Open Access Journals (Sweden)

    Shi Zumin

    2009-06-01

    Full Text Available Abstract Background There is little information about meal patterns and food consumption of adolescents in Palestine. The objective of this study was to describe the association between sociodemographic factors and food intake, and meal patterns among Palestinian school adolescents (12–15 year in North Gaza Strip. Methods A cross-sectional study was conducted in 2002 comprising 944 subjects in 10 schools in Gaza city, Jabalia village and Jabalia refugee camp. Self-administered questionnaires were filled in by students and parents to obtain data on frequency of meals, food intake and sociodemographic characteristics. Results High household socioeconomic status (SES was associated with the increased number of meals and the increased intakes of many nutritious foods such as; animal food items, fruits and vegetables and dairy foods. The percentage of adolescents having breakfast daily of high and low SES was 74.5% vs 55% in boys and 65.6% vs 45% in girls. The percentage of girls with refugee status who had lunch was higher (90.2% compared to the local citizen girls (83.9%, (p = 0.03. Girls were less likely to skip daily lunch (OR = 0.55, 95% CI = 0.36–0.87, p = 0.01 compared to boys. Risk of skipping lunch was three times higher among adolescents living in the village compared to Gaza well-off area (OR = 3.3, 95% CI = 1.72–6.31, p Conclusion Meal skipping is common, particularly among those of low SES and the intakes of many nutritious foods such as animal food items, fruits and vegetables and dairy foods seem to be low among adolescents of low SES. The results of this study could be used as an important base-line for future monitoring of the nutritional situation of adolescents.

  12. Factors affecting patients’ self-management in chronic venous disorders: a single-center study

    Directory of Open Access Journals (Sweden)

    Barański K

    2016-08-01

    Full Text Available Kamil Barański,1,2 Jerzy Chudek2,3 1Department of Epidemiology, Medical School in Katowice, 2Department of Pathophysiology, Medical University of Silesia, Katowice, 3Angiology Outpatient Clinic “Combi-Med,” Częstochowa, Poland Background: The conservative treatment of chronic venous disorders (CVDs includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors. Objective: The aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management. Methods: A structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23–87 years. All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP classification. Results: Pharmacotherapy was the most frequently (85.0% of respondents used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99–3.05] and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16–2.62] were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08–3.03]. Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61–3.88] and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35–26.4]. Longer duration of CVD (≥15 years increased (OR =1.78 [95% CI 1.16–2.71] while obesity decreased (OR =0.38 [95% CI 0.20–0.72] the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97–2.90]. Physiotherapy was rarely

  13. Excited-State Spin Manipulation and Intrinsic Nuclear Spin Memory using Single Nitrogen-Vacancy Centers in Diamond

    Science.gov (United States)

    Fuchs, Gregory

    2011-03-01

    Nitrogen vacancy (NV) center spins in diamond have emerged as a promising solid-state system for quantum information processing and precision metrology at room temperature. Understanding and developing the built-in resources of this defect center for quantum logic and memory is critical to achieving these goals. In the first case, we use nanosecond duration microwave manipulation to study the electronic spin of single NV centers in their orbital excited-state (ES). We demonstrate ES Rabi oscillations and use multi-pulse resonant control to differentiate between phonon-induced dephasing, orbital relaxation, and coherent electron-nuclear interactions. A second resource, the nuclear spin of the intrinsic nitrogen atom, may be an ideal candidate for a quantum memory due to both the long coherence of nuclear spins and their deterministic presence. We investigate coherent swaps between the NV center electronic spin state and the nuclear spin state of nitrogen using Landau-Zener transitions performed outside the asymptotic regime. The swap gates are generated using lithographically fabricated waveguides that form a high-bandwidth, two-axis vector magnet on the diamond substrate. These experiments provide tools for coherently manipulating and storing quantum information in a scalable solid-state system at room temperature. We gratefully acknowledge support from AFOSR, ARO, and DARPA.

  14. Whisking kinematics enables object localization in head-centered coordinates based on tactile information from a single vibrissa

    Directory of Open Access Journals (Sweden)

    Anne En-Tzu Yang

    2016-07-01

    Full Text Available During active tactile exploration with their whiskers (vibrissae, rodents can rapidly orient to an object even though there are very few proprioceptors in the whisker muscles. Thus a long-standing question in the study of the vibrissal system is how the rat can localize an object in head-centered coordinates without muscle-based proprioception. We used a three-dimensional model of whisker bending to simulate whisking motions against a peg to investigate the possibility that the 3D mechanics of contact from a single whisker are sufficient for localization in head-centered coordinates. Results show that, for nearly all whiskers in the array, purely tactile signals at the whisker base – as would be measured by mechanoreceptors, in whisker-centered coordinates – could be used to determine the location of a vertical peg in head-centered coordinates. Both the roll and the elevation components of whisking kinematics contribute to the uniqueness and resolution of the localization. These results offer an explanation for a behavioral study showing that rats can more accurately determine the horizontal angle of an object if one column, rather than one row, of whiskers is spared.

  15. Whisking Kinematics Enables Object Localization in Head-Centered Coordinates Based on Tactile Information from a Single Vibrissa

    Science.gov (United States)

    Yang, Anne E. T.; Hartmann, Mitra J. Z.

    2016-01-01

    During active tactile exploration with their whiskers (vibrissae), rodents can rapidly orient to an object even though there are very few proprioceptors in the whisker muscles. Thus a long-standing question in the study of the vibrissal system is how the rat can localize an object in head-centered coordinates without muscle-based proprioception. We used a three-dimensional model of whisker bending to simulate whisking motions against a peg to investigate the possibility that the 3D mechanics of contact from a single whisker are sufficient for localization in head-centered coordinates. Results show that for nearly all whiskers in the array, purely tactile signals at the whisker base – as would be measured by mechanoreceptors, in whisker-centered coordinates – could be used to determine the location of a vertical peg in head-centered coordinates. Both the “roll” and the “elevation” components of whisking kinematics contribute to the uniqueness and resolution of the localization. These results offer an explanation for a behavioral study showing that rats can more accurately determine the horizontal angle of an object if one column, rather than one row, of whiskers is spared. PMID:27486390

  16. Whisking Kinematics Enables Object Localization in Head-Centered Coordinates Based on Tactile Information from a Single Vibrissa.

    Science.gov (United States)

    Yang, Anne E T; Hartmann, Mitra J Z

    2016-01-01

    During active tactile exploration with their whiskers (vibrissae), rodents can rapidly orient to an object even though there are very few proprioceptors in the whisker muscles. Thus a long-standing question in the study of the vibrissal system is how the rat can localize an object in head-centered coordinates without muscle-based proprioception. We used a three-dimensional model of whisker bending to simulate whisking motions against a peg to investigate the possibility that the 3D mechanics of contact from a single whisker are sufficient for localization in head-centered coordinates. Results show that for nearly all whiskers in the array, purely tactile signals at the whisker base - as would be measured by mechanoreceptors, in whisker-centered coordinates - could be used to determine the location of a vertical peg in head-centered coordinates. Both the "roll" and the "elevation" components of whisking kinematics contribute to the uniqueness and resolution of the localization. These results offer an explanation for a behavioral study showing that rats can more accurately determine the horizontal angle of an object if one column, rather than one row, of whiskers is spared.

  17. Investigation of Line Width Narrowing and Spectral Jumps of Single Stable Defect Centers in ZnO at Cryogenic Temperature.

    Science.gov (United States)

    Neitzke, Oliver; Morfa, Anthony; Wolters, Janik; Schell, Andreas W; Kewes, Günter; Benson, Oliver

    2015-05-13

    Finding new solid state defect centers in novel host materials is crucial for realizing integrated hybrid quantum photonic devices. We present a preparation method for defect centers with photostable bright single photon emission in zinc oxide, a material with promising properties in terms of processability, availability, and applications. A detailed optical study reveals a complex dynamic of intensity fluctuations at room temperature. Measurements at cryogenic temperatures show very sharp (<60 GHz) zero phonon lines (ZPLs) at 580 nm to  620 nm (≈ 2.0 eV) with frozen out fast fluctuations. Remaining discrete jumps of the ZPL, which depend on the excitation power, are observed. The low temperature results will narrow down speculations on the origin of visible-near-infrared (NIR) wavelength defect emission in zinc oxide and provide a basis for improved theoretical models.

  18. Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

    DEFF Research Database (Denmark)

    Kumar, Shailesh; Larsen Lausen, Jens; García Ortíz, César Eduardo

    2016-01-01

    polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces...... protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the first case, we concentrate on monitoring differences in fluorescence spectra obtained from a source ND, which is illuminated by a pump laser, and from a scattering ND illuminated only...

  19. Congenital anomalies: 15 years of experience in a level III hospital

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    Carolina Félix

    2017-01-01

    Full Text Available Background: Congenital anomalies (CAs are a leading cause of fetal and infant mortality and morbidity worldwide. They may be identified prenatally, at the moment of birth or later in life.Purpose: To describe the cases of CAs registered over the last 15 years at a level III hospital, comparing individuals who were detected through prenatal (preN diagnosis with those detected through postnatal (postN diagnosis.Methods: All records were collected from the Registo Nacional de Anomalias Congénitas (RENAC online platform between 1st January 2000 to 31st December 2014, in a level III hospital, where cases of CAs were notified voluntarily (n = 1,222. We tested differences for selected variables between the years in study. A multivariate analysis was performed to identify potential factors associated to preN diagnosis.Results: We observed a total of 1,510 anomalies, being 493 (40.3% circulatory, 252 (20.6% chromosomal, 187 (15.3% musculoskeletal, 138 (11.3% digestive, 133 (10.9% urinary, 117 (9.6% nervous, 37 (3.0% respiratory, 35 (2.9% genital, 25 (2% anomalies of the eye, ear, face and neck, 20 (1.6% cleft lip/cleft palate and 73 (6.0% others. Time of diagnosis was known for all subjects: 770 (63.0% were diagnosed prenatally and 452 (37.0% were diagnosed at birth or during the first month of life. We found statistically significant differences between groups for several variables. Assisted reproduction techniques (p = 0.023, maternal medications during the first trimester of pregnancy (p = 0.004 and the number of anomalies per individual (p ≤ 0.001 had a statistically significant impact on receiving preN diagnosis.Conclusion: Our data confirm the importance of both RENAC national database and preN diagnosis in improving perinatal healthcare. However, in order to determine the national prevalence of CAs and understand any involved factors, it is desirable to enhance the notification in the whole country, facilitating the adjustment of national

  20. Drivers of Productivity Trends in Cork Oak Woodlands over the Last 15 Years

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    Maria João Santos

    2016-06-01

    Full Text Available Higher biodiversity leads to more productive ecosystems which, in turn, supports more biodiversity. Ongoing global changes affect ecosystem productivity and, therefore, are expected to affect productivity-biodiversity relationships. However, the magnitude of these relationships may be affected by baseline biodiversity and its lifeforms. Cork oak (Quercus suber woodlands are a highly biodiverse Mediterranean ecosystem managed for cork extraction; as a result of this management cork oak woodlands may have both tree and shrub canopies, just tree and just shrub canopies, and just grasslands. Trees, shrubs, and grasses may respond differently to climatic variables and their combination may, therefore, affect measurements of productivity and the resulting productivity-biodiversity relationships. Here, we asked whether the relationship between productivity and climate is affected by the responses of trees, shrubs, and grasses in cork oak woodlands in Southern Portugal. To answer this question, we linked a 15-year time series of Enhanced Vegetation Index (EVI derived from Landsat satellites to micrometeorological data to assess the relationship between trends in EVI and climate. Between 2000 and 2013 we observed an overall decrease in EVI. However, EVI increased over cork oaks and decreased over shrublands. EVI trends were strongly positively related to changes in relative humidity and negatively related to temperature. The intra-annual EVI cycle of grasslands and sparse cork oak woodland without understorey (savannah-like ecosystem had higher variation than the other land-cover types. These results suggest that oaks and shrubs have different responses to changes in water availability, which can be either related to oak physiology, to oaks being either more resilient or having lagged responses to changes in climate, or to the fact that shrublands start senesce earlier than oaks. Our results also suggest that in the future EVI could improve because the

  1. Marine mammal strandings and environmental changes: a 15-year study in the St. Lawrence ecosystem.

    Directory of Open Access Journals (Sweden)

    Marie-Hélène Truchon

    Full Text Available Understanding the effects of climatic variability on marine mammals is challenging due to the complexity of ecological interactions. We used general linear models to analyze a 15-year database documenting marine mammal strandings (1994-2008; n = 1,193 and nine environmental parameters known to affect marine mammal survival, from regional (sea ice to continental scales (North Atlantic Oscillation, NAO. Stranding events were more frequent during summer and fall than other seasons, and have increased since 1994. Poor ice conditions observed during the same period may have affected marine mammals either directly, by modulating the availability of habitat for feeding and breeding activities, or indirectly, through changes in water conditions and marine productivity (krill abundance. For most species (75%, n = 6 species, a low volume of ice was correlated with increasing frequency of stranding events (e.g. R(2adj = 0.59, hooded seal, Cystophora cristata. This likely led to an increase in seal mortality during the breeding period, but also to increase habitat availability for seasonal migratory cetaceans using ice-free areas during winter. We also detected a high frequency of stranding events for mysticete species (minke whale, Balaenoptera acutorostrata and resident species (beluga, Delphinapterus leucas, correlated with low krill abundance since 1994. Positive NAO indices were positively correlated with high frequencies of stranding events for resident and seasonal migratory cetaceans, as well as rare species (R(2adj = 0.53, 0.81 and 0.34, respectively. This contrasts with seal mass stranding numbers, which were negatively correlated with a positive NAO index. In addition, an unusual multiple species mortality event (n = 114, 62% of total annual mortality in 2008 was caused by a harmful algal bloom. Our findings provide an empirical baseline in understanding marine mammal survival when faced with climatic variability. This is a

  2. Injuries to Professional and Amateur Kickboxing Contestants: A 15-Year Retrospective Cohort Study.

    Science.gov (United States)

    Lystad, Reidar P

    2015-11-01

    Kickboxing is a group of full-contact combat sports that allows both kicking and punching from a standing position. Despite its popularity, there is a scarcity of published data elucidating the injury epidemiology in kickboxing. To determine the injury incidence, describe the injury pattern, and identify potential risk factors for injury in kickboxing. Descriptive epidemiology study. Data describing fight outcomes and injuries sustained during professional and amateur kickboxing contests over a 15-year period were obtained from the official records of the Nevada Athletic Commission, United States. Injury incidence rates and rate ratios were calculated with 95% confidence intervals (95% CIs) per 1000 athlete-exposures (AEs) and per 1000 minutes of exposure. The injury pattern was described using frequencies and proportions of injuries by anatomic region and type of injury. In addition, Poisson mixed-effects generalized linear modeling was used to examine the multivariate relationships between injury incidence rates and potential risk factors. The sample consisted of 481 unique fighters competing across 57 events, 976 AEs, 9562 minutes of exposure, and 380 injuries. The mean ± SD age of the fighters was 29.0 ± 5.3 years (range, 15-48 years). The overall injury incidence rates were 390.1 injuries (95% CI, 351.9-431.4) per 1000 AEs and 39.7 injuries (95% CI, 35.8-43.9) per 1000 minutes of exposure. The most commonly injured anatomic regions were the head (57.8%) and lower extremity (26.1%), while the most common types of injury were laceration (70.6%) and fracture (20.6%). Professional fighters were 2.5 times more likely to get injured compared with amateurs (rate ratio, 2.51; 95% CI, 1.39-4.55), while defeated fighters were 3.5 times more likely to get injured compared with winners (rate ratio, 3.48; 95% CI, 2.73-4.44). Injuries are frequent and often significant in kickboxing, and better injury surveillance is strongly recommended. The scarcity of good

  3. Hospital-based, prospective, multicentre surveillance to determine the incidence of intussusception in children aged below 15 years in Germany

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    Bissantz Kathrin

    2011-03-01

    Full Text Available Abstract Background A new vaccine against Rotavirus (RV gastroenteritis was introduced in Germany in 2006. In 1997 the first RV vaccine was withdrawn due to an increased incidence in intussusception (IS. Thus, an accurate estimation of the incidence of IS is important for post-licensure surveillance. Methods IS-Data were obtained from the 'Erhebungseinheit für seltene pädiatrische Erkrankungen Deutschland' (ESPED, German surveillance unit for rare pediatric diseases collaborations' central register where all cases of intussusception in Germany for the years 2006 and 2007 are collected (n = 1200. In order to obtain an unbiased estimate of the incidence, it is necessary to determine the population under risk out of which these cases originated, and the proportion of real cases not reported to the registry (underreporting. In order to assess underreporting, a random sample of 31 hospitals was re-assessed by an outside reviewer. The estimation of incidence was done using a single Maximum-Likelihood (ML estimator based on data from both the registry and the sample. Results The uncorrected observed incidence was calculated to be 26.6/100,000 child-years for children below 1 year old, 23.8 for those below 2 years old, and 5.2 for those below 15 years old. The review revealed a mean reporting quota of about 41% and the ML approach yielded an incidence of 51.5/100,000 child-years (95%CI [41.7;61.1] for children below 2 years of age. Conclusions While substantial under-reporting led to very conservative estimates of the IS incidence, the approach described here allows an accurate estimation of IS incidence including corresponding confidence bands. Therefore, ML estimation is a straightforward instrument to derive stable, unbiased estimates in epidemiological studies with incomplete data.

  4. Determinants of Subclinical Vitamin A Deficiency among children 1-5 years in a rural community of Jammu

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    Shivali Suri

    2015-06-01

    Full Text Available Background: The burden of sub-clinical vitamin A deficiency (VAD, as evident by serum retinol levels, is huge (62% among preschool children in India. Sub-clinical VAD increases children’s' susceptibility to infections, reduces physical growth and decreases the ability to survive from serious illnesses. Aims & Objectives: To assess the burden of subclinical VAD and study the various risk factors associated with it among children 1-5 years of age. Material Methods: A cross sectional community based study was conducted among 750 children selected from 15 villages adopting multistage random sampling from January to December 2011. Heller Keller International Food Frequency Questionnaire (HKI- FFQ was used to assess intakes of 28 food-items including vitamin A rich foods for the past 7 days. Various risk factors like socio-demographic profile, dietary pattern, vitamin A supplementation and breast feeding patterns were also studied. Results: Twelve of the fifteen cluster villages studied were found to be at risk of subclinical VAD. 30.6 % of study subjects had not received even a single dose of Vitamin A. Almost one-third of the subjects had not been breast-fed for the recommended 6 months. Age and socio-economic status were significantly associated with the risk of sub-clinical VAD. Among the dietary factors, consumption of purely vegetarian foods and intake of green leafy vegetables less than thrice a week were significantly associated with enhanced risk of sub-clinical VAD. Conclusion: Sub Clinical VAD is a public health problem of wide-spread importance.   Dietary diversification along with enhanced coverage of Vitamin A supplementation can tackle the problem of subclinical VAD

  5. Intimate relationships and childbearing after adolescent depression: a population-based 15 year follow-up study.

    Science.gov (United States)

    Jonsson, U; Bohman, H; Hjern, A; von Knorring, L; Paaren, A; Olsson, G; von Knorring, A-L

    2011-08-01

    Adolescent depression is associated with a range of interpersonal adversities. We hypothesized that depressed adolescents are at subsequent increased risk of problems related to intimate relationships and childbearing in adulthood, and used longitudinal data to examine this. A population-based investigation of depression in 16 to 17 year olds was followed up after 15 years, at around the age of 30 years. Comparisons were made between adolescents with depression (n = 361, 78% females) and non-depressed peers (n = 248, 77% females). Data from both national registers and personal interviews were used. At follow-up, the former depressed and non-depressed adolescents had become parents to a similar extent. The former depressed females were more likely than the non-depressed females to report abortion, miscarriage, intimate partner violence and sexually transmitted disease. They also reported a higher number of intimate relationships and were more likely to have divorced and to be registered as single mothers. Depressed females with a comorbid disruptive disorder had a particularly poor outcome. In the depressed females without a disruptive disorder, only those who subsequently had recurrent depressions in adulthood were at increased risk of poor outcome. There was no indication that the formerly depressed males were at increased risk of subsequent problems related to intimate relationships. Females with adolescent depression subsequently have problems related to intimate relationships and childbearing. Disruptive disorders and recurrence of depression appear to be instrumental in this association. Attention should be given to intimate relationship problems and sexual and reproductive health issues in young women with depression.

  6. A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes.

    Science.gov (United States)

    Cordeiro, Peter G; Chen, Constance M

    2012-01-01

    Reconstruction of complex midfacial defects is best approached with a clear algorithm. The goals of reconstruction are functional and aesthetic. Over a 15-year period (1992 to 2006), a single surgeon (P.G.C.) performed 100 flaps to reconstruct the following midfacial defects: type I, limited maxillectomy (n = 20); type IIA, subtotal maxillectomy with resection of less than 50 percent of the palate (n = 8); type IIB, subtotal maxillectomy with resection of greater than 50 percent of the palate (n = 8); type IIIA, total maxillectomy with preservation of the orbital contents (n = 22); type IIIB, total maxillectomy with orbital exenteration (n = 23); and type IV, orbitomaxillectomy (n = 19). Free flaps were used in 94 cases (94 percent), and pedicled flaps were used in six (6 percent). One hundred flaps were performed in 96 patients (69 males, 72 percent; 27 females, 28 percent); four patients underwent a second flap reconstruction due to recurrent disease (n = 4, 4 percent). Average patient age was 49.2 years (range, 13 to 81 years). Free-flap survival was 100 percent, with one partial flap loss (1 percent). Five patients suffered systemic complications (5.2 percent), and four died within 30 days of hospitalization (4.2 percent). Over 50 percent of patients returned to normal diet and speech. Almost 60 percent were judged to have an excellent aesthetic result. Free-tissue transfer offers the most effective and reliable form of reconstruction for complex maxillectomy defects. Rectus abdominis and radial forearm free flaps in combination with immediate bone grafting or as osteocutaneous flaps consistently provide the best functional and aesthetic results. Therapeutic, IV.

  7. Para onde caminham os Cieps? Uma análise após 15 anos Where are the Cieps headed? An analysis after 15 years

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    Ana Maria Cavaliere

    2003-01-01

    Full Text Available O trabalho descreve aspectos da realidade dos Centros Integrados de Educação Pública - Cieps -, da rede estadual do Rio de Janeiro, baseando-se em pesquisa, realizada em 2001, com 50 diretores. Estabelece comparações com a época em que essas escolas foram implantadas sob a forma de programa especial de governo, levando em conta o funcionamento em horário integral, as dificuldades de gestão, as atividades oferecidas, a quantidade de alunos por escola, a utilização e conservação dos espaços. Conclui que a variedade dos níveis de ensino abarcados e a convivência de diferentes regimes horários num mesmo estabelecimento demonstram a vocação ainda pouco definida de tais escolas. A opinião dos gestores sobre o trabalho desenvolvido nos Cieps que mantiveram o horário integral mostra que eles o consideram, muitas vezes, assistencialista, embora essa definição seja vaga e muito variada. Após mais de 15 anos de existência, a tendente municipalização do ensino fundamental e a pressão por vagas no ensino médio parecem ser os maiores entraves para a manutenção dessas escolas segundo seu projeto original.Based on research done by 50 principals of Integrated Centers for Public Education, the Cieps, of the Rio de Janeiro state educational system, this article describes aspects of reality in schools in the year 2001. Comparisons are made with the time when they were implemented as a special government program, taking into consideration their functioning on a full time basis, their management difficulties, the activities offered, the number of students per school and the utilization and conservation of the facilities. It concludes that the variety in levels of teaching which they encompass and the concurrence of different time schedules in a single establishment demonstrate that the purpose of these schools is still poorly defined. The managers' opinions about the work developed in the Cieps which maintained a full time schedule

  8. Metastases of esophageal carcinoma to skeletal muscle:Single center experience

    Institute of Scientific and Technical Information of China (English)

    Jan Cincibuch; Miroslav Myslive(c)ek; Bohuslav Melichar; (C)estmír Neoral; Iva Metelková; Michaela Zezulová; Hana Procházková-(S)tudentová

    2012-01-01

    Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

  9. Convergence of CI single center calculations of positron-atom interactions

    CERN Document Server

    Mitroy, J

    2006-01-01

    The Configuration Interaction (CI) method using orbitals centered on the nucleus has recently been applied to calculate the interactions of positrons interacting with atoms. Computational investigations of the convergence properties of binding energy, phase shift and annihilation rate with respect to the maximum angular momentum of the orbital basis for the e^+Cu and PsH bound states, and the e^+-H scattering system were completed. The annihilation rates converge very slowly with angular momentum, and moreover the convergence with radial basis dimension appears to be slower for high angular momentum. A number of methods of completing the partial wave sum are compared, an approach based on a Delta X_J = a/(J + 1/2)^n + b/(J + 1/2)^(n+1) form (with n = 4 for phase shift (or energy) and n = 2 for the annihilation rate) seems to be preferred on considerations of utility and underlying physical justification.

  10. Neonatal screening of hearing function by otoacustic emissions: A single center experience

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    Živić Ljubica

    2012-01-01

    Full Text Available Background/Aim. Nowadays development of techniques enables detection of hearing impairment in a very short time, immediately after birth by using otoacoustic emissions. They are low-pitched sounds produced in physiologically clear cochlea and can be recorded in cochlear outer meatus. By this method, complete data are found on a whole presynaptic auditory nervous system functioning that has mostly been affected by pathological changes making it a perfect screening test. Reliability and sensibility of this method is up to 98%. The aim of this study was to present the first results of systematic neonatal screening of hearing function by otoacoustic emissions in the Clinical Center Kragujevac (Kragujevac, Serbia. Methods. This prospective study of neonatal hearing screening function, initiated systematically by the 2008 at the Clinical Center Kragujevac, included full-term newborns and premature born ones, within the first 24 h after birth, using a DPOAEs interacoustics otoread-screener. Retesting was done after a month. Results. From January 1st, 2009 to December 1st, 2010, a total number of examined infants by this method was 1,994 out of which 1,778 were full-term and 216 were premature born. The test passing was higher in the group of full-term babies (92.5% than in the preterm ones (55.1%. No bilateral answers were recorded in premature born children compared to the full-term ones, of whom a larger number was with missing lateral responses. The results of re-examination test in the group of full-term born and premature newborns were 83.7%, and 61%, respectively. Conclusion. Deliberately provoked transient otoacoustic emission is an efficient method in testing hearing function in newborns, since it is non-invasive, rapid and objective. Its correlation with audibly evoked potentials is very high, which confirms its reliability.

  11. Blood blister-like aneurysms: single center experience and systematic literature review.

    Science.gov (United States)

    Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan; Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl; Lovblad, Karl-Olof; Pereira, Vitor Mendes

    2014-01-01

    Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity-mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Blood blister-like aneurysms: Single center experience and systematic literature review

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl [Service of Neurosurgery, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes, E-mail: vitormpbr@hotmail.com [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland)

    2014-01-15

    Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity–mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy.

  13. Clinical Characteristics of Pediatric Esophagitis in Southern Iran; A Single-Center Experience

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    Mozhgan Zahmatkeshan

    2013-06-01

    Full Text Available Background: We sought to determine the clinical characteristics of pediatric esophagitis in southern Iran. Methods: This cross-sectional study was conducted over a 4-year period, from 2005 to 2009, in Nemazee Hospital, a tertiary healthcare center in Shiraz, southern Iran. We consecutively included all pediatric patients (<18 years who underwent endoscopy in our center and had pathology-confirmed diagnosis of esophagitis. Data regarding the patients’ demographic characteristics, comorbidities, and clinical findings were recorded using a questionnaire. All the patients underwent upper gastrointestinal endoscopy and biopsy of the esophagus, and the findings were recorded in the questionnaire. Results: We studied 125 children, comprising 61 (48.8% girls and 64 (51.2% boys at a mean age of 6.6±5.5 years. Repeated vomiting was the prominent symptom in our series, with it being reported by 75 (60% patients, followed by fever in 35 (28%. Erythema (33.6%, esophageal ulcer (11.2%, and whitish patch (8.0% were the most common endoscopic findings, while reflux esophagitis (32.8%, chronic (6.4% and acute esophagitis (5.6%, and candida esophagitis (5.6% were the most common histological diagnoses. Only one (0.8% patient was diagnosed as having eosinophilic esophagitis, aspergillosis, and graft-versus-host disease. Conclusion: Reflux was the most common cause of esophagitis in the pediatric population of southern Iran. Contrary to previous reports, the prevalence of eosinophilic esophagitis was far less than that estimated, while the prevalence of opportunistic infections was higher secondary to post-liver transplantation immunosuppression.

  14. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

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    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  15. Radiotherapy for calcaneodynia. Results of a single center prospective randomized dose optimization trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Jeremias, C.; Gaipl, U.S.; Frey, B.; Schmidt, M.; Fietkau, R. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-04-15

    The aim of this work was to compare the efficacy of two different dose fractionation schedules for radiotherapy of patients with calcaneodynia. Between February 2006 and April 2010, 457 consecutive evaluable patients were recruited for this prospective randomized trial. All patients received radiotherapy using the orthovoltage technique. One radiotherapy series consisted of 6 single fractions/3 weeks. In case of insufficient remission of pain after 6 weeks a second radiation series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before, immediately after, and 6 weeks after radiotherapy using a visual analogue scale (VAS) and a comprehensive pain score (CPS). The overall response rate for all patients was 87 % directly after and 88 % 6 weeks after radiotherapy. The mean VAS values before, immediately after, and 6 weeks after treatment for the 0.5 and 1.0 Gy groups were 65.5 {+-} 22.1 and 64.0 {+-} 20.5 (p = 0.188), 34.8 {+-} 24.7 and 39.0 {+-} 26.3 (p = 0.122), and 25.1 {+-} 26.8 and 28.9 {+-} 26.8 (p = 0.156), respectively. The mean CPS before, immediately after, and 6 weeks after treatment was 10.1 {+-} 2.7 and 10.0 {+-} 3.0 (p = 0.783), 5.6 {+-} 3.7 and 6.0 {+-} 3.9 (p = 0.336), 4.0 {+-} 4.1 and 4.3 {+-} 3.6 (p = 0.257), respectively. No statistically significant differences between the two single dose trial arms for early (p = 0.216) and delayed response (p = 0.080) were found. Radiotherapy is an effective treatment option for the management of calcaneodynia. For radiation protection reasons, the dose for a radiotherapy series is recommended not to exceed 3-6 Gy. (orig.)

  16. Etiology of male urethral strictures-Evaluation of temporal changes at a single center, and review of the literature

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    C.F. Heyns

    2012-03-01

    Conclusions: Over the past 15 years there was an increase in education levels, illegal drug usage and number of sex partners in men with urethral strictures. There was a decrease in urethritis and external trauma, and an increase in iatrogenic trauma as stricture etiology.

  17. Preoperative Embolization to Improve the Surgical Management and Outcome of Juvenile Nasopharyngeal Angiofibroma (JNA) in a Single Center

    DEFF Research Database (Denmark)

    Lutz, J; Holtmannspötter, M; Flatz, W;

    2016-01-01

    . RESULTS: In these 15 patients (mean age, 15 years), a total of 27 surgical procedures were performed. One patient was at stage Ia, two were at stage Ib, two were at stage IIa, six were at stage IIb, one was at stage IIc, and three were at stage IIIa based on the Radkowsky classification. All patients...

  18. Purcell-enhanced single-photon emission from nitrogen-vacancy centers coupled to a tunable microcavity

    CERN Document Server

    Kaupp, Hanno; Mader, Matthias; Schlederer, Benedikt; Benedikter, Julia; Haeusser, Philip; Chang, Huan-Cheng; Fedder, Helmut; Hänsch, Theodor W; Hunger, David

    2016-01-01

    Optical microcavities are a powerful tool to enhance spontaneous emission of individual quantum emitters. However, the broad emission spectra encountered in the solid state at room temperature limit the influence of a cavity, and call for ultra-small mode volume. We demonstrate Purcell-enhanced single photon emission from nitrogen-vacancy (NV) centers in nanodiamonds coupled to a tunable fiber-based microcavity with a mode volume down to $1.0\\,\\lambda^{3}$. We record cavity-enhanced fluorescence images and study several single emitters with one cavity. The Purcell effect is evidenced by enhanced fluorescence collection, as well as tunable fluorescence lifetime modification, and we infer an effective Purcell factor of up to 2.0. With numerical simulations, we furthermore show that a novel regime for light confinement can be achieved, where a Fabry-Perot mode is combined with additional mode confinement by the nanocrystal itself. In this regime, effective Purcell factors of up to 11 for NV centers and 63 for si...

  19. Early liver retransplantation versus late liver retransplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    CHEN Gui-hua; ZHANG Jun-feng; ZHANG Tong; WANG Guo-ying; FU Bin-sheng; YANG Yang; CAI Chang-jie; LU Min-qiang; LI Hua; WANG Gen-shu; YI Shu-hong; XU Chi

    2008-01-01

    Background Orthotopic liver retransplantation (re-OLT) is the only effective therapy for irreversible failure of a liver graft. Early and late graft failure gives way to two different clinical conditions that should be discussed separately. This study was designed to compare early and late re-OLT for patients with poor graft function after primary transplantation at our center and sum up our clinical experience in re-OLT.Methods The clinical data of 31 re-OLTs at our center from January 2004 to February 2007 were analyzed retrospectively, consisting of the first group with 14 cases of early re-OLT and the second group with 17 cases of late re-OLT.Results Biliary tract complications were the main indications for early re-OLT (57.1%) and late re-OLT (52.9%). Other common indications were vascular complications in early re-OLT and recurrence of primary diseases in late re-OLT. No significant differences were found between the groups with regard to the volume of bleeding during operation, cold ischemia time, operative duration, and perioperative mortality; except for the model of end-stage liver disease (MELD) score. Outcome was fatal for 7 patients in early re-OLT and 9 patients in late re-OLT. Two deaths were due to multiple organ failure with 3 deaths due to severe sepsis-related disease in early re-OLT, and 4 deaths were due to severe sepsis-related disease with 3 deaths due to recurrence of hepatocellular carcinoma (HCC) in late re-OLT. One and 2-year actuarial survival rates after re-OLT were 55.2% and 36.9%, respectively, for patients in early re-OLT, and 65.1% and 52% respectively, for patients in late re-OLT. No significant differences were found regarding survival rates between the two groups.Conclusions Similar clinical results can be achieved in early and late re-OLT. Proper indications and optimal operation timing, adequate preoperative preparation, experienced surgical procedures, and effective perioperative anti-infection strategy contribute to the

  20. Efficacy of liver transplantation for acute hepatic failure:a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Xian-Jie Shi; Hong-Bin Xu; Wen-Bin Ji; Yu-Rong Liang; Wei-Dong Duan; Lei He; Ming-Jun Wang; Zhi-Ming Zhao

    2011-01-01

    BACKGROUND: Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate. The outcome of AHF varies with etiology, but liver transplantation (LT) can significantly improve the prognosis and survival rate of such patients. This study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this disease. METHODS: A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center. We analyzed and compared the etiology, outcome, prognosis, and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) group. RESULTS: AHF was due to viral hepatitis in 25 patients (52.1%; hepatitis B virus in 22), drug or toxic reactions in 14 (29.2%; acetaminophen in 6), Wilson disease in 4 (8.3%), unknown reasons in 3 (6.3%), and miscellaneous conditions in 2 (4.2%). In the LT group, 36 patients (7 underwent living donor LT, and 29 cadaveric LT) had an average model for end-stage liver disease score (MELD) of 35.7. Twenty-eight patients survived with good graft function after a follow-up of 27.3± 4.5 months. During the waiting time, 6 patients were treated with ALSS and 2 of them died during hospitalization. The 30-day, 12-month, and 18-month survival rates were 77.8%, 72.2%, and 66.7%, respectively. In the N-LT group, 12 patients had an average MELD score of 34.5. Four patients were treated with ALSS and all died during hospitalization. The 90-day and 1-year survival rates were only 16.7% and 8.3%, respectively. CONCLUSIONS: Hepatitis is the most prominent cause of AHF at our center. Most patients with AHF, who fulfill the Kings College Criteria for LT, did not survive longer without LT. ALSS did not improve the prognosis of AHF patients, but may extend the waiting time for a donor. Currently, LT is still the most effective way to improve the prognosis

  1. Bariatric surgery outcomes: a single-center study in the United Arab Emirates

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    Abusnana S

    2015-09-01

    Full Text Available Salah Abusnana,1 Sarah Abdi,1 Brigette Tagure,1 Murtada Elbagir,1 Almantas Maleckas2 1Rashid Center for Diabetes and Research, Ministry of Health, Ajman, United Arab Emirates; 2Kaunas University of Medicine, Kaunas, LithuaniaBackground: Bariatric surgery has become an attractive treatment for severe obesity over the last decade, due to its impacts on weight loss and remission of type 2 diabetes and metabolic syndrome. In the United Arab Emirates, a country where the rate of obesity is dramatically increasing bariatric surgery has gained popularity in recent years; however, published data on its outcomes in the Emirati population are lacking.Methods: We retrospectively reviewed the medical records of 95 patients who underwent bariatric surgery (ie, laparoscopic Roux-en-Y gastric bypass [RYGB] or laparoscopic sleeve gastrectomy at the Rashid Center for Diabetes and Research in Ajman, United Arab Emirates. Weight outcomes and metabolic marker data were abstracted at baseline and at 3, 6, and 12 months postoperatively.Results: Laparoscopic RYGB was the main procedure performed by our bariatric unit. All variables demonstrated postoperative improvement. An average excess weight loss of 68% was observed at 12 months. Fat mass was the body component that decreased the most, with an average reduction of 46%. Additionally, lipid profiles were significantly different (P<0.01 at 12 months, with triglyceride levels improving by 27% and low-density lipoprotein levels improving by 21%. Similarly, glycated hemoglobin (HbA1c levels decreased significantly (P<0.001 in patients with type 2 diabetes, with an average reduction of 73%.Conclusion: Our results show that a substantial short-term reduction in weight and significant improvements in metabolic markers followed bariatric surgery in severely obese Emirati patients. Our results are consistent with the outcomes of other internationally published studies. Additional studies are warranted to determine whether

  2. Benign painful elbow syndrome. First results of a single center prospective randomized radiotherapy dose optimization trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Hertel, S.; Gaipl, U.S.; Frey, B.; Schmidt, M.; Fietkau, R. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2012-10-15

    Background and purpose: The goal of the present study was to evaluate the efficacy of two different dose-fractionation schedules for radiotherapy (RT) of patients with painful elbow syndrome. Patients and methods: Between February 2006 and February 2010, 199 consecutive evaluable patients were recruited for this prospective randomized trial. All patients received RT in orthovoltage technique. One RT course consisted of 6 single fractions/3 weeks. In case of insufficient remission of pain after 6 weeks a second radiation series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before, right after, and 6 weeks after RT by a visual analogue scale (VAS) and a comprehensive pain score (CPS). Results: The overall response rate for all patients was 80% direct after and 91% 6 weeks after RT. The mean VAS values before, after and 6 weeks after treatment for the 0.5 and 1.0 Gy groups were 59.6 {+-} 20.2 and 55.7 {+-} 18.0 (p = 0.463), 32.1 {+-} 24.5 and 34.4 {+-} 22.5 (p = 0.256), and 27.0 {+-} 27.7 and 23.5 {+-} 21.6 (p = 0.818). The mean CPS before, after, and 6 weeks after treatment was 8.7 {+-} 2.9 and 8.1 {+-} 3.1 (p = 0.207), 4.5 {+-} 3.2 and 5.0 {+-} 3.4 (p = 0.507), 3.9 {+-} 3.6 and 2.8 {+-} 2.8 (p = 0.186), respectively. No statistically significant differences between the two single dose trial arms for early (p = 0.103) and delayed response (p = 0.246) were found. Conclusion: RT is an effective treatment option for the management of benign painful elbow syndrome. For radiation protection reasons the dose for a RT series is recommended not to exceed 3.0 Gy. (orig.)

  3. Radiotherapy for achillodynia. Results of a single-center prospective randomized dose-optimization trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Jeremias, C.; Gaipl, U.S.; Frey, B.; Schmidt, M.; Fietkau, R. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-02-15

    Background and purpose: The aim of this study was to compare the efficacy of two different dose-fractionation schedules for radiotherapy of patients with achillodynia. Patients and methods: Between February 2006 and February 2010, 112 consecutive evaluable patients were recruited for this prospective randomized trial. All patients underwent radiotherapy with an orthovoltage technique. One radiotherapy course consisted of 6 single fractions over 3 weeks. In case of insufficient remission of pain after 6 weeks, a second radiation series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. The endpoint was pain reduction. Pain was measured before, right after, and 6 weeks after radiotherapy with a visual analogue scale (VAS) and a comprehensive pain score (CPS). Results: The overall response rate for all patients was 84% directly after and 88% 6 weeks after radiotherapy. The mean VAS values before, directly after, and 6 weeks after treatment for the 0.5 and 1.0 Gy groups were 55.7 {+-} 21.0 and 58.2 {+-} 23.5 (p = 0.526), 38.0 {+-} 23.2 and 30.4 {+-} 22.6 (p = 0.076), and 35.4 {+-} 25.9 and 30.9 {+-} 25.4 (p = 0.521), respectively. The mean CPS before, directly after, and 6 weeks after treatment was 8.2 {+-} 3.0 and 8.9 {+-} 3.3 (p = 0.239), 5.6 {+-} 3.1 and 5.4 {+-} 3.3 (p = 0.756), 4.4 {+-} 2.6 and 5.3 {+-} 3.8 (p = 0.577), respectively. No statistically significant differences were found between the two single-dose trial arms for early (p = 0.366) and delayed response (p = 0.287). Conclusion: Radiotherapy is an effective treatment option for the management of achillodynia. For radiation protection, the dose of a radiotherapy series is recommended not to exceed 3-6 Gy. (orig.)

  4. Physical activity 11-15 years old children with oncological disease: pilot study disHBSC

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    Tomáš Vyhlídal

    2016-12-01

    Full Text Available Background: As of 1993, the Czech and Slovak Republic, along with other countries of Europe and North America, participating in regular intervals to 4 year international project HBSC (Health Behavior in The School-aged Children, for our purposes disHBSC - "with disability". The main objective of this research study is to identify determinants of health and lifestyle pupils and compare the results on the international level. Up to this time, however, the research could not include pupils with disabilities and physical handicaps. On the initiative of WHO were within these categories in the survey also included pupils with cancer. In order to integrate these students, a new study disHBSC, which aims to increase knowledge of health and health behaviors, related to them this target group. Objectives: The aim of the research investigation is to determine the selected determinants affecting the participation of pupils with oncological diseases in the age 11-15 years in physical activities. Part of the aim is to find out their self-assessment and aspiration level, which with the realization of physical activities can immediately relate to. The purpose of the investigation is, however, in particular the pilot revealed any organizational and substantive uncertainties and upgrade research technique with regard to the needs and options of the target group. Methods: The research survey used a pilot version of the questionnaire protocol disHBSC. This pilot version is derived from the questionnaire protocol that was used in 2010 and based on the international version of the questionnaire HBSC. A pilot version of the questionnaire contained 41 questions, which are divided into several thematic areas - basic sociodemographic characteristics and behaviors specific areas (which have a significant relationship to physical and mental health of children and youth youth health, eating habits, physical activity and leisure use substance abuse, self-esteem and

  5. EPR characterisation of the triplet state in photosystem II reaction centers with singly reduced primary acceptor Q(A).

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    Feikema, W Onno; Gast, Peter; Klenina, Irina B; Proskuryakov, Ivan I

    2005-09-05

    The triplet states of photosystem II core particles from spinach were studied using time-resolved cw EPR technique at different reduction states of the iron--quinone complex of the reaction center primary electron acceptor. With doubly reduced primary acceptor, the well-known photosystem II triplet state characterised by zero-field splitting parameters |D|=0.0286 cm(-1), |E|=0.0044 cm(-1) was detected. When the primary acceptor was singly reduced either chemically or photochemically, a triplet state of a different spectral shape was observed, bearing the same D and E values and characteristic spin polarization pattern arising from RC radical pair recombination. The latter triplet state was strongly temperature dependent disappearing at T=100 K, and had a much faster decay than the former one. Based on its properties, this triplet state was also ascribed to the photosystem II reaction center. A sequence of electron-transfer events in the reaction centers is proposed that explains the dependence of the triplet state properties on the reduction state of the iron--quinone primary acceptor complex.

  6. Thermally stimulated current observation of trapping centers in undoped GaSe layered single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Gasanly, N.M.; Salihoglu, Oe. [Middle East Technical Univ., Ankara (Turkey). Dept. of Physics; Aydinli, A. [Middle East Technical Univ., Ankara (Turkey). Dept. of Physics; Bilkent Univ., Ankara (Turkey). Dept. of Physics

    2001-07-01

    Undoped p-GaSe layered single crystals were grown using Bridgman technique. Thermally stimulated current measurements in the temperature range of 10-300 K were performed at a heating rate of 0.18 K/s. The analysis of the data revealed three trap levels at 0.02, 0.10 and 0.26 eV. The calculation for these traps yielded 8.8 x 10{sup -27}, 1.9 x 10{sup -25}, and 3.2 x 10{sup -21} cm{sup 2} for capture cross sections and 3.2 x 10{sup 14}, 1.1 x 10{sup 16}, and 1.2 x 10{sup 16} cm{sup -3} for the concentrations, respectively. (orig.)

  7. Survival of living donor renal transplant recipients in Sri Lanka: a single-center study.

    Science.gov (United States)

    Galabada, Dinith Prasanna; Nazar, Abdul L M; Ariyaratne, Prasad

    2014-11-01

    Chronic kidney disease is one of the main public health concerns in Sri Lanka. In comparison with dialysis, successful kidney transplantation improves both patient survival and quality of life, relieves the burden of dialysis in patients suffering from end-stage renal disease and decreases the cost of healthcare to the society and government. The objective of this retrospective cohort study was to evaluate graft and patient survival rates in patients who were transplanted from living donors at the Nephrology Unit of the National Hospital of Sri Lanka from January 2005 to January 2011. Data were collected using an interviewer-administered questionnaire and through a review of past medical records. The Kaplan-Meier method was used to determine the survival rate, the log rank test was used to compare survival curves and the Cox proportional hazard model was used for multivariate analysis. Mean follow-up was 26.44±16.6 months. The five-year death-censored graft survival of kidney transplant recipients from living donors in our center was 93.5% and the five-year patient survival was 82.2%, which is comparable with other transplant programs around the world. The number of acute rejection episodes was an independent risk factor for graft survival. Delayed graft function, younger recipient age and unknown cause of end-stage renal disease were found to be risk factors for graft failure but after adjusting for confounding factors, and the difference was not apparent.

  8. Survival of living donor renal transplant recipients in Sri Lanka: A single-center study

    Directory of Open Access Journals (Sweden)

    Dinith Prasanna Galabada

    2014-01-01

    Full Text Available Chronic kidney disease is one of the main public health concerns in Sri Lanka. In comparison with dialysis, successful kidney transplantation improves both patient survival and quality of life, relieves the burden of dialysis in patients suffering from end-stage renal disease and decreases the cost of healthcare to the society and government. The objective of this retrospective cohort study was to evaluate graft and patient survival rates in patients who were transplanted from living donors at the Nephrology Unit of the National Hospital of Sri Lanka from January 2005 to January 2011. Data were collected using an interviewer-administered questionnaire and through a review of past medical records. The Kaplan-Meier method was used to determine the survival rate, the log rank test was used to compare survival curves and the Cox proportional hazard model was used for multivariate analysis. Mean follow-up was 26.44 ± 16.6 months. The five-year death-censored graft survival of kidney transplant recipients from living donors in our center was 93.5% and the five-year patient survival was 82.2%, which is comparable with other transplant programs around the world. The number of acute rejection episodes was an independent risk factor for graft survival. Delayed graft function, younger recipient age and unknown cause of end-stage renal disease were found to be risk factors for graft failure but after adjusting for confounding factors, and the difference was not apparent.

  9. A Polysomnography Study of Kleine-Levin Syndrome in a Single Center

    Institute of Scientific and Technical Information of China (English)

    Yan-Wen Luo; Huan Yu; Lu-Hua Yuan; Guo-Xing Zhu

    2016-01-01

    Background:Kleine-Levin syndrome (KLS) is a rare sleep disorder characterized by recurrent episodes of hypersomnia.Polysomnographic (PSG) researches of KLS have been reported only in few publications in the past decades.This study aimed to investigate the characteristics of PSG of KLS.Methods:This study,which was conducted from March 2010 to July 2014,included seven patients diagnosed with KLS in the Sleep and Wake Disorder Center of Huashan Hospital,Fudan University (Shanghai,China).PSG and multiple sleep latency tests (MSLT) were performed during their episodes and the results were evaluated.Results:Five of the seven patients were males.The mean age at KLS onset was 15.6 ± 3.6 years.The number of episodes ranged from 2 to 7.The duration of episodes lasted from 4 to 11 days.The sleep architecture and proportion were normal in most of the patients.The average value of mean sleep latency was 6.9 ± 4.1 min.No sleep-onset rapid eye movement (SOREM) was detected in three of the patients,whereas one patient experienced one period of SOREM,and such episodes occurred twice in other two patients.Conclusions:We found that sleep architecture and proportion were normal in most KLS patients.However,the results of PSG and MSLT had no specificity for KLS patients.

  10. Hyperhemolysis in Patients With Hemoglobinopathies: A Single-Center Experience and Review of the Literature.

    Science.gov (United States)

    Danaee, Anicee; Inusa, Baba; Howard, Jo; Robinson, Susan

    2015-10-01

    Hyperhemolysis is a severe and potentially life-threatening complication of transfusion described in numerous case reports and gaining recognition since 2009 via the UK Serious Hazards of Transfusion scheme. Although it is predominantly seen in patients with sickle cell disease, there are several reports of this complication in patients with other hemoglobinopathies as well as patients with a range of other hematologic diagnoses who have blood transfusions as part of their management. Our understanding of the underlying pathophysiology of this subtype of delayed transfusion reaction has increased over the last few years; however, there are still questions, which remain unanswered. In our center alone, we have encountered 9 cases in the last 5 years both in the adult and pediatric population. Here we discuss our experience in the diagnosis and management of this complication, and review other cases reported in the literature and the various existing theories behind the pathophysiology of this process. We also discuss the role of genotyping and using DNA technology to aid selection of the most appropriate blood for this patient group. With an increased awareness of hyperhemolysis, it would be advantageous to finally develop international registries to determine the true incidence of hyperhemolysis, better understand the pathophysiology, identify markers to predict which patients are at risk, and inform management guidelines.

  11. Liver transplantation using organs from deceased organ donors: a single organ transplant center experience.

    Science.gov (United States)

    Han, Ming; Guo, Zhi-Yong; Zhao, Qiang; Wang, Xiao-Ping; Yuan, Xiao-Peng; Jiao, Xing-Yuan; Yang, Chun-Hua; Wang, Dong-Ping; Ju, Wei-Qiang; Wu, Lin-Wei; Hu, An-Bin; Tai, Qiang; Ma, Yi; Zhu, Xiao-Feng; He, Xiao-Shun

    2014-08-01

    In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program. From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively. Among the 29 donors, 24 were China Category II donors (organ donation after cardiac death), and five were China Category III donors (organ donation after brain death followed by cardiac death). The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422 (2-696) days. Among the five mortalities during the follow-up, three died of tumor recurrence. In terms of post-transplant complications, 9 recipients (34.6%) experienced early allograft dysfunction, 1 (3.8%) had non-anastomotic biliary stricture, and 1 (3.8%) was complicated with hepatic arterial thrombosis. None of these complications resulted in patient death. Notably, primary non-function was not observed in any of the grafts. With careful donor selection, liver transplant from deceased donors can be performed safely and plays a critical role in overcoming the extreme organ shortage in China.

  12. Simultaneous pancreas-kidney transplantation in a single center:10-year retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    ZHENG Jian-ming; SONG Wen-li; TU Jin-peng; FENG Gang; MO Chun-bai; SHEN Zhong-yang

    2011-01-01

    Background Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.Methods We retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.Results Of all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively.After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations)with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.Conclusion Although SPKT provides a successful and effective treatment for diabetics with end-stage renal disease,how to reduce the complications of this treatment still need further effort.

  13. Long-term outcome on kidney retransplantation: a review of 100 cases from a single center.

    Science.gov (United States)

    Barocci, S; Valente, U; Fontana, I; Tagliamacco, A; Santori, G; Mossa, M; Ferrari, E; Trovatello, G; Centore, C; Lorenzi, S; Rolla, D; Nocera, A

    2009-05-01

    Renal transplantation has become an effective form of treatment for end-stage renal failure. Unfortunately, as a consequence of immunological and nonimmunological pathogenic mechanisms, chronic allograft nephropathy is responsible for the loss of a large proportion of kidney grafts after several years and return to dialysis. We have reported herein our 24 years of experience with second kidney transplantations. Of 1,302 kidney transplantations between January 1983 and June 2007 performed in our transplantation center, 100 were second transplantations. Kidney retransplantation was performed in 74 men and 26 women of overall mean age of 35.4 +/- 12.6 years. Cadaveric donor grafts were transplanted in 92 patients, whereas the remaining 8 were living-related donor kidneys. At 1, 5, and 10 years after kidney transplantation, patient survival rates were 100%, 96%, and 92%, respectively, whereas graft survival rates were 85%, 72%, and 53%, respectively. Immunosuppressive therapy included induction therapy with polyclonal anti-lymphocyte antibodies (ALG/ATG) or (starting from 1999) monoclonal anti CD 25 antibody. Our results demonstrated good outcomes for kidney retransplantations with allocation based on anti- HLA antibody identification together with induction immunosuppression.

  14. Rituximab for the therapy of systemic sclerosis: a series of 10 cases in a single center.

    Science.gov (United States)

    Vilela, Verônica Silva; Maretti, Giselle Baptista; Silva Gama, Lívia Marques da; Costa, Claudia Henrique da; Rufino, Rogério Lopes; Levy, Roger A

    2016-06-26

    Systemic sclerosis (SSc) is a chronic autoimmune disease with a high morbidity and mortality. Although cyclophosphamide is effective for severe and refractory cases, there is demand for new treatments. The biological treatment with B-cell depletion with rituximab (RTX) has demonstrated efficacy for this demand in open-label studies. This study was conducted with the aim to retrospectively evaluate all patients who used RTX for the treatment of SSc in our center. We retrospectively evaluated medical records of all patients with SSc who used RTX to treat this disease from January 2009 to January 2015. Systemic, cutaneous, and pulmonary involvement data and laboratory results before and six months after the first infusion of RTX were collected. Ten patients received treatment during the study period and were included in this series. All patients had a diffuse form of the disease. Five patients suffered from an early (duration of disease shorter or equal to four years), rapidly progressive disease, and another five received RTX at late stages of the disease. In both groups of patients, stabilization of the pulmonary picture was observed, with a fall in the skin score in those patients with early forms of the disease. Similar to findings in previous studies, RTX was effective in treating early and rapidly progressive forms of SSc. We also found that patients with long-term illness may benefit from the treatment. Copyright © 2016. Published by Elsevier Editora Ltda.

  15. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

    Science.gov (United States)

    Liu, Wei-Cheng; Wan, Song-Lin; Yaseen, SM; Ren, Xiang-Hai; Tian, Cui-Ping; Ding, Zhao; Zheng, Ken-Yan; Wu, Yun-Hua; Jiang, Cong-Qing; Qian, Qun

    2016-01-01

    Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented. PMID:27672293

  16. The Spectrum of Glomerular Diseases on Renal Biopsy: Data From A Single Tertiary Center In Oman

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    Dawood Al Riyami

    2013-05-01

    Full Text Available Objective: To study the pattern of glomerular disease (GD from the result of renal biopsies at our center.Methods: We conducted a retrospective review of 190 adult native renal biopsy reports from the pathology registry of renal biopsy performed at our hospital between 1992 and 2010.Results: Lupus nephritis was the most common pathology 48/133 (36.1% with a female preponderance. The most common primary glomerular disease was focal segmental glomerulosclerosis (FSGS 26/133(19.5%, followed by membranous glemerulopathy (MGN 13/133 (9.8%, and mesangial proliferative glomerulonephritis 6/133 (4.5%. IgA nephropathy and acute proliferative glomerulonephritis each accounted for 4/133 (3.0%. Membranoproliferative glomerulonephritis accounted for 3/133 (2.3%. Focal proliferative and cresentic glomerulonephritis each accounted for 2/133 (1.5%. Vasculitis was not common and there was no report of anti-GBM disease.Conclusion: Among the secondary glomerular diseases, lupus nephritis was the commonest condition with a female preponderance. Among the primary glomerular diseases, FSGS was the commonest. These results are consistent with global trend. IgA nephropathy is not common as the case in the Caucasian population. Vasculitis was not common and there was no report of anti-GBM disease.

  17. Rocket injector single element characterization at the Marshall Space Flight Center

    Science.gov (United States)

    Hutt, J.; Robertson, T.; Mcdaniels, D.; Eskridge, R.; Fisher, M.

    1993-01-01

    The paper describes three experimental facilities which are being developed at NASA's Marshall Space Flight Center (MSFC) for rocket injector cold-flow characterization. The first of these is an already operational cold-flow ambient-backpressure facility, which uses water and air to simulate LOX and gaseous hydrogen, respectively; the facility can be used to obtain discharge coefficients, to measure flow uniformity, and to develop diagnostic techniques for use in the high-backpressure cold-flow chamber that is being currently developed at MSFC. The second is a cold-flow acrylic model facility to be used for evaluating the effect of changes in the internal flow geometry on the performance and combustion stability characteristics of a swirl coaxial LOX post. The third is a high-pressure cold-flow facility to be used for the characterization of the injector elements' performance; a specific application is to determine the effect of swirl elements on the temperature striations in the SSME preburners.

  18. Prevalence and Severity of Anemia in Pediatric Hemodialysis Patients; A Single Center Study

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    Alaleh Ghasari

    2007-04-01

    Full Text Available Objective: To determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis and to identify independent predictor for anemia in children on hemodialysis. Material & Methods: A cross sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7−20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan, Iran. Findings: A total of 22 (82% patients had hemoglobin level of 200 pg/ml in 16 patients (66% and >400 pg/ml in 9 patients (37.5%. There was a reverse correlation between PTH level>200 pg/ml and hemoglobin level (r=-0.505, P=0.046. Conclusion: The prevalence of anemia in children on hemodialysis in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis (less than 6 months, low albumin and severe hyperparathyroidism.

  19. Infections caused by Fusobacterium in children: a 14-year single-center experience.

    Science.gov (United States)

    Shamriz, Oded; Engelhard, Dan; Temper, Violeta; Revel-Vilk, Shoshana; Benenson, Shmuel; Brooks, Rebecca; Tenenbaum, Ariel; Stepensky, Polina; Koplewitz, Benjamin; Kaufmann, Michal; Averbuch, Diana

    2015-12-01

    This study aimed at reviewing our experience with infections caused by Fusobacterium in children. A retrospective analysis of medical records of children admitted to Hadassah-Hebrew University Medical Center from 2000 to 2013, in whom Fusobacterium spp. was identified in any specimen. A total of 22 patients (males = 12) at a mean ± SE age of 5 ± 1 (range 1-17) years, were identified. The most common complication was abscess formation (n = 11, 50 %). Eight children (36.4 %) had intracranial complications, including brain abscess (n = 4), meningitis (n = 4) and cerebral sinus vein thrombosis (CSVT, n = 5). Seventeen children (77 %) had bacteremia. Primary site of infection was otogenic (n = 9), oropharyngeal (n = 7), respiratory (n = 2), sinuses (n = 2), intra-abdominal (n = 1) and mucositis (n = 1). Fourteen cases were caused by Fusobacterium necrophorum, including four cases with CSVT, 7/8 cases of mastoiditis, four of them with subperiosteal abscess formation; all four cases with meningitis and two brain abscesses. Fifteen (68 %) patients required surgical intervention and 3 (14 %) received anti-coagulation therapy. Excluding one patient with overwhelming sepsis with fatal outcome, all patients recovered. Fusobacterium infections in children can cause a diverse spectrum of disease and is associated with high rates of abscess formation and intracranial complications. Although Fusobacterium nucleatum is abundant in the oral cavity, F. necrophorum is the main pathogen that causes severe infections in healthy children.

  20. Acquired hemophilia a: retrospective analysis of 49 cases from a single Chinese hemophilia center.

    Science.gov (United States)

    Yang, Yanhui; Xue, Feng; Shi, Hao; Wang, Hongmei; Zhang, Lei; Ji, Linxiang; Yang, Renchi

    2015-01-01

    Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the autoantibody directed against factor VIII in patients without previous history of a bleeding disorder. We retrospectively analyzed the characteristics and outcomes of 49 patients with AHA diagnosed in our center from February 1994 to October 2012. Twenty-four patients with acute bleeding episodes were treated with prothrombin complex concentrate (PCC) at a relative low dose of 30 to -50 U/kg/d and achieved good outcomes without any adverse reaction. Corticosteroids alone or in combination with cyclophosphamide were used as the first-line therapy to eradicate the inhibitors. In 39 evaluable patients, 35 (89.7%) achieved complete remission (CR). This study demonstrates that when bypassing agents such as recombinant activated factor VII and activated PCCs are not affordable or available, low dose PCC is effective and safe to control acute bleeding in patients with AHA. First-line therapy achieved good outcomes with a CR rate of 89.7%.

  1. Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

    Directory of Open Access Journals (Sweden)

    Xiquan Tian

    2015-04-01

    Full Text Available Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys. Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed. Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes and the mean estimated blood loss was 134 mL (80-650 mL.The mean postoperative hospital stay was 3.6 days (3-5days and the mean return to normal activity was 11.6 days (10-14days. Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur. Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.

  2. Safety of Early Carotid Artery Stenting after Systemic Thrombolysis: A Single Center Experience

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    Fabrizio Sallustio

    2012-01-01

    Full Text Available Background. Patients with acute ischemic stroke due to internal carotid artery (ICA disease are at high risk of early stroke recurrence. A combination of IV thrombolysis and early carotid artery stenting (CAS may result in more effective secondary stroke prevention. Objective. We tested safety and durability of early CAS following IV thrombolysis in stroke patients with residual stenosis in the symptomatic ICA. Methods. Of consecutive patients treated with IV rtPA, those with residual ICA stenosis ≥70% or 24 hours. The protocol included pre-rtPA MRI and MR angiography, and post-rtPA carotid ultrasound and CT angiography. Stroke severity was assessed by the NIH Stroke Scale (NIHSS. Three- and twelve-month stent patency was assessed by ultrasound. Twelve-month functional outcome was assessed by the modified Rankin Scale (mRS. Results. Of 145 consecutive IV rtPA-treated patients, 6 (4% underwent early CAS. Median age was 76 (range 67–78 years, median NIHSS at stroke onset was 12 (range 9–16 and 7 (range 7-8 before CAS. Median onset-to-CAS time was 48 (range 30–94 hours. A single self-expandable stent was implanted to cover the entire lesion in all patients. The procedure was uneventful in all patients. After 12 months, all patients had stent patency, and the functional outcome was favourable (mRS ≤ 2 in all but 1 patient experiencing a recurrent stroke for new-onset atrial fibrillation. Conclusion. This small case series of a single centre suggests that early CAS may be considered a safe alternative to CEA after IV rtPA administration in selected patients at high risk of stroke recurrence.

  3. Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Holme Hansen, Ebba; Due, Pernille

    2003-01-01

    To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep.......To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep....

  4. "Awake Veno-arterial Extracorporeal Membrane Oxygenation" in Pediatric Cardiogenic Shock: A Single-Center Experience.

    Science.gov (United States)

    Schmidt, F; Jack, T; Sasse, M; Kaussen, T; Bertram, H; Horke, A; Seidemann, K; Beerbaum, P; Koeditz, H

    2015-12-01

    In pediatric patients with acute refractory cardiogenic shock (CS), extracorporeal membrane oxygenation (ECMO) remains an established procedure to maintain adequate organ perfusion. In this context, ECMO can be used as a bridging procedure to recovery, VAD or transplantation. While being supported by ECMO, most centers tend to keep their patients well sedated and supported by invasive ventilation. This may be associated with an increased risk of therapy-related morbidity and mortality. In order to optimize clinical management in pediatric patients with ECMO therapy, we report our strategy of veno-arterial ECMO (VA-ECMO) in extubated awake and conscious patients. We therefore present data of six of our patients with CS, who were treated by ECMO being awake without continuous analgosedation and invasive ventilation. Of these six patients, four were 14 years of age. Median time on ECMO was 17.4 days (range 6.9-94.2 days). Median time extubated, while receiving ECMO support was 9.5 days. Mean time extubated was 78 % of the total time on ECMO. Three patients reached full recovery of cardiac function on "Awake-VA-ECMO," whereas the other three were successfully bridged to destination therapy (VAD, heart transplantation, withdrawal). Four out of our six patients are still alive. Complications related to ECMO therapy (i.e., severe bleeding, site infection or dislocation of cannulas) were not observed. We conclude that "Awake-VA-ECMO" in extubated, spontaneously breathing conscious pediatric patients is feasible and safe for the treatment of acute CS and can be used as a "bridging therapy" to recovery, VAD implantation or transplantation.

  5. Hepatobilio-pancreatic robotic surgery: initial experience from a single center institute.

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    Quijano, Yolanda; Vicente, Emilio; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Malave, Luis; Ferri, Valentina; Plaza, Carlos; Lindemann, Jan Lammel; D'Andrea, Vito; Caruso, Riccardo

    2016-12-30

    The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy. There were two left hepatectomies, one right hepatectomy, one associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), three bisegmentectomies and three segmentectomies, eight wedge resections, and three pericystectomies. The mean operating time was 282 min. The overall conversion rate and postoperative complication rate were 4.7 and 19%, respectively. The mean length of hospital stay was 13.4 days (range 4-64 days). Of the 45 patients subjected to pancreatic resection, 22 were male and 23 female. The average age of all patients was 62 years (range 31-82 years). The mean operating room (OR) time was 370 min (120-780 min). Among the procedures performed were 15 pancreatico-duodenectomies, 19 distal pancreatectomies, and 11 enucleations. All procedures in the HBP area were R0. Our early experience shows that robotic surgery is a safe and feasible procedure in the HBP area. The complication and mortality rates are comparable to those of open surgery, but with the advantages of minimally invasive surgery.

  6. Hepatitis C virus infection among patients on hemodialysis: A report from a single center in Iran

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    Nemati Eghlim

    2009-01-01

    Full Text Available The aim of this study is to evaluate the incidence of hepatitis C virus (HCV infec-tion among the hemodialysis (HD patients at the Nephrology and Urology Research Center, Tehran, Iran, and identify the potential risk factors. A total of 112 patients on HD in our two dia-lysis units were studied. The mean duration of follow-up was 27 ± 27 months (range, 6-132. All study subjects were HCV-negative at entry to the study and were tested for anti-HCV antibody by ELISA II every six months thereafter. Positive samples were re-examined by RT/PCR for confir-mation. Factors that might be implicated in HCV transmission were evaluated. Six patients (5.3% were labeled as HCV infected, at the end of the follow-up period. Thus, the incidence of HCV infection in our dialysis units was 1.8 per 100 person years. A total of 64.5% of the study popu-lation had previous history of blood transfusion(s and 8% had undergone prior transplantation. Univariate analysis showed a significant relationship between number of blood transfusions and duration on dialysis and HCV infection. Multivariate analysis revealed that only duration on HD was significantly associated with HCV positivity (OR: 1.03, p=0.008. Our study further suggests that nosocomial transmission plays a major role in HCV transmission among patients on HD. Meticulous practice of preventive measures is essential to eradicate the spread of HCV in HD units.

  7. Healthcare Resource Utilization Associated with Burns and Necrotizing Fasciitis: A Single-Center Comparative Analysis.

    Science.gov (United States)

    Burnett, Eileen; Gawaziuk, Justin P; Shek, Kevin; Logsetty, Sarvesh

    2017-03-06

    Necrotizing fasciitis (NF) patients are increasingly managed in burn units. Although treated similarly to burns, the healthcare resource utilization (HRU) in NF appears to be greater. Accurate knowledge of the HRU is important to better allocate resources and to compare outcomes between units. The goal of this study is to provide better understanding of the HRU for NF compared with burns. A retrospective chart review of patients ≥18 years admitted to two regional tertiary referral centers with either NF or burns requiring surgery. The authors examined age, sex, %TBSA, geographic region, anatomical location, length of stay (LOS) in hospital, LOS in intensive care unit, number of operative procedures, number of packed red blood cells transfused, amputation, death, and use of free tissue transfer or skin graft. There were 210 NF and 209 burn patients. The NF cohort had a smaller TBSA (3.3 vs 10.0%), longer LOS (20 vs 14 days), and consequently a longer LOS/%TBSA (6.0 vs 1.5 days). This difference persisted after adjusting for age. More of the NF cohort (44.8%) spent ≥1 day in the intensive care unit. The NF cohort also had more procedures (median 2 vs 1), required blood (46.2 vs 16.7%), died in hospital (13.3 vs 4.3%), had an amputation (12.4 vs 4.8%), or required free tissue transfer (7.6 vs 2.9%). This study shows that NF requires substantially more HRU compared with burns. This information is important in recognizing the impact of these patients on burn units and planning for allocation of appropriate resources.

  8. Is Antibiotic Usage Necessary after Donor Nephrectomy? A Single Center Experience

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    Zomorrodi Afshar

    2008-01-01

    Full Text Available Proper management of living kidney donors is a very important aspect of all renal transplants. To date, approximately 60,000 living donor nephrectomies have been performed worldwide and about 20 deaths directly related to the operation have been reported. The most common cause of death has been pulmonary embolism. Wound infection following surgery is the third most common nosocomial infection, and is dependent on the surgeon and his/her team, the operating room, number and virulence of contaminated bacteria, patient characteristics (immunity and defense, as well as time and duration of administration of antibiotics. Approach to the prophylaxis of wound infection in kidney donors varies in different transplant centers. This study was conducted at the Emam Hospital, Tabriz, Iran in order to delineate the protocol regarding antibiotic usage after donor nephrectomy. One hundred kidney donors were enrolled in the study. They were classified randomly in two groups: Group-1, comprising 50 donors, who received antibiotics immediately following surgery and for at least seven days thereafter. Group-2, comprised of 50 donors, in whom one gram of cephazoline was injected intravenously before anesthesia and continued for 24 hours after surgery. The patients were followed-up for one month with particular emphasis on occurrence of wound infection. One patient in Group-1, and two in Group-2 had wound infection; the difference was not statistically significant (p = > 0.5. Our study suggests that antibiotic prophylaxis started before incision and continued for 24 hours after donor nephrectomy is safe and effective in preventing wound infection.

  9. Fertility preservation in female cancer patients:a single center experience

    Institute of Scientific and Technical Information of China (English)

    Cristina Sigismondi; Enrico Papaleo; Paola Viganò; Simona Vailati; Massimo Candiani; Jessica Ottolina; Valentina E. Di Mattei; Giorgia Mangili

    2015-01-01

    Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer treatment and to facilitate fertility preservation, including oocyte and ovarian tissue cryopreservation. These fertility issues are often inadequately addressed, and referral rates to oncofertility centers are low. The aim of this study was to report the 3-year experience of the San Raffaele Oncofertility Unit. A total of 96 patients were referred to the Oncofertility Unit for evaluation after the diagnosis of cancer and before gonadotoxic treatment between April 2011 and June 2014. Of the 96 patients, 30 (31.2%) were affected by breast cancers, 20 (20.8%) by sarcomas, 28 (29.2%) by hematologic malignancies, 13 (13.5%) by central nervous system cancers, 3 (3.1%) by bowel tumors, 1 (1.0%) by Wilms’ tumor, and 1 (1.0%) by a thyroid tumor; 47 (49.0%) were referred for oocyte cryopreservation before starting chemotherapy, 20 (20.8%) were referred for ovarian tissue cryopreservation, and 29 (30.2%) were not recruited. The mean time between the patients’ counseling and oocyte retrieval was 15 days (range, 2–37 days). The mean time between the laparoscopic surgery and the beginning of treatment was 4 days (range, 2–10 days). The number of patients who were referred increased over time, whereas the rate of patients who were not recruited decreased, showing an improvement in referrals to the Oncofertility Unit and in the patients’ counseling and understanding. Our results indicate that an effective multidisciplinary oncofertility team is necessary for prompt referrals and treatment.

  10. CryoPlasty therapy of the superficial femoral and popliteal arteries: a single center experience.

    Science.gov (United States)

    Samson, Russell H; Showalter, David P; Lepore, Michael R; Ames, Scott

    Long-term patency remains a significant hurdle in the minimally invasive treatment of arteriosclerosis in the superficial femoral and popliteal arteries. New technologies designed to address the sources of restenosis have recently been introduced. CryoPlasty therapy (Boston Scientific, Natick, Mass) is a new approach designed to significantly reduce injury, elastic recoil, stent implantation, neointimal hyperplasia, and constrictive remodeling. The technique combines the dilatation forces of percutaneous transluminal angioplasty with cold thermal energy applied to the plaque and vessel wall. The cumulative effect of limiting the sources of restenosis with CryoPlasty therapy was shown to demonstrate longer term patency in a prospective, multicenter, Investigational Device Exemption study of the PolarCath Peripheral Dilatation System. The CryoPlasty therapy experience of 1 center is reported, in which 47 lesions in 32 consecutive patients (34 procedures, 33 limbs) were treated. The technical success rate was 96%. There were no type 3 flow-limiting dissections, and only 4 (8.5%) lesions were stented. There were no unanticipated adverse events, specifically no thrombus, acute occlusions, distal embolizations, aneurysms, or groin complications. With an average follow-up of 12 months, only 5 lesions have recurred, 4 requiring re-intervention. The 12-month freedom from restenosis for lesions and limbs treated was 82.2% and 84.4%, respectively. These results are similar to the findings of the Investigational Device Exemption study and are encouraging. CryoPlasty therapy appears to be a viable endovascular therapeutic option to achieve longer term patency without compromising options for future interventions. The lack of early occlusions may be due to a low rate of spiral dissection that may be a particular benefit of this form of angioplasty.

  11. Laparoscopic versus open distal pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors: a large single-center study.

    Science.gov (United States)

    Han, Sang Hyup; Han, In Woong; Heo, Jin Seok; Choi, Seong Ho; Choi, Dong Wook; Han, Sunjong; You, Yung Hun

    2017-06-29

    Pancreatic neuroendocrine tumors (PNETs) account for 1-2% of all pancreatic neoplasms. Nonfunctioning PNETs (NF-PNETs) account for 60-90% of all PNETs. Laparoscopic distal pancreatectomy (LDP) is becoming the treatment of choice for benign lesions in the body and tail of the pancreas. However, LDP has not yet been widely accepted as the gold standard for NF-PNETs. The purpose of this study is to evaluate the clinical and oncologic outcomes after laparoscopic versus open distal pancreatectomy (ODP) for NF-PNETs. Between April 1995 and September 2016, 94 patients with NF-PNETs underwent open or laparoscopic distal pancreatectomy at Samsung Medical Center. Patients were divided into two groups: those who underwent LDP and those who underwent ODP. Both groups were compared in terms of clinical and oncologic variables. LDP patients had a significantly shorter hospital stay compared with ODP patients, amounting to a mean difference of 2 days (p < 0.001). Overall complication rates did not differ significantly between the ODP and LDP groups (p = 0.379). The 3-year overall survival rates in the ODP and LDP groups were 93.7 and 100%, respectively (p = 0.069). In this study, LDP for NF-PNETs had similar oncologic outcomes compared with ODP. In addition, LDP was associated with a shorter hospital stay compared with ODP. Therefore, LDP is a safe and effective procedure for patients with NF-PNETs. A multicenter study and a randomized controlled trial are needed to better assess the clinical and oncologic outcomes.

  12. Premarital screening for hemoglobinopathies: experience of a single center in Kurdistan, Iraq.

    Science.gov (United States)

    Al-Allawi, Nasir A S; Al-Doski, Adnan A S; Markous, Raji S D; Mohamad Amin, Khyria A K; Eissa, Adil A Z; Badi, Ameer I A; Asmaro, Rafal R H; Hamamy, Hanan

    2015-01-01

    A program for the prevention of major hemoglobinopathies was initiated in 2008 in the Kurdistan region of Iraq. This study reports on the achievements and challenges of the program. A total of 102,554 individuals (51,277 couples) visiting a premarital center between 2008 and 2012 were screened for carrier status of hemoglobinopathies, and at-risk couples were counseled. A total of 223 (4.3/1,000) couples were identified and counseled as high-risk couples. Available data on 198 high-risk couples indicated that 90.4% proceeded with their marriage plans, and 15% of these married couples decided to have prenatal diagnosis (PND) in subsequent pregnancies with the identification of 8 affected fetuses; all were terminated as chosen by the parents. Thirty affected births were recorded among the high-risk couples. The premarital program managed to reduce the affected birth rate of major hemoglobinopathies by 21.1%. Of the 136 affected babies born during the study period, 77.9% were born to couples married prior to the start of the program, while 22.1% were born to couples identified as having a high risk. The main reason for not taking the option of PND was unaffordable costs. Financial support would have increased opting for PND by high-risk couples. Further reduction in affected birth rates could be achieved by including parallel antenatal screening programs to cover those married before the initiation of the premarital program and improving the public health education and counseling programs. © 2015 S. Karger AG, Basel.

  13. Five years renal transplantation data: Single-center experience from Iraq

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    Ala A Ali

    2016-01-01

    Full Text Available Renal transplantation is the treatment of choice for patients with end-stage renal disease. In Iraq, renal transplantation started in 1973 and has continued until now with live donor transplantation, since deceased donor transplant program is not approved as yet. Long-term transplant data are still scarce. The aim of our study is to present data on transplantation and medical follow-up at one year and, survival analysis at one, three and five years. A total of 250 renal transplantations were performed at the Nephrology and Renal Transplantation Center, Baghdad between January 2009 and January 2014. It is a living donor, blood group compatible donor program. All patients received triple immunosuppression (calcineurine inhibitor, mycophenolate mofetil or mycophenolic acid, and steroid. The Kaplan-Meier method was used to determine the survival rate. There were 92 live related donors, 143 unrelated donors, and 15 spouse donors. The mean age was 34.07 ± 12.2 years. The one-year graft survival for related and unrelated donor transplants was 98.9% and 91.8%, respectively. Graft survival was lower (82.9% in recipients with acute rejection episodes. The patient survival at one-year was 94%. The three-year graft and patient survival was 91% and 90%, respectively, and five-year survival for grafts and patients was 87.1% and 88%, respectively. The outcome of the renal transplantation in Iraq is improving. Long-term patient follow-up needs more meticulous attention. The development of renal transplant registry is critical for future planning. Moreover, renal transplantation practice in Iraq needs more social, religious, and governmental support.

  14. Management of autoimmune hemolytic anemia in children and adolescents: A single center experience

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    Nazan Sarper

    2011-09-01

    Full Text Available Objective: To present and discuss the treatment of autoimmune hemolytic anemia (AIHA. Materials and Methods: The medical records of all patients (n=19 diagnosed in a tertiary hematology center between 1999 and 2010 were retrospectively reviewed.Results: Median age at diagnosis of AIHA was 5 years (range: 4 months-17 years. In all, 13 patients had primary (idiopathic AIHA, whereas 2 had primary Evans Syndrome (ES, 2 had autoimmune lymphoproliferative syndrome (ALPS+ES, and 1 had Wiskott-Aldrich syndrome (WAS+AIHA. Among the 13 primary idiopathic AIHA patients, 9 recovered following a 4-8-week course of prednisolone treatment without relapses, whereas 3 patients required a longer course of prednisolone. One AIHA patient that was very resistant to prednisolone recovered after cyclosporine A was added to the treatment. All patients with primary idiopathic AIHA were in remission for a median of 3 years (range: 4 months-10 years at the time this manuscript was written. Among the patients with primary ES, 2 had relapses similar to the ALPS patients. Splenectomy was performed in 1 primary ES patient, who at the time this report was written was also in remission. One ALPS patient required the addition of mycophenolate mofetil due to prednisolone resistance. The WAS patient was treatment resistant and died due to septicemia.Conclusions: Primary AIHA in pediatric patients generally has an acute onset and good response to corticosteroids. Primary or secondary ES has a chronic or relapsing course, and treatment may require other immunosuppressive agents in addition to corticosteroids. Complications of splenectomy must not be underestimated in patients with underlying immunodeficiency. AIHA often causes considerable morbidity and mortality in WAS.

  15. Management and outcomes of intramedullary spinal cord tumors: A single center experience from a developing country

    Science.gov (United States)

    Bakhshi, Saqib K.; Waqas, Muhammad; Shakaib, Baila; Enam, Syed A.

    2016-01-01

    Background: Intraoperative neurophysiology, high magnification microscopes, and ultrasonic aspirators are considered essential aid for the safe resection of intramedullary spinal cord tumors (IMSCTs). Most centers in developing countries such as Pakistan still lack these facilities. The purpose of this study was to review the management of IMSCTs at our hospital and to determine factors associated with the outcomes of surgery. Methods: This was a retrospective review of medical records of adult patients undergoing surgery for IMSCT over 12 years. The institutional ethical review committee approved this study. Data were collected regarding demographics, clinical and radiological features, and surgical details. Modified McCormick Scale was used to grade patients’ neurological status at admission, discharge, and follow-up. Statistical analysis was performed using the Statistical Package for Social Sciences version 22. Results: Forty three cases were reviewed. Mean age was 33.8 ± 15.1 years whereas median follow-up was 5 months (range: 0.25–96 months). Most patients had ependymoma (n = 16; 73%). Cervical region was the most commonly involved (n = 15; 34.9%). Gross total resection (GTR) was achieved in 30 cases (69.8%). The preoperative McCormick grade was significantly associated with follow-up McCormick grade (P value = 0.002). Eight patients (18.6%) underwent intraoperative electrophysiological monitoring, out of which GTR was achieved in all cases, and none had disease progression or recurrence. Ten patients received postoperative radiotherapy. Thirty five patients (81.4%) had progression free survival at last follow-up. Conclusions: We achieved a GTR rate of 68.9% for IMSCTs with limited resources. In few cases, where intraoperative electrophysiology was used, the rate of GTR was 100%. Preoperative neurological status was associated with better postoperative McCormick score. PMID:27656322

  16. New insights into folliculotropic mycosis fungoides (FMF): A single-center experience.

    Science.gov (United States)

    Hodak, Emmilia; Amitay-Laish, Iris; Atzmony, Lihi; Prag-Naveh, Hadas; Yanichkin, Natalia; Barzilai, Aviv; Kershenovich, Ruben; Feinmesser, Meora

    2016-08-01

    It is generally accepted that folliculotropic mycosis fungoides (FMF) is usually typified by indurated plaques and tumors mainly on the head/neck and an aggressive course. However, its clinical manifestations have long been recognized to be quite variable, and some studies indicate a better prognosis for certain presentations. We sought to summarize our experience with the clinicopathological presentations of FMF and impact on prognosis. Data were collected retrospectively for adults with FMF followed up prospectively at a tertiary medical center in 1995 through 2014. In all, 34 patients presented with follicle-based patch/flat plaques, keratosis pilaris-like lesions, and/or acneiform lesions, defined clinically as early stage (IA, IB), and 15 presented with follicle-based infiltrated plaques and/or tumors, defined as advanced stage (IIB). The head/neck was involved in all tumor-stage cases, whereas early-stage lesions involved mainly the trunk/limbs. The tumor stage was characterized by more pruritus, heavier perifollicular infiltrates, greater vertical depth, and more frequent presence of eosinophils. On multivariate analysis, infiltrate density was the only significant histopathological discriminator between the stages. Estimated 5-year survival was 0.94 in the early-stage group and 0.69 in the tumor-stage group. Lack of long-term follow-up and relatively small sample are limitations. FMF presents with 2 distinct patterns of clinicopathologic features, early stage and advanced stage, each with different prognostic implications. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

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    Yazmin Yaacob

    2013-01-01

    Full Text Available Purpose: To report our early experience in image-guided chemoport insertions by interventional radiologists. Materials and Methods: This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. Results: The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%, followed by catheter-related infection (9/161; 5.6%. Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8% chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Conclusion: Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication.

  18. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  19. Laparoscopic splenectomy: a single center experience. Unusual cases and expanded inclusion criteria for laparoscopic approach.

    Science.gov (United States)

    Marte, Gianpaolo; Scuderi, Vincenzo; Rocca, Aldo; Surfaro, Giuseppe; Migliaccio, Carla; Ceriello, Antonio

    2013-06-01

    Laparoscopic splenectomy (LS) is nowadays considered as the gold standard for most hematological diseases where splenectomy is necessary, but many questions still remain. The aim of this study was to analyze our 5-years experiences consisting of 48 consecutive LS cases in order to assess the optimal approach and the feasibility of the procedure also in malignant diseases and unusual cases such as a primary spleen lymphoma, a big splenic artery aneurism, or a spleen infarct due to a huge pancreatic pseudo-cyst. Forty-eight consecutive patients underwent LS from January 2006 to January 2011 with at least 1-year follow-up. Clinical data and immediate outcome were retrospectively recorded; age, diagnosis, operation time, perioperative transfusion requirement, conversion rate, accessory incision, hospital stay, and complications were analyzed. We had 14 cases of malignant splenic disease, the most frequent malignant diagnosis was non-Hodgkin's lymphoma (12/14, 85.7 %). Splenomegaly (interpole diameter (ID) >20 cm) was observed in 12 cases (25 %) and massive splenomegaly (ID >25 cm) in 3 cases (6.25 %). Conversion to laparotomy occurred in two patients (4.16 %), both associated to uncontrollable bleeding in patients with splenomegaly. Mean operative time was 138 ± 22 min. Mean hospital stay was 4.5 days. Postoperative morbidity rate was 8.8 % for the benign group and 35.7 % in the malignant group. Mortality occurred in 1/48 patients (2.08 %), as a result of overwhelming post-splenectomy infection (OPSI). LS can be performed safely for malignant splenic disease and splenomegaly without any statistically significant increase of morbidity and mortality rate. Conversion rate is increased for massive splenomegaly. LS should be considered as the preferential approach even in patients with malignant disease, splenomegaly, or unusual cases. Massive splenomegaly should be considered as relative contraindication to LS even at experienced centers.

  20. Acute kidney injury and mortality in hematopoietic stem cell transplantation: A single-center experience

    Directory of Open Access Journals (Sweden)

    B Sehgal

    2017-01-01

    Full Text Available Hematopoietic stem cell transplant (HSCT is a life-saving procedure for patients with several malignant and nonmalignant hematological disorders. Acute kidney injury (AKI is a common complication after HSCT. The aim of the study was to identify the incidence and outcomes of AKI associated with HSCT in our center. Sixty-six HSCT recipients from October 2008 to March 2014 at Christian Medical College, Ludhiana, were followed up till July 31, 2014. RIFLE criteria utilizing serum creatinine was used to diagnose and stage AKI. Mortality and AKI were the primary outcomes studied. The risk of AKI in relation to conditioning regimen, type of HSCT (allogeneic and autologous, co-morbidities, graft versus host disease, drug toxicity, and veno-occlusive disease were analyzed. Sixty-five patients were included in the study. Male: Female ratio was 3.6:1 with a median age of 17 years (1.5–62. Forty-nine (75.4% patients had AKI over 3 months, R 17 (26.2%, I 19 (29.2%, and F 13 (20%. AKI occurred at a mean of 19.4 ± 29.2 days after the HSCT. AKI was more commonly observed in patients undergoing allogeneic versus autologous HSCT (85.2% in allogeneic vs. 27.8% in autologous, P = 0.005. Mortality was seen in 20 patients (30.8% in 3 months. AKI in the first 2 weeks (P < 0.016 was a significant risk factor for mortality. Incidence of AKI in HSCT is high and accounts for significant mortality and morbidity. RIFLE classification of AKI has prognostic significance among HSCT patients with an incremental trend in mortality.

  1. Cinacalcet in pediatric and adolescent chronic kidney disease: a single-center experience.

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    Alharthi, Abdulla A; Kamal, Naglaa M; Abukhatwah, Mohamed W; Sherief, Laila M

    2015-01-01

    Cinacalcet, a calcimimetic drug, has been shown to be efficacious in adult chronic kidney disease (CKD) patients; however, it was not fully studied in pediatric CKD patients. We aimed at assessing the effect of cinacalcet on intact parathyroid hormone (iPTH) secretion in children with CKD-4/5 with iPTH consistently ≥ 300 pg/mL refractory to conventional treatment. This is a prospective cohort analysis of 28 children with uncontrolled hyper-parathyroidism secondary to stage 4 and 5 CKD admitted to a tertiary center during the period from April 2012 to April 2014. Twenty-eight patients with CKD-4/5 were assessed prospectively regarding bone biochemistry, renal ultrasonography, serum iPTH level, and medications. Patients were classified into 3 groups: group 1, 6 patients with CKD-4 on supplemental and supportive therapy; group 2, 6 patients with CKD-5 on hemodialysis and; group 3, 16 patients with CKD-5 on automated peritoneal dialysis. Patients were between the ages of 9 months and 18 years on commencing cinacalcet at doses of 0.5 to 1.5 mg/kg. All patients showed at least a 60% reduction in iPTH (60%-97%). Highly significant reduction in iPTH and serum alkaline phosphatase levels was detected post-cinacalcet. The serum calcium (Ca), phosphate (P), and Ca × P product were unaffected. Treatment was well tolerated with no hypophosphatemia, hypocalcemia, or other adverse effects almost in all patients. Cinacalcet use was proven safe for all pediatric and adolescent patients with CKD-4/5 during the study period, and at the same time most of the patients reached the suggested iPTH target values.

  2. Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience

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    Özdemir, Nihal; Tüysüz, Gülen; Çelik, Nigar; Yantri, Leman; Erginöz, Ethem; Apak, Hilmi; Özkan, Alp; Yıldız, İnci; Celkan, Tiraje

    2016-01-01

    Aim: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. Material and Methods: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients’ files. Results: A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen. Conclusions: In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving

  3. Endovascular treatment of ruptured proximal pica aneurysms: A single-center 5-years experience

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    Vivek Gupta

    2014-01-01

    Full Text Available Background and Purpose: Posterior inferior cerebellar artery (PICA like other intracranial arteries is prone to aneurysm formation. Aneurysms usually arise from the vertebral artery (VA - PICA junction and the proximal segment of the PICA. The use of endovascular treatment as an alternative treatment to surgery has been increasing. We present our last 5 years experience in treating the ruptured proximal PICA aneurysms. Materials and Methods: Retrospective analysis of records of all patients with ruptured VA-PICA junction aneurysms treated at our referral center between July 2008 and July 2013 was performed. Over the last 5 years, we came across 17 patients who had aneurysms of proximal PICA or VA-PICA junction out of which 13 patients underwent endovascular treatment for ruptured saccular VA-PICA junction aneurysms and were the focus of this research. Follow-up studies ranged from 6 months to 3 years. Results: All the patients presented with an acute intracranial hemorrhage on NCCT. All the aneurysms were at VA-PICA junction with partial or complete incorporation of PICA origin in the sac. Endovascular treatment of all the 13 aneurysm was successful in the first attempt. Aneurysms were treated with balloon assisted coiling either by placing the balloon across the VA-PICA junction (n = 3 or in the vertebral artery proper (n = 9. Stent assisted coiling VA-PICA was performed in one aneurysm (n = 1. There was no intra-procedural rupture of the aneurysms. Conclusion: Endovascular therapy of ruptured proximal PICA aneurysms is possible and safe with the use of adjuvant devices and should be considered as first line treatment.

  4. Demographic and Clinical Characteristics of Type 1 Diabetes Mellitus in Omani Children - Single Center Experience

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    Saif Al-Yaarubi

    2014-03-01

    Full Text Available Objectives: To describe the demographic characteristics and clinical presentation of Omani children with type 1 diabetes mellitus at Sultan Qaboos University Hospital, Muscat, Oman. Methods: A retrospective analysis of all children with type 1 diabetes mellitus attending the Pediatric Endocrine Unit at Sultan Qaboos University Hospital, Oman from June 2006 to May 2013. Results: One hundred and forty-four patients were included in the study. The mean±SD of age at diagnosis was 6.7 ± 3.7 years. The median duration of symptoms was 10 days (IQR; 5-14. The most commonly reported presenting symptoms were polyuria (94%, polydipsia (82%, and weight loss (59%. Diabetic ketoacidosis at initial presentation was diagnosed in 31% of the patients. Different insulin regimens were prescribed: multiple daily injections in 109 (76% patients, twice daily insulin regimen in 23 (16% patients, and insulin pump therapy in 12 (8% patients. Family history of type 1 diabetes mellitus was present in 31 (22% patients. There were no significant differences in presenting complaints (polyuria, p=0.182; polydipsia, p=0.848, duration of symptoms (p=0.331, reported weight loss (p=0.753, or diabetic ketoacidosis at presentation (p=0.608 between patients with and without family history of type 1 diabetes mellitus. Conclusion: Polyuria, polydipsia and weight loss are the most common presenting symptoms. Family history of type 1 diabetes mellitus is highly prevalent among the studied patients. Diabetic ketoacidosis was found to be less common in Oman compared to other diabetes centers in the Middle East.

  5. Comparison of endoscopic stenting for malignant biliaryobstruction: A single-center study

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM: To evaluate the efficacy and safety of single-stependoscopic placement of self-expandable metallic stents(SEMS) for treatment of obstructive jaundice.METHODS: A retrospective study was performedamong 90 patients who underwent transpapillarybiliary metallic stent placement for malignant biliaryobstruction (MBO) between April 2005 and October2012. The diagnosis of primary disease and MBO wasbased on abdominal ultrasound, computed tomography,magnetic resonance imaging, endoscopic ultrasound,endoscopic retrograde cholangiopancreatography withbrush cytology, biopsy, and/or a combination of thesemodalities. The type of SEMS (covered or non-covered,8 mm or 10 mm in diameter) was determined by theendoscopist. Ninety patients were divided into twogroups: group 1 (49 patients) who underwent a singlestepSEMS placement and group 2 (41 patients) whounderwent a two-step SEMS placement. The technicalsuccess rate, complication rate, stent patency, andpatient survival rate were compared between thegroups. In addition, to identify the clinical prognosticfactors associated with patient survival, the followingvariables were evaluated in Cox-regression analysis:gender, age, etiology of MBO (pancreatic cancer or nonpancreaticcancer), clinical stage (Ⅳb; with distant metastases or Ⅳa 〉; without distant metastases),chemotherapy (with or without), patency of the stent,and the use of single-step or two-step SEMS.RESULTS: Immediate technical success was achievedin 93.9% (46/49) in group 1 and in 95.1% (39/41)in group 2, with no significant difference (P = 1.0).Similarly, there was no difference in the complicationrates between the groups (group 1, 4.1% and group 2,4.9%; P = 0.62). Stent failure was observed in 10 casesin group 1 (20.4%) and in 16 cases in group 2 (39.0%).The patency of stent and patient survival revealed nodifference between the two groups with Kaplan-Meieranalysis, with a mean patency of 111 ± 17

  6. Evaluating the single seizure clinic model: Findings from a Canadian Center.

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    Rizvi, Syed; Hernandez-Ronquillo, Lizbeth; Moien-Afshari, Farzad; Hunter, Gary; Waterhouse, Karen; Dash, Dianne; Téllez-Zenteno, José F

    2016-08-15

    The effect of the single seizure clinic (SSC) model on patient diagnose, work-up, wait-times, and clinical care is poorly characterized and its efficacy unclear. The present study assesses patient characteristics and evaluates the impact of a single seizure clinic (SSC) model on wait-times and access to care. A prospective study of all patients (n=200) referred to our SSC for first seizure evaluation. Demographic, clinical, and paraclinicial variables were systematically collected and analyzed against a historical cohort. Binary logistic regression analysis was performed to predict impact of dichotomized variables on diagnosis of epilepsy. Diagnostic concordance between SSC nurses and epileptologists was also assessed. Predominant referral sources were emergency department physicians and general practitioners. Mean wait-time for first assessment was significantly reduced by 70.5% employing the SSC model versus historical usual care. A diagnosis was established at first-contact in 80.5% of cases while 16.0% of patients required a second visit. Eighty-two patients (41.0%) were diagnosed with epilepsy. An abnormal EEG was found in 93.9% of patients diagnosed with epilepsy. Sixty-three patients were started on anti-epileptic drugs (63.5% lamotrigine, 7.0% levetiracetam, 5.0% phenytoin, and 5.0% topiramate). In 18% of cases driving restrictions were initiated by the SSC. The most common non-seizure diagnosis was syncope (24.0%). The SSC reduced wait-times for assessment and investigations, clarified diagnoses, affected management decisions with respect to further workup, pharmacotherapy, and driving. There was moderate correlation between SSC nurses and physicians (kappa=0.54; pepilepsy. Key factors identified as predictors of epilepsy were: presence of abnormalities on electroencephalography and imaging studies, patients stratified as high or medium-risk for seizure recurrence, semiological characteristics such as amnesia and limb stiffening, and presence of tongue

  7. Hypovitaminosis D in Patients Undergoing Shoulder Arthroplasty: A Single-Center Analysis.

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    Inkrott, Bradley P; Koberling, Jessica L; Noel, Curtis R

    2016-07-01

    Vitamin D is recognized as an essential component in bone health, muscle function, and immune system regulation. This study sought to characterize the prevalence of hypovitaminosis D in patients undergoing total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RSA), and shoulder hemiarthroplasty (HA). Between September 2013 and December 2014, a total of 218 patients undergoing TSA, RSA, and HA by a single surgeon were screened for hypovitaminosis D and retrospectively reviewed. Demographic variables and risk factors were recorded. Overall, 93 shoulder arthroplasty patients (43%) were vitamin D insufficient (hypovitaminosis D (odds ratio [OR], 8.234, Phypovitaminosis D. Almost half (43%) of the study population was insufficient, and both the absence of supplementation prior to serum testing and BMI of 30 kg/m(2) or greater were found to be predictive of lower serum 25-hydroxyvitamin D levels. Given the extent of vitamin D involvement in normal musculoskeletal physiology, routine preoperative evaluation is merited. [Orthopedics. 2016; 39(4):e651-e656.].

  8. Abdominal aorta aneurysms in children: single-center experience of six patients.

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    Ye, Caisheng; Yin, Henghui; Lin, Ying; Zhou, Li; Ye, Runyi; Li, Xiaoxi; Han, Anjia; Wang, Shenming

    2012-01-01

    Abdominal aortic aneurysms (AAA) are rare in children and are associated with significant morbidity and mortality as in adults. We summarize our experience in the diagnosis and management of AAAs in 6 children at a single institution. The clinical data of 6 pediatric patients with AAAs treated at our hospital from November 2005 to November 2008 were retrospectively analyzed. There were 4 males and 2 females with a mean age at diagnosis of 8 years (range, 17 months to 18 years). All patients presented with pulsatile abdominal masses. Color Doppler ultrasonography and computed tomography angiography were the primary diagnostic tools. One patient has a history of tuberous sclerosis, and 1 had Takayasu's arteritis; no risk factors or identifiable causes were found in the other patients. All of the AAAs identified were infrarenal. Surgical reconstruction with aneurysm resection and prosthetic graft placement was performed successfully in all 6 cases. No intraoperative or postoperative complications occurred. Mean follow-up has been 48 months (range, 32 to 69). In 1 patient, recurrence was noted at 3 years postoperatively. The patient's family declined further surgery, and the patient died, likely of rupture of the aneurysm at 41 months postoperatively. All other patients are currently alive and well. Our experience indicates that good outcomes can be obtained in children with AAAs with prompt and accurate diagnosis and surgical management with artificial grafts. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Revision Knee Arthroplasty in Patients with Inherited Bleeding Disorders: A Single-Center Experience

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    Kotela, Andrzej; Wilk-Frańczuk, Magdalena; Żbikowski, Piotr; Łęgosz, Paweł; Ambroziak, Paweł; Kotela, Ireneusz

    2017-01-01

    Background The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD. Material/Methods A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed. The clinical status of the patients was assessed based on the Knee Society Score, and the Numeric Rating Scale was used to assess knee pain severity and patient satisfaction with the surgery. Radiological examination, post-operative complications, and reinterventions were recorded and analyzed. Results Very good results were obtained in all patients treated for aseptic loosening of the implant. However, inferior results were found in cases with infection. All patients operated on for aseptic loosening required only single-stage TKA, whereas patients with infection underwent multiple interventions. Complications were observed only in cases with infection. Conclusions Our study clearly outlined the differences in results based on failure mode, with far inferior results obtained in cases with infection. Given the lack of data in this area as well as the high specificity of this population, further high-quality studies are needed. PMID:28068306

  10. Analysis of endoscopic management of occluded metal biliary stents at a single tertiary care center.

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    Rogart, Jason N; Boghos, Ara; Rossi, Federico; Al-Hashem, Hashem; Siddiqui, Uzma D; Jamidar, Priya; Aslanian, Harry

    2008-10-01

    A significant number of self-expandable metal stents (SEMSs) placed to palliate malignant biliary obstruction will occlude. Few data exist as to what constitutes optimal management. Our purpose was to review the management and outcomes of patients with biliary SEMS occlusion. Retrospective chart review at a single tertiary care hospital. From January 1999 to October 2005, a total of 90 patients had SEMSs placed for malignant biliary obstruction, and 27 of these occluded. Technical success of treating SEMS occlusion, stent patency and need for reintervention, and incremental cost analysis. A total of 60 ERCPs were performed to treat SEMS occlusions in 27 patients. The success rate was 95%; however, 52% of patients eventually required more than 1 intervention. Placing a second SEMS through the existing SEMS (n = 14) provided the lowest reocclusion rate (43% vs 55% and 100%), the longest time to reintervention (172 days vs 66 and 43 days, P = .03), and a trend toward longer survival (285 days vs 188 and 194 days) compared with plastic stent and mechanical balloon cleaning, respectively. Incremental cost analysis showed both uncovered SEMSs and plastic stents to be cost effective strategies. Small number of patients, retrospective study. Treatment of biliary SEMS occlusion with SEMS insertion provides for longer patency and survival, decreases the number of subsequent ERCPs by 50% compared with plastic stents, and is cost-effective.

  11. Risk Factors for Cryptococcal Meningitis: A Single United States Center Experience.

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    Henao-Martínez, Andrés F; Gross, Lilyana; Mcnair, Bryan; McCollister, Bruce; DeSanto, Kristen; Montoya, Jose G; Shapiro, Leland; Beckham, J David

    2016-12-01

    Cryptococcal meningitis carries a high mortality. Further understanding of immune suppression factors associated with neuroinvasive infection will improve risk stratification and enhance early diagnosis and treatment with antifungal therapy. The aim of the study was to corroborate established or find novel clinical predictors for cryptococcal meningitis. We performed a matched case-control study of Cryptococcus infection in immunocompromised patients with or without cryptococcal meningitis. Data of all patients with a diagnosis of cryptococcal disease were collected at University of Colorado Hospital between 2000 and 2015 (n = 51). Thirty patients were diagnosed with cryptococcal meningitis. We built a logistic regression model for risk factors associated with cryptococcal meningitis. The single-predictor univariate model found that a positive blood culture, positive serum cryptococcal antigen, current malignancy, and headaches were significantly associated with cryptococcal meningitis (p = 0.02). In the adjusted multivariate model, central nervous system disease was significantly associated with a diagnosis of HIV infection (OR 24.45, 95 % CI 1.62-350.37; p = 0.022) and a positive serum cryptococcal antigen test (OR 42.92, 95 % CI 3.26-555.55; p = 0.0055). In patients with HIV infection or a positive serum cryptococcal antigen, the pretest probability of neuroinvasive Cryptococcus infection is increased and an aggressive diagnostic evaluation should be conducted to exclude infection and consider empiric therapy.

  12. A single center series highlights on incidence and management of gastric neuroendocrine tumours with literature review

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    Fahmy WF

    2015-06-01

    Full Text Available Neuroendocrine tumours of the digestive system (GEP-NET are relatively rare. Nevertheless, their diagnoses is rising as seen from studies in the US and elsewhere. Gastric neuroendocrine tumours (Gastric NETs vary through a wide clinical spectrum, from asymptomatic cases to functioning tumours. Gastrointestinal specialists need to be aware and pursue these lesions as they are indolent with a malignant variant and a potential for metastasis. A computerised search through our pathology laboratory data base, using codes for gastric, carcinoid and neuroendocrine tumour/ hyperplasia, was used to identify cases from January 2008 to September 2014. Medical charts were retrieved, examined. Eleven cases were identified and re-examined by one consultant pathologist. There were 5 females - mean age of 50 years (39-59 and 6 males - mean age of 57 years (41-73. Mean follow up period was 4.5 years (1-9. Gastric NETs fall into Type I, II and III (WHO Classification. Our series showed eight cases of Type I managed by biopsy/ endoscopic mucosal resection (EMR. No Type II cases were identified and one case of Type III had a subtotal gastrectomy and lymphadenectomy. Two neuroendocrine hyperplasia cases were managed by biopsy only. Cases were followed up (except one who refused with regular upper endoscopy and imaging as indicated. A literature review of managing Gastric NETs was discussed. We aim to alert gastrointestinal specialists by presenting a retrospective study of Gastric NETs from a single teaching institution.

  13. Lung transplantation in a Chinese single center:7 years of experience

    Institute of Scientific and Technical Information of China (English)

    HE Wen-xin; ZHANG Peng; LIU Ming; JIANG Ge-ning; DING Jia-an; GAO Wen; ZHU Yu-ming; ZHOU Xiao; CHEN Chang; WANG Hao; FAN Jiang

    2011-01-01

    Background Lung transplantation (LT) is a viable option for patients with end-stage lung diseases,but in China,the supply is limited,and the experience with LT is rare too. This study aimed to evaluate the survival and postoperative complications of recipients undergone LT.Methods From January 2003 to May 2010,all patients who underwent LT were included. The clinical data of recipients were analyzed retrospectively,including demographic characteristics,survival rate,and the occurrences of postoperative complications,acute rejection and bronchiolitis obliterans syndrome. Results In total,37 patients underwent LT. The early mortality (<30 days) was 14% (5/37). Cumulative survival rate was 78%,70%,70% and 42% at 1,3,5 and 6 years,respectively. In 37 patients,5 (14%) developed fungal infections,9 (24%)pulmonary bacterial infections,and 6 (16%) had bronchial anastomosis complications after LT. At three months posttransplantation,a significant improvement was observed in lung function (P <0.05). Fifteen recipients (41%) developed acute rejection within the first year. Freedom from bronchiolitis obliterans syndrome was 89%,85% and 80% at 1,2 and 3years after transplantation.Conclusions Despite the limited number of cases,the survival and occurrences of complications after LT were comparable to the international experience. Single LT may be a reasonable option for some patients with end-stage pulmonary diseases.

  14. Percutaneous transluminal angioplasty and stenting in the management of chronic mesenteric angina: A single center experience

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    Tixon Thomas

    2016-01-01

    Full Text Available Introduction: The objective of our study was to review the results of percutaneous angioplasty (PTA/stenting in the treatment of patients who presented with symptoms and angiographic findings of chronic mesenteric ischemia (CMI. Materials and Methods: We performed a retrospective analysis of 13 consecutive patients from a single institution who underwent PTA/stenting for the treatment of symptoms suggestive of CMI. Results: All 13 patients in our study were men, and most common presenting symptoms were weight loss and postprandial pain. Atherosclerosis was the most common cause. PTA and stenting was performed in 9 patients and PTA alone was done in 4 patients. Primary technical success rate was 92% with complete resolution of symptoms within 2 weeks in all patients. No statistical difference was noted in primary clinical success rate based on the number of vessels treated or the method of treatment. However, in patients whom SMA was treated had longer duration of symptom-free survival as compared to other vessels. Conclusion: PTA and stenting are very effective therapeutic options for patients presenting with CMI symptoms. It should be considered as the first-line of management in such patients.

  15. Clinical Characteristics of Bowel Obstruction in Southern Iran; Results of a Single Center Experience

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    Majid Akrami

    2015-01-01

    Full Text Available Objective: To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. Methods: This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as well as their management and outcome was recorded in data gathering forms. The data were then analyzed according to the outcome and clinical characteristics. Results: Among the 411 patients with initial diagnosis of bowel obstruction, 253 (61.5% were men and 158 (38.5% were women. The mean age of the patients was 48.2±19.7 years. Besides, 73.6% were observed and 26.4% were operated. Those who were operated had those who underwent operation had significantly lower frequency of obstipation (28.1% vs. 71.9%; p=0.045 and abdominal distention (32.3% vs. 67.7%; p=0.007. Intraoperative findings included adhesion band formation in 50 (48.1%, mass 18 (17.3%, and hernia 7 (6.7%. We found that the frequency of malignancy was significantly higher in those who were managed conservatively compared to those undergoing operation (64.3% vs. 35.7%; p=0.042. The mean hospital stay was significantly higher in those who underwent operation (8.1±7.5 vs. 2.6±2.2 days; p=0.035. Conclusion: The results of this study demonstrates although some signs and symptoms, such as abdominal pain, vomiting, abdominal tenderness, abdominal distention, and obstipation, were more common among the patients with bowel obstruction, they were not sensitive and specific enough for definite diagnosis. Due to the lack of positive predictive value of clinical signs and symptoms in diagnosis of bowel obstruction, a reasonable and logical modality is needed for bowel obstruction diagnosis with better

  16. Impact of hepatitis C infection on renal transplant patients: A single-center experience in Libya

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    Abdel-Naser Y Elzouki

    2014-01-01

    Full Text Available The objective of this study was to assess the effect of hepatitis C virus (HCV infection on graft and patient survival in a cohort of Libyan renal transplant recipients. Medical records of 241 renal transplant (RT patients who have been followed-up at the Benghazi Nephrology Center up to February 2010 were reviewed. Based on the presence or absence of anti-HCV antibodies and HCV-RNA in the serum, patients were divided into two groups: HCV-positives and HCV-negatives. Anti-HCV antibodies were detected by the enzyme-linked immunosorbent assay technique and HCV-RNA by the polymerase chain reaction. Of the 241 RT patients, 162 were male and 79 were female. One hundred and ten patients (45.6% were HCV-positives and 131 (54.4% were HCV-negatives. Acute graft rejection was significantly higher among HCV-negative than HCV-positive patients (42 patients versus 28 patients, respectively; P < 0.001. Conversely, chronic graft rejection was higher among HCV-positives than that among HCV-negative patients (35 patients versus 24 patients, respectively; P <0.05, and this difference became more significant after a 12-month period of transplantation (P <0.01. Seventeen patients died during the follow-up: Seven HCV-positives (6.3% and 10 HCV-negatives (7.6%, and there was no significant difference in the death rate following RT between the two groups (P = 0.08. Among the seven deaths of HCV-positives, liver disease-related complications were the main cause of death in three (42.8% HCV-positive patients compared with none in the HCV-negative patients. The presence of HCV infection influenced chronic graft survival in RT patients and a higher proportion of HCV-infected patients had hepatic dysfunctions after RT. An increase in fatal liver complications was noted in HCV-positive patients with RT. In addition to pre-RT-specific therapy of HCV infection, all measures should be taken to prevent HCV infection pre- and post-RT. HCV-infected RT recipients need close

  17. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience

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    Prabhakar

    2015-01-01

    Full Text Available Hemodialysis (HD is one of the important modalities of renal replacement therapy in acute renal failure (ARF as well as chronic renal failure (CRF. This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%, nausea and vomiting seen in 1125 sessions (26.4%, fever and chills seen in 818 sessions (19.2%, headache seen in 665 sessions (15.6%, cramps seen in 85 sessions (2.0%, chest pain and back pain seen in 82 sessions (1.92%, hypoglycemia seen in 77 sessions (1.8%, first-use syndrome seen in 72 sessions (1.7% and femoral hematoma seen in 31 sessions (0.73%. In the CRF group, common complications were hypotension in 2230 sessions (26.1%, nausea and vomiting in 1211 sessions (14.2%, fever and chills in 1228 sessions (14.4%, chest pain and back pain in 1108 cases (13.0%, hypertension in 886 sessions (10.4%, headache in 886 sessions (10.4%, cramps in 256 sessions (3.0%, hematoma in 55 sessions (0.64%, intracerebral hemorrhage in three sessions (0.03% and catheter tip migration in three sessions (0.03%. There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.

  18. Impact of hepatitis C infection on renal transplant patients: a single-center experience in Libya.

    Science.gov (United States)

    Elzouki, Abdel-Naser Y; Gargoum, Huda M; Habas, Elmukhtar M; Rayani, Amnna A; Othman, Muftah

    2014-11-01

    The objective of this study was to assess the effect of hepatitis C virus (HCV) infection on graft and patient survival in a cohort of Libyan renal transplant recipients. Medical records of 241 renal transplant (RT) patients who have been followed-up at the Benghazi Nephrology Center up to February 2010 were reviewed. Based on the presence or absence of anti-HCV antibodies and HCV-RNA in the serum, patients were divided into two groups: HCV-positives and HCV-negatives. Anti-HCV antibodies were detected by the enzyme-linked immunosorbent assay technique and HCV-RNA by the polymerase chain reaction. Of the 241 RT patients, 162 were male and 79 were female. One hundred and ten patients (45.6%) were HCV-positives and 131 (54.4%) were HCV-negatives. Acute graft rejection was significantly higher among HCV-negative than HCV-positive patients (42 patients versus 28 patients, respectively; P<0.001). Conversely, chronic graft rejection was higher among HCV-positives than that among HCV-negative patients (35 patients versus 24 patients, respectively; P<0.05), and this difference became more significant after a 12-month period of transplantation (P<0.01). Seventeen patients died during the follow-up: Seven HCV-positives (6.3%) and 10 HCV-negatives (7.6%), and there was no significant difference in the death rate following RT between the two groups (P=0.08). Among the seven deaths of HCV-positives, liver disease-related complications were the main cause of death in three (42.8%) HCV-positive patients compared with none in the HCV-negative patients. The presence of HCV infection influenced chronic graft survival in RT patients and a higher proportion of HCV-infected patients had hepatic dysfunctions after RT. An increase in fatal liver complications was noted in HCV-positive patients with RT. In addition to pre-RT-specific therapy of HCV infection, all measures should be taken to prevent HCV infection pre- and post-RT. HCV-infected RT recipients need close monitoring for graft