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Sample records for 30-year retrospective analysis

  1. Testicular Feminization or Androgen Insensitivity Syndrome (AIS in Iran: a Retrospective Analysis of 30-Year Data

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    Dariush. D FARHUD

    2016-02-01

    Full Text Available Background: Androgen insensitivity syndrome (AIS or testicular feminization is a partial or complete inability of cell response to androgen. The cause is enzymatic defect in synthesis of testosterone, resulting sexually immature phenotypically female, with primary amenorrhea. There are three categories of AIS, complete, partial and mild, depending on the degree of external genital masculinization. The aim of this study was to find out chromosomal abnormalities, and correlation between AIS and maternal/paternal age, parents' consanguineous marriage, family history and clinical observation, in Iranian AIS patients.  Method: This study includes a retrospective data analysis of 72,000 families' medical records in the Genetic Clinic in Tehran, during a 30-yr period (1984-2014. The essential basis for the patients' referral to the clinic by gynecologists was primary amenorrhea. Cytogenetic abnormalities has been confirmed by chromosome G-banding and conventional staining methods.Results: Seventy AIS female patients with 46XY pattern were cytogenetically diagnosed and the frequency of AIS syndrome was estimated about 0.05% (~70/140000. The results showed no association between AIS and maternal or paternal age nor were the marital pattern of the parents. The clinical findings illustrated that primary amenorrhea had the highest indication for referral of AIS patients for genetic counseling and cytogenetic study.Conclusion: No correlation was observed between AIS and maternal or paternal age or consanguineous marriages. Amenorrhea is the most clinically observed sign of AIS patients.  Keywords: Androgen insensitivity syndrome (AIS, Testicular feminization, Human androgen receptor (HAR, Amenorrhea, Iran

  2. A retrospective analysis of heterophoria values in a clinical population aged 18 to 30 years

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    N.T. Makgaba

    2006-01-01

    Full Text Available Information on heterophoria values in South Africans  is  scanty. The  purpose  of  this  paper therefore, is to present information on the distribution of heterophoria in a clinical popula-tion aged 18 to 30 years, which hitherto is not available. The data presented here was obtained from  the  record  cards  of  475  black  South African  patients  examined  at  the  Optometry clinic, University of Limpopo (Turfloop cam-pus between 2000 and 2005. The patients were examined by final year students under the supervision  of  qualified  optometrists.  Heterophoria was  measured  for  each  patient  using  the  von Graefe  method.  The  horizontal  heterophoria for distance vision (6 m ranged from 16 prism diopters (pd esophoria to 12 pd exophoria with a mean of 0.74 pd exophoria (SD = ± 2.84 pd. For  distance  vision,  esophoria  ranged  from 0.5 to 16 pd with a mean of 3.08 pd (SD = ± 3.09, while exophoria ranged from 0.5 pd to 12 pd with a mean of 2.21 pd (SD = 1.82 pd. For near vision (0.4 m, the horizontal phorias ranged from 17 pd esophoria to 15 pd exopho-ria with a mean of 3.84 pd exophoria (SD = ± 4.80 pd. The near esophorias ranged from 0.5 to 17 pd with a mean 4.88 pd (SD = ± 3.41, while the exophorias ranged from 1.0 to 15 pd with a mean of 6.30 pd (SD = ± 2.58. Vertical heterophoria for distance vision ranged from 5 to 3 pd right hyperphoria with a mean of 0.05 pd right hyperphoria (SD = ± 0.76 whereas at near it ranged from 4 to 6 pd right hyperphoria with a mean of 0.08 pd right hypophoria (SD =  ±  0.96.  The  distributions  of  heterophoria at distance and near were non-normal.  There was  no  significant  gender  variation  in  the horizontal  values  for  distance  vision  and  the vertical  (distance  and  near  ones.  However, there was a statistically significant gender varia-tion  in  the  near  horizontal  values  (p

  3. Lunokhod 2 - A retrospective Glance after 30 Years

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    Gromov, V.; Kemurdjian, A.; Bogatchev, A.; Koutcherenko, V.; Malenkov, M.; Matrossov, S.; Vladykin, S.; Petriga, V.; Khakhanov, Y.

    2003-04-01

    30 years have passed since the second Soviet research Lunokhod-2 rover landed on the Moon on January 16, 1973 within the framework of the Luna-21 mission. Scientific explorations of the lunar surface and space, begun with the Lunokhod-1 rover (1970-1971), were continued with Lunokhod-2. Creation of Lunokhod-1 and Lunokhod-2 marked realization of direction on study of planets using mobile self-propelled robots. Other direction connected with using planetary rovers to transport astronauts, scientific equipment and weights was realized as a result of creation of the American LRV lunar rover. Astronauts during Apollo-15 (1971), Apollo-15 (1972) and Apollo-15 (1972) missions used it. Programs of operation for Lunokhod-1,-2 on the Moon envisaged investigations of topographic and morphological peculiarities of the terrain, determination of the chemical composition and physical and mechanical properties of soil, experiments on the laser detection and ranging of the Moon and, etc. Successful fulfilment of programs was ensured, to a considerable extent, with the self-propelled chassis developed at VNIITRANSMASH to order of the Lavochkin Scientific and Production Association (NPOL). The chassis, on the one hand, ensured necessary cross-country ability for Lunokhod-1,-2, on the other hand, it was as the independent scientific instrument, which provided investigation as temperature measurement of the lunar surface, surface topography and craters distribution, physical and mechanical properties of soil with the special PROP instrument equipped with the penetrometer, chassis traction-cohesive characteristics, upper surface layer by a character its deformation by the mover, etc. A number of improvements of Lunokhod-2 improving its operating characteristics were performed on the basis of results of Lunokhod-1 operation. Lunokhod-1,-2 operation confirmed that automatic mobile robots can be used as effective means for studying planets and their satellites. At the same time, an

  4. Clinical Analysis of Lung Cancer Patients Younger Than 30 Years

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    Guangjie HOU

    2011-05-01

    Full Text Available Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth. In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years. This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients. Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total. In this group, there were 34 non-small cell lung cancer (NSCLC patients and 19 small cell lung cacer (SCLC patients. The male/female ratio was 1.5:1. In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved. In these patients, 12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment. Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection. Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis. The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.

  5. What We Learned From the Oil Crisis of 1973: A 30-Year Retrospective

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    Roeder, John L.

    2005-01-01

    Thirty years ago, the Arab Oil Embargo caused us to stop taking gasoline for granted and caused the author to start teaching students about the importance of energy in our lives. This retrospective shows the same general patterns discerned from a 20-year retrospective a decade ago: a sharp decrease in energy use following each of the two energy…

  6. 30 Years Retrospective Review of Tuberculosis Cases in a Tuberculosis Dispensary in Bursa/Nilufer, Turkey (1985-2014

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    Kayıhan PALA

    2016-11-01

    Full Text Available Abstract Objective: The aim of this study was to evaluate tuberculosis control programmes of patients who applied to the Bursa Nilufer Tuberculosis Dispensary and by investigating the changes in the variables over 3 decades. Method: In this retrospective descriptive study, the records of all tuberculosis cases (1662 people treated in the last 30 years (1985-2014 at the Bursa Nilufer Tuberculosis Dispensary were examined. In the analysis, the chi-square test, the trend chi-square test and Fisher's exact test were used. Results: Males comprised 65.2% of the patients. The ages of the patients ranged from 1 to 87 years, and the mean age was 37.4 (95% CI:36.6-38.2. Among the cases, 86.7% were new and 74.1% were pulmonary tuberculosis. In the last decade, the proportion of women, the education level, the proportion of patients who had received a BCG vaccination and the proportion of active employees among women increased by a statistically significant amount, while the proportion of employees among men decreased. Clinical symptoms, such as weakness, anorexia, weight loss, and cough, decreased to a statistically significant degree. In the last decade, the mortality rate was 3.6%, a statistically significant increase compared with previous decades. Mortality was statistically significant higher among patients who were elderly, male, did not have a BCG scar or had a chronic disease. Conclusion: This study reveals the need for studies that determine the risk factors associated with tuberculosis mortality and examine the effectiveness of tuberculosis control programmes. Direct measures to address mortality risk factors can reduce the number of deaths from tuberculosis.

  7. Philosophic Thinking in Social Work: An Analysis of 30 Years of "Social Work" Editorials

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    Martinez-Brawley, Emilia E.; Zorita, Paz M-B

    2016-01-01

    This article looks at 30 years of editorial perspectives and trends in social work as a profession through the analysis of editorials from the journal "Social Work." It identifies the wax and wane of philosophic (intellectual or scholarly) questions in social work thinking in the past three decades. It defines what philosophic thinking…

  8. Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis.

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    Nkenke, Emeka; Seemann, Rudolf; Vairaktaris, Elefterios; Schaller, Hans-Günter; Rohde, Maximilian; Stelzle, Florian; Knipfer, Christian

    2015-07-01

    The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery.

  9. Retrospective landscape analysis

    DEFF Research Database (Denmark)

    Fritzbøger, Bo

    2011-01-01

    On the basis of maps from the 18th and 19th centuries, a retrospective analysis was carried out of documentary settlement and landscape data extending back to the Middle Ages with the intention of identifying and dating general structural and dynamic features of the cultural landscape in a selected...

  10. An empirical analysis of issues and trends in manufacturing productivity through a 30-year literature review

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    Lee, Choonghyun

    2016-08-01

    Full Text Available This paper analysed the keywords in manufacturing productivity- related studies over the last 30 years to consider the change in the concept of ‘productivity’, a longstanding and important factor in studies about manufacturing. After first identifying 110,269 keywords in related research through 11,237 academic papers, we narrowed them down to 97 in nine categories by applying certain criteria. Most of the previous studies dealt with productivity in the context of corporate data; but this study investigated the change in the concept of manufacturing productivity by analysing the keywords of many studies of this concept. We classified the 30 years from 1980 to 2009 into five eras of productivity, according to their representative characteristics, using the analysed keywords. We expect that this study will serve as a practical guideline for managers in industry, and as an academic foundation for future research into productivity.

  11. MEAD retrospective analysis report

    DEFF Research Database (Denmark)

    Hasager, Charlotte Bay; Carstensen, J.; Frohn, L.M.;

    2003-01-01

    The retrospective analysis investigates links between atmospheric nitrogen deposition and algal bloom development in the Kattegat Sea from April to September 1989-1999. The analysis is based on atmospheric deposition model results from the ACDEP model,hydrodynamic deep-water flux results...... with an increase above 0.5 µg/l chlorophyll a, but severalconsecutive days of high nitrogen inputs create the potential for blooms. The physical and chemical conditions before and during a bloom revealed that blooms occurred under higher salinity and wind conditions on 2-6 days prior to the observed bloom...... the bottom waters. Yet the cumulative atmospheric deposition is always larger than the marine deep-water flux. The mixing of nutrient-rich water from belowthe pycnocline into the euphotic zone is also a process of highly episodic character and provides sufficient nitrogen to the euphotic zone to sustain...

  12. Clinical characteristics of myotonia congenita in China Literature analysis of the past 30 years

    Institute of Scientific and Technical Information of China (English)

    Yangwei Zhang; Shushan Zhang; Huifang Shang

    2008-01-01

    AIM:To understand the distinct,clinical features of myotonia congenita in China.METHODS:Case reports of myotonia congenita were retrieved from the Chinese Journal Full-text database,dating between 1980 and 2007,and analyzed for clinical characteristics of myotonia congenita. RESULTS:There were 35 published reports and 258 cases about myotonia congenita.Six reports(62 cases)were excluded due to lack of clinical data,imprecise diagnosis,or duplication.Finally,29 published reports and 196 cases(140 males and 56 females)were included in this analysis.About 78.6% of patients were diagnosed with myotonia congenita before the age of 20,and among these, 86.1% were classified as dominant inheritance.Lower and upper extremities were frequently affected with severe symptoms.Eyelids,mouth and lingual muscles,and trunk muscles and cervical muscles were less frequently involved.However,muscles for swallowing,sphincter muscles,and smoothmuscles were not involved.There were no reports of cataracts,cardiac conduction block,or dyscrinism. Myotonia congenita symptoms were induced or aggravated by cold temperatures in 71.9% of the patients and warming-up effect occurred in 95.6% of the patients.Muscle hypertrophy was observed in 69.6% and percussion of muscles in 76.5% of the patients.Myotonia potential or myotonia-likepotential was detected in all patients using electromyography.Muscle fiber swelling or hypertrophy was frequently detected through muscular biopsy.CONCLUSION:Myotonia congenita frequently occurs in males before the age of 20,in particular as the autosomal dominant form of myotonia congenita.Skeletal muscles throughout the body,especially the lower and upper extremities,are involved.However,muscles for swallowing,sphincter muscles, and smooth muscles are not involved.Warming-up effect is the main characteristic of myotonia congenita.

  13. Paul Goodman, 30 Years Later: "Growing Up Absurd"; "Compulsory Mis-Education, and The Community of Scholars"; and "The New Reformation"--A Retrospective

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    Kaminsky, James S.

    2006-01-01

    This article is a retrospective account of the legacy of Paul Goodman's major educational works: "Growing Up Absurd"; "Compulsory Mis-education, and The Community of Scholars"; and "The New Reformation." It is argued here that what remains of interest in Goodman's work is to be found in the tropes and the anarchic Zeitgeist of his work. The legacy…

  14. Ceramic membrane technology:30 years retrospect and prospect%陶瓷膜分离技术发展30年回顾与展望

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    孟广耀; 陈初升; 刘卫; 刘杏芹; 彭定坤

    2011-01-01

    值庆贺《膜科学与技术》杂志创刊三秩之年,陶瓷分离膜技术从核燃料浓缩分离转而民生应用至今也走过了大约30个春秋.现借机简要回顾其三个十年的历史性发展,阅历现状、展望未来,以期对促进无机膜在新工业革命中发挥关键创新作用有所助益.%On the 30th anniversary of the Journal "Membrane Science and Technology", it has also been a-bout 30 years since ceramic membrane separation technology was employed for the civil purpose though it had served for long time in the concentration and separation of nuclear bomb fuels. This article would briefly recall its historical development; introduce the present status and prospect for the future in order to promote its key and innovative functions in the new industrial revolution.

  15. Public Release of 30-year (1979-2008) NLDAS High-resolution Products - Analysis and Validation for Soil Moisture and Temperature

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    Xia, Y.; Ek, M. B.; Wood, E. F.; Luo, L.; Sheffield, J.; Lettenmaier, D. P.; Livneh, B.; Mocko, D. M.; Cosgrove, B.; Meng, C. J.; Wei, H.; Koren, V.; Schaake, J. C.; Mo, K. C.; Mitchell, K.

    2009-12-01

    The NCEP Environmental Modeling Center (EMC) collaborated with its CPPA (Climate Prediction Program of the Americas) partners to develop a North American Land Data Assimilation System (NLDAS, http://www.emc.ncep.noaa.gov/mmb/nldas). The NLDAS includes multi-model analysis/monitoring products to focus on drought and flooding monitoring. NLDAS products consist of 30-year (1979-2008) retrospective and 0.5-year near realtime (2009-current time, with a 4-day lag) water (i.e., evapotranspiration, runoff, canopy evaporation, sublimation) and energy (sensible heat flux, latent heat flux, ground heat flux, net radiation) fluxes, and state (i.e., soil moisture with different layers, soil temperatures, snow water equivalent, snow depth, snow cover) variables with an hourly temporal resolution and a 1/8th degree spatial resolution for four land surface models (NCEP/Noah, NASA/Mosaic, OHD/SAC, and Princeton/VIC). This study used common hourly land surface forcing derived from NCEP's retrospective and realtime North American Regional Reanalysis System (NARR) except for precipitation. The precipitation forcing is anchored to a daily gauge-only precipitation analysis over CONUS that applies the Parameter-elevation Regressions on Independent Slopes Model (PRISM) correction. This daily precipitation analysis is then temporally disaggregated to hourly precipitation amounts using stage II radar and satellite retrieved precipitation products. The NARR-based surface downward solar radiation is bias-corrected using seven years (1997-2004) of GOES satellite-derived solar radiation retrievals. This presentation summarizes the NLDAS concept, configuration, forcing data, the four land surface models and their output. All 30-year hourly forcing and hourly outputs from four land surface models are stored on a NCEP public server, which can be download by public users. In this presentation, we analyze soil moisture and temperature for four models and validate them using the Illinois soil

  16. The decreasing importance of acidification episodes with recovery from acidification: an analysis of the 30-year record from Birkenes, Norway

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    R. F. Wright

    2007-09-01

    Full Text Available The 30-year record 1975–2004 of weekly samples of streamwater chemistry from Birkenes, Norway, shows 106 acid episodes below the threshold of ANC –50 μeq l−1. The frequency, severity and duration of episodes have diminished since about 1990 due to chemical recovery following reduced deposition of sulphur. In particular SO4-driven episodes in the first runoff following drought have become less intense and less frequent, whereas episodes driven by climate (wind, high flow continue. The data show significant empirical relationships between strength of the driver, degree of chemical recovery, and severity of ANC depression.

  17. The decreasing importance of acidification episodes with recovery from acidification: an analysis of the 30-year record from Birkenes, Norway

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    R. F. Wright

    2008-03-01

    Full Text Available The 30-year record 1975–2004 of weekly samples of streamwater chemistry from Birkenes, Norway, shows 106 acid episodes below the threshold of ANC−50 µeq l−1. The frequency, severity and duration of episodes have diminished since about 1990 due to chemical recovery following reduced deposition of sulphur. In particular SO4-driven episodes in the first runoff following drought have become less intense and less frequent, whereas episodes driven by climate (wind, high flow continue. The data show significant empirical relationships between strength of the driver, degree of chemical recovery, and severity of ANC depression.

  18. Social Tie Strength and Online Victimization: An Analysis of Young People Aged 15–30 Years in Four Nations

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    Teo Keipi

    2017-01-01

    Full Text Available Online interaction through the use of social networking sites (SNS continues to be a significant component of the socialization of young people today, yet little research exists toward linking various relational forms to prevalent and much-studied online risks cross-nationally. This article provides a link between relational dynamics and online risks identified in previous research toward a new perspective on how social tie strength is related to experiences of hate victimization and harassment online. The analysis is based on survey data of Finnish (n = 555, American (n = 1033, German (n = 978, and British (n = 999 young people aged 15–30 years. Variables, including age, gender, main activity, SNS use, quantity, and extent of online and offline social networks including social tie strength and online community identification, were analyzed toward finding their associations with online hate victimization and harassment. Results showed that experiences of hate victimization and harassment were similar cross-nationally and that those who were personally harassed online also reported high SNS activity. Furthermore, no association was found between social network size and negative experiences. Notable cross-national differences were also detected in the results. Findings emphasize the importance of understanding variables fostering online risks for young people while providing a new perspective on what aspects of social life may help negate negative effects online.

  19. Clinical Analysis of Lung Cancer Patients Younger Than 30 Years%小于30岁低龄肺癌患者的临床分析

    Institute of Scientific and Technical Information of China (English)

    侯广杰; 张连斌; 初向阳; 王继云

    2011-01-01

    Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth.In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years.This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients.Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total In this group, there were 34 non-small cell lung cancer (NSCLC) patients and 19 small cell lung cacer (SCLC) patients.The male/female ratio was 1.5:1.In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved.In these patients,12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment.Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection.Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis.The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.%背景与目的青年肺癌患者肿瘤恶性程度高,侵袭性强,预后差,已成为多数共识.既往对青年肺癌患者的研究多以40岁或45岁为界,而<30岁的低龄肺癌患者临床资料少见报道.本文回顾分析了解放军总医院从1993年至今17

  20. 30 Years of Archaeological Research

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    China’s archaeology has achieved remarkable outcomes during the 30 years after the carrying out of the reform and opening up policy. In theoretical research, various archaeological theories and genres have been introduced to China, which have influenced the development of the archaeology of China.

  1. Hand infections: a retrospective analysis

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    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  2. Flooding dynamics in a large low-gradient alluvial fan, the Okavango Delta, Botswana, from analysis and interpretation of a 30-year hydrometric record

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    P. Wolski

    2006-01-01

    Full Text Available The Okavango Delta is a flood-pulsed wetland, which supports a large tourism industry and the subsistence of the local population through the provision of ecosystem services. In order to obtain insight into the influence of various environmental factors on flood propagation and distribution in this system, an analysis was undertaken of a 30-year record of hydrometric data (discharges and water levels from one of the Delta distributaries. The analysis revealed that water levels and discharges at any given channel site in this distributary are influenced by a complex interplay of flood wave and local rainfall inputs, modified by channel-floodplain interactions, in-channel sedimentation and technical interventions, both at the given site and upstream. Additionally, cyclical variation of channel vegetation due to intermittent nutrient loading, possibly sustained by nutrient recycling, may play a role. It is shown that short and long-term flood dynamics are mainly due to variation in floodplain flows. As a consequence, discharge data collected within the main channels of distributaries do not adequately represent flooding dynamics in the system. The paper contributes to the understanding of seasonal and long-term flood pulsing and their variation in low gradient systems of channels and floodplains.

  3. Solid waste 30-year volume summary

    Energy Technology Data Exchange (ETDEWEB)

    Valero, O.J.; Armacost, L.L.; DeForest, T.J.; Templeton, K.J.; Williams, N.C.

    1994-06-01

    A 30-year forecast of the solid waste volumes to be generated or received at the US Department of Energy Hanford Site is described in this report. The volumes described are low-level mixed waste (LLMW) and transuranic/transuranic mixed (TRU/TRUM) waste that will require treatment, storage, and disposal at Hanford`s Solid Waste Operations Complex (SWOC) during the 30-year period from FY 1994 through FY 2023. The data used to complete this document were collected from onsite and offsite waste generators who currently, or are planning to, ship solid wastes to the Hanford Site. An analysis of the data suggests that over 300,000 m{sup 3} of LLMW and TRU/TRUM waste will be managed at Hanford`s SWOC over the next 30 years. An extensive effort was made this year to collect this information. The 1993 solid waste forecast was used as a starting point, which identified approximately 100,000 m{sup 3} of LLMW and TRU/TRUM waste to be sent to the SWOC. After analyzing the forecast waste volume, it was determined that additional waste was expected from the tank waste remediation system (TWRS), onsite decontamination and decommissioning (D&D) activities, and onsite remedial action (RA) activities. Data presented in this report establish a starting point for solid waste management planning. It is recognized that forecast estimates will vary (typically increasing) as facility planning and missions continue to change and become better defined, but the information presented still provides useful insight into Hanford`s future solid waste management requirements.

  4. [Biliary peritonitis: retrospective analysis of the disease].

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    Sirakov, M; Chupetlovski, S; Panov, Ts; Iliev, I

    2001-01-01

    The authors have done a biliary retrospective analysis of 10 deceased patients with a diagnosis of biliary peritonitis (BP). It is reported that the patients who died of BP are 9.5% of all who died of diffuse purulent peritonitis. All deceased patients were advanced and well advanced in years with prolonged complaints--in over 50% of them over 5 years. The complications set in 50% of the cases are recorded in the postoperative period. The perforation of the gallbladder and the biliopancreatitis are in the second place. Intrabiliary fistulas with 4 patients and 1 with a vesicocolon fistula; tumor of the pancreas with 4 patients; empyema of the gallbladder--3; diabetes with 3 of the patients and others are recorded as accompanying troubles which complicate the operation and the outcome of it. The time between the beginning of the complication and the operation with all the deceased patients is over 72 hours.

  5. China’s 30-year Industrial Reform in Retrospect

    Institute of Scientific and Technical Information of China (English)

    金碚

    2008-01-01

    Industrial reform in China truly embodies the rich content and hard experience of exploration along the path of socialism with Chinese characteristics. At the first stage of industrial reform,a thought revolution was started,which laid the foundation for the development of the market economy,i.e. "to get away from poverty,we have to help ourselves and pursue self-interests". Society then began to realize that the action of individuals and enterprises to pursue income,profit and wealth was not only a proper and rational behavior of discrete entities,but also a reasonable behavior bene cial to society. This profound thought revolution played a decisive role in the transformation from a planned to market economy. At the second stage of industrial reform,some bold assaults were launched on every aspect of the planned economy,while the socialist market economy was identified as the objective of system reform. In this process,Chinese industry courageously,boldly and confidently moved towards an open market economy. As a result,China can now proclaim to the world:"we are not afraid of market competition,but rather,we look forward to it!" At the third stage of industrial reform,the focus has shifted from resolving issues of the transition from a planned to market economy into addressing common institutional and policy issues facing countries worldwide with regard to the effective operation of the market economy. From then on,industrial reform in China was no longer the business of China alone,but the business of the whole world.

  6. The development of an open economy in China——A retrospective analysis of 30 years of opening to the outside world

    Institute of Scientific and Technical Information of China (English)

    裴长洪

    2008-01-01

    China’s three decades of opening to the outside world are a historical process of establishing and developing an open economy. This process can be divided into four stages:1) reducing regulation,rejuvenating the trade regulatory regime and delegating management rights to foreign-trade operators;2) developing foreign trade firms into de facto market entities; 3)pursuing trade liberalization and establishing an open economic system in conformity with international rules;4) furthering improvement and innovation in infrastructure. At the initial stage of establishing an open economy,China restructured its foreign trade system and learned valuable lessons about liberalization through system transition.China experimented with bold breakthrough initiatives in special economic zones and open coastal cities,and correctly selected an export-oriented development strategy. Two core policies underlying China’s open economy are the strengthening of bilateral and multilateral trade relationships,and realigning the institutional environment to comport with international rules.China’s open economy occupies an important position in the national economy. Moreover,it has become an important part of state’s macro-economic regulation and is exerting growing influence on the world economy.

  7. Outcome in acromegaly: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2012-01-01

    Full Text Available Introduction: Many of the treatment modalities recommended for acromegaly are either too expensive or not available in large parts of India. There is a dearth of treatment and outcome data in Indian patients. Aims and Objectives: The purpose of this study was to analyze the treatment modalities used and the respective outcomes which include remission, recurrence, hypopituitarism, other complications, and mortality. Materials and Methods: This is a retrospective data analysis of 15 acromegaly patients treated at a tertiary care hospital in eastern India. A remission criteria of nadir growth hormone level <1 μg/dl after Oral Glucose tolerance test (OGTT and normal age related IGF-1 levels was used. Results: All patients (100% had macroadenomas. Surgery could not be done in five (33%; three (19.8% refused, two (13.2% had comorbidities. Transsphenoidal surgery (TSS achieved remission in four out of ten (40%. Conventional radiotherapy (CRT failed in all five patients and caused hypopituitarisn in three (60%. Cabergoline (CAB either alone or following surgery achieved remission in one out of four (25% though symptomatic relief and tolerability were remarkable. One patient (7% had pituitary apoplexy with remission, two patients (14.3% died due to CVA. Conclusions: TSS remains the treatment of choice in acromegaly, though in macroadenomas the success is limited. A sizeable proportion of patients refuse or are unfit for surgery. As most of the recommended options are very costly or unavailable, alternative treatment options generally used are CRT or CAB which have limited efficacy. Incidence of hypopituitarism, following CRT is very high.

  8. LARYNGEAL MALIGNANCY: A RETROSPECTIVE DESCRIPTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2016-06-01

    Full Text Available BACKGROUND Laryngeal cancer is the second most common head and neck cancer in India. The onset, rate of progression and duration of symptoms are variable for supraglottic, glottic and subglottic cancer. Smoking and alcohol are also most important risk factors for laryngeal cancer. Data regarding cases of laryngeal cancer in relation to age, sex, symptoms and signs, aetiological factors with special reference to smoking and alcohol, histopathological types, tumour staging, treatment and outcomes are important to assess changing trends in laryngeal cancer treatment. MATERIALS AND METHODS This study is about retrospective descriptive analysis of diagnosed and treated cases of laryngeal cancer in the Department of ENT from 2005 to 2008. Total fifty patients with laryngeal malignancy were seen from May 2005 to May 2008 with average 1 year of follow-up. Data regarding cases of laryngeal cancer in relation to age, sex, symptoms and signs, aetiological factors with special reference to smoking and alcohol, histopathological types, tumour staging, treatment and outcomes were analysed using SPSS software. All patients who were diagnosed to have laryngeal cancer and treated were included in the study. RESULTS In this descriptive analysis, 62% patients are between 51-70 years. Most of the patients had been symptomatic for 3-5 months; 58% patients presented with voice change followed by other complaints like throat pain, foreign body sensation, otalgia, breathing difficulty. Voice change was distinctly the most common symptom regardless of tumour site. It was more prevalent in glottis cases, but it was also the leading symptom in supraglottic tumours. Glottis tumours were more often found at an early stage and patients with a supraglottic tumour presented more often with neck node metastasis. CONCLUSION Laryngeal malignancy is one of the head and neck malignancies, which are more common in males. Tobacco is an important risk factor in causation of the

  9. [Pacemaker implantation in dogs: results of the last 30 years].

    Science.gov (United States)

    François, L; Chetboul, V; Nicolle, A; Carlos, C; Borenstein, N; Pouchelon, J L

    2004-07-01

    Pacemaker implantation in veterinary practice is still not well known and remains uncommon. However, this technique is the only possible way to cure animals suffering from symptomatic bradycardia whose state does not improve with a medical treatment. In most cases, the use of pacemakers in veterinary medicine leads to the disappearance of the clinical and electrocardiographic signs. This retrospective study concerning the last 30 years draws up an evaluation of the improvements, advantages and drawbacks of this method. Moreover, this study allows the understanding of the evolution of pacemakers' use in veterinary cardiology.

  10. TARDEC 30-Year Strategy Value Stream Analysis

    Science.gov (United States)

    2015-07-01

    surface roadways may cause roller instability or bank flutter. ii. Operating dismounted C-IED payload in vegetation; grass build up can significantly...wastewater monitoring • ARO Grant, UCLA, $0.514M - Cyst assay using cell-phone camera Future Opportunities - FY 16: o Provide COTS sensors for pH

  11. Lessons from 30 Years of Flight Software

    Science.gov (United States)

    McComas, David C.

    2015-01-01

    This presentation takes a brief historical look at flight software over the past 30 years, extracts lessons learned and shows how many of the lessons learned are embodied in the Flight Software product line called the core Flight System (cFS). It also captures the lessons learned from developing and applying the cFS.

  12. Eighteen- to 30-year-olds more likely to link to hepatitis C virus care: an opportunity to decrease transmission.

    Science.gov (United States)

    Young, K L; Huang, W; Horsburgh, C R; Linas, B P; Assoumou, S A

    2016-04-01

    Hepatitis C virus (HCV) infection incidence among 18- to 30-year-olds is increasing and guidelines recommend treatment of active injection drug users to limit transmission. We aimed to : measure linkage to HCV care among 18- to 30-year-olds and identify factors associated with linkage; compare linkage among 18- to 30-year-olds to that of patients >30 years. We used the electronic medical record at an urban safety net hospital to create a retrospective cohort with reactive HCV antibody between 2005 and 2010. We report seroprevalence and demographics of seropositive patients, and used multivariable logistic regression to identify factors associated with linkage to HCV care. We defined linkage as having evidence of HCV RNA testing after reactive antibody. Thirty two thousand four hundred and eighteen individuals were tested, including 8873 between 18 and 30 years. The seropositivity rate among those ages 18-30 was 10%. In multivariate analysis, among those 18-30, diagnosis location (Outpatient vs Inpatient/ED) (OR 1.78, 95% CI 1.28-2.49) and number of visits after diagnosis (OR 5.30, 95% CI 3.91-7.19) were associated with higher odds of linking to care. When we compared linkage in patients ages 18-30 to that among those older than 30, patients in the 18-30 years age group were more likely to link to HCV care than those in the older cohort even when controlling for gender, ethnicity, socioeconomic status, birthplace, diagnosis location and duration of follow-up. Eighteen- to 30-year-olds are more likely to link to HCV care than their older counterparts. During the interferon-free treatment era, there is an opportunity to prevent further HCV transmission in this population.

  13. Economists Evaluate China’s 30 Year Reform

    Institute of Scientific and Technical Information of China (English)

    李明锋

    2008-01-01

    The Guanghua School of Management at Peking Universityorganized a new forum entitled "30 Years of China’s Reform:A Review and Outlook" several months ago,inviting many economists such as Cheng Siwei,Wu Jinglian,Li Yining,Mao Yushi,Zhang Weiying,Justin Lin,Fan Gang,Zhou Qiren,Qian Yingyi and Chen Zhiwu to conduct in-depth analysis and discussion on the issues of widespread concern about 30 Years of China’s Reform.

  14. Retrospective Analysis of Women with Only Mastalgia

    Science.gov (United States)

    Arslan, Mehmet; Küçükerdem, Halime Seda; Can, Hüseyin; Tarcan, Ercüment

    2016-01-01

    Objective Mastalgia is the most common symptom in women, who has gone under breast imaging. 70% of women face with mastalgia at least once in their lifetime. In our study, we aimed to investigate the examinations and the results of the females referred to our outpatient clinics with mastalgia and to determine the frequency of malignancy. Materials and Methods Files of all women patients referred to General Surgery Outpatient Clinics between 01.06.2014–31.05.2015 has been investigated retrospectively. Cases only with breast pain complaint (n=789) out of 2798 women has been included in the study. Women with lump in breast, nipple discharge, redness, breast retraction and pregnant and lactating women were excluded. Breast examination findings, ultrasonography (USG), mammography results, whether biopsies are done or not and diagnoses have been investigated retrospectively. Results Mean age was 42.97±12.36 (16–74) years. 59.7% (n=471) of the women had bilateral mastalgia and 91.1% (n=719) of the breast examinations were found to be normal. USG was required from 664 (84.2%) women and mammography was required from 448 (56.8%) women. Considering diagnoses; fibrocystic changes in 32.3% (n=201), ductal ectasia in 8.8% (n=55), fibroadenomas in 6.1% (n=38), reactive lymphoid hyperplasia in 1.1% (n=7) was observed. Only 1 (0.2%) woman was diagnosed with invasive ductal carcinoma. Conclusion According to researches, 0.5% of the women with mastalgia were diagnosed with breast cancer. In our study this rate was found as 0.2%. Women with only mastalgia without any abnormality in physical examination should be informed about dealing with pain. PMID:28331753

  15. Adaptionism-30 years after Gould and Lewontin

    DEFF Research Database (Denmark)

    Nielsen, Rasmus

    2009-01-01

    Gould and Lewontin's 30-year-old critique of adaptionism fundamentally changed the discourse of evolutionary biology. However, with the influx of new ideas and scientific traditions from genomics into evolutionary biology, the old adaptionist controversies are being recycled in a new context......, it is still difficult to construct strong arguments in favor of adaptation. However, despite the difficulties in establishing scientific arguments in favor of specific historic evolutionary events, there is still much to learn about evolution from genomic data....

  16. Stereotactic radiosurgery for glioblastoma: retrospective analysis

    Directory of Open Access Journals (Sweden)

    Walter Kevin A

    2009-03-01

    Full Text Available Abstract Purpose This retrospective study was done to better understand the conditions for which stereotactic radiosurgery (SRS for glioblastoma may be efficacious. Methods Between 2000 and 2007, 33 patients with a pathological diagnosis of glioblastoma received SRS with the Novalis® Shaped Beam Radiosurgery system. Eighteen patients (54% underwent salvage SRS for recurrence while 15 (45% patients received upfront SRS following standard fractionated RT for newly diagnosed glioblastoma. Results There were no RTOG grade >2 acute side effects. The median survival after SRS was 6.7 months (range 1.4 – 74.7. There was no significant difference in overall survival (from the time of initial diagnosis with respect to the timing of SRS (p = 0.2. There was significantly better progression free survival in patients treated with SRS as consolidation versus at the time of recurrence (p = 0.04. The majority of patients failed within or at the margin of the SRS treatment volume (21/26 evaluable for recurrence. Conclusion SRS is well tolerated in the treatment of glioblastoma. As there was no difference in survival whether SRS is delivered upfront or at recurrence, the treatment for each patient should be individualized. Future studies are needed to identify patients most likely to respond to SRS.

  17. Neurocysticercosis in Nepal: a retrospective clinical analysis

    Directory of Open Access Journals (Sweden)

    Rajeev Ojha

    2015-01-01

    Full Text Available Aim: The prevalence of epilepsy is higher in Nepal. This study was conducted to analyze the clinical manifestations of neurocysticercosis (NCC among seizure patients admitted to our center. Methods: We retrospectively studied all the NCC patients admitted to Neurology Department, Bir Hospital, Kathmandu, Nepal from April 2012 to February 2014. Computer tomography/magnetic resonance imaging (CT/MRI head, clinical profile, lab investigations and exclusion of other causes were the basis of the NCC diagnosis. Chi-square and Student′s t-test were used for comparison of variables. Results: Out of 131 seizure patients admitted, 21 patients were diagnosed with NCC (mean age: 33.95 ± 16.41; male: 15 (71.4%, female: 6 (28.6%. Generalized tonic clonic seizure was the most common seizure type in NCC patients (18 patients; 85.7%, two of them had status epilepticus during presentation in Emergency Department. Three patients had focal seizure, one with epilepsia partialis continua. Neuroimaging showed multiple NCC lesions in 8 (38.1% and a single NCC lesion in 13 (61.9% patients. Seven of them (33.3% sought traditional healers before being presented to our center. Eight patients (38.1% were treated with antiepileptics in local health-post without neuroimaging studies done. Calcified stage of NCC was the most frequent CT/MRI findings (12 patients; 57.1%. Phenytoin was preferred both by physicians and patients due to its low cost. Conclusion: NCC is a common finding among seizure patients in Nepal. Poor economic status, illiteracy and underdeveloped rural society are the major challenges in prevention and treatment of NCC.

  18. Conservatively treated acetabular fractures: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu

    2012-01-01

    Full Text Available Background: There are a few studies reporting the long term outcome of conservatively treated acetabular fractures. The present study aims to evaluate the quality of reduction, and radiological and functional outcome in displaced acetabular fractures treated conservatively. Materials and Methods: Sixty-nine patients (55 men and 14 women with 71 displaced acetabular fractures (mean age 38.6 years managed conservatively were retrospectively evaluated. There were 11 posterior wall, 5 posterior column, 6 anterior column, 13 transverse, 2 posterior column with posterior wall, 9 transverse with posterior wall, 6 T-shaped, 1 anterior column with posterior hemi-transverse, and 18 both-column fractures. The follow-up radiographs were graded according to the criteria developed by Matta J. Functional outcome was assessed using Harris hip score and Merle d′Aubigne and Postel score at final followup. Average follow-up was 4.34 years (range 2-11 years. Results: Patients with congruent reduction (n=45 had good or excellent functional outcome. Radiologic outcome in incongruent reduction (n=26 was good or excellent in 6 and fair or poor in 20 hips. The functional outcome in patients with incongruent reduction was good or excellent in 16 and satisfactory or poor in 10 hips. Good to excellent radiologic and functional outcome was achieved in all patients with posterior wall fractures including four having more than 50% of broken wall. Good to excellent functional outcome was observed in 88.8% of both-column fractures with secondary congruence despite medial subluxation. Conclusions: Nonoperative treatment of acetabular fractures can give good radiological and functional outcome in congruent reduction. Posterior wall fractures with a congruous joint without subluxation on computed tomography axial section, posterior column, anterior column, infratectal transverse or T-shaped, and both-column fractures may be managed conservatively. Small osteochondral fragments

  19. Retrospective analysis of cases with Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Bulat Aytek Şık

    2016-12-01

    Full Text Available We planned this study with the aim of determining histological types, clinical, surgical stage and grade of endometrial cancer cases which were followed-up and operated on in our clinic and giving an opinion on epidemiological features. Our study was a retrospective study consisted of 298 patients who had medical operations with the diagnosis of endometrial cancer. Endometrial cancer was diagnosed via dilatation and curettage. Routine preoperative examinations were wanted from the cases. Clinical stage was determined. After the diagnosis, total abdominal hysterectomy and bilateral salpingo-ooforectomy (TAH+BSO were applied; while only pelvic lymph node dissection was applied on the patients who had good prognostic data, total pelvic and paraaortic lymph node dissection were applied to the group with bad prognostic data. All materials were examined in the pathology laboratory of our hospital. In endometrial cancer staging, FIGO surgical staging system -2009 was used. FIGO was used in grade classification and World Health Organization Classification of Tumors system was used for the histological classification. Our study was composed of 298 patients who had endometrial cancer. Of the patients who were included in the study, average age was 56.54±9.69, BMI average was 31.47±6.20, gravida average was 4.16±2.59, and parity average was 3.41±2.15. Distributions of the patients by surgical stages were as follows; there were 32 patients whose tumor stage was in 1A (%10.7, 127 patients in 1B  (42.6%, 47 patients in 1C  (15.8%, 18 patients in 2A  (6.0%, 7 patients in 2B   (2.3%, 30 patients in 3A  (10.1%, 2 patients in 3B  (0.7%, 30 patients in 3C  (10.1%, 2 patients in 4A  (0.7% and 3 patients in 4B  (1.0%. Of the patients with endometrial cancer in our study, tumors of 102 patients were (34.2% in grade I, 139 were (46.6% in grade II and 57 were (19.1% in grade III. Because endometrial cancer shows earlier symptoms than the other

  20. 30 Years of HIV/AIDS

    Centers for Disease Control (CDC) Podcasts

    2011-06-02

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses the 30 year anniversary of the first reported cases of acquired immunodeficiency syndrome, or AIDS. Dr. Fenton also reflects on the HIV/AIDS epidemic – past, present, and future.  Created: 6/2/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 6/2/2011.

  1. Test anxiety inventory: 30 years later.

    Science.gov (United States)

    Szafranski, Derek D; Barrera, Terri L; Norton, Peter J

    2012-11-01

    Research suggests that test anxiety is associated with a number of maladaptive factors. The majority of test anxiety research includes the Test Anxiety Inventory (TAI) as a primary outcome variable. However, the TAI was normed on college undergraduates in 1980. The academic landscape has altered in a variety of ways in the past 30 years, which may result in out-of-date norms. This study examined changes in TAI scores in college undergraduates (n =437) as well as convergent validity with measures of trait anxiety and academic performance. Results indicated increases in TAI scores for females while holding constant for males. Additionally, females and males displayed positive correlations between the TAI and state-trait anxiety inventory, while only females displayed a significant negative correlation between the TAI and grade point average. Data provide evidence of changes in TAI scores. As a result, researchers should be careful when drawing conclusions based on original TAI norms, especially in the case of female undergraduates.

  2. Dysnatremias and Survival in Adult Burn Patients: A Retrospective Analysis

    Science.gov (United States)

    2013-01-11

    DOI: 10.1159/000346206 Dysnatremias and Survival in Adult Burn Patients: A Retrospective Analysis Ian J. Stewart a Benjamin D. Morrow a... mortality rate of 4.3%. On Cox proportional hazard regres- sion age, %TBSA, ISS, and AKIN stage were found to be sig- nificant predictors of mortality ...hypernatremia [1–4] and hyponatremia [1, 4, 5] have been examined in the hospital setting and have been found to be significantly associated with mortality

  3. Epithelial ovarian carcinoma in women aged below 30 years

    Institute of Scientific and Technical Information of China (English)

    Chen Rong; Shen Keng; Wu Ming; Pan Ling-ya; Huang Hui-fang; Yang Jia-xin; Lang Jing-he

    2005-01-01

    Objective: To study the manifestation, pathohistologic type, stage of disease, treatment and outcome of epithelial ovarian carcinoma in women under the age of 30 years.Methods: The 21 cases of epithelial ovarian carcinoma in women aged below 30 years between Jan, 1986 and Mar, 2002 were analyzed retrospectively.Results: The median age at the time of diagnosis was 24 years (range, 16-29 years). All carcinomas occurred after menarche. The most common symptoms were abdominal pain (50%), followed by tympanites (25%) and menstrual disorders (19%). The initial diagnosis was usually made by physical examination, ultrasonography and serum CA125. The mean maximal tumor diameter was 17.6 cm. Ten patients had Stage I disease (5 Ia, 5 Ic), five had Stage Ⅲ disease, and the other six were unknown during staging operation. There were nine mucinous tumors, six serous tumors. Most tumors were well-differentiated and classified as Grade1 in 11 cases, Grade2 in 2 cases, Grade3 in 2 cases, unknown in 6 cases. Optimal and suboptimal cytoreduction was achieved in 14 patients in primary treatment and 5 in recurrent treatment. 8 patients were treated with conservative surgery. 18 patients were treated with chemotherapy and 7 patients had experienced six or more than six courses of chemotherapy. The median follow-up was 50 months (range, 2-192 months). There were 6 deaths, 2 alive with tumor, 11 alive without the disease, 2 losing follow-up. The 3-year survival rate was 89%, and 5-year survival rate was 76%.Conclusion: Young patients with epithelial ovarian carcinoma appeared to have a less aggressive form of the disease and a more favorable prognosis.

  4. Five year retrospective survival analysis of triple negative breast cancer in North-West India

    Directory of Open Access Journals (Sweden)

    B Sharma

    2013-01-01

    Full Text Available Background: In our institute, about 10% of total cancer is female breast cancer. This analysis was performed to check triple negativity among these patients with their survival strength up to 5 years in relation to different age groups, stage and chemotherapy protocols. Materials and Methods: 208 immunohistochemistry proved triple negative breast cancer patients registered and treated until 2008 were retrospectively selected for the study. Overall survival up to 5 years was observed on the basis of stage, different age groups and chemotherapy regimens. All patients had undergone surgery, conventional external beam radiation therapy and adjuvant chemotherapy. The survival analyses were performed using the Kaplan-Meier method. Results: The majority of patients (41% were in the age group 21-30 years. Stage IV was seen in 18% of the patients at diagnosis and mainly in 21-40 years age group. Only 3% of females were >70 years age and were of Stage I and II. Overall 5 year survival in Stage I in Cyclophosphamide, Adriamycin/Epirubicin, 5-Flurouracil group was 37.5% as compared with Docetaxel/Paclitaxel, Epirubicin group 93% (P < 0.0001. Conclusion: Triple negativity in North-West India is about 11.8%. We observed it in younger patients mainly with highly aggressive behaviors. Taxane based chemotherapy gives better result as compared with anthracycline based regimens in all stages.

  5. Retrospective analysis of duodenal injuries: A comprehensive overview

    Directory of Open Access Journals (Sweden)

    Sanjay Pandey

    2011-01-01

    Full Text Available Background/Aim: Duodenal injury is an uncommon finding, accounting for about about 3 - 5% of abdominal trauma, mainly resulting from both penetrating and blunt trauma, and is associated with significant mortality (6 - 25% and morbidity (30 - 60%. Patients and Methods : Retrospective analysis was performed in terms of presentation, management, morbidity and mortality on 14 patients of duodenal injuries out of a total of 172 patients of abdominal trauma attending Subharti Medical College. Results: Epigastric pain (100% along with vomiting (100% is the usual presentation of duodenal injuries in blunt abdominal trauma, especially to the upper abdomen. Computed tomography (CT was diagnostic in all cases. Isolated duodenal injury is a rare finding and the second part is mostly affected. Conclusion: Duodenal injury should always be suspected in blunt upper abdominal trauma, especially in those presenting with epigastric pain and vomiting. Investigation by CT and early surgical intervention in these patients are valuable tools to reduce the morbidity and mortality.

  6. Retrospect and Prospect on Social Security Undertakings over the Past 30 Years of Reform and Opening-up in China%改革开放30年来我国社会保障事业的回顾与展望

    Institute of Scientific and Technical Information of China (English)

    机关事业单位社会保障研究课题组

    2008-01-01

    Since reform and opening-up , economy and society has undergone great changes, and social security has also taken a huge transition during the past 30 years. Either in term of the contents of system or macro-management, the cause of social security has obtained remarkable achievements. Especially in recent decade, it has stepped into the stage of comprehensive transition. Reviewing the development of social security, we can draw lessons for the directions of research in future.%改革开放以来,我国的经济社会经历了巨大的变化,社会保障事业在这30年间也进行了巨大的转型,不管是制度内容方面,还是宏观管理方面,都取得了骄人的成绩,特别是最近十年,社会保障事业进入转型的全面攻坚阶段.回顾改革开放以来我国社会保障事业的发展是为了总结经验,吸取教训,为未来社会保障事业的发展指明方向.

  7. Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

    Science.gov (United States)

    Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie

    2016-01-01

    Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428

  8. CLINICOPATHOLOGICAL STUDY OF LICHENOID REACTIONS: A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Ravikant

    2015-04-01

    Full Text Available BACKGROUND: Lichenoid dermatose s refer to various, clinically different inflammatory dermatoses which share in common, various essential lichenoid histologic features. AIMS AND OBJECTIVE: In this study we have analysed the different clinicopathological aspects in lichenoid reactions, as prompt diagnosis of these lesions can greatly influence the morbidity associated with the disease. STUDY DESIGN: This was a 14 month retrospective analysis of cases presenting to the department of dermatology from June 2013 till July 2014. MATERIALS AND METHODS: All new patients diagnosed with lichenoid reaction clinically and histopathologically were included in the study. INCLUSION CRITERIA: All newly diagnosed cases of Lichenoid tissue reactions within the time period mentioned above . EXCLUSION CRITERI A: Patients whose adequate records were unavailable Statistical Analysis: The SPSS, version 13 software was used to statistically analyse the data. RESULTS: A total of 66 cases were diagnosed as lichenoid reactions, 51 were lichen planus and 15 had licheno id eruptions. Males (53% were more commonly affected than female s (47%, with lower limbs (69. 69% being the most common site of predilection. Oral lesions were seen among eleven patients. Histopathologically, the most consistent findings with lichenoid r eaction was the presence of a lymphocytic infiltrate followed by vacuolar degeneration of basal cell layer, hyperkeratosis, hypergranulosis, acanthosis, pigment incontinence and a band like infiltrate over the basal layer. CONCLUSION: In our study, Licheno id reactions were more common among adults from the 2 nd to 4 th decade and can show ed a male preponderance, with the most frequent archetype being lichen planus. Thus this study emphasises on the need of histological analysis in various clinically similar c ases of lichenoid dermatoses in order to arrive at a definitive diagnosis.

  9. Key elements on team achievement: a retrospective analysis.

    Science.gov (United States)

    Taveira, Alvaro D

    2008-07-01

    This study is a historical reconstruction and in-depth scrutiny of one very successful team initiative within a Quality Improvement (QI) program in a municipal government organization. The identification of the essential concepts that contributed to the team's success and their integration into a local explanatory theory of team achievement is the final purpose of the study. The focus of this retrospective study is on the team process, with primary attention given to team members' perspectives and reflections on the project development. Data collection and analysis were conducted with methods drawn from the qualitative research tradition and from Quality Management. Main findings point to the importance of consistent management support, correct team composition with an emphasis on the team leader choice and demeanor, and to the central role of training in the group conduct. The negotiated approach to decision-making employed by the team, which reflected its organizational context, and the effort and mechanisms that allowed the group to reach equilibrium between internal and external interests proved critical for its ultimate achievement.

  10. Retrospective Clinical Analysis of 38 Cases of Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    Ruiyun Liang; Wei Zhang; Wei Wu; Shanping Jiang; Zhiqiang Lü

    2007-01-01

    To investigate the clinical feature of acute pulmonary embolism.Methods Retrospective clinical analysis was performed according to the data of 38 cases of pulmonary embolism.Results There were ground diseases and predisposing factors in 36 cases of pulmonary embolism among 38 cases,the ratio was 94.7 %,among the total predisposing factors,tumor,cardiovascular disease,venous thrombosis of lower extremity,smoking and long-term bed were common.There was no specificity in clinical feature,physical sign and rout chest X ray,electrocardiography,and their appearances were diversified.There were specificity and sensitivity in echocardiogram (UCG) and D-dimer to some extent.But,the final diagnosis must depend on some special examinations,such as selective pulmonary arteriography,CTPA,MRA and so on.Conclusions The special examinations must be done to make a definite diagnosis to confirm pulmonary embolism when the high risk factors and ground diseases are existing.It is necessary to some cases when the clinical feature can not be explained by other diseases.

  11. Evaluation of treatment for camptodactyly: retrospective analysis on 40 fingers,

    Directory of Open Access Journals (Sweden)

    Saulo Fontes Almeida

    2014-04-01

    Full Text Available OBJECTIVE: to retrospectively assess the results from cases treated in the hand surgery service, starting from a preestablished protocol; and to conduct a critical analysis on the results achieved, with separation of the cases into their respective subgroups.METHODS: twenty-three patients and a total of 40 fingers were evaluated between January 2004 and December 2011. We correlated the altered anatomical structures found in the cases that underwent the surgical procedure and its results, with regard to both conservative and surgical treatment, emphasizing the main indications.RESULTS: the results were analyzed using the Sierget method of the Mayo Clinic.CONCLUSION: we observed that the cases of camptodactyly of the little finger alone in the flex-ible form (>60◦ that underwent surgical treatment uniformly presented excellent results. In the rigid forms, our observations indicated that there were benefits comprising gains of extension and correction of the deformity. However, the range of motion with active flexion in the proximal interphalangeal joint was always partial. With evolution over time, some cases presented some loss of the gain previously achieved, which corroborates the need for continual vigilance during the follow-up, with systematic use of braces until the final phase of skeletal growth.

  12. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    Science.gov (United States)

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination.

  13. Analysis of Virechana karma with Danti avaleha: A retrospective study

    Directory of Open Access Journals (Sweden)

    Sreelakshmi Chaganti

    2015-01-01

    Full Text Available Virechana (therapeutic purgation is a common procedure that is widely practiced among the panchakarma treatments (pentad treatments. Various Virechaka dravyas (purgative drugs have been described for Virechana. Even after critical analysis of Virechaka dravyas in the literature, still there is difficulty in the fixation of dose. Hence, the retrospective analysis of varied outcomes of Virechana with Danti (Baliospermum montanum avaleha (linctus is discussed in this paper. The study included twenty-seven case reports of patients who were administered Virechana with Danti avaleha. These case reports are of patients suffering from various ailments such as irregular menstrual cycles, polycystic ovarian syndrome, primary and secondary infertility, and psoriasis. Danti avaleha was administered at dose of 10 g and 5 g in the Krura (~strong and Madhyama (~moderate/normal Koshta (~GI tract patients, respectively. Among seven Krura koshta patients, three of them resulted with Pravara (excellent Shuddhi and other four resulted with Madhyama (medium Shuddhi. In twenty Madhyama koshta patients, sixteen of them resulted with avara (minimum Shuddhi and remaining four patients resulted with Madhyama shuddhi. Complications like Udara shoola (spasmodic pain of abdomen and Vamana (emesis were observed during Virechana. Majority of the patients suffered with Udara shoola were of Madhyama koshta. Vamana was seen in both Krura and Madhyama koshta patients. Irrespective of the type of Shuddhi and complications, all the patients resulted with Samyak Kaphaantiki Virikta lakshana (signs of perfect purgation with end expulsion of Kapha. The study concluded that the Krura koshta patients were tolerable for dose of 10 g and are expected to attain Pravara Shuddhi. Whereas Madhyama koshta patients were intolerable even to mild dose of 5 g, producing Avara shuddhi.

  14. Analysis of genetic variation in rice paddy landraces across 30 years as revealed by microsatellite DNA markers%微卫星标记分析水稻地方品种30年的遗传变异

    Institute of Scientific and Technical Information of China (English)

    严红梅; 董超; 张恩来; 汤翠凤; 阿新祥; 杨文毅; 杨雅云; 张斐斐; 徐福荣

    2012-01-01

    为揭示水稻(Oryza sativa)地方品种30年的遗传变异状况,文章通过60个SSR标记,对元阳哈尼梯田农户在20世纪70年代种植的6个(简称“过去的品种”)和近10年间种植的对应6个(简称“当前的品种”)代表性水稻地方品种进行检测.结果表明,共检测到159个等位基因(Na),等位基因数1~4不等,当前的品种较过去的品种减少7个等位基因.平均每个标记检测到的等位基因数(Na)、有效等位基因数(Ne)、基因型多样性(H')和 位点多态信息含量(PIC)4个指标均为过去的品种高于当前的品种,分别是(Na)为2.567>2.450,(Ne)为2.052>1.968,(H')为0.768>0.722,(PIC)为0.469>0.439.基于60个SSR标记,过去6个品种间的遗传相似性系数(GS)平均值为0.437,变幅为0.117 ~ 0.667,而当前6个品种间平均值为0.473,变幅为0.200 ~ 0.700.总的说来,水稻地方品种经过30年自然和人工选择,遗传多样性降低,不同品种存在等位基因大小的差异程度不同.%To reveal the genetic variation of rice paddy landraces across 30 years, we compared the genetic variation of between 6 paddy rice landraces grown in Yuanyang Hani's terraced fields in Yuanyang County, Yunnan Province in the 1970s (past-grown landraces) and 6 paired ones that have been grown during the past decade (current-grown landraces) using 60 SSR markers. The results showed that one to four alleles were amplified in 60 loci and 159 alleles in all the land-races tested. The number of alleles from the current-grown landraces decreased by 7 alleles compared to the past-grownlandraces. The average number of alleles (Na), effective number of alleles (Ne), locus polymorphism information content (PIC), and genotype diversity (H1) of the past-grown landraces were higher than those of the current-grown landraces, with Na of 2.567>2.450, Ne of 2.052>l .968, PIC of 0.469>0.439, and H' of 0.768>0.722. The average genetic similarity coefficient (GS) of the past

  15. STAPHYLOCOCCAL SCALDED SKIN SYNDROME:RETROSPECTIVE ANALYSIS OF 82 CASES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To explore distinctive clinical manifestations and appropriate treatment, and assess prognosis of staphylococcal scalded skin syndrome ( SSSS). Methods A retrospective analysis was conducted of the data of 82 cases of SSSS hospitalized at Xinhua Hospital during the period from May 1993 to September 2003.Results The disease in all the 82 patients occurred in their first decade ( mean 2.5 years). Possible predisposing factors were found in 48 (58. 5% ). Fever was present in 78 (95. 1% ). Radial spokes of crusting around mouth were present in 80 (97. 6% ). Erythema began on the face, especially around the mouth and eye in 63 (76. 8% ).The course was acute in all cases and the eruptions quickly spread to the whole body within one day to two days. Of the 82 cases of SSSS, 47 were complete form of SSSS, 27 were abortive form of SSSS, and 8 were between the two forms. Staphylococcus aureus with positive staphylocoagulase was isolated from the possible primary infection sites including pharynx, eyelid, conjunctiva, nose, ear, and skin in 18 of 31 patients. Microbiological cultures of bullae and little pustulae developed after the onset were negative in 16 cases. All the 82 patients completely recovered after receiving antibiotic therapy ( ceftriaxone, oxacillin ) alone or in combination with human immunoglobulin (IVIG) therapy. Additional IVIG therapy was used in those patients who had systemic involvements such as pneumonia, fever higher than 38. 5℃ or leukocytosis. Conclusion SSSS is a spectrum disease. Besides abortive and complete forms, presenting between the two forms a new form might be appeared in 8 cases who developed both scarlatiniform rash and flaccid bullae. The abortive form and complete form are usually misdiagnosed clinically. Radial spokes of crusting around mouth seem to be characteristic manifestation of SSSS. All the patients in this study had favorable prognosis after receiving prompt diagnosis and appropriate treatment.

  16. Risk factors for progressive ischemic stroke A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, thc potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome.OBJECTIVE: To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke.DESIGN: A retrospective analysis.SETTING: Department of Neurology, General Hospital of Beijing Coal Mining Group.PARTICIPANTS: Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of (62±7) years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack, and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile,200 inpatients with non-progressive ischemic stroke (135 males and 65 females) were selected as the control group.METHODS: After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis.MAIN OUTCOME MEASURES

  17. Retrospective analysis on acute respiratory distress syndrome in ICU

    Institute of Scientific and Technical Information of China (English)

    LI Jin-bao; ZHANG Liang; ZHU Ke-ming; DENG Xiao-ming

    2007-01-01

    Objective:To assess the incidence, etiology, physiological and clinical features, mortality, and predictors of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU).Methods: A retrospective analysis of 5 314 patients admitted to the ICU of our hospital from April 1994 to December 2003 was performed in this study. The ARDS patients were identified with the criteria of the American-European Consensus Conference ( AECC ). Acute physiology and chronic health evaluation Ⅲ ( APACHE in), multiple organ dysfunction syndrome score (MODS score), and lung injury score (LIS) were determined on the onset day of ARDS for all the patients. Other recorded variables included age, sex, biochemical indicators, blood gas analysis, length of stay in ICU, length of ventilation, presence or absence of tracheostomy, ventilation variables, elective operation or emergency operation.Results:Totally, 131 patients (2.5%) developed ARDS, among whom, 12 patients were excluded from this study because they died within 24 hours and other 4 patients were also excluded for their incomplete information. Therefore, there were only 115 cases (62 males and 53 females, aged 22-75 years, 58 years on average) left,accounting for 2. 2% of the total admitted patients. Their average ICU stay was (11. 27±7. 24) days and APACHE in score was 17.23±7.21. Pneumonia and sepsis were the main cause of ARDS. The non-survivors were obviously older and showed significant difference in the ICU length of stay and length of ventilation as compared with the survivors. On admission, the non-survivors had significantly higher MODS and lower BE ( base excess). The hospital mortality was 55. 7%. The main cause of death was multiple organ failure. Predictors of death at the onset of ARDS were advanced age, MODS≥8, and LIS≥2.76.Conclusions: ARDS is a frequent syndrome in this cohort. Sepsis and pneumonia are the most common risk factors. The main cause of death is multiple organ failure. The mortality is

  18. Retrospective Analysis of Inflight Exercise Loading and Physiological Outcomes

    Science.gov (United States)

    Ploutz-Snyder, L. L.; Buxton, R. E.; De Witt, J. K.; Guilliams, M. E.; Hanson, A. M.; Peters, B. T.; Pandorf, M. M. Scott; Sibonga, J. D.

    2014-01-01

    Astronauts perform exercise throughout their missions to counter the health declines that occur as a result of long-term exposure to weightlessness. Although all astronauts perform exercise during their missions, the specific prescriptions, and thus the mechanical loading, differs among individuals. For example, inflight ground reaction force data indicate that subject-specific differences exist in foot forces created when exercising on the second-generation treadmill (T2) [1]. The current exercise devices allow astronauts to complete prescriptions at higher intensities, resulting in greater benefits with increased efficiency. Although physiological outcomes have improved, the specific factors related to the increased benefits are unknown. In-flight exercise hardware collect data that allows for exploratory analyses to determine if specific performance factors relate to physiological outcomes. These analyses are vital for understanding which components of exercise are most critical for optimal human health and performance. The relationship between exercise performance variables and physiological changes during flight has yet to be fully investigated. Identifying the critical performance variables that relate to improved physiological outcomes is vital for creating current and future exercise prescriptions to optimize astronaut health. The specific aims of this project are: 1) To quantify the exercise-related mechanical loading experienced by crewmembers on T2 and ARED during their mission on ISS; 2) To explore relationships between exercise loading variables, bone, and muscle health changes during the mission; 3) To determine if specific mechanical loading variables are more critical than others in protecting physiology; 4) To develop methodology for operational use in monitoring accumulated training loads during crew exercise programs. This retrospective analysis, which is currently in progress, is being conducted using data from astronauts that have flown long

  19. Low-pressure valves in hydrocephalic children : a retrospective analysis

    NARCIS (Netherlands)

    Breimer, G. E.; Sival, Deborah; Hoving, E. W.

    2012-01-01

    A series of 100 children under 2 years of age treated for hydrocephalus is described. All patients received a standard differential low-pressure (SD low) valve as the first cerebrospinal fluid (CSF) shunt treatment. The performance of this group during follow-up is analysed. A retrospective cohort s

  20. A retrospective pooled analysis assessing the effect of age on the immunogenicity of Havrix™ in healthy adults.

    Science.gov (United States)

    Van Der Meeren, Olivier; Crasta, Priya; de Ridder, Marc

    2015-01-01

    Over recent decades, the global incidence of hepatitis A virus infection has been reduced by improvements in sanitation infrastructure and through immunization programs. The immunogenicity and field efficacy of the inactivated hepatitis A vaccine (Havrix™, GSK, Belgium) has been demonstrated in clinical trials, population-impact studies as well as in several outbreak settings. However, immunological data in older populations are limited, with only few studies assessing the immune response of this vaccine in adults aged ≥ 40 years. This retrospective pooled analysis of 4 2-dose primary vaccination studies compared the immunogenicity and safety of the inactivated hepatitis A vaccine in adults aged ≥ 40 years with subjects aged 20-30 years (control group; N = 80 in each group). Fifteen days after the first vaccine dose, 79.7% (95% CI: 68.8-88.2) and 92.3% (95% CI: 84.0-97.1) of subjects were seropositive in the ≥ 40 years and control groups, respectively; 97.5% (95% CI: 91.2-99.7) and 97.4% (95% CI: 91.0-99.7), respectively, were seropositive one month after the first dose. All subjects in both groups (95% CIs: 95.4-100 and 95.3-100, respectively) were seropositive one month after the second dose. Safety profiles were similar in both groups. In conclusion, the inactivated hepatitis A vaccine induced similar immune responses in adults aged ≥ 40 and 20-30 years one month after the first and second dose whereas younger subjects may demonstrate a higher seroconversion rate 15 days after the first dose.

  1. 30 years of finite-gap integration theory.

    Science.gov (United States)

    Matveev, Vladimir B

    2008-03-28

    The method of finite-gap integration was created to solve the periodic KdV initial problem. Its development during last 30 years, combining the spectral theory of differential and difference operators with periodic coefficients, the algebraic geometry of compact Riemann surfaces and their Jacobians, the Riemann theta functions and inverse problems, had a strong impact on the evolution of modern mathematics and theoretical physics. This article explains some of the principal historical points in the creation of this method during the period 1973-1976, and briefly comments on its evolution during the last 30 years.

  2. Complications in lumbar spine surgery: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Luca Proietti

    2013-01-01

    Full Text Available Background: Surgical treatment of adult lumbar spinal disorders is associated with a substantial risk of intraoperative and perioperative complications. There is no clearly defined medical literature on complication in lumbar spine surgery. Purpose of the study is to retrospectively evaluate intraoperative and perioperative complications who underwent various lumbar surgical procedures and to study the possible predisposing role of advanced age in increasing this rate. Materials and Methods: From 2007 to 2011 the number and type of complications were recorded and both univariate, (considering the patients′ age and a multivariate statistical analysis was conducted in order to establish a possible predisposing role. 133 were lumbar disc hernia treated with microdiscetomy, 88 were lumbar stenosis, treated in 36 cases with only decompression, 52 with decompression and instrumentation with a maximum of 2 levels. 26 patients showed a lumbar fracture treated with percutaneous or open screw fixation. 12 showed a scoliotic or kyphotic deformity treated with decompression, fusion and osteotomies with a maximum of 7.3 levels of fusion (range 5-14. 70 were spondylolisthesis treated with 1 or more level of fusion. In 34 cases a fusion till S1 was performed. Results: Of the 338 patients who underwent surgery, 55 showed one or more complications. Type of surgical treatment ( P = 0.004, open surgical approach (open P = 0.001 and operative time ( P = 0.001 increased the relative risk (RR of complication occurrence of 2.3, 3.8 and 5.1 respectively. Major complications are more often seen in complex surgical treatment for severe deformities, in revision surgery and in anterior approaches with an occurrence of 58.3%. Age greater than 65 years, despite an increased RR of perioperative complications (1.5, does not represent a predisposing risk factor to complications ( P = 0.006. Conclusion: Surgical decision-making and exclusion of patients is not justified only

  3. Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

    OpenAIRE

    2016-01-01

    Aim: In our study, we assessed symptoms and treatment outcomes in patients with deep neck infections (DNI). It often has a rapid onset and can cause lethal complications. Methods: A retrospective designed study of 85 patients diagnosed with DNI such as peritonsillar, parapharyngeal, and submandibular abscesses. Results: A total of 85 patients were diagnosed with DNI. 33 of the 85 patients were younger than 18 (group of children), and 52 were older than 18 years of age (group of adults)....

  4. Primary Care Psychologists in the Netherlands: 30 Years of Experience

    NARCIS (Netherlands)

    Derksen, J.J.L.

    2009-01-01

    The primary care psychologist (PCP) in the Netherlands has 30 years of experience. The PCP is a generalist who, in close cooperation with the family physician and other providers of primary health care, has a mindset and manner of working that is largely determined by the context in which the PCP wo

  5. UNCORRECTED TETRALOGY OF FALLOT IN A 30 - YEARS OLD

    Directory of Open Access Journals (Sweden)

    Dihingia

    2015-03-01

    Full Text Available Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. Survival after the age of 12 years without corrective surgery is rare. We present the case of a 30 year - old man with uncorrected tetralogy of Fallot.

  6. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

    Science.gov (United States)

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.

    2016-01-01

    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  7. Demodex Dermatitis: A Retrospective Analysis of Clinical Diagnosis and Successful Treatment with Topical Crotamiton

    OpenAIRE

    Bikowski, Joseph B.; Del Rosso, James Q.

    2009-01-01

    Given the reported common occurrence of Demodex dermatitis in the general population, Demodex dermatitis—considered as a separate condition from rosacea and seborrheic dermatitis—was evaluated in a retrospective case analysis.

  8. A 10-Year Retrospective Analysis of Methyl Aminolevulinate Photodynamic Therapy Consultation at the Hospital de Braga

    OpenAIRE

    Brito, C; Resende, C.; Oliveira, P.

    2016-01-01

    Introduction Photodynamic therapy (PDT) is a well-established treatment for actinic keratosis (AK), basal cell carcinoma (BCC), and Bowen’s disease (BD). The object of this study was to describe the results of a retrospective analysis of patients treated with methyl aminolevulinate PDT (MAL-PDT) with red light, over the past decade at the Hospital de Braga (Braga, Portugal). Methods This study is based on the retrospective analysis of the clinical records of patients treated with MAL-PDT from...

  9. Predictors of attrition and academic success of medical students: a 30-year retrospective study.

    Directory of Open Access Journals (Sweden)

    Silvija Maslov Kruzicevic

    Full Text Available AIM: To determine attrition and predictors of academic success among medical students at University of Split, Croatia. METHODS: We analysed academic records of 2054 students enrolled during 1979-2008 period. RESULTS: We found that 26% (533/2054 of enrolled students did not graduate. The most common reasons for attrition were 'personal' (36.4%, transfer to another medical school (35.6%, and dismissal due to unsatisfactory academic record (21.2%. Grade point average (GPA and study duration of attrition students were significantly associated with parental education. There were 1126 graduates, 395 men and 731 women. Their average graduation GPA was 3.67±0.53 and study duration 7.6±2.44 years. During 5-year curriculum only 6.4% (42/654 of students graduated in time, and 55% (240/472 of students graduated in time after curriculum was extended to 6 years. Variables predicting whether a student will graduate or not were high school grades, entrance exam score and year of enrollment. Significant predictors of graduation grades were high school grades and entrance exam score. Entrance exam score predicted length of studying. CONCLUSION: Preadmission academic qualifications and year of enrollment predict academic success in medical school. More attention should be devoted to high attrition.

  10. Predictors of Attrition and Academic Success of Medical Students: A 30-Year Retrospective Study

    OpenAIRE

    Silvija Maslov Kruzicevic; Katarina Josipa Barisic; Adriana Banozic; Carlos David Esteban; Damir Sapunar; Livia Puljak

    2012-01-01

    AIM: To determine attrition and predictors of academic success among medical students at University of Split, Croatia. METHODS: We analysed academic records of 2054 students enrolled during 1979-2008 period. RESULTS: We found that 26% (533/2054) of enrolled students did not graduate. The most common reasons for attrition were 'personal' (36.4%), transfer to another medical school (35.6%), and dismissal due to unsatisfactory academic record (21.2%). Grade point average (GPA) and study duration...

  11. MYRINGOPLASTY IN CHILDREN - RETROSPECTIVE ANALYSIS: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-06-01

    Full Text Available Myringoplasty is the surgical closure of the perforation of pars tensa of the tympanic membrane. Perforation of the tympanic membrane in children can cause significant disability. It is a simple and effective procedure that results in the success ful closure of the perforation in most cases. This retrospective study was conducted in our hospital, for 06 years. Myringoplasty is a beneficial procedure in the pediatric population in the hands of a skilled and experienced surgeon. This paper will discu ss the success rate of perforation closure, improvement in hearing and complications during surgery and postoperative period in pediatric age group.

  12. Early conduct problems, school achievement and later crime: findings from a 30-year longitudinal study

    DEFF Research Database (Denmark)

    Jakobsen, Ida Skytte; Fergusson, David; Horwood, John L.

    2012-01-01

    This study used dato from a 30-year longitudinal study to esamine the associations between early conduct problems, school achievement and later crime. The analysis showed that, even following extensive adjustment for confounding, both early conduct problems and later educational achievement made...

  13. Analysis of Temporal and Spatial Distribution Patterns of Rainfall in Wuzhou in Recent 30 Years%梧州市近30年降雨量时空变化分布分析

    Institute of Scientific and Technical Information of China (English)

    朱颖洁

    2016-01-01

    The interpolation effect of Kriging,IDW,Spline and Trend method is analyzed,and the suitable ones have been chosen for the analysis of the rainfall in Wuzhou,and the distribution characteristics of time and space change of seasonal and annual rainfall in wuzhou are studied.Results show that:Kriging,IDW and Spline method are good for spatial interpolation for seasonal and annual rain-fall.rainfall decreasesfrom north to south in spring;rainfall decreases from northwest to southeast in summer;rainfall decreases from south,northwest to central in autumn;rainfall decreases from north and south to central and eastern in winter;annual rainfall decreases from north and south to west,southeast.most of Wuzhou rainfall increasesin spring;rainfall increasesin Wuzhou in summer;rainfall in-creasesin most of Wuzhou in autumn;rainfall increases in most of Wuzhou in winter;annual rainfall increases in most of Wuzhou.rain-fallrelatively decreases in the 80s of the 20th century;rainfall in the 90s of the 20th century is more than that in the 80s;rainfall in the 10s of the 21st century is less than that in the 90s of the 20st century.%分析Kriging、IDW、Spline和Trend法的插值效果,选出适合梧州市降雨量的空间插值方法,分析梧州市季年降雨量的时空变化分布特征。结果表明Kriging、IDW和Spline法在季年降雨量空间插值中的应用效果较好;春季降雨量分布自北部向南部递减,夏季降雨量分布自西北部向东南部和北部递减,秋季降雨量分布自南部、西北部向中部递减,冬季降雨量分布自北部与南部向中部和东部递减,年降雨量分布自北部与南部向西部和东南部递减。梧州市大部地区四季和年降雨量呈增加趋势;梧州市20世纪80年代降雨总体相对较少,90年代降雨较80年代增多,21世纪前10年降雨较90年代有所减少。

  14. OBSTETRIC PATIENTS IN MULTIDISIPLINARY INTENSIVE CARE UNIT: RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Semih ARICI

    2014-03-01

    The aim of this study is to retrospectively evaluate the obstetric cases who referred to intensive care unit, and define the frequency, cause and clinic outcomes of the patients. Demographic data, causes of reference, interventions in the intensive care and the outcomes of 15 obstetric cases in the pregnancy and postpartum period, whose referred to Gaziosmanpasa University Hospital Intensive Care Unit between 2007 and 2013 were included and retrospectively evaluated. The frequency of patients who referred from another center to our intensive care unit was 10 (%66.6. The mean age of the patients was 28.80 +/- 5.74. The mean hospital stay time was 3.20 +/- 2.51. The most cause to refer into intensive care unit was postpartum hemorrhage. One of the cases was resulted in death. The mortality ratio was found as %6.7. In conclusion, the frequent cause of intensive care requirement of the obstetric cases were obstetric bleeding and uncontrolled hypertension. The maternal morbidity and mortality will be substantially decreased with advanced treatment modalities and maternal care before pregnancy. [J Contemp Med 2014; 4(1.000: 14-17

  15. Social resources and cognitive ageing across 30 years

    DEFF Research Database (Denmark)

    Gow, Alan J.; Mortensen, Erik Lykke

    2016-01-01

    Background: to examine associations between social resources and cognitive ageing over 30 years. Methods: participants in the Glostrup 1914 Cohort, a year of birth sample, completed a standardarised battery of cognitive ability tests every 10 years from age 50 to 80, summarised as general cognitive...... ability. Participants also provided information concerning a range of social resources, including marital status and living arrangements from age 50, and from age 70, details regarding social support, social contact and loneliness. Results: across the follow-up, participants were less likely to be married...... together (and accounting for sex, education and social class), loneliness was associated with lower cognitive ability level and greater cognitive decline, while married individuals experienced less decline. Conclusions: in a relatively large cohort followed for up to 30 years, marital status and loneliness...

  16. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    Science.gov (United States)

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis.

  17. Vertebrate Paleontology in Central America: 30 years of progress

    OpenAIRE

    2014-01-01

    Vertebrate paleontology began in Central America in 1858 with the first published records, but the last 30 years have seen remarkable advances. These advances range from new localities, to new taxa to new analyses of diverse data. Central American vertebrate fossils represent all of the major taxonomic groups of vertebrates—fishes, amphibians, reptiles (especially turtles), birds and mammals (mostly xenarthrans, carnivores and ungulates)—but coverage is very uneven, with many groups (especial...

  18. The enduring legacy of Alma Ata: 30 years on.

    Science.gov (United States)

    Exworthy, Mark

    2008-01-01

    The 1978 Alma Ata conference and declaration was a landmark in defining and providing a direction for primary healthcare. Despite the initial enthusiasm for Alma Ata, its impact appeared to have declined in the 1990s. However, in recent years, there has been a revitalisation of primary healthcare. This article reviews the Alma Ata conference and declaration, assesses its waxing and waning, and examines its recent revival. The paper draws conclusions about the relevance of Alma Ata, 30 years on.

  19. Acta Pharmacologica Sinica:Celebrating 30 years of publishing

    Institute of Scientific and Technical Information of China (English)

    Jian DING

    2010-01-01

    @@ Acta Pharmacologica Sinica(APS) is now celebrating 30 years of publication.I am happy to summarize what has been accomplished over the past three decades.First I would like to sincerely thank the founding editor-in-chief(1980-2003),Professor Guang-sheng DING.He is well known for his strict-ness,tireless work ethic,and remarkable editing skills.

  20. Transient Unexplained Shock in 30-year-old Trauma Patient

    OpenAIRE

    Rahmani, Farzad; Ebrahimi Bakhtavar, Hanieh; Shahsavari Nia, Kavous; Mohammadi, Neda

    2014-01-01

    Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic (hemorrhagic), obstructive (cardiac tamponade, tension pneumothorax), cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and symptoms of shock referred while had unknown origin; it was finally recognized as anaphylactic shock.

  1. Transient Unexplained Shock in 30-year-old Trauma Patient.

    Science.gov (United States)

    Rahmani, Farzad; Ebrahimi Bakhtavar, Hanieh; Shahsavari Nia, Kavous; Mohammadi, Neda

    2014-01-01

    Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic (hemorrhagic), obstructive (cardiac tamponade, tension pneumothorax), cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and symptoms of shock referred while had unknown origin; it was finally recognized as anaphylactic shock.

  2. Gastrointestinal bleeding 30 years after a complicated cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Thorsten; Brechmann; Wolff; Schmiegel; Volkmar; Nicolas; Markus; Reiser

    2010-01-01

    Gastrointestinal bleeding from small-bowel varices is a rare and difficult to treat complication of portal hypertension. We describe the case of a 79-year-old female patient with recurrent severe hemorrhage from smallbowel varices 30 years after a complicated cholecystectomy. When double balloon enteroscopy was unsuccessful to reach the site of bleeding, a rendezvous approach was favored with intraoperative endoscopy. Active bleeding from varices within a biliodigestive anastomosis was found and controlled ...

  3. [Ventricular tachyarrhythmias. A retrospective analysis of etiology, demography and treatment

    DEFF Research Database (Denmark)

    Christensen, A.H.; Henningsen, K.; Svendsen, Jesper Hastrup

    2008-01-01

    to ventricular tachyarrhythmias. MATERIALS AND METHODS: We conducted a retrospective review of 993 patients discharged from Rigshospitalet over 6 years and 5 months with the diagnostic codes ventricular tachycardia, ventricular fibrillation or premature ventricular contractions. RESULTS: The population had...... an average age of 59 years (ranging 15-95 years) with a majority of males (76%). Among the patients with known etiology ischemic heart disease (60%), dilated cardiomyopathy (6%) and arrhythmogenic right ventricular cardiomyopathy (6%) were the most frequent. A substantial number of the patients (15%) had...... unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted...

  4. Retrospective analysis of phone queries to an epilepsy clinic hotline.

    Science.gov (United States)

    Laforme, Anny; Jubinville, Suzie; Gravel, Micheline; Cossette, Patrick; Nguyen, Dang K

    2014-01-01

    We undertook a retrospective study of 5,189 telephone calls made between January 2004 and June 2011 through our adult epilepsy clinic hotline to a single epileptologist initially and two epileptologists from June 2010 onwards. The majority of calls were made by patients themselves (72%), followed by family members (16%) and health care providers (11%). Half of the calls originated from outside the city limits. Most were related to medication (25%), notification of seizures (23%), appointments or tests (12%), and side effects (9%). Half of the workload was generated by 10% of patients. The hotline service appears to respond to needs, with most calls requiring rapid intervention. It is desirable to develop novel approaches to address the needs of high-frequency callers.

  5. [Retrospective analysis of 39 child cases of paragonimiasis].

    Science.gov (United States)

    Guo, Mei; Wang, Wei; Jiang, Jian-yu

    2011-08-01

    Clinical data of 39 children with paragonimiasis treated in Chongqing Three Gorges Central Hospital during 2008-2010 were retrospectively analyzed. The cases aged from 3 to 10 years old, with 25 cases of polyserositis (64.1%), 14 cases of cerebral paragonimiasis (35.9%). Among the cases of polyserositis, all showed dyspnea,tachypnea and diminished respiration (100%). Other symptoms or signs included purulent pleurisy, orthopnea, restricted activity, distant heart sounds, purulent pericarditis, abdominal distension, and hepatomegaly. In the 14 cases of cerebral paragonimiasis, 10 cases (71.4%) complained headache, 8 cases (57.1%) with vomiting, and other symptoms such as seizures, limb rigidity associated with conscious disturbance. Eight patients were treated with surgery and praziquantel, while others with praziquantel alone. After treatment 25 cases (64.1%) were cured, 13 cases (33.3%) improved, and 1 case (2.6%) showed no change.

  6. Nasolabial cyst: a retrospective analysis of 18 cases.

    Science.gov (United States)

    Choi, Jin Ho; Cho, Jae Hoon; Kang, Hee Joon; Chae, Sung Won; Lee, Sang Hag; Hwang, Soon Jae; Lee, Heung-Man

    2002-02-01

    Nasolabial cysts are rare but easily identifiable when they do occur. They are thought to arise from the remnants of the nasolacrimal ducts, but most of the available information on these cysts is limited to isolated case reports. The purpose of our study was to examine the clinical and pathologic features of nasolabial cysts in order to provide a basis for their correct diagnosis and treatment. Eighteen patients with nasolabial cysts were treated at Korea University's Guro Hospital between Jan. 1, 1988, and Dec. 31, 1999. We retrospectively analyzed the clinical appearance, pathologic findings, and treatment results in each case. All patients underwent surgery via the sublabial approach. The lining epithelia were identified as either pseudostratified, stratified squamous, or simple cuboidal. A cyst recurred in only one case, and there were no surgical complications on follow-up. The results of our study provide a basis for sound diagnosis and treatment.

  7. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    Science.gov (United States)

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.

  8. Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

    Directory of Open Access Journals (Sweden)

    Cemal Hacı

    2016-09-01

    Full Text Available Aim: In our study, we assessed symptoms and treatment outcomes in patients with deep neck infections (DNI. It often has a rapid onset and can cause lethal complications. Methods: A retrospective designed study of 85 patients diagnosed with DNI such as peritonsillar, parapharyngeal, and submandibular abscesses. Results: A total of 85 patients were diagnosed with DNI. 33 of the 85 patients were younger than 18 (group of children, and 52 were older than 18 years of age (group of adults. The mean age of the patients was 24.109±14.003 (4-54 years. Trismus, fever, odynophagia and pain were the most common complaints in both groups. In the adults group, the peritonsillar space was the most common site of infection (49%. In children group, the parapharyngeal space was the most common site of infection (35%. All patients were given intravenous antibiotic therapy and additional drainage of the abscess was also carried out for some of the patients. Most frequently, intravenous ampicillin-sulbactam alone or in combination with metronidazole was administrated to the patients. Conclusion: Most of the cases of DNI can be treated with intravenous antibiotics in spite of the fact that if there is no clinical healing, drainage is needed.

  9. A RETROSPECTIVE ANALYSIS OF SURGICAL TREATMENT FOR BREAST MALIGNANT TUMORS

    Institute of Scientific and Technical Information of China (English)

    范志民; 刘国津; 盖学良; 王晓军; 辛志泳

    2002-01-01

    Objective: To review the evolution of the current surgical treatment for breast malignant tumors over the past twenty years in the First Hospital of Jilin University (the former Bethune University of Medical Sciences). Methods: 1195 eligible patients with primary breast malignant tumor diagnosed and surgically treated at the First Teaching Hospital from January 1980 and December 2000 were retrospectively analyzed. Results: The peak frequency was in 40-49 years of age (40.00%), the age of the patients with breast malignant tumors trends to become young. The most common pTNM classification was Stage Ⅱ. The most common histological type was infiltrating ductal carcinoma (398 patients, 33.31%), and simple carcinoma (279 patients, 23.53%). Modified radical mastectomy was the most common operation procedure performed (779 patients, 65.19%), and was increasingly used while radical mastectomy was adopted decreasingly in recent decade. Conclusion: The variation of operation procedures performed on patients with breast malignant tumors reflected the advance of our understanding of the biology of cancer and the progression of new treatment principles.

  10. [The historical analysis of migration: the pertinence of longitudinal analysis based on retrospective histories].

    Science.gov (United States)

    Piche, V; Gregory, J; Lavoie, J

    1984-01-01

    The appropriateness of longitudinal analysis as a technique for studying migration is considered. Migration in Upper Volta (now Burkina Faso) is used as the example. Data are taken from the 1974-75 National Survey of Migration, in which 36,785 men and 38,987 women were questioned. The authors begin with a theoretical discussion of the biases to be expected in retrospective histories. They next look at the migration data using first longitudinal analysis and then cross-sectional analysis. Results, at least for this example, show that cross-sectional analysis of migration has the advantage over longitudinal analysis of allowing the correlations between changes in migration patterns and particular historical events to be seen more readily.

  11. Plus or minus 30 years in the language sciences.

    Science.gov (United States)

    Newport, Elissa L

    2010-07-01

    The language sciences—Linguistics, Psycholinguistics, and Computational Linguistics—have not been broadly represented at the Cognitive Science Society meetings of the past 30 years, but they are an important part of the heart of cognitive science. This article discusses several major themes that have dominated the controversies and consensus in the study of language and suggests the most pressing issues of the future. These themes include differences among the language science disciplines in their view of numbers and symbols and of modular and distributed cognition, and the need for an increasing prominence of questions concerning language and the brain.

  12. Tuberculosis of hip in children: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Myung-Sang Moon

    2012-01-01

    Full Text Available Background: Tuberculosis (TB of hip constitutes nearly 15% of all cases of osteoarticular tuberculosis. We report a retrospective study carried out on 43 children with hip TB. Materials and Methods: Forty-three children of TB hip treated between 1971 and 2000 were analysed. Twenty-four children of the early series were treated with streptomycin (S, isoniazid (H and PAS (Pa for 18 months (3HPaS, 15 HPa, while 19 children in the later series were treated with isoniazid (H, rifampicin (R and ethambutol (E or pyrazinamide (Z for 12 months [(12 RHE(Z]. Five out of 18 children with radiologically normal appearing type hip TB were treated with chemotherapy alone and 38 children were subjected to surgery; simple synovectomy alone in 31 hips, joint debridement in six hips, and proximal femoral varisation osteotomy in one. After surgery hips were immobilized in cast for one to three months according to the severity of the disease and patients pain tolerance, and then were mobilized under leg traction in bed gradually till pain subsided completely. Results: TB of hip healed with minimum sequelae in all children. In 18 Type one hip TB, normal hip (synovial form anatomy was maintained, and in 25 patients with advanced lesions some defect in the femoral head and acetabulum was noticed, though painless good hip motion was maintained. Excellent to good results were obtained in 31 children (73.1%, fair in eight (18.6%, and poor in four (9.3%. In four patients with poor results, there was some residual morphological defect in the hip. None developed ankylosis of hip. Conclusion: We achieved good outcome with minimum sequelae in this series. The management goal should be aimed not only to heal the disease but also to maintain a painless mobile hip and anatomical cephalocotyloid relationship until maturity, and retard the development of secondary osteoarthritis.

  13. Antiretroviral outcomes in South African prisoners: a retrospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Natasha E C G Davies

    Full Text Available BACKGROUND AND METHODS: Little is known about antiretroviral therapy (ART outcomes in prisoners in Africa. We conducted a retrospective review of outcomes of a large cohort of prisoners referred to a public sector, urban HIV clinic. The review included baseline characteristics, sequential CD4 cell counts and viral load results, complications and co-morbidities, mortality and loss to follow-up up to 96 weeks on ART. FINDINGS: 148 inmates (133 male initiated on ART were included in the study. By week 96 on ART, 73% of all inmates enrolled in the study and 92% of those still accessing care had an undetectable viral load (<400 copies/ml. The median CD4 cell count increased from 122 cells/mm(3 at baseline to 356 cells/mm(3 by 96 weeks. By study end, 96 (65% inmates had ever received tuberculosis (TB therapy with 63 (43% receiving therapy during the study: 28% had a history of TB prior to ART initiation, 33% were on TB therapy at ART initiation and 22% developed TB whilst on ART. Nine (6% inmates died, 7 in the second year on ART. Loss to follow-up (LTF was common: 14 (9% patients were LTF whilst still incarcerated, 11 (7% were LTF post-release and 9 (6% whose movements could not be traced. 16 (11% inmates had inter-correctional facility transfers and 34 (23% were released of whom only 23 (68% returned to the ART clinic for ongoing follow-up. CONCLUSIONS: Inmates responded well to ART, despite a high frequency of TB/HIV co-infection. Attention should be directed towards ensuring eligible prisoners access ART programs promptly and that inter-facility transfers and release procedures facilitate continuity of care. Institutional TB control measures should remain a priority.

  14. VOL AR PLATING OF DISTAL RADIUS FRACTURE : A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Victor

    2015-06-01

    Full Text Available BACKGROUND: Treatment of distal radius has undergone remarkable changes since the time of Abraham colles. Conservative treatment with cast application has given way to operative techniques for better o utcome in high demand young individuals. Volar plating fo r distal end radius fractures is an effective technique which allows early mobilisation with re storation of r adial inclination , radial length , articular congruity and palmar tilt. MATERIALS AND METHODS: T his study was performed in chettinad hospital and research institute between January 2013 and M arch 2014. 24 patients with closed isolated distal end radius fractures treated with open reduction and internal fixation with plates and screws by volar approach were followed up retrospectively for a minimum period of one year . There were 17 men and 7 women. Mean age was 44 years (Range, 22 - 75 years. The fractures were classified based on the AO system. There were 4 A2, 12 B3, 5 C1, 3 C2 fracture types. RESULTS : All the patients were evaluated with standard anteroposterior and lateral radiographs and CT scans in c ase of intraarticular fractures . In all patie nts plating of distal end radius done by volar approach. Patients were followed postoperatively for one y ear radiologically and clinically by modified clinical scoring system by Green and O Brien. Five patients had excellent results, thirteen patients had good results with twenty five percent restriction of wrist function . Five patients had fair results. One patient had postop wound infection which required implant removal and external fixator application . CONCLUSION: With proper patient selection a nd accurate surgical techniques , volar plating continues to be a useful method of treatment for distal end radius fractures with minimal complications and allowing early return of patients to normal activities.

  15. Semantic Verbal Fluency test in dementia: Preliminary retrospective analysis

    Directory of Open Access Journals (Sweden)

    Marcos Lopes

    Full Text Available Abstract The Semantic Verbal Fluency (SVF test entails the generation of words from a given category within a pre-set time of 60 seconds. Objectives: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. Methods: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. Results: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p<0.001 but correlation between the number of clusters and responses was strong (r=0.883, p<0.001. The number of items on the SVF was statistically significant with MMSE score (p=0.01 and there was a tendency for significance on the CDR (p=0.06. The results indicated little activity regarding what we propose to call cluster recalling in the two groups. Discussion: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

  16. Histopathological features of post-mortem pituitaries: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Francisco José Tortosa Vallecillos

    Full Text Available SUMMARY Objective: As a result of the use of neuroimaging techniques, silent pituitary lesions are diagnosed more and more frequently; however, there are few published post-mortem studies about this gland. Incidence data of pituitary lesions are rare and in Portugal they are outdated or even non-existent. The aim of this study is to determine the prevalence of normal patterns and incidental post-mortem pituitary pathology at Centro Hospitalar Lisboa Norte, analyzing the associations with clinical data and assessing the clinical relevance of the findings. Method: We reviewed retrospectively and histologically 167 pituitaries of a consecutive series of autopsies from the Department of Pathology of this centre. They were done between 2012 and 2014, and in all cases medical records were reviewed. The morphological patterns observed, were classified into three major groups: 1 Normal histological patterns and variants; 2 Infectious-inflammatory pathology, metabolic and vascular disorders; 3 Incidental primary proliferation and secondary to systemic diseases. Results: The subjects included in this study were of all age groups (from 1 day to 91 years old, 71 were female and 96 male. Fifty-seven of these glands didn’t show any alteration; 51 showed colloid cysts arising from Rathke cleft; 44 presented hyperplasia in adenohypophysis and we identified 20 adenomas in 19 glands (immunohistochemically, eight PRL-producing and five ACTH-producing tumors, ten of which associated with obesity, 11 to hypertension and six to diabetes mellitus. There were two cases with metastasis. Conclusion: Subclinical pathology in our country is similar to that seen in other parts of the world, but at older ages.

  17. Retrospective Analysis of 119 Osteosarcomas in a Single Centre Experience

    Directory of Open Access Journals (Sweden)

    Meral Gunaldi

    2016-01-01

    Full Text Available Aim: Osteosarcomas must be managed by a team which includes pathologists, radiologists, surgeons, radiation therapists, and medical oncologists. Treatment modalities and demographic charasteristics of osteosarcomas were analysed in this study. Material and Method: Primary osteosarcomas treated between 1999-2010 in Cukurova University Medical Faculty Department of Medical Oncology were analysed retrospectively. Results: Of the total 119 patients, 74% were male and 26% female. The median age was 19. The median follow up time was 37 months. The most frequently seen sarcomas were osteoblastic at 82.4%. Localization of the disease was found to be 55% in the lower extremity, 14.1% in the upper extremity, 13% in the head-neck, 6.6% in the thoracic area, and 4.1 % in the pelvic region. Some 6.41% were local stage, 25.64% locally advanced, 15.8% metastatic, and 14.10% were diagnosed with nuks disease. Chemotherapy was administered in 77 of 119 patients. Patients received different treatments: 23.1% were treated with preoperative chemotherapy, 16.67% postoperative, 9.52% palliative, 33.33% preoperative postoperative, 2.38% postoperative palliative, 9.52% preoperative postoperative palliative chemotherapy, and 4.76% of the patients did not receive chemotherapy. Both radical and conservative surgery was performed. The most common metastatic site was the lungs. The overall length of survival was 65 months (95%CI 30-59. The survival rates did not vary between the groups of preoperative, postoperative, preoperative postoperative chemotherapy and other groups (respectively 23 versus 36 versus 28 versus 44 months (p=0.8. No differences were evident for radiotherapy (p=0.06. Discussion: Osteosarcomas can be treated successfully with surgery, chemotherapy, and radiotherapy. There was no cumulative survival difference in results based on the types of chemotherapy used in this study. These results show the importance of a multimodality treatment approach including

  18. RETROSPECTIVE ANALYSIS OF MAGNETIC RESONANCE MYOCARDIAL DELAYED ENHANCEMENT

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Lin-yan Kong; Feng Feng; Hui You; Hong-yi Sun; Wen-min Zhao; Li-ren Zhang; Zheng-yu Jin; Qi Miao; Song-bai Lin; Shu-yang Zhang; Dong-jing Li; Li-bo Chen; Heng Zhang; Yi-ning Wang; Lu Zhou

    2006-01-01

    Objective To explore the imaging and related clinical characteristics of magnetic resonance (MR) delayed enhancement in patients with ischemic or nonischemic heart disease.Methods Thirty-two cases who underwent MR myocardial cine and delayed enhancement imaging from January 2004 to October 2006 were retrospectively analyzed.The cine sequence imaging included the four-chamber view and the left ventricular short axis view.The delayed enhancement imaging was taken 10 minutes after the infusion of gadolinium from the antecubital vein with a segmented inversion-recovery-prepared T1-weighted fast gradient echo sequence.Patients underwent coronary computed tomography angiography (CTA) two weeks before or after the MR imaging examination.Combined with clinical history,the clinical and MR imaging characteristics of the patients who had delayed enhancement were analyzed.Results MR delayed enhancement could be found in 16 cases.Among them,12 cases had ischemic heart disease.Their coronary CTA showed one to three vessel diseases.The delayed enhancement was transmural or subendocardium,and the area of delayed enhancement corresponded well with one or more coronary arteries which had severe stenosis or occlusion.Four cases had nonischemic heart diseases.One case was dilated cardiomyopathy,with diffuse small midwall spots in delayed enhancemen and only 30% stenosis of the anterior descending coronary artery in coronary CTA.One case was hypertrophic cardiomyopathy,with delayed enhancement of strip- and patch-shaped at midwall of the hypertrophic myocardium.One case was restrictive cardiomyopathy,and the delayed enhancement was located in the area of subendocardium of both the right and left ventricles.Coronary CTA of these two cases were normal.The other case was a mass of the lateral wall of the left ventricle,and the delayed enhancement with a clumpy shape was located in the lateral wall of the left ventricle.Conclusions MR myocardial delayed enhancement is not a specific sign

  19. Simultaneus bilateral spontaneus pneumothoraces: A Retrospective Analysis of 11 Cases

    Directory of Open Access Journals (Sweden)

    Ufuk Cobanoglu

    2011-09-01

    Full Text Available Spontaneous pneumothorax (SP is relatively common in clinical practice and occurs more frequently in young, tall thin men, and in smokers. However, simultaneous bilateral spontaneous pneumothorax (SBSP is a rare clinical condition that often presents with significant respiratory distress. It is often dangerous; therefore, the chest drain should be inserted immediately. In this study, simultaneus bilateral spontaneus pneumothoraces cases were divided into two groups and retrospectively evaluated according to age, sex, diagnostic methods, treatments, and results. Material and Methods :Between January 2006 and May 2009, 11 patients with SBSP were enrolled into our study. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, duration of chest tube and postoperative hospital stay of the patients were reviewed. Arterial blood gas values (before and after intervention in patiens with primary and secondary spontaneous pneumothorax were evaluated. Results; 7 patients (63.63 % were male and 4 patients (36.37 % were female and their mean age was 34,5±6.81 years. There were 4 (36.37% primary SP and 4 (36.37% secondary SP patients. Chronic obstructive pulmonary disease (COPD was the most common cause in secondary SP patients. In two (18.18% patients recurrency were observed. Eight (72.72% patients had smoking history. The most common symptom in both groups was dyspnea. All patients had immediate bilateral chest tubes on admission. We treated these patients with chest drain insertion, VATS (Video-Assisted Thoracoscopic Surgery, axillary thoracotomy, and chemical pleurodesis. Postoperative morbidity was detected in 3 (27.27% patients (prolonged air leak in 1 case, empyema in 1 case and pneumonia in 1 case. No mortality was observed in alll cases. Recurrence developed in 3 (27.27% patients in this series. Conclusions: An urgent and effective treatment requires in the

  20. What Has 30 Years of HIV Vaccine Research Taught Us?

    Directory of Open Access Journals (Sweden)

    José Esparza

    2013-10-01

    Full Text Available When HIV was discovered and established as the cause of AIDS in 1983–1984, many people believed that a vaccine would be rapidly developed. However, 30 years have passed and we are still struggling to develop an elusive vaccine. In trying to achieve that goal, different scientific paradigms have been explored. Although major progress has been made in understanding the scientific basis for HIV vaccine development, efficacy trials have been critical in moving the field forward. Major lessons learned are: the development of an HIV vaccine is an extremely difficult challenge; the temptation of just following the fashion should be avoided; clinical trials are critical, especially large-scale efficacy trials; HIV vaccine research will require long-term commitment; and sustainable collaborations are needed to accelerate the development of an HIV vaccine. Concrete actions must be implemented with the sense of urgency imposed by the severity of the AIDS epidemic.

  1. What Has 30 Years of HIV Vaccine Research Taught Us?

    Science.gov (United States)

    Esparza, José

    2013-10-30

    When HIV was discovered and established as the cause of AIDS in 1983-1984, many people believed that a vaccine would be rapidly developed. However, 30 years have passed and we are still struggling to develop an elusive vaccine. In trying to achieve that goal, different scientific paradigms have been explored. Although major progress has been made in understanding the scientific basis for HIV vaccine development, efficacy trials have been critical in moving the field forward. Major lessons learned are: the development of an HIV vaccine is an extremely difficult challenge; the temptation of just following the fashion should be avoided; clinical trials are critical, especially large-scale efficacy trials; HIV vaccine research will require long-term commitment; and sustainable collaborations are needed to accelerate the development of an HIV vaccine. Concrete actions must be implemented with the sense of urgency imposed by the severity of the AIDS epidemic.

  2. Interactions between libraries and technology over the past 30 years

    DEFF Research Database (Denmark)

    Greifeneder, Elke; Seadle, Michael; Lynch, Clifford

    2012-01-01

    Purpose – The purpose of this paper is to look back on the last 30 years of technology development for libraries. Design/methodology/approach – The paper presents an interview that took place at the American Library Association Annual Meeting in Anaheim, California. Findings – The paper reveals...... that many of the developments are slow. There are very few really sudden revolutions in social-scale technologies. They do not switch on quickly and cannot be sudden because the installed base is too thin. Originality/value – The paper reveals that there should be some renewed conversation about how...... libraries can help the public. In the early days of the internet libraries played an enormous uncredited role in teaching the adult population about the it. There are some opportunities like that now, and one place where we are starting to see signs of it is digital preservation, not as libraries doing...

  3. Forensic age estimation of living individuals: a retrospective analysis.

    Science.gov (United States)

    Santoro, Valeria; De Donno, Antonio; Marrone, Maricla; Campobasso, Carlo Pietro; Introna, Francesco

    2009-12-15

    In recent years, skeletal age determination has become increasingly important in criminal investigations for determining the age of living individuals. To increase diagnostic accuracy, a physical examination, an X-ray examination of the left hand, as well as a dental examination including the determination of the dental status and an X-ray of the dentition should always be performed. In this work, the authors analyze a sample of 52 illegal immigrants who came under their observation in the period from May 1989 to September 2007. A statistical analysis of the results of dental and skeletal age estimations was performed as well as an analysis between the reported and assessed ages. The results showed a significant difference between reported age and assessed biological age (p<0.001); however, no statistical difference was shown between skeletal and assessed dental age (p=0.431).

  4. Onset of Indian Summer Monsoon: a retrospective analysis

    Science.gov (United States)

    Sruthi, S.; Mrudula, G.

    2016-05-01

    The monsoon onset over Kerala is considered as the beginning of rain fall over India and it is the end of hot summer. Different criteria have been used to define the monsoon onset over Kerala, with the one given by India Meteorological Department taken as the standard criteria. The analysis of the past 20 years of observations shows that the variables during the monsoon onset do not behave in the same way always. The purpose of this paper is to analyses the monsoon onset phases and to find possible reasons behind the variable nature of the monsoon onset. Different meteorological parameters like precipitation, outgoing long wave radiation (OLR), winds, air temperature, and specific humidity at different levels are analyzed for the same. Research has been done on various distinct features of monsoon such as Low Level Jet (LLJ), Tropical Easterly Jet (TEJ), monsoon trough, and depressions etc., during the onset phase. The analysis showed that in some years the strength of LLJ is lesser compared to the normal years. It is also seen that in some years the wind flow pattern is different from that observed during a standard onset year. The results of these analyses will be presented in detail in the paper.

  5. Retrospective analysis of outcomes from two intensive comprehensive aphasia programs.

    Science.gov (United States)

    Persad, Carol; Wozniak, Linda; Kostopoulos, Ellina

    2013-01-01

    Positive outcomes from intensive therapy for individuals with aphasia have been reported in the literature. Little is known about the characteristics of individuals who attend intensive comprehensive aphasia programs (ICAPs) and what factors may predict who makes clinically significant changes when attending such programs. Demographic data on participants from 6 ICAPs showed that individuals who attend these programs spanned the entire age range (from adolescence to late adulthood), but they generally tended to be middle-aged and predominantly male. Analysis of outcome data from 2 of these ICAPs found that age and gender were not significant predictors of improved outcome on measures of language ability or functional communication. However, time post onset was related to clinical improvement in functional communication as measured by the Communication Activities of Daily Living, second edition (CADL-2). In addition, for one sample, initial severity of aphasia was related to outcome on the Western Aphasia Battery-Revised, such that individuals with more severe aphasia tended to show greater recovery compared to those with mild aphasia. Initial severity of aphasia also was highly correlated with changes in CADL-2 scores. These results suggest that adults of all ages with aphasia in either the acute or chronic phase of recovery can continue to show positive improvements in language ability and functional communication with intensive treatment.

  6. Modern Era Retrospective Restrospective-Analysis for Research and Applications (MERRA) Data and Services at the GES DISC

    Science.gov (United States)

    Berrick, Stephen W.; Shen, Suhung; Ostrenga, Dana

    2008-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) dataset is a NASA satellite era, 30 year (1979 - present), reanalysis using the Goddard Earth Observing System Data Assimilation System, Version 5 (GEOS-5). The project, run out of NASA's Global Modeling and Assimilation Office at Goddard Space Flight Center, provides the science and application communities with a state-of-the-art global analysis with emphasis on improved estimates of the hydrological cycle over a broad range of weather and climate time scales. MERRA products are generated as a long-term synthesis that places the NASA EOS suite of observations in a climate context. The MERRA analysis is performed at a horizontal resolution of 2/3 longitude x 1/2 latitude (540x361 global gridpoints) with observational analyses every 6 hours. The MERRA output data will include 3 dimensional state fields for every 6 hourly analysis cycle on 42 pressure levels (or 72 terrain following model coordinate levels) from the surface through the stratosphere. Several data products are specifically designed to support chemistry and stratosphere transport modeling. The 2 dimensional surface and atmospheric diagnostics (numbering 259) are being stored on the native grid at 1 hourly intervals. These include radiation and vertical integrals of the atmosphere for water and energy budget studies and also surface diagnostics where the diurnal cycle is important. The one hourly surface and near surface data product will also facilitate research on the integrated analysis of Earth system observations in the land, ocean and cryosphere. The MERRA products are archived and distributed by the Goddard Earth Sciences Data and Information Services Center (GES DISC) through its Modeling DISC Web (MDISC) portal. Multiple data access methods and services are available for MERRA data through MDISC: (1) Mirador offers a quick, comprehensive search of MERRA and all GES DISC archived data holdings, allowing searches on

  7. 30 years of experience in safe transportation of nuclear materials

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, K. [Nuclear Fuel Transport Co., Ltd., Tokyo (Japan)

    2004-07-01

    In April 2003, Nuclear Fuel Transport Co., Ltd. (NFT) marked the 30{sup th} anniversary of its founding. NFT was established in 1973 and in 1978, commenced SF transport to the reprocessing plant in Tokai-mura. And then, after making preparations to transport nuclear materials to the various facilities at the Nuclear Fuel Cycle Center in Rokkasho-mura, NFT successfully started transportation of LLW (low level waste) to Rokksho-mura's LLW disposal center in 1992, domestic land transportation of HLW returned from overseas to the HLW storage center in 1995, domestic land transportation of natural hexafluoride delivered from overseas to the uranium enrichment plant in 1996, and transportation of SF to the reprocessing plant in 2000. NFT has realized an annual SF transportation capacity of 300 MTU and is currently making great company wide efforts to meet the Rokkasho Reprocessing Plant's future SF annual reprocessing capacity of 800MTU. At the end of FY2003, NFT had successfully transported 560 casks (about 1,730 MTU) of SF in more than 200 voyages in total, about 160,000 drums of LLW in around 100 voyages in total. This paper introduces the record of safe transport and its experience over the past 30 years and prospect for future transport business.

  8. American Meteorological Society (AMS) - The Modern Era Retrospective-Analysis for Research and Applications (MERRA) Data and Accessibility

    Science.gov (United States)

    daSilva, Arlindo

    2009-01-01

    The AM Short Course on The Modern Era Retrospective-analysis for Research and Applications (MERRA) data and accessibility will be held on January 11, 2009 preceding the 89th Annual Meeting in Phoenix, Arizona. Preliminary programs, registration, hotel, and general information will be posted on the AMS Web site in mid-September 2008. Retrospective-analyses (or reanalyses) have been established as an important tool in weather and climate research over the last decade. As computer power increases, the data assimilation and modeling systems improve and become more advanced, the input data quality increases and so reanalyses become more reliable. In 2008, NASA Global Modeling and Assimilation Office began producing a new reanalysis called the Modem Era Retrospective-analysis for Research and Applications (MERRA). The initial data from the reanalysis has been made available to the community and should be complete through 30 years (1979-present) by Fall of 2009. MERRA has taken advantage of the advancement of computing resources to provide users more data than previously available. The native spatial resolution is nominally 1/2 degrees and the surface two dimensional data are one hourly frequency. In addition to the meteorological analysis data, complete mass, energy and momentum budget data and also stratospheric data are provided. The eventual data holdings will exceed 150Tb. In order to facilitate user accessibility to the data, it will be stored in online hard drives (not tape storage) and available through several portals. Subsetting tools will also be available to allow users to tailor their data requests. The goals of this short course are to provide hands on users of reanalyses instruction on MERRA systems and also interactive experience with the online data and access tools. The course is intended for students and research scientists who will be actively interested in accessing and applying MERRA data in their weather, climate or applications work. The course has

  9. NPY and stress 30 years later: the peripheral view.

    Science.gov (United States)

    Hirsch, Dalay; Zukowska, Zofia

    2012-07-01

    Almost 30 years ago, neuropeptide Y (NPY) was discovered as a sympathetic co-transmitter and one of the most evolutionarily conserved peptides abundantly present all over the body. Soon afterward, NPY's multiple receptors were characterized and cloned, and the peptide's role in stress was first documented. NPY has proven to be pivotal for maintaining many stress responses. Most notably, NPY is known for activating long-lasting vasoconstriction in many vascular beds, including coronary arteries. More recently, NPY was found to play a role in stress-induced accretion of adipose tissue which many times can lead to detrimental metabolic changes. It is however due to its prominent actions in the brain, one of which is its powerful ability to stimulate appetite as well as its anxiolytic activities that NPY became a peptide of importance in neuroscience. In contrast, its actions in the rest of the body, including its role as a stress mediator, remained, surprisingly underappreciated and not well understood. Our research has focused on that other, "peripheral" side of NPY. In this review, we will discuss those actions of NPY on the cardiovascular system and metabolism, as they relate to adaptation to stress, and attempt to both distinguish NPY's effects from and integrate them with the effects of the classical stress mediators, glucocorticoids, and catecholamines. To limit the bias of someone (ZZ) who has viewed the world of stress through the eyes of NPY for over 20 years, fresh insight (DH) has been solicited to more objectively assess NPY's contributions to stress-related diseases and the body's ability to adapt to stress.

  10. Hydrological Response to ~30 years of Agricultural Surface Water Management

    Directory of Open Access Journals (Sweden)

    Giulia Sofia

    2017-01-01

    Full Text Available Amongst human practices, agricultural surface-water management systems represent some of the largest integrated engineering works that shaped floodplains during history, directly or indirectly affecting the landscape. As a result of changes in agricultural practices and land use, many drainage networks have changed producing a greater exposure to flooding with a broad range of impacts on society, also because of climate inputs coupling with the human drivers. This research focuses on three main questions: which kind of land use changes related to the agricultural practices have been observed in the most recent years (~30 years? How does the influence on the watershed response to land use and land cover changes depend on the rainfall event characteristics and soil conditions, and what is their related significance? The investigation presented in this work includes modelling the water infiltration due to the soil properties and analysing the distributed water storage offered by the agricultural drainage system in a study area in Veneto (north-eastern Italy. The results show that economic changes control the development of agro-industrial landscapes, with effects on the hydrological response. Key elements that can enhance or reduce differences are the antecedent soil conditions and the climate characteristics. Criticalities should be expected for intense and irregular rainfall events, and for events that recurrently happen. Agricultural areas might be perceived to be of low priority when it comes to public funding of flood protection, compared to the priority given to urban ones. These outcomes highlight the importance of understanding how agricultural practices can be the driver of or can be used to avoid, or at least mitigate, flooding. The proposed methods can be valuable tools in evaluating the costs and benefits of the management of water in agriculture to inform better policy decision-making.

  11. Synthesising 30 years of mathematical modelling of Echinococcus transmission.

    Directory of Open Access Journals (Sweden)

    Jo-An M Atkinson

    Full Text Available BACKGROUND: Echinococcosis is a complex zoonosis that has domestic and sylvatic lifecycles, and a range of different intermediate and definitive host species. The complexities of its transmission and the sparse evidence on the effectiveness of control strategies in diverse settings provide significant challenges for the design of effective public health policy against this disease. Mathematical modelling is a useful tool for simulating control packages under locally specific transmission conditions to inform optimal timing and frequency of phased interventions for cost-effective control of echinococcosis. The aims of this review of 30 years of Echinococcus modelling were to discern the epidemiological mechanisms underpinning models of Echinococcus granulosus and E. multilocularis transmission and to establish the need to include a human transmission component in such models. METHODOLOGY/PRINCIPAL FINDINGS: A search was conducted of all relevant articles published up until July 2012, identified from the PubMED, Web of Knowledge and Medline databases and review of bibliographies of selected papers. Papers eligible for inclusion were those describing the design of a new model, or modification of an existing mathematical model of E. granulosus or E. multilocularis transmission. A total of 13 eligible papers were identified, five of which described mathematical models of E. granulosus and eight that described E. multilocularis transmission. These models varied primarily on the basis of six key mechanisms that all have the capacity to modulate model dynamics, qualitatively affecting projections. These are: 1 the inclusion of a 'latent' class and/or time delay from host exposure to infectiousness; 2 an age structure for animal hosts; 3 the presence of density-dependent constraints; 4 accounting for seasonality; 5 stochastic parameters; and 6 inclusion of spatial and risk structures. CONCLUSIONS/SIGNIFICANCE: This review discusses the conditions under

  12. Whole blood donor deferral analysis at Genera l hospital blood bank – A retrospective study.

    Directory of Open Access Journals (Sweden)

    Hinal Gajjar

    2014-07-01

    Full Text Available Background: A blood transfusion is a life saving procedure in many instances and it requir es an adequate supply of safe blood. The most important is the selection of blood donors by donor selection criteria. A large number of blood donors are deferred from donating blood for several reasons either temporarily or permanently. A shortage of safe blood donor is frequent and it is important to understand the causes of deferral of potential donors. Aims: 1. Primary objective of this study was to record and document the current rate and reasons for donor deferred in our blood bank. 2. Apply relevant findings to modify recruitment strategy for blood donors. Materials and methods: Data for WBD presenting for blood donation in a blood bank V S General Hospital and outdoor camps over two and half years from January 2011 to June 2013 were analysed retrospectively. National Guidelines were used for selection & deferral of WBD. Results: 3836 (11.16% WBD were deferred out of 34373 registered donors during the study period. Donor deferrals were tabulated into temporary and permanent reasons. Temporary deferrals were 3113 (81.15% and permanent deferrals were 723 (18.85%. The most common reasons were low haemoglobin (48.33%, high blood pressure (11.94%, underweight donors (7.95% and history of medication use (6.13% among total deferral donors. Majority of donors (47.16% deferred were between 18 -30 years. Females were found to have higher deferral rate (25.48% than males (10.76%. Discussion and conclusion: A deferral study in blood donors may shed light on the health status of general population which may affect the present and future blood supply. It is important to provide donors with a clear message on their deferral status so that most of temporary deferral donors will return for donation in future.

  13. Ectopic pregnancy rates with day 3 versus day 5 embryo transfer: a retrospective analysis

    OpenAIRE

    Jun Sunny H; Milki Amin A

    2003-01-01

    Abstract Background Blastocyst transfer may theoretically decrease the incidence of ectopic pregnancy following IVF-ET in view of the decreased uterine contractility reported on day 5. The purpose of our study is to specifically compare the tubal pregnancy rates between day 3 and day 5 transfers. Methods A retrospective analysis of all clinical pregnancies conceived in our IVF program since 1998 was performed. The ectopic pregnancy rates were compared for day 3 and day 5 transfers. Results Th...

  14. [Hair Analysis for the Retrospective and Prospective Consume-Monitoring: Substance Abuse, Abstinence- and Compliance Control].

    Science.gov (United States)

    Binz, Tina M; Baumgartner, Markus R

    2016-01-06

    The possibilities and applications of modern hair analytics have rapidly developed in recent years. The compounds that can be detected in hair comprise, next to a multitude of drugs, also medications, alcohol markers, and endogenous compound like the stress hormone cortisol. Hair analysis is suitable for both forensic and clinical applications because it enables a retrospective overview of the consumption behavior during an extended time interval.

  15. Retrospective analysis of follow-up results in patients with skin lymphomas of low degree malignancy

    OpenAIRE

    Tarasov V.V.

    2011-01-01

    Administration of specific chemotherapy (cytostatics) has great significance in the treatment of skin lymphomas of low degree malignancy. The research goal is to study follow-up results of cytostatic therapy of skin lymphomas. Retrospective observation of survival of patients with T-cell epidermothropic skin lymphomas using special therapy and without its use has been studied. Comparative analysis of survival rate in two groups of patients has been done. 40 patients received cytostatics and 3...

  16. Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sarah J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wei, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-01

    Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes in the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.

  17. Developmental psychobiology: a look back on 30 years.

    Science.gov (United States)

    Bacher, L F; Romm, R; Spanier, H; Tellefsen, L; Yip, S; Smotherman, W P

    2000-07-01

    Developmental Psychobiology publishes papers from the disciplines of psychology, biology, neuroscience, and medicine that contribute to an understanding of behavioral development. Research focuses on development in the embryo/fetus, neonate, juvenile, and adult as well as multidisciplinary research that relates behavioral development to anatomy, physiology, biochemistry, genetics, and evolution. The journal represents a broad phylogenetic perspective on behavioral development by including studies on invertebrates, fish, birds, non-human primates, and humans. This paper presents an analysis of empirical articles published since its first issue in 1968. This analysis covers number of authors, sex of first author; evidence of grant support, and participation of investigators from outside the US. Additionally, the analysis includes the topic of research, level of analysis, and subject of experimental study. Over its 32-year history, Developmental Psychobiology has published papers on a wide range of topics representing a broad phylogenetic perspective with a continued focus on behavioral investigation. This analysis revealed trends such as an increase in the number of studies at a physiology/anatomy level, an increase in studies with human subjects, and increases in contributions from investigators outside of the United States as well as women.

  18. Changes in Tropical Cyclone Intensity Over the Past 30 Years: A Global and Dynamic Perspective

    Science.gov (United States)

    Wu, Liguang; Wang, Bin; Braun, Scott A.

    2006-01-01

    The hurricane season of 2005 was the busiest on record and Hurricane Katrina (2005) is believed to be the costliest hurricane in U. S. history. There are growing concerns regarding whether this increased tropical cyclone activity is a result of global warming, as suggested by Emanuel(2005) and Webster et al. (2005), or just a natural oscillation (Goldenberg et al. 2001). This study examines the changes in tropical cyclone intensity to see what were really responsible for the changes in tropical cyclone activity over the past 30 years. Since the tropical sea surface temperature (SST) warming also leads to the response of atmospheric circulation, which is not solely determined by the local SST warming, this study suggests that it is better to take the tropical cyclone activities in the North Atlantic (NA), western North Pacific (WNP) and eastern North Pacific (ENP) basins as a whole when searching for the influence of the global-scale SST warming on tropical cyclone intensity. Over the past 30 years, as the tropical SST increased by about 0.5 C, the linear trends indicate 6%, 16% and 15% increases in the overall average intensity and lifetime and the annual frequency. Our analysis shows that the increased annual destructiveness of tropical cyclones reported by Emanuel(2005) resulted mainly from the increases in the average lifetime and annual frequency in the NA basin and from the increases in the average intensity and lifetime in the WNP basin, while the annual destructiveness in the ENP basin generally decreased over the past 30 years. The changes in the proportion of intense tropical cyclones reported by Webster et a1 (2005) were due mainly to the fact that increasing tropical cyclones took the tracks that favor for the development of intense tropical cyclones in the NA and WNP basins over the past 30 years. The dynamic influence associated with the tropical SST warming can lead to the impact of global warming on tropical cyclone intensity that may be very

  19. The Equal Pay Act: The First 30 Years.

    Science.gov (United States)

    Crampton, Suzanne M.; Hodge, John W.; Mishra, Jitendra M.

    1997-01-01

    Analysis by decade of the effects of the Equal Pay Act of 1963 shows that women's earnings relative to men's increased by 10 cents from 1960-1990. Black and Hispanic women's earnings lagged further behind. More education and experience did not help women narrow the gap. (SK)

  20. Epidemiology, diagnosis and management of superficial mycoses: ours three years retrospective analysis

    Directory of Open Access Journals (Sweden)

    Barbara Pieretti

    2013-04-01

    Full Text Available Mycotic infections of the skin, hair and nails are disorder with high prevalence. Dermatophytes are the most frequently etiologic agents followed by yeasts and non-dermatophyte moulds. The geographic distribution is variable because of migration, lifestyle and socio-economics conditions. In this study, based on ours three years retrospective data analysis, we evaluate the epidemiology of etiologic agents, diagnosis and management of superficial mycoses. Our data and our experience suggest the importance of this microbiological diagnosis and the role of the Clinical Microbiologist to assess with Dermatologist and Primary Care Phyisician an appropriate diagnostic and therapeutic plan.

  1. Method for Visually Integrating Multiple Data Acquisition Technologies for Real Time and Retrospective Analysis

    Science.gov (United States)

    Bogart, Edward H. (Inventor); Pope, Alan T. (Inventor)

    2000-01-01

    A system for display on a single video display terminal of multiple physiological measurements is provided. A subject is monitored by a plurality of instruments which feed data to a computer programmed to receive data, calculate data products such as index of engagement and heart rate, and display the data in a graphical format simultaneously on a single video display terminal. In addition live video representing the view of the subject and the experimental setup may also be integrated into the single data display. The display may be recorded on a standard video tape recorder for retrospective analysis.

  2. Retrospective Analysis of Thrombolysis Therapy for 64 Cases of Acute Myocardial Infarction with Elevated ST Segment

    Institute of Scientific and Technical Information of China (English)

    傅晓霞; 肖文剑; 吕健; 吴乐文; 杨帆

    2009-01-01

    Objective:To explore the cardiac protective effect of integrative therapy in acute myocardial infarction(AMI) with elevated ST segment after reperfusion.Methods:Sixty-four AMI patients who having received decimalization by thrombolysis were assigned to two groups by retrospective analysis,36 patients in the treated group and 28 in the control group.Both were treated by intravenous administering of urokinase for thrombolysis,and to the treated group,intravenous dripping of Xueshuantong Injection(血栓通注射液,XS...

  3. Sample size in psychological research over the past 30 years.

    Science.gov (United States)

    Marszalek, Jacob M; Barber, Carolyn; Kohlhart, Julie; Holmes, Cooper B

    2011-04-01

    The American Psychological Association (APA) Task Force on Statistical Inference was formed in 1996 in response to a growing body of research demonstrating methodological issues that threatened the credibility of psychological research, and made recommendations to address them. One issue was the small, even dramatically inadequate, size of samples used in studies published by leading journals. The present study assessed the progress made since the Task Force's final report in 1999. Sample sizes reported in four leading APA journals in 1955, 1977, 1995, and 2006 were compared using nonparametric statistics, while data from the last two waves were fit to a hierarchical generalized linear growth model for more in-depth analysis. Overall, results indicate that the recommendations for increasing sample sizes have not been integrated in core psychological research, although results slightly vary by field. This and other implications are discussed in the context of current methodological critique and practice.

  4. Unidata: 30 Years of FOSS for the Geosciences

    Science.gov (United States)

    Davis, E.; Ramamurthy, M. K.; Young, J. W.; Fisher, W. I.; Rew, R. K.

    2015-12-01

    Unidata's core mission is to serve academic research and education communities by facilitating access and use of real-time weather data. To this end, Unidata develops, distributes, and supports several Free and Open Source Software (FOSS) packages. These packages are largely focused on data management, access, analysis and visualization. This presentation will discuss the lessons Unidata has gathered over thirty years of FOSS development, support, and community building. These lessons include what it takes to be a successful FOSS organization, how to adapt to changing "best practices" and the emergence of new FOSS tools and services, and techniques for dealing with software end-of-life. We will also discuss our approach when supporting a varied user community spanning end users and software developers. Strong user support has been an important key to Unidata's successful community building.

  5. Radiographic evaluation of INBONE total ankle arthroplasty: a retrospective analysis of 30 cases

    Energy Technology Data Exchange (ETDEWEB)

    Datir, Abhijit [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Emory Orthopaedics and Spine Center, Division of Musculoskeletal Radiology, Atlanta, GA (United States); Xing, Minzhi; Kakarala, Aparna; Terk, Michael R. [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Labib, Sameh A. [Emory University Hospital, Department of Orthopaedic Surgery, Atlanta, GA (United States)

    2013-12-15

    The objectives of this work were to retrospectively describe the radiographic assessment of INBONE total ankle arthroplasty in 30 patients using validated linear and angular measurements and to correlate these findings with the final surgical outcome over a 2-year follow-up period. Thirty consecutive patients (21 females, nine males; mean age, 64.8 years) underwent INBONE total ankle arthroplasty during 2007-2011. After IRB approval, a retrospective pre- and post-operative radiographic analysis was performed using validated linear and angular measurements. The pre- and post-operative assessment included the tibial angle, talar angle, tibial slope, and coronal deformity. Post-operative measurements also included the talocalcaneal angle, joint space height, talar height, lateral tibial component angle, lateral talar component angle, and anteroposterior tibial component angle. The post-operative bone loss, subluxation, positioning, and subsidence were also assessed. Statistical analysis was performed using two-sample t test and Fisher's exact test. Out of 30 patients, 23 had a successful clinical outcome with intact prosthesis at a 2-year follow-up. The only variables with significant correlation (p < 0.05) to the post-surgical outcome were the lateral talar component angle (p = 0.002) and the mean difference between pre- and post-operative tibial slope (p = 0.001). The coronal deformity had significant mean difference between pre- and post-operative values (p < 0.001); however, it lacked a significant correlation to the final surgical outcome. None of the categorical variables had a significant correlation with post-surgical outcome. In our retrospective study, only the lateral talar component angle and the mean difference between the pre- and post-operative tibial slope had significant correlation with post-surgical outcome in INBONE ankle arthroplasty. These measurements may be helpful in radiographic assessment of the INBONE ankle arthroplasty. (orig.)

  6. Management of enterocutaneous fistulas: 30-year clinical experience

    Institute of Scientific and Technical Information of China (English)

    黎介寿; 任建安; 朱维铭; 尹路; 韩建明

    2003-01-01

    Objectives To explore successful models of management of enterocutaneous fistulas and u nresolved problems requiring further study. Method Analysis of therapeutic results of 1168 cases treated in one center from January 1971 to December 2000. Results In this group of patients, the recovery rate was 93% and 37% of fistulas healed spontaneously after non-operative treatment. The mortality rate was 5.5%, mos t of which occurred due to sepsis. Of 659 cases receiving definitive operations for enteric fistula, 98% recovered. Recovery, mortality and operational succes s rates (94.2%, 4.4%, 99.7%) of cases treated between January 1985 and Decemb er 2000 were significantly better than those (90.4%, 8.2%, 95.5%) of cases treated earlier (January 1971-December 1984) (P<0.05). Conclusions The results from this study were better overall than those reported in previous literatures. The change in therapeutic strategy, improved technique in control of sepsis, rational nutritional support and careful monitoring of vital organs are the key reasons for improvement of managing enteric fistulas. However, incre asing spontaneous closure of fistula, improving the therapeutic rate of specific enteric fistula (IBD or radiation enteritis) and performing definitive operations for enteric fistula at early stages are still problematic and require further study.

  7. [30 years' development of economic theories in confrontation with facts].

    Science.gov (United States)

    Levy, F

    1994-01-01

    In 1969, R. Frish and J. Tinbergen received the first Nobel Price in Economics. 200 years after Quesnay's "economic tables", economics were at last considered as a science. During the last thirty years, economics haven't lost their scientific reputation, but, confronted with different situations in the world and in France, economics have been unable to bring appropriate solutions to every problem. Nowadays, economics are quite far from the promises born after the Second World War: indeed, until the 1974 world crisis, Keynes' theory (from a macro-economic point of view) and Walras' formalisation of the markets (from a micro-economic point of view) were sufficient to give satisfying representations of any economic reality and mechanism. Nevertheless, these theories were unable to deal with both growing unemployment and raising inflation in the late 70's and early 80's. Today, economics present a wide variety of efficient analysis of society. Game theory, behaviour theory or econometrics are new means used to found new kinds of reality representation. Therefore, if economics can no longer be considered as an exact science, it remains nevertheless scientific.

  8. The cost of cancer: a retrospective analysis of the financial impact of cancer on young adults.

    Science.gov (United States)

    Landwehr, Michelle S; Watson, Samantha E; Macpherson, Catherine F; Novak, Katherine A; Johnson, Rebecca H

    2016-05-01

    Young adult cancer survivors (YAs) are confronted with immense financial challenges in the wake of their treatment. Medical bills and loss of savings may cause YAs to forgo recommended medications or follow-up appointments. Young survivors with financial concerns also report depression, stress and anxiety. The Samfund is a national nonprofit organization that provides financial support to YAs post-treatment. To quantify the financial burden of cancer in YAs, a retrospective analysis was performed of data collected from Samfund grant applications of 334 YA cancer survivors. Grants were awarded between 2007 and 2013 and grant recipients were consented electronically in 2014 for retrospective data analysis. Recipients ranged from 19 to 39 years of age at the time of their grant applications. Descriptive statistics were calculated and compared to the Medical Expenditure Panel Survey (MEPS) and U.S. census data on age-matched peers. Financial indicators of YA cancer survivors are worse in many domains than those of age-matched controls. Furthermore, YA survivors in their 30s report more perilous prefunding financial situations than younger grant recipients. Cancer has a devastating and age-specific impact on the finances of YAs. Philanthropic grants from the cancer support community, in conjunction with healthcare policy reforms, have the potential to break the cycle of financial need and help YAs move forward with their lives after cancer treatment.

  9. SEARCH OF INHIBITORS OF HERPES VIRAL REPLICATION: 30 YEARS AFTER ACYCLOVIR

    Directory of Open Access Journals (Sweden)

    Korovina A. N.

    2013-08-01

    Full Text Available Analysis of study and using of different chemical compounds as inhibitors of herpes virus replication is given in the review. However, it does not apply for full details of all the studies on active antiherpetic drugs finding. It’s been over 30 years since the discovery of the first antiherpetic drugs ? acyclovir. Meanwhile, lots of active chemical compounds appeared that have been brought to the antiviral drugs. An essential understanding of strategies for finding drugs came in, one of which was establishment of depot forms of antiherpetic drugs. On the basis of the vast published experimental material the authors concluded that the study of the herpes virus and search for inhibitors of its replication is still an important issue and requires the efforts of chemists, biologists, pharmacists.

  10. [Maternal mortality in Brazil: what has the scientific literature shown in the last 30 years?].

    Science.gov (United States)

    Morse, Marcia Lait; Fonseca, Sandra Costa; Barbosa, Mariane Doelinger; Calil, Manuele Bonatto; Eyer, Fernanda Pinella Carvalhal

    2011-04-01

    The aim of this study was to analyze maternal mortality in Brazil in the last 30 years, by means of a literature review. The authors performed an electronic search of scientific articles from 1980 to 2010 in LILACS and MEDLINE and found 486 abstracts, of which 50 articles were selected. Studies showed a decrease in the maternal mortality ratio (MMR), although varying across regions of the country. A few articles evaluated maternal mortality factors, identifying social inequalities associated with skin color and schooling. There was persistent underreporting of maternal deaths and inadequate completion of death certificates. Direct obstetric causes were the most frequent, mainly hypertensive diseases of pregnancy. Analysis of avoidability revealed deficiencies in prenatal and childbirth care. Despite the relevance of maternal mortality in Brazil, there are few studies on the subject. Although MMR has decreased, it is still above the desired levels. Improvements are thus needed in the quality of prenatal and perinatal care.

  11. Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Carpenter, Alberta [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-01-06

    This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular, the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.

  12. Identification of Design Work Patterns by Retrospective Analysis of Work Sheets

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1999-01-01

    project is carried out where we seek to identify design work patterns by retrospective analysis of documentation created during design projects.An elements to satisfy the wish for an efficient design process could be to identify work patterns applied by engineering designers, evaluate these patterns...... with respect to their efficiency, and reuse the most efficient in future projects. Thus, the objective of this research is to analyse design projects in order to identify the work patterns applied. Based on an evaluation of identified work patterns we expect a recommendation of work patterns supporting...... an efficient design process can be established.In this paper we describe the analysis method, and present observations from analyses of three projects....

  13. Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice

    Directory of Open Access Journals (Sweden)

    Prager W

    2012-06-01

    Full Text Available Welf Prager,1 Jürgen Huber-Vorländer,2 A Ziah Taufig,3 Matthias Imhof,4 Ulrich Kühne,4 Ruth Weissberg,5 Lars-Peter Kuhr,6 Volker Rippmann,3 Wolfgang G Philipp-Dormston,7 Thomas M Proebstle,8 Claudia Roth,9 Martina Kerscher,10 Claudius Ulmann,11 Tatjana Pavicic121Dermatologikum, Hamburg, 2Fort Malakoff Klinik, Mainz, 3Praxisklinik für Plastische und Ästhetische Chirurgie, Cologne, 4Ästhetische Dermatologie im Medico Palais, Bad Soden, 5Taimerhofstrasse 28, Munich, 6Aqua Medical Spa, Munich; 7Hautzentrum Köln, Cologne, 8Privatklinik Proebstle GmbH, Mannheim, 9Kö-Klinik, Düsseldorf, 10MIN Fakultät/Department Chemie/Kosmetikwissenschaft, Hamburg, 11Kosmas Klinik, Bad Neuenahr-Ahrweiler, 12Klinik und Poliklinik für Dermatologie und Allergologie, Munich, GermanyBackground: Botulinum toxin type A treatment has been used for over 20 years to enhance the appearance of the face. There are several commercially available botulinum toxin type A products used in aesthetic clinical practice. The aim of this retrospective analysis was to compare the clinical efficacy of the most commonly used botulinum toxin type A preparations in daily practice.Methods: Physicians from 21 centers in Germany completed questionnaires based on an inspection of subject files for subjects 18 years of age or over who had received at least two, but not more than three, consecutive treatments with incobotulinumtoxinA, onabotulinumtoxinA, or abobotulinumtoxinA within a 12-month period in the previous 2 years. Data on subject and physician satisfaction, treatment intervals, dosages, and safety were collected from 1256 subjects.Results: There were no statistically significant differences between incobotulinumtoxinA and onabotulinumtoxinA with respect to physician and subject satisfaction, dosages, and adverse effects experienced. Both botulinum toxin type A preparations were well tolerated and effective in the treatment of upper facial lines. Due to low treatment numbers

  14. Spontaneous resolution rates of vesicoureteral reflux in Brazilian children: a 30-year experience

    Directory of Open Access Journals (Sweden)

    Miguel Zerati Filho

    2007-04-01

    Full Text Available OBJECTIVE: We evaluated clinical characteristics of primary vesicoureteral reflux (VUR in infants in a 30-year period in Brazil with special reference to the relation of renal parenchymal damage to urinary tract infection and gender. MATERIALS AND METHODS: From 1975 through 2005, 417 girls (81.6% and 94 boys (18.4% with all grades of reflux were retrospectively reviewed. Patients were categorized by the worst grade of reflux, maintained on antibiotic prophylaxis and underwent yearly voiding cystourethrography until the reflux was resolved. VUR was considered resolved when a follow-up cystogram demonstrated no reflux. Surgical correction was recommended for those who fail medical therapy, severe renal scarring or persistent VUR. RESULTS: Grades I to V VUR resolved in 87.5%, 77.6%, 52.8%, 12.2% and 4.3%, respectively. Renal scars were present at presentation in 98 patients (19.2%. Neither gender nor bilaterality versus unilaterality was a helpful predictor of resolution. The significant difference was found among the curves using the log rank (p < 0.001 or Wilcoxon (p < 0.001 test. CONCLUSION: Despite the current use of screening prenatal ultrasound, many infants are still diagnosed as having vesicoureteral reflux only after the occurrence of urinary tract infection in our country. Scarring may be associated to any reflux grade and it may be initially diagnosed at any age but half of the scars are noted with higher grades of reflux (IV and V. The incidence of reflux related morbidity in children has significantly diminished over the last three decades.

  15. 30-year International Pediatric Craniofacial Surgery Partnership: Evolution from the “Third World” Forward

    Science.gov (United States)

    Swanson, Jordan W.; Skirpan, Jan; Stanek, Beata; Kowalczyk, Maciej

    2016-01-01

    Background: Craniofacial diseases constitute an important component of the surgical disease burden in low- and middle-income countries. The consideration to introduce craniofacial surgery into such settings poses different questions, risks, and challenges compared with cleft or other forms of plastic surgery. We report the evolution, innovations, and challenges of a 30-year international craniofacial surgery partnership. Methods: We retrospectively report a partnership between surgeons at the Uniwersytecki Szpital Dzieciecy in Krakow, Poland, and a North American craniofacial surgeon. We studied patient conditions, treatment patterns, and associated complications, as well as program advancements and limitations as perceived by surgeons, patient families, and hospital administrators. Results: Since partnership inception in 1986, the complexity of cases performed increased gradually, with the first intracranial case performed in 1995. In the most recent 10-year period (2006–2015), 85 patients have been evaluated, with most common diagnoses of Apert syndrome, Crouzon syndrome, and single-suture craniosynostosis. In the same period, 55 major surgical procedures have been undertaken, with LeFort III midface distraction, posterior vault distraction, and frontoorbital advancement performed most frequently. Key innovations have been the employment of craniofacial distraction osteogenesis, the use of Internet communication and digital photography, and increased understanding of how craniofacial morphology may improve in the absence of surgical intervention. Ongoing challenges include prohibitive training pathways for pediatric plastic surgeons, difficulty in coordinating care with surgeons in other institutions, and limited medical and material resources. Conclusion: Safe craniofacial surgery can be introduced and sustained in a resource-limited setting through an international partnership. PMID:27200233

  16. Suicidal hanging in Kuwait: retrospective analysis of cases from 2010 to 2012.

    Science.gov (United States)

    Abd-Elwahab Hassan, Dalia; Ghaleb, Sherein S; Kotb, Heba; Agamy, Mervat; Kharoshah, Magdy

    2013-11-01

    Suicide is an important health hazard worldwide. We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine between 2010 and 2012 to document the characteristics of fatalities resulting from hanging in Kuwait. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. A retrospective study was carried out on 118 suicidal hanging cases autopsied at Forensic Medicine Center in Kuwait (from 2010 to 2012). Of these cases, 86 (73%) were males and 32 females (27%). There was an increasing trend of hanging among ages between 21 and 50 years (87.3%) and the third decade had the highest number of victims (about 43%) between all age groups. Local Kuwaiti nationals comprised a small proportion of cases (7 persons, 5.9%), while the others were foreigners working in Kuwait with an Indian precedence (54 persons, 54.8%), followed by other 12 different nationalities representing 39.3% of the cases. In conclusion, there was a decreasing trend of suicide by hanging in Kuwait from 44 cases in 2010 to 25 cases in 2012.

  17. Determining the utility of veterinary tissue archives for retrospective DNA analysis

    Directory of Open Access Journals (Sweden)

    Firas M. Abed

    2016-05-01

    Full Text Available Histopathology tissue archives can be an important source of specimens for retrospective studies, as these include samples covering a large number of diseases. In veterinary medicine, archives also contain samples from a large variety of species and may represent naturally-occurring models of human disease. The formalin-fixed, paraffin-embedded (FFPE tissues comprising these archives are rich resources for retrospective molecular biology studies and pilot studies for biomarkers, as evidenced by a number of recent publications highlighting FFPE tissues as a resource for analysis of specific diseases. However, DNA extracted from FFPE specimens are modified and fragmented, making utilization challenging. The current study examines the utility of FFPE tissue samples from a veterinary diagnostic laboratory archive in five year intervals from 1977 to 2013, with 2015 as a control year, to determine how standard processing and storage conditions has affected their utility for future studies. There was a significant difference in our ability to obtain large amplicons from samples from 2015 than from the remaining years, as well as an inverse correlation between the age of the samples and product size obtainable. However, usable DNA samples were obtained in at least some of the samples from all years tested, despite variable storage, fixation, and processing conditions. This study will help make veterinary diagnostic laboratory archives more useful in future studies of human and veterinary disease.

  18. 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.

  19. Thrombophilia diagnosis: a retrospective analysis of a single-center experience.

    Science.gov (United States)

    Spychalska-Zwolińska, Marta; Zwoliński, Tomasz; Mieczkowski, Artur; Budzyński, Jacek

    2015-09-01

    It is estimated that 30-50% of patients suffering from deep vein thrombosis (DVT) could be diagnosed with congenital or acquired thrombophilia. Its diagnosis, however, rarely changes the clinical management, but is associated with significant costs and negative psychological and social aspects. The aim of this study was to perform a retrospective analysis of the causes and clinical consequences of diagnostics for thrombophilia. A retrospective review of the medical records of 5600 patients was performed, 62 of whom had, at the time, been diagnosed for thrombophilia because of a thromboembolic event. A review of the current literature on the validity of diagnostic tests for hypercoagulability in certain clinical conditions was also performed. The most common reason for thrombophilia testing was episodes of lower limb DVT (56%). The most frequently diagnosed abnormalities were the heterozygous form of the V Leiden gene (18%), protein S deficiency (11%), and the anti cardiolipin antibody IgG (11%). In 45% of the patients, laboratory results did not confirm the presence of any congenital thrombophilia. After receiving the results, 11% of the respondents completed oral anticoagulation therapy after 3 months, and 28% of patients qualified for indefinite use of oral anticoagulant therapy. In most of the cases examined, the diagnosis of thrombophilia did not significantly affect the treatment. A common aberration identified in patients with a history of thromboembolic incidents was the coexistence of risk factors for atherosclerosis.

  20. Founders lecture 2007. Metabolic bone disease: what has changed in 30 years?

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, Murali [Cleveland Clinic, Diagnostic Radiology, MSK, Cleveland, OH (United States)

    2009-09-15

    To provide an update on imaging of metabolic bone disease based on new developments, findings, and changing practices over the past 30 years. Literature review of osteoporosis, osteomalacia, renal osteodystrophy, Paget's disease, bisphosphonates, with an emphasis on imaging. Cited references and pertinent findings. Significant developments have occurred in the imaging of metabolic bone disease over the past 30 years. (orig.)

  1. McBride's operation for hallux valgus can be used in patients older than 30 years

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Larsen, T;

    1992-01-01

    . In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite...

  2. Treatment results of glioblastoma during the last 30 years in a single institute.

    Science.gov (United States)

    Kumabe, Toshihiro; Saito, Ryuta; Kanamori, Masayuki; Chonan, Masashi; Mano, Yui; Shibahara, Ichiyo; Kawaguchi, Tomohiro; Kato, Hideaki; Yamashita, Yoji; Sonoda, Yukihiko; Kawagishi, Jun; Jokura, Hidefumi; Watanabe, Mika; Katakura, Ryuichi; Kayama, Takamasa; Tominaga, Teiji

    2013-01-01

    Treatment results of glioblastoma (GB) during the last 30 years in Tohoku University were analyzed to identify any improvements in patient outcome in all 332 histologically proven cases of newly diagnosed GB treated consecutively in our department between 1982 and 2011. These 30 years was divided into 5 treatment eras, Group 1 (1982-1988, without preoperative evaluation by magnetic resonance [MR] imaging, n = 46), Group 2 (1989-1996, with preoperative MR imaging, n = 41), Group 3 (1997-1999, additionally underwent intraoperative functional brain mapping and neuronavigation system, n = 38), Group 4 (2000-August 2006, underwent 30 Gy of whole brain radiation followed by 30 Gy of extended local accelerated hyperfractionated radiation therapy, n = 96), and Group 5 (September 2006-2011, adjuvant usage of temozolomide [TMZ], n = 111). Overall survival (OS) was calculated from the date of surgery to the death from any cause. The median survival time/2-year OS/5-year OS of Groups 1 to 5 were 10.7 months/10.9%/0%, 17.3 months/26.2%/6.9%, 15.9 months/23.7%/5.3%, 20.1 months/34.8%/15.5%, and 20.9 months/45.5%/19.7%. The prognosis for patients with GB improved significantly after the introduction of MR imaging. Younger GB, defined as patients aged below 60 years, or total tumor resection with all ages in Group 5 had 5-year 0S of 31.0% and 30.1%, respectively. The prognosis of GB was improved significantly after the introduction of TMZ for elderly GB, recursive partitioning analysis class 5, or totally resected GB. Introduction of MR imaging and TMZ, and total resection of the tumor were important in the improvement of outcome for patients with GB.

  3. Validation of a 30+ year soil moisture record from multi-satellite observations

    Science.gov (United States)

    de Jeu, R.; Dorigo, W.; Wagner, W.; Chung, D.; Parinussa, R.; van der Werf, G.; Liu, Y.; Mittelbach, H.; Hirschi, M.

    2012-12-01

    As part of the ESA Climate Change Initiative soil moisture project a 30+ year consistent soil moisture dataset is currently in development by harmonizing retrievals from both passive and active microwave satellite observations. The harmonization of these datasets incorporates the advantage of both microwave techniques and spans the entire period from 1978 onwards. A statistical methodology based on scaling, ranking and blending was developed to address differences in sensor specifications to create one consistent dataset. A soil moisture dataset provided by a land surface model (GLDAS-1-Noah) was used to scale the different satellite-based products to the same range. The blending of the active and passive datasets was based on their respective performance, which is closely related to vegetation cover. While this approach imposes the absolute values of the land surface model dataset to the final product, it preserves the relative dynamics (e.g., seasonality, inter-annual variations) and trends of the original satellite derived retrievals. Different validation methods were performed to quantify the skill of the various soil moisture datasets at different temporal and spatial scales. In situ data from the International Soil Moisture Network (ISMN) were used to calculate the local correlation (both Pearson and Spearman) and Root Mean Square Difference between ground observations and the satellite retrievals for different climate regimes. In addition a triple collocation analysis was applied on the passive and active satellite products in order to analyze the error structures at a global scale for the different sensors. Furthermore, indirect proxies like tree ring width data were used to study the consistency of the inter-annual variability within the 30+ year dataset. The combination of these techniques revealed a strong dynamical behavior in data quality in both time and space. In the future this additional information on error dynamics could be used to further

  4. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin;

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  5. Retrospective analysis of follow-up results in patients with skin lymphomas of low degree malignancy

    Directory of Open Access Journals (Sweden)

    Tarasov V.V.

    2011-03-01

    Full Text Available Administration of specific chemotherapy (cytostatics has great significance in the treatment of skin lymphomas of low degree malignancy. The research goal is to study follow-up results of cytostatic therapy of skin lymphomas. Retrospective observation of survival of patients with T-cell epidermothropic skin lymphomas using special therapy and without its use has been studied. Comparative analysis of survival rate in two groups of patients has been done. 40 patients received cytostatics and 32 patents were not treated by chemotherapy. The first group of patients showed the reduction of survival level and increase of mortality level from skin lymphomas of low degree malignancy. The research findings proved the influence of cytostatic therapy on the survival of patients with skin lymphomas of low degree malignancy

  6. Anemia and growth failure among HIV-infected children in India: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Shet Anita

    2009-06-01

    Full Text Available Abstract Background Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods We analyzed retrospective data from 248 HIV-infected children aged 1–12 years attending three outpatient clinics in South India (2004–2006. Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses. Results The overall prevalence of anemia (defined as hemoglobin Conclusion The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children.

  7. Retrospective analysis of "new" flame retardants in the global atmosphere under the GAPS Network.

    Science.gov (United States)

    Lee, Sum Chi; Sverko, Ed; Harner, Tom; Pozo, Karla; Barresi, Enzo; Schachtschneider, JoAnne; Zaruk, Donna; DeJong, Maryl; Narayan, Julie

    2016-10-01

    A retrospective analysis was conducted on air samples that were collected in 2005 under the Global Atmospheric Passive Sampling (GAPS) Network around the time period when the Stockholm Convention on Persistent Organic Pollutants came into force. Results are presented for several new flame retardants, including hexabromocyclododecane (HBCD), which was recently listed under the Convention (2013). These results represent the first global-scale distributions in air for these compounds. The targeted compounds are shown to have unique global distributions in air, which highlights the challenges in understanding the sources and environmental fate of each chemical, and ultimately in their assessments as persistent organic pollutants. The study also demonstrates the feasibility of using the PUF disk passive air sampler to study these new flame retardants in air, many of which exist entirely in the particle-phase as demonstrated in this study using a KOA-based partitioning model.

  8. Ascites due to pre-sinusoidal portal hypertension in dogs: a retrospective analysis of 17 cases.

    Science.gov (United States)

    James, F E; Knowles, G W; Mansfield, C S; Robertson, I D

    2008-05-01

    Accumulation of a pure transudate abdominal effusion in the absence of significant hypoalbuminaemia is uncommon in dogs and is due to pre-sinusoidal portal hypertension. Reported causes of pre-sinusoidal portal hypertension vary, but suggest a reasonable prognosis. A retrospective analysis of 17 dogs that presented to our institution with ascites due to pre-sinusoidal portal hypertension identified idiopathic hepatic fibrosis or canine chronic hepatitis as the underlying cause in the majority of cases. Twelve (70.5%) dogs were 4 years of age or younger at time of presentation. Total serum protein was higher in dogs with chronic hepatitis than it was in dogs without inflammatory disease. The prognosis was generally poor and no histological, imaging or biochemical parameters were useful as prognostic indicators. Dogs died or were euthanased due to severe clinical signs associated with the portal hypertension and/or perceived poor prognosis.

  9. Cytogenetic analysis in couples with recurrent miscarriages: a retrospective study from Punjab, north India

    Indian Academy of Sciences (India)

    NEHA SUDHIR; TAJINDER KAUR; ARCHANA BERI; ANUPAM KAUR

    2016-12-01

    Human reproduction is considered as the most inefficient event as ∼15–20% of human pregnancies end in miscarriage and in the product of miscarriages, chromosomal anomalies are a common occurrence. The aim of the present retrospective study was to assess the frequency of chromosomal aberrations in couples with recurrent miscarriages in the region of Punjab and to compare with worldwide frequencies. In this study, a total of 440 cases were referred between the period 1995– 2015. After lymphocyte culturing, giemsa–trypsin banding was done for each case to assess the chromosomal anomalies. The frequency of chromosomal aberrations among couples was found to be 3.41% in our study. Among these aberrations, balanced reciprocal translocations formed the largest group with 60% anomalies. We would conclude that clinicians should understandthe importance of chromosomal analysis in these couples and refer them for karyotyping after two miscarriages to rule out the possible genetic cause of recurrent miscarriages.

  10. Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

    Energy Technology Data Exchange (ETDEWEB)

    Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

    2006-06-08

    This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

  11. Prevalence of acid fast bacilli in Ajmer: A retrospective analysis of eight years data

    Directory of Open Access Journals (Sweden)

    Rathore R

    2001-01-01

    Full Text Available To assess prevalence of acid fast bacilli (AFB in Ajmer, a retrospective analysis of 8 years was done in 1905 AFB cultures in various clinical specimens. All specimens were cultured on Lowenstein-Jensen slants after decontamination and concentration using modified Petroff′s method. Smears were stained by Ziehl-Neelsen technique with acid and alcohol to exclude rapid growers. Four hundred and twenty eight AFB positive cultures were reported using morphological, staining and microscopic characteristics. Over all, AFB positive culture rate was 22.46%. Maximum positive cultures were from urinary system (253 followed by respiratory system (151, female genital systems (9, reticuloendothelial system (6, CNS (6, GIT (2, and CVS (1.

  12. Retrospective analysis of snake victims in Northern India admitted in a tertiary level institute

    Directory of Open Access Journals (Sweden)

    Syed Moied Ahmed

    2012-01-01

    Full Text Available Context: Snake bites are the common cause of morbidity and mortality in tropical countries. Aims: To analyze the outcome of snake bite victims Settings and Design: Retrospective analysis of data from Intensive care unit, Department of Anesthesiology. Materials and Methods: All the patients admitted in the intensive care unit for snake bite management during the year May 2004 - April 2009 were retrospectively reviewed. The data included age, sex, month and time of incident, site of bite, dose of anti--snake venom, time of anti--snake venom, administration, duration of mechanical ventilation, complications and death of a victim. Statistical analysis used: Pearson′s correlation test, paired samples t-test. Results and Conclusions: 113 patients reported to the Accident and Emergency with history of snake bite. 26 patients were referred to other hospital, 17 patients were brought dead, and 70 patients were admitted to the intensive care unit. In 59 snake-bite victims, maximum data could be recovered. Krait was the most common type of snake bite reported. There was a male preponderance (69.4% with age ranging between 20 and 40 years (52.5%. The mean lag time (time elapsed between bite and first dose of anti--snake venom was 5.3 ± 1.4 h and the mean anti-snake venom dose was 12.3 ± 2.4 vials. There was a positive and significant correlation between lag time and total dose of anti--snake venom (correlation coefficient =0.956, P<0.0001. Overall 72.9% patients required mechanical ventilation with a mean duration of 56.2 ± 16.1 h. 10.2% patients sustained cardiac arrest, 8.7% patients developed ventilator associated pneumonia, 6.7% suffered mild anti-snake venom reaction, 6.7% had hypotension and 5.1% patients developed renal failure. The overall mortality was 5.1%.

  13. Retrospective, monocentric analysis of late effects after total body irradiation (TBI) in adults

    Energy Technology Data Exchange (ETDEWEB)

    Boelling, Tobias [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy; Paracelsus Clinic Osnabrueck (Germany). Dept. of Radiotherapy; Kreuziger, David Christoph; Ernst, Iris; Elsayed, Hassan; Willich, Normann [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy

    2011-05-15

    Purpose: Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center. Patients and Methods: Patients {>=} 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test. Results: A total of 308 patients {>=} 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019). Conclusion: Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects. (orig.)

  14. A Retrospective Analysis of Patients’ Conditions Using Acupuncture in a Traditional Korean Medicine Hospital

    Directory of Open Access Journals (Sweden)

    Kyung-Jin Yun

    2015-01-01

    Full Text Available Objective. The aim of this study was to identify the patient demographics, health issues, and type of acupuncture treatments who visited a traditional Korean medical hospital for acupuncture treatment. Methods. We retrospectively analysed the data using the electronic medical records (EMRs of patients treated with at least one treatment of acupuncture from 1 January 2010 to December 2012 in the Chung-Ju Korean hospital at Semyung University. Results. The total number of identified patients was 1189 inpatients and 10138 outpatients. The 50–59 age group received acupuncture treatment in the hospital the most, followed by the 40–49 age group. Among the patients undergoing acupuncture treatment because of a diagnosis of pain, 82.74% were outpatients and 72.85% were inpatients. Additionally, all patients with a spine condition received acupuncture treatment. The most common musculoskeletal conditions of patients at the traditional Korean medicine (TKM hospital were associated with spine conditions, such as low back pain and neck pain. Various treatments have been performed at the hospital in conjunction with acupuncture. The study results show a high prevalence of acupuncture treatment for diagnosed diseases. Conclusion. Our study suggests the need to investigate additional TKM hospitals to analyse characteristics of patients who received specific treatments. Analysis of the characteristics of patients treated with Korean acupuncture at the TKM hospital in this study will help future researchers who want to implement strong clinical evidence. However, we cannot completely discount all symptoms because of the retrospective nature of this study, and only one hospital was used, which limits the generalisation of our findings.

  15. Strongest Tropical cyclones: 1980-2009: A 30-year collage of Hurricane Satellite (HURSAT) data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Strongest Tropical Cyclones: 1980-2009 poster - a 30-year collage of Hurricane Satellite (HURSAT) data. This poster depicts a series of 5 degree grids where within...

  16. Modern Era Retrospective-analysis for Research and Applications (MERRA) Global Water and Energy Budgets

    Science.gov (United States)

    Bosilovich, Michael G.; Chen, Junye

    2009-01-01

    In the Summer of 2009, NASA's Modern Era Retrospective-analysis for Research and Applications (MERRA) will have completed 28 years of global satellite data analyses. Here, we characterize the global water and energy budgets of MERRA, compared with available observations and the latest reanalyses. In this analysis, the climatology of the global average components are studied as well as the separate land and ocean averages. In addition, the time series of the global averages are evaluated. For example, the global difference of precipitation and evaporation generally shows the influence of water vapor observations on the system. Since the observing systems change in time, especially remotely sensed observations of water, significant temporal variations can occur across the 28 year record. These then are also closely connected to changes in the atmospheric energy and water budgets. The net imbalance of the energy budget at the surface can be large and different signs for different reanalyses. In MERRA, the imbalance of energy at the surface tends to improve with time being the smallest during the most recent and abundant satellite observations.

  17. Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

    Institute of Scientific and Technical Information of China (English)

    Shi-Xing Li; Yao Zhang; Mei Sun; Bo Shi; Zhong-Yi Xu; Ying Huang; Zhi-Qin Mao

    2008-01-01

    AIM: To investigate the clinical value of ultrasonographic diagnosis of biliary atresia (BA), a retrospective analysis of the sonogram of 20 children with BA was undertaken.METHODS: Ultrasonography (US) was performed in 20 neonates and infants with BA, which was confirmed with cholangiography by operation or abdominoscopy. The presence of triangular cord, the size and echo of liver, the changes in empty stomach gallbladder and postprandial gallbladder were observed and recorded.RESULTS: The triangular cord could be observed at the porta hepatis (thickness: 0.3-0.6cm) in 10 cases. Smaller triangular cord (0.2-0.26cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed a streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and hetreogeneous echogenicity. Statistical analysis was performed to compare the hepatomegaly and hetreogeneous echogenicity and the stage of hepatic fibrosis.CONCLUSION: The presence of the triangular cord at the porta hepatis is specific. However, it is not the only diagnostic criterion, since flat and small gallbladder and poor contraction are also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and hetreogeneous echogenicity is proportional with liver fibrosis, and able to indicate the duration of course and prognosis.

  18. Science Engagement and Literacy: A retrospective analysis for students in Canada and Australia

    Science.gov (United States)

    Woods-McConney, Amanda; Colette Oliver, Mary; McConney, Andrew; Schibeci, Renato; Maor, Dorit

    2014-07-01

    Given international concerns about students' pursuit (or more correctly, non-pursuit) of courses and careers in science, technology, engineering and mathematics, this study is about achieving a better understanding of factors related to high school students' engagement in science. The study builds on previous secondary analyses of Programme for International Student Assessment (PISA) datasets for New Zealand and Australia. For the current study, we compared patterns of science engagement and science literacy for male and female students in Canada and Australia. The study's secondary analysis revealed that for all PISA measures included under the conceptual umbrella of engagement in science (i.e. interest, enjoyment, valuing, self-efficacy, self-concept and motivation), 15-year-old students in Australia lagged their Canadian counterparts to varying, albeit modest, degrees. Our retrospective analysis further shows, however, that gender equity in science engagement and science literacy is evident in both Canadian and Australian contexts. Additionally, and consistent with our previous findings for indigenous and non-indigenous students in New Zealand and Australia, we found that for male and female students in both countries, the factor most strongly associated with variations in engagement in science was the extent to which students participate in science activities outside of school. In contrast, and again for both Canadian and Australian students, the factors most strongly associated with science literacy were students' socioeconomic backgrounds, and the amount of formal time spent doing science. The implications of these results for science educators and researchers are discussed.

  19. Prevalence of multidrug resistant pathogens in children with urinary tract infection: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Srinivasan S, Madhusudhan NS

    2014-11-01

    Full Text Available Urinary tract infection (UTI is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria. Aims & Objectives: To know the bacteriological profile and susceptibility pattern of urinary tract infections in children and to know the prevalence of multidrug resistant uropathogens. Materials & Methods: A retrospective analysis was done on all paediatric urine samples for a period of one year. A total of 1581 samples were included in the study. Antimicrobial susceptibility testing was done on samples showing significant growth by Kirby-Bauer disc diffusion method. Statistical analysis: Prevalence and pattern were analyzed using proportions and percentages. Results: E.coli was the most predominant organism (56% causing UTI in children followed by Klebsiella sp (17%. Fifty three percent of gram negative organisms isolated from children were found to be multidrug resistant. Majority of E. coli isolates were found to be highly resistant to Ampicillin (91% and Cotrimoxazole (82% and highly sensitive to Imipenem (99% and Amikacin (93%. Conclusion: Paediatric UTI was common in children less than 5 years of age. Gram negative bacteria (E. coli and Klebsiella sp were more common than gram positive bacteria. Our study revealed that multidrug resistance was higher in E.coli.

  20. Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island (China)

    Science.gov (United States)

    Titlyanov, Eduard A.; Titlyanova, Tamara V.; Xia, Bangmei; Bartsch, Inka

    2016-09-01

    Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island in the period 1933-1992 is presented in this paper. There are two extensive sample collection periods of benthic macroalgae: the early collection (EC) covers a period between the early 1930s and the 1980s before considerable urbanization and reef degradation took place and a late collection (LC) was performed in 1990/1992 during a phase of rapid urbanization. Analysis of data also including an earlier published inventory of green algae covering the same collection sites (Titlyanov et al. 2011a) revealed that the marine flora of the island comprises 426 taxa in total, with 59% red algae, 18% brown algae and 23% green algae. In total 59 species of red algae, 11 species of brown algae and 37 species of green algae sampled during the LC are new records for Hainan Island. Considerable floristic changes between EC and LC became evident. In the LC there were significantly more filamentous, tubular or fine blade-like, and often epiphytic, green and red algae with a high surface-to-volume ratio. Additionally a reduction of green, brown and red algal species with larger fleshy or foliose thalli and a low surface-to-volume ratio was observed. It is assumed that the changes reflect the degradation of the coral reef ecosystem around Hainan, which was damaged by human activities especially in the 1950s-1970s.

  1. NASA's Modern Era Retrospective-Analysis for Research and Applications (MERRA): Early Results and Future Directions

    Science.gov (United States)

    Schubert, Siegfried

    2008-01-01

    This talk will review the status and progress of the NASA/Global Modeling and Assimilation Office (GMAO) atmospheric global reanalysis project called the Modern Era Retrospective-Analysis for Research and Applications (MERRA). An overview of NASA's emerging capabilities for assimilating a variety of other Earth Science observations of the land, ocean, and atmospheric constituents will also be presented. MERRA supports NASA Earth science by synthesizing the current suite of research satellite observations in a climate data context (covering the period 1979-present), and by providing the science and applications communities with of a broad range of weather and climate data with an emphasis on improved estimates of the hydrological cycle. MERRA is based on a major new version of the Goddard Earth Observing System Data Assimilation System (GEOS-5), that includes the Earth System Modeling Framework (ESMF)-based GEOS-5 atmospheric general circulation model and the new NOAA National Centers for Environmental Prediction (NCEP) unified grid-point statistical interpolation (GST) analysis scheme developed as a collaborative effort between NCEP and the GMAO. In addition to MERRA, the GMAO is developing new capabilities in aerosol and constituent assimilation, ocean, ocean biology, and land surface assimilation. This includes the development of an assimilation capability for tropospheric air quality monitoring and prediction, the development of a carbon-cycle modeling and assimilation system, and an ocean data assimilation system for use in coupled short-term climate forecasting.

  2. Exhibition on the 30 Years of Reform and Opening-up Held

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ In commemoration of the 30 years of reform and opening-up, under the authorization of the State Council, the "Review Exhibition on the 30-Year Reform and Opening-Up of China," jointly sponsored by the Ministry of Commerce of the PRC, the International Communication Office of the CPC Central Committee, the Party Literature Research Center of the CPC Central Committee and Xinhua News Agency, opened in the Exhibition Hall of the China World Trade Center on December 18.

  3. Key trends in environmental advertising across 30 years in National Geographic magazine.

    Science.gov (United States)

    Ahern, Lee; Bortree, Denise Sevick; Smith, Alexandra Nutter

    2013-05-01

    This longitudinal retrospective case study describes the sponsors, ad types, frames and message factors in green advertising over three decades in National Geographic magazine, the bellwether nature publication in the USA. In addition to providing a clearer picture of the extent and nature of environmental strategic messaging over three decades, results provide empirical support for theoretical relationships between the level of green advertising and economic indicators. After providing historical and theoretical context, detailed results are presented for both overall and longitudinal analysis. Limitations and implications for future research are discussed.

  4. Global drought in the 20th and 21st centuries : analysis of retrospective simulations and future projections of soil moisture

    NARCIS (Netherlands)

    Sheffield, J.

    2008-01-01

    We describe the analysis of global and regional drought over the second half of the 20th century from a retrospective model simulation of the terrestrial water cycle, and projected 21st century changes using multi-scenario data from multiple climate models. A global meteorological forcing dataset is

  5. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and ne

  6. Retrospective analysis of perioperative factors on outcome of patients undergoing surgery for Moyamoya disease

    Directory of Open Access Journals (Sweden)

    Navneh Samagh

    2015-01-01

    Full Text Available Background: The short term outcome of patients undergoing surgery for Moyamoya disease can be affected by various perioperative factors. However, due to lesser prevalence of this disease in our country, data relating the effect of perioperative factors on the overall neurological outcomes of these patients is lacking. Aims: To analyze the effect of perioperative factors on the duration of postoperative hospital stay in patients undergoing surgery for Moyamoya disease. Settings and Design: It is a retrospective study analyzing various perioperative factors influencing the overall outcome of patients undergoing surgery for Moyamoya disease at a tertiary care centre in North India. Methods and Material: The medical records of all patients who underwent revascularization surgeries for Moyamoya disease from 2007 to till January 2014 were included for retrospective analysis. Various preoperative, intraoperative, and postoperative data were recorded. The data was statistically compared for short and prolonged hospital stay for various perioperative factors. The duration of post operative hospital stay was categorized as short (5 days. Statistical Analysis: Kolmogrov Smirnov test was applied to see the normality of continuous data. The association of various categorically classified data with 2 groups was found using Fisher Exact test. The trends in intraoperative hemodynamics were analysed using 2 way repeated measure Anova test. T-test was used for comparing two group means for various parameters. Results: A total of 15 patients were included in the study. One patient underwent surgery twice on two different occasions. Thirteen patients belonged to paediatric age group (<18 years. The type of anaesthetics used for induction and maintenance had no effect on patient outcome. Mean duration of anaesthesia was 2.45 (1.3-4.0 hours. The mean duration of hospital stay was 5.13 (3-10 days. Most of the parameters did not have significant effect on postoperative

  7. Retrospective analysis of perioperative factors on outcome of patients undergoing surgery for Moyamoya disease

    Science.gov (United States)

    Samagh, Navneh; Bhagat, Hemant; Grover, Vinod K.; Sahni, Neeru; Agarwal, Ashish; Gupta, Sunil K.

    2015-01-01

    Background: The short term outcome of patients undergoing surgery for Moyamoya disease can be affected by various perioperative factors. However, due to lesser prevalence of this disease in our country, data relating the effect of perioperative factors on the overall neurological outcomes of these patients is lacking. Aims: To analyze the effect of perioperative factors on the duration of postoperative hospital stay in patients undergoing surgery for Moyamoya disease. Settings and Design: It is a retrospective study analyzing various perioperative factors influencing the overall outcome of patients undergoing surgery for Moyamoya disease at a tertiary care centre in North India. Methods and Material: The medical records of all patients who underwent revascularization surgeries for Moyamoya disease from 2007 to till January 2014 were included for retrospective analysis. Various preoperative, intraoperative, and postoperative data were recorded. The data was statistically compared for short and prolonged hospital stay for various perioperative factors. The duration of post operative hospital stay was categorized as short (5 days). Statistical Analysis: Kolmogrov Smirnov test was applied to see the normality of continuous data. The association of various categorically classified data with 2 groups was found using Fisher Exact test. The trends in intraoperative hemodynamics were analysed using 2 way repeated measure Anova test. T-test was used for comparing two group means for various parameters. Results: A total of 15 patients were included in the study. One patient underwent surgery twice on two different occasions. Thirteen patients belonged to paediatric age group (<18 years). The type of anaesthetics used for induction and maintenance had no effect on patient outcome. Mean duration of anaesthesia was 2.45 (1.3-4.0) hours. The mean duration of hospital stay was 5.13 (3-10) days. Most of the parameters did not have significant effect on postoperative hospital stay

  8. Retrospective analysis of outcomes and prognostic factors of chemotherapy for small-cell lung cancer

    Directory of Open Access Journals (Sweden)

    Minami S

    2016-04-01

    Full Text Available Seigo Minami, Yoshitaka Ogata, Shouichi Ihara, Suguru Yamamoto, Kiyoshi Komuta Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan Background: Small-cell lung cancer (SCLC is responsive to initial chemotherapy but becomes resistant to cytotoxic drugs. The aim of this study was to evaluate what proportion of patients with SCLC had received the first- and further-line chemotherapy and which patients had benefited from chemotherapy. Methods: We retrospectively reviewed medical records of patients with SCLC who had been treated with the best supportive care alone and the first-, second-, or third-line chemotherapy at the Osaka Police Hospital from June 2007 until March 2015. Results: Among 145 patients diagnosed with SCLC and eligible for analysis, 118 patients received chemotherapy. We added five patients who initiated the second-line chemotherapy during the study period at our institution. Sixty-five and 31 patients received the second- and third-line chemotherapies, respectively. Multivariate logistic regression analysis detected age ≥75 years (odds ratio, 2.80; 95% confidence interval, 1.01–7.75; P=0.047 and European Clinical Oncology Group Performance Status (ECOG PS 3–4 (14.3; 4.86–41.9; P<0.01 as factors disturbing the introduction of chemotherapy. Multivariate Cox hazard analyses also detected ECOG PS 2–4 (3.34; 2.00–5.58; P<0.01 as a factor decreasing overall survival after the first-line chemotherapy, and C-reactive protein level ≥1.0 mg/dL (2.67; 1.30–5.47; P<0.01 and progression-free survival after the first-line chemotherapy ≥6 months (2.85; 1.50–5.43; P<0.01 as factors influencing overall survival after the second-line chemotherapy. Conclusion: Approximately two-thirds and one-third of the patients who receive chemotherapy proceed to the second- and third-line chemotherapies, respectively. Several factors, such as age, ECOG PS, C-reactive protein level, and progression-free survival after

  9. A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans

    Energy Technology Data Exchange (ETDEWEB)

    Li, Guangjun [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China); Wu, Kui [Department of Radiotherapy, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province (China); Peng, Guang; Zhang, Yingjie [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China); Bai, Sen, E-mail: baisen@scu.edu.cn [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China)

    2014-01-01

    Volumetric-modulated arc therapy (VMAT) is now widely used clinically, as it is capable of delivering a highly conformal dose distribution in a short time interval. We retrospectively analyzed patient-specific quality assurance (QA) of VMAT and examined the relationships between the planning parameters and the QA results. A total of 118 clinical VMAT cases underwent pretreatment QA. All plans had 3-dimensional diode array measurements, and 69 also had ion chamber measurements. Dose distribution and isocenter point dose were evaluated by comparing the measurements and the treatment planning system (TPS) calculations. In addition, the relationship between QA results and several planning parameters, such as dose level, control points (CPs), monitor units (MUs), average field width, and average leaf travel, were also analyzed. For delivered dose distribution, a gamma analysis passing rate greater than 90% was obtained for all plans and greater than 95% for 100 of 118 plans with the 3%/3-mm criteria. The difference (mean ± standard deviation) between the point doses measured by the ion chamber and those calculated by TPS was 0.9% ± 2.0% for all plans. For all cancer sites, nasopharyngeal carcinoma and gastric cancer have the lowest and highest average passing rates, respectively. From multivariate linear regression analysis, the dose level (p = 0.001) and the average leaf travel (p < 0.001) showed negative correlations with the passing rate, and the average field width (p = 0.003) showed a positive correlation with the passing rate, all indicating a correlation between the passing rate and the plan complexity. No statistically significant correlation was found between MU or CP and the passing rate. Analysis of the results of dosimetric pretreatment measurements as a function of VMAT plan parameters can provide important information to guide the plan parameter setting and optimization in TPS.

  10. Challenges in management of phyllodes tumors of the breast: A retrospective analysis of 150 patients

    Directory of Open Access Journals (Sweden)

    P Ramakant

    2013-01-01

    Full Text Available Introduction: Phyllodes tumors (PT of the breast seem to get pre-operatively misdiagnosed as fibroadenomas resulting in inadequate resections and high local recurrence rates. Materials and Methods: Data of 150 patients with PT of the breast managed from January, 2003 to February, 2013 were retrospectively analyzed. Statistical analysis performed using SPSS version 17 (Pearson Chi-square test and analysis of variance test for analysis. Aim: The aim of this study is to compare clinico-pathological profile and recurrence rates in patients with benign (B, borderline malignant (BL and malignant (M PT. Results: In a total of 150 patients with PT (n = 77 B, n = 24 BL, n = 49 M, mean age was 36.92, 44.04 and 40.46 years respectively (P 0.015 and mean tumor size being 8.15 cm, 14.7 cm and 12.9 cm respectively (P 0.000. Pre-operatively cytology suggestive of PT in 24% patients with B PT and 63% in M PT; core tissue biopsy suggestive of PT in 85.4% patients with B PT and 100% in M PT. Recurrence seen in 34.7% out of which 32.7% were post-lumpectomy performed elsewhere. Majority of B PT had lumpectomy (49.3%/wide local excision (WLE, 31.2% compared with M PT where 55.1% had simple mastectomy (SM due to large tumor size. Local recurrence was more in M PT (53% compared with B PT (20%. We found recurrence rates in L (39.3% compared with WLE (27.3% and SM (33.9% (P 0.049. Conclusions: Larger tumor size, incomplete resection and M/BL histology predicted higher recurrence in PT. Core biopsy is much more accurate than fine needle cytology in the diagnosis.

  11. Liver resection for benign hepatic lesions: A retrospective analysis of 827 consecutive cases

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions.METHODS: A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation.RESULTS: The effect of operative and perioperative factors on the outcome of patients were analyzed. Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%, 316 (38.21%) required transfusion of blood products during operation. The average operating time was 220.59 ± 109.13 min, the average hospital stay after operation was 13.55 ± 9.38 d. Child-Pugh A accounted for 98.13%. The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%. Multivariate analysis showed that operating time (P = 0.004, OR = 1.003) and albumin value (P = 0.040, OR = 0.938) were the independent predictors of morbidity and indicated that operating time, blood transfusion, complication rate, and LOS had a trend to decrease.CONCLUSION: Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality, provided that it is carried out with optimized perioperative management and an innovative surgical technique.

  12. A retrospective analysis of growth of the constructed condyle-ramus in children with hemifacial microsomia.

    Science.gov (United States)

    Mulliken, J B; Ferraro, N F; Vento, A R

    1989-10-01

    A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.

  13. Retrospective stable isotope analysis reveals ecosystem responses to river regulation over the last century.

    Science.gov (United States)

    Turner, Thomas F; Krabbenhoft, Trevor I; Collyer, Michael L; Krabbenhoft, Corey A; Edwards, Melanie S; Sharp, Zachary D

    2015-12-01

    Disruption of natural flow regimes, nutrient pollution, and other consequences of human population growth and development have impacted most major rivers of the world. Alarming losses of aquatic biodiversity coincide with human-caused river alteration, but effects of biotic homogenization on aquatic ecosystem processes are not as well documented. This is because unaltered systems for comparison are scarce, and some ecosystem-wide effects may take decades to manifest. We evaluated aquatic ecosystem responses to extensive river- floodplain engineering and nutrient addition in the Rio Grande of southwestern North America as revealed by changes in trophic structure of, and resource availability to, the fish community. Stable Isotope Analysis (SIA) was conducted on museum-preserved fishes collected over a 70-year period of intensive river management and exponential human population growth. Trophic complexity and resource heterogeneity for fish consumers (measured as "isotopic niche breadth") decreased following sediment deprivation and channelization, and these effects persist into the present. Increased nutrient inputs led to δ15N enrichment in the entire fish community at all affected sites, and a shift to autochthonous sources of carbon at the most proximal site downstream of wastewater release, probably via bottom-up transfer. Overall, retrospective SIA of apex consumers suggests radical change and functional impairment of a floodplain river ecosystem already marked by significant biodiversity loss.

  14. Epidemiology of superficial fungal diseases in French Guiana: a three-year retrospective analysis.

    Science.gov (United States)

    Simonnet, Christine; Berger, Franck; Gantier, Jean-Charles

    2011-08-01

    A three-year retrospective analysis of fungi isolated from specimens of patients with superficial fungal infections in French Guiana is presented. Clinical samples from 726 patients with presumptive diagnoses of onychomycosis (28.2% of the patients), tinea capitis (27.8%), superficial cutaneous mycoses of the feet (22.0%), and of other areas of the body (21.9%), were assessed by microscopic examination and culture. Dermatophytes accounted for 59.2% of the isolates, followed by yeasts (27.5%) and non-dermatophytic molds (13.1%). Trichophyton rubrum was the most common dermatophyte recovered from cases of onychomycosis (67.4%), tinea pedis (70.6%) and tinea corporis (52.4%). In contrast, Trichophyton tonsurans was the predominant species associated with tinea capitis (73.9%). Yeasts were identified as the principal etiologic agents of onychomycosis of the fingernails (74.2%), whereas molds were found mainly in cases of onychomycosis of the toenails. In such instances, Neoscytalidium dimidiatum (70.8%) was the most common mold recovered in culture. In conclusion, the prevalence of T. rubrum and the occurrence of onychomycosis and fungal infections of the feet in French Guiana are similar to results reported from Europe, whereas the frequency of tinea capitis and the importance of T. tonsurans in such infections are similar to the situation in the Americas.

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

    Directory of Open Access Journals (Sweden)

    Hualei Li

    2014-01-01

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

  16. Gandhi and Mao on manual labour in the school: A retrospective analysis

    Science.gov (United States)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

    Mahatma Gandhi's views on relating the world of formal education to the world of work were developed first in his experimental `Tolstoy Farm' in South Africa. On his return to India, Gandhi insisted that a required manual labour component in the curriculum would help regenerate India's village economy, develop in India's children a deeper understanding of India's cultural roots, motivate children to relate `book learning' to life in society, and destroy invidious caste distinctions. The major proposals and suggestions in Gandhi's writing will be discussed in the context of his hopes for using schooling as an agent of progress in India. Mao Ze-Dong's views, on the other hand, were developed in the context of his Yenan experience in the 1930s, i.e. the decision to consolidate a power base in the interior of China before waging a class war against the landlords and capitalists of China. Mao's views were also, to some extent, rooted in the Chinese reality of stagnant, poverty-stricken rural areas. But, Mao's writings indicate that Marxist hopes to relate theory and practice (as understood in dialectical materialism) and to ensure that everyone participated in mental as well as manual labour in a socialist society had led him to formulate his proposals. Both Gandhi's and Mao's views and proposals have been more or less abandoned in India and China respectively. The similar and dissimilar reasons which led to such a fate are examined in this retrospective analysis.

  17. Cardiac arrests in patients undergoing gastrointestinal endoscopy: A retrospective analysis of 73,029 procedures

    Directory of Open Access Journals (Sweden)

    Basavana Goudra

    2015-01-01

    Full Text Available Background/Aims: Airway difficulties leading to cardiac arrest are frequently encountered during propofol sedation in patients undergoing gastrointestinal (GI endoscopy. With a noticeable increase in the use of propofol for endoscopic sedation, we decided to examine the incidence and outcome of cardiac arrests in patients undergoing gastrointestinal (GI endoscopy with sedation. Patients and Methods: In this retrospective study, cardiac arrest data obtained from the clinical quality improvement and local registry over 5 years was analyzed. The information of patients who sustained cardiac arrest attributable to sedation was studied in detail. Analysis included comparison of cardiac arrests due to all causes until discharge (or death versus the cardiac arrests and death occurring during the procedure and in the recovery area. Results: The incidence of cardiac arrest and death (all causes, until discharge was 6.07 and 4.28 per 10,000 in patients sedated with propofol, compared with non–propofol-based sedation (0.67 and 0.44. The incidence of cardiac arrest during and immediately after the procedure (recovery area for all endoscopies was 3.92 per 10,000; of which, 72% were airway management related. About 90.0% of all peri-procedural cardiac arrests occurred in patients who received propofol. Conclusions: The incidence of cardiac arrest and death is about 10 times higher in patients receiving propofol-based sedation compared with those receiving midazolam–fentanyl sedation. More than two thirds of these events occur during EGD and ERCP.

  18. A retrospective analysis of the first Indian experience on Artisan phakic intraocular lens

    Directory of Open Access Journals (Sweden)

    Senthil Sirisha

    2006-01-01

    Full Text Available Purpose: To evaluate the efficacy, safety, predictability and stability of implanting a polymethylmethacrylate phakic intraocular lens (PIOL in high myopia. Materials and Methods: A retrospective analysis of the data of patients who underwent Artisan phakic IOL implantation between 2002 and 2003 with a follow-up of at least 24 months. Results: An Artisan myopia lens was implanted in 60 eyes of 36 patients with preoperative myopia ranging from -5.0 to -24.0 D. Mean patient age was 22.6 years. Mean spherical equivalent of manifest refraction stabilized by the first postoperative week. At three months follow-up, 54 eyes (90% had a postoperative refraction within ± 1D emmetropia and 45 eyes (75% had uncorrected visual acuity of 20/40 or better. Seven eyes (11.6% had loss of one Snellen line and none had loss of two Snellen lines or more at three months. The mean endothelial cell loss was 3.8% at three months, 5.2% at six months, 5.25% at 12 months and 6.38% at two years, which was not significant. Postoperative complications included anterior chamber reaction in two eyes (3.3%, rise in intraocular pressure in six eyes (10% and dislocation of PIOL in two eyes (3.3%. Conclusion: Implantation of Artisan myopia lens to correct high myopia resulted in a stable and fairly predictable refractive outcome with few complications. Significant endothelial damage was not detected in two years of follow-up.

  19. Management of Esophageal Carcinoma Associated with Cirrhosis: A Retrospective Case-Control Analysis

    Directory of Open Access Journals (Sweden)

    Florence Trivin

    2009-01-01

    Full Text Available Objectives. Esophageal carcinoma and cirrhosis have the overlapping etiologic factors. Methods. In a retrospective analysis conducted in 2 Breton institutions we wanted to asses the frequency of this association and the outcome of these patients in a case-control study where each case (cirrhosis and esophageal cancer was paired with two controls (esophageal cancer. Results. In a 10-year period, we have treated 958 esophageal cancer patients; 26 (2.7% had a cirrhosis. The same treatments were proposed to the 2 groups; cases received nonsignificantly different radiation and chemotherapy dose than controls. Severe toxicities and deaths were more frequent among the cases. At the end of the treatment 58% of the cases and 67% of the controls were in complete remission; median and 2-year survival were not different between the 2 groups. All 4 Child-Pugh B class patients experienced severe side effects and 2 died during the treatment. Conclusions. This association is surprisingly infrequent in our population! Child-Pugh B patients had a dismal prognosis and a bad tolerance to radiochemotherapy; Child-Pugh A patients have the same tolerance and the same prognosis as controls and the evidence of a well-compensated cirrhosis has not modified our medical options.

  20. Annual performance appraisal: one organization's process and retrospective analysis of outcomes.

    Science.gov (United States)

    Geddes, E Lynne; Gill, Caroline

    2012-01-01

    Performance assessment of personnel is an important component of an organization's quality management program, benefiting the organization, individuals and clients. Performance appraisal is the most common method. This article describes the three-part performance appraisal tool used at the authors' organization, a private inter-professional healthcare agency providing rehabilitation services to clients in the community, and presents the results of a retrospective analysis of the outcomes. Performance appraisals of 13 personnel were randomly selected, representing 39 chart audits and 25 joint client visits. The achievement of mandatory chart audit standards demonstrated 95 ± 7.2% compliance; expected standards showed 96 ± 3.3% compliance. Qualitative findings from the joint visits and interviews showed that therapists enjoyed the process and experience, valued the feedback and appreciated the support they received. Benefits and challenges of the process were identified, resulting in new initiatives being implemented. The authors confirmed that the tool achieves its intended purpose and is relevant in the home care setting.

  1. [Coexistence of bronchial asthma and diabetes mellitus type 2--retrospective analysis].

    Science.gov (United States)

    Glück, J; Rogala, B

    1999-01-01

    Bronchial asthma and diabetes mellitus type 2 are often found among adult patients. However, coincidence of these two diseases is very rare. The aim of the study was the retrospective analysis of all patients with bronchial asthma and diabetes mellitus type 2 hospitalised in Department and Clinic of Internal Diseases and Allergology in Zabrze, Silesian School of Medicine in Katowice in 1988-1997. Diabetes mellitus type 2 was diagnosed according to WHO criteria of 1985 and bronchial asthma was diagnosed with the use of American Thoracic Society criteria. Bronchial asthma and diabetes mellitus type 2 occurring together were found in 18 patients (0.3% of all hospitalized patients). In most patients the symptoms of bronchial asthma preceded the diagnosis of diabetes mellitus by a few years. All these cases were heterogeneous in terms of the duration of the diseases, clinical picture, and therapeutical approaches. In patients with bronchial asthma the existence of diabetes mellitus type 2 was not related to use of glikocorticosteroids. Patients in whom the coexistence of bronchial asthma and diabetes mellitus type 2 was found should be subjects of further studies to extend our knowledge of patomechanism of these diseases.

  2. [Neonatal bronchoscopy: a retrospective analysis of 67 cases and a review of their indications].

    Science.gov (United States)

    Oliveira-Santos, J A; Pereira-da-Silva, L; Clington, A; Serelha, M

    2004-01-01

    The availability of newer, more sophisticated and versatile bronchoscopes has expanded the spectrum and scope of the indications for bronchoscopy in the newborn infant both for diagnostic and therapeutic purposes. The aim of this study was to carry out a retrospective analysis of the bronchoscopies performed on newborn infants, and to review the indications of this procedure in this age group. Sixty-three patients were submitted to 67 bronchoscopies in a period of 13 years, allowing the diagnosis of 45 anomalies and malformations of the tracheo-bronchial tree, and the performance of 24 bronchoalveolar lavages. In six cases, endoscopic removal of secretions helped to resolve resistant atelectasia, while in another case, with esophageal atresia, intra-operative definition of the fistula tract was possible through catheterisation of the fistula with the bronchoscope. The flexible bronchoscope was preferred for diagnosis by direct visualisation, and the rigid bronchoscope for some diagnostic and therapeutic procedures. Stridor, unexplained cyanosis, hemoptysis, persistent or recurrent pulmonary images, difficulties in the intubation or extubation, and persistent disturbances in ventilation are among the main indications for bronchoscopy in the newborn infant. Bronchoscopy also allows the performance of subsidiary techniques, such as bronchoalveolar lavage, biopsy and laser therapy.

  3. Retrospective analysis of selected predictors of mortality within a veterinary intensive care unit.

    Science.gov (United States)

    Simpson, Kerry E; McCann, Theresa M; Bommer, Nicholas X; Pereira, Yolanda Martinez; Corston, Claire; Reed, Nicola; Gunn-Moore, Danièlle A

    2007-10-01

    The records of 204 cats entering the intensive care unit (ICU) at the University of Edinburgh Small Animal Hospital between December 2002 and October 2006 were retrospectively analysed. Of these, 37 cats over 12 months of age had a systolic blood pressure recorded on entry into the ICU, and this group comprised our study population. Of these 37 cats, 36 had both heart rate and respiratory rate recorded on entry into the ICU, whilst 24 of these cats also had body temperature recorded. The relationship between (i) survival to discharge and (ii) survival until 21 days after admission to the ICU was analysed using univariate generalised linear models with binomial errors. The robustness of any significant relationship was assessed using multivariate analysis methods. In addition, receiver operator curves (ROC) were generated for any of the significant predictors of mortality and from these curves the threshold values, optimal sensitivity and specificity were calculated. Using these values survival curves were generated for any significant prognostic indexes. A decreased blood pressure at the time of admission to the ICU was found to be a significant negative predictor of survival until discharge from the hospital. Overall, a systolic blood pressure of 124 mmHg or higher at the time of admission to the ICU has a sensitivity of 47.8% and a specificity of 85.7% for predicting that a cat will survive until discharge from the hospital.

  4. Pediatric unilateral below-elbow amputees: retrospective analysis of 34 patients given multiple prosthetic options.

    Science.gov (United States)

    Crandall, Robin C; Tomhave, Wendy

    2002-01-01

    Thirty-four unilateral below-elbow amputees from the Shriners Hospitals for Children/Twin Cities were retrospectively analyzed in long-term follow-up. All of these patients were provided with a variety of prosthetic options, including a "passive" cosmetic upper extremity device. Most of the patients were also fitted with conventional prostheses using a body-powered voluntary closing terminal device (97%) as well as myoelectric prostheses (82%). These patients were considered consistent prosthetic users by the clinic team. The average follow-up was 14 years, with many of the patients being followed up throughout their entire childhood. All patients were sent questionnaires, and the authors carried out patient interviews and chart review. Final analysis indicated that 15 patients (44%) selected a simple cosmetic "passive hand" as their prosthesis of choice. In long-term follow-up 14 patients (41%) continued as multiple users. Fourteen patients (41%) selected the conventional prosthesis using a voluntary closing terminal device as the prosthesis of choice. Only five patients (15%) selected the myoelectric device as their primary prosthesis. The authors conclude that successful unilateral pediatric amputees may choose multiple prostheses on the basis of function and that frequently the most functional prosthesis selected in the long term is the simplest in design. The authors believe strongly that unilateral pediatric amputees should be offered a variety of prosthetic options to help with normal activities of daily living.

  5. Diagnosis and treatment of small intestinal bleeding: Retrospective analysis of 76 cases

    Institute of Scientific and Technical Information of China (English)

    Ming-Chen Ba; San-Hua Qing; Xiang-Cheng Huang; Ying Wen; Guo-Xin Li; Jiang Yu

    2006-01-01

    AIM: To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches.METHODS: A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years.RESULTS: In these patients, tumor was the most frequent cause of small intestinal bleeding (37/76), followed by Meckel's diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients,21 were diagnosed by digital subtraction angiography,13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications.CONCLUSION: Tumor is the major cause of small intestinal bleeding followed by Meckel's diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.

  6. The use of oral cyclosporin to treat feline dermatoses: a retrospective analysis of 23 cases.

    Science.gov (United States)

    Vercelli, A; Raviri, G; Cornegliani, L

    2006-06-01

    Limited information is available regarding the use of cyclosporin A (CsA) for the treatment of feline dermatoses. The aim of this retrospective study was therefore to describe the efficacy of CsA for the therapy of eosinophilic granuloma (EG), eosinophilic plaque, indolent ulcer, linear granulomas, idiopathic pruritus and stomatitis. A computer search for feline dermatological cases treated with CsA between 1999 and 2004 was performed. Based on history, clinical signs and laboratory diagnostic tests, it was then possible to divide cases into three groups and to select 23 cats. Seven cats had one or more of the following conditions: EG, eosinophilic plaque, indolent ulcer and/or linear granuloma (group A); eight cats had idiopathic pruritus (group B) and eight cats had plasmacytic stomatitis (group C). Doses ranged from 5.8 to 13.3 mg kg(-1) oral CsA. All cats were monitored, with complete serum blood analysis and physical examination, monthly for a minimum of 6 months. Response to therapy was scored (severity of lesions and pruritus) with a 0-10 visual analogue scale at each visit (day 0, day, 30, day 60, day 90). All cats in groups A and B were cured and were maintained on alternate day therapy. In group C, 4/8 patients went into remission, while remaining cats have a fair to good improvement. Routine haematological and biochemical examination failed to reveal abnormalities related to CsA administration.

  7. Retrospective analysis of bottlenose dolphin foraging: a legacy of anthropogenic ecosystem disturbance

    Science.gov (United States)

    Rossman, Sam; Barros, Nélio B.; Ostrom, Peggy H.; Stricker, Craig A.; Hohn, Aleta A.; Gandhi, Hasand; Wells, Randall S.

    2013-01-01

    We used stable isotope analysis to investigate the foraging ecology of coastal bottlenose dolphins (Tursiops truncatus) in relation to a series of anthropogenic disturbances. We first demonstrated that stable isotopes are a faithful indicator of habitat use by comparing muscle isotope values to behavioral foraging data from the same individuals. δ13C values increased, while δ34S and δ15N values decreased with the percentage of feeding observations in seagrass habitat. We then utilized stable isotope values of muscle to assess temporal variation in foraging habitat from 1991 to 2010 and collagen from tooth crown tips to assess the time period 1944 to 2007. From 1991 to 2010, δ13C values of muscle decreased while δ34S values increased indicating reduced utilization of seagrass habitat. From 1944 to 1989 δ13C values of the crown tip declined significantly, likely due to a reduction in the coverage of seagrass habitat and δ15N values significantly increased, a trend we attribute to nutrient loading from a rapidly increasing human population. Our results demonstrate the utility of using marine mammal foraging habits to retrospectively assess the extent to which anthropogenic disturbance impacts coastal food webs.

  8. Compliance with periodontal maintenance at the University of Pittsburgh: Retrospective analysis of 315 cases.

    Science.gov (United States)

    Famili, Pouran; Short, Elizabeth

    2010-01-01

    Maintenance care is the most important part of periodontal treatment because maintenance - adherence to the schedule of recall dental appointments after treatment - is believed to be the key in preventing the recurrence of periodontal disease. This article is a retrospective analysis of 315 cases from the Department of Periodontics and Preventive Dentistry at the University of Pittsburgh to determine compliance with periodontal maintenance schedules over a two-year period. Following the completion of periodontal surgical treatment, patients were placed on a regimen of maintenance care that included recalls every three months, professional prophylaxis by the hygiene faculty, and repeated instructions in home self-care. Medical records and patient charts of 315 subjects were selected randomly and reviewed in terms of the patient's attending the scheduled recall visit. It was hypothesized that female subjects would show better compliance with the maintenance care regimen than male subjects, as suggested in the literature. Among the 315 subjects, 112 (54 women and 58 men) followed the recommended recall schedule; 30% ultimately returned for the three-month prophylaxis recall visit after the initial periodontal surgical appointment, and thus were considered to have complied with the suggested maintenance program. The investigators failed to reject the stated hypothesis that women would display better compliance than men (p = 0.3).

  9. Retrospective Analysis of Arthroscopic Superior Labrum Anterior to Posterior Repair: Prognostic Factors Associated with Failure

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank

    2013-01-01

    Full Text Available Background. The purpose of this study was to report on any prognostic factors that had a significant effect on clinical outcomes following arthroscopic Type II SLAP repairs. Methods. Consecutive patients who underwent arthroscopic Type II SLAP repair were retrospectively identified and invited to return for follow-up examination and questionnaire. Statistical analysis was performed to determine associations between potential prognostic factors and failure of SLAP repair as defined by ASES of less than 50 and/or revision surgery. Results. Sixty-two patients with an average age of years met the study criteria with a mean followup of 3.3 years. There were statistically significant improvements in mean ASES score, forward elevation, and external rotation among patients. Significant associations were identified between ASES score less than 50 and age greater than 40 years; alcohol/tobacco use; coexisting diabetes; pain in the bicipital groove on examination; positive O’Brien’s, Speed’s, and/or Yergason’s tests; and high levels of lifting required at work. There was a significant improvement in ASES at final followup. Conclusions. Patients younger than 20 and overhead throwers had significant associations with cases requiring revision surgery. The results from this study may be used to assist in patient selection for SLAP surgery.

  10. Decitabine of reduced dosage in Chinese patients with myelodysplastic syndrome: a retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Xiao Li

    Full Text Available Decitabine has been approved for the treatment of all subtypes of myelodysplastic syndrome (MDS. However, the optimal regimen for decitabine treatment is not well established. In this study, an observational, retrospective and multi-center analysis was performed to explore the decitabine schedule for the treatment of MDS. A total of 79 patients received reduced dosage decitabine treatment (15 mg/M2/day intravenously for five consecutive days every four weeks. Fifty-three out of the 79 patients were defined as intermediate-2/high risk by international prognostic scoring system (IPSS risk category. 67.1% of MDS patients achieved treatment response including complete response (CR (n = 23, Partial response (n = 1, marrow CR (mCR with hematological improvement (HI (n = 11, mCR without HI (n = 11 and HI alone (n = 7 with a median of 4 courses (range 1-11. The median overall survival (OS was 18.0 months. The median OS was 22.0, 17.0 and 12.0 months in the patients with CR, those with other response, and those without response, respectively. In addition, this regimen contributed to zero therapy-related death and punctual course delivery, although III or IV grade of cytopenia was frequently observed. In conclusion, the 15 mg/M2/d×5 day decitabine regimen was effective and safe for Chinese MDS patients with IPSS score of 0.5 or higher.

  11. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    Energy Technology Data Exchange (ETDEWEB)

    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  12. Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

    Institute of Scientific and Technical Information of China (English)

    Changchun Su; Qinbao Qin

    2006-01-01

    BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis.Nerve conductive velocity is helpful in the diagnosis of atypical cases.OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG),motor and sensory nerve conduction velocity of patients with PMA.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, Guangzhou First People's Hospital.PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old,admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited.Informed consents were obtained from all the patients.METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed.MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients.RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA.Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ② Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down,especially in 16 patients with type Ⅰ PMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m

  13. THE RISKS OF DEVIANT BEHAVIOR ADOLESCENCE: EXPERIENCE IN A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Aminat Danjalovna Vislova

    2015-10-01

    Full Text Available The problem of the risks of drug abuse as a form of deviant behavior in the context of adolescence. In this study deviant behavior appears as actions (or willingness to commit them, contrary to the generally accepted cultural and moral values, as well as socio-psychological and legal norms, including the abuse of alcohol, drugs and other psychoactive substances Study prerequisites for the formation of drug addiction in adolescence age allows us to trace the link between awareness about drugs and those at risk of developing dependence on them, which are due to the age and psychological characteristics described L.S. Vygotsky and other scientists working in the paradigm of cultural-historical psychology. The article hypothesized that narcogene information can act as a factor of risk of drug use. It is argued that the basis of the commission of a narcotic substance samples is narcogene information and control over the sources that may contribute to the prevention of mass anesthesia teenagers. This assertion is supported by the results of a retrospective study of social and psychological factors in the emergence of drug abuse conducted in the Kabardino-Balkaria republic dispensary, which was attended by 24 active addict aged 18-28 who are registered with the method of questioning.Purpose. To study the role of information on drugs and drug addiction in the range of solutions «for» or «against» in a situation narcogene risk.Methodology. Questioning of active drug abusers.Results. Based on a retrospective analysis of risk factors for drug abuse as a form of deviant behavior found that narcogene information may lead to introduction to drugs. Lack of knowledge about the effects of drugs on the human body, and the temptation to create a stable, creates a high risk on narcotics debut. Drug use leads to a decrease of expression of fear and inadequate assessment of the degree of its danger. It creates a false impression that the drug is easy to give

  14. Incidence of venous thromboembolism in oral and maxillofacial surgery: a retrospective analysis

    NARCIS (Netherlands)

    T. Forouzanfar; M.W. Heymans; A. van Schuilenburg; S. Zweegman; E.A.J.M. Schulten

    2010-01-01

    This study retrospectively investigates the incidence and risk factors for venous thromboembolism (VTE) in patients undergoing maxillofacial surgery. Data were obtained from patients treated between January 2005 and June 2006. Patients’ records were reviewed for complaints and information relating t

  15. A retrospective benefit-cost analysis of the 1997 stair-fall requirements for baby walkers.

    Science.gov (United States)

    Rodgers, Gregory B; Leland, Elizabeth W

    2008-01-01

    Based on estimates from the U.S. Consumer Product Safety Commission (CPSC), there were about 25,000 baby walker-related injuries treated annually in U.S. hospital emergency departments during the early 1990s. This amounted to about 8 injuries for every 1000 baby walkers in use. Most injuries resulted from falls down stairs. After CPSC initiated a regulatory proceeding in 1994, the CPSC staff worked with industry to address the stair-fall hazard. This cooperative effort resulted in requirements designed to prevent stair-fall injuries that became effective in 1997 as part of a revised voluntary safety standard. This study presents a retrospective benefit-cost analysis of the 1997 stair-fall requirements. The benefits were defined as the reduction in the costs of injuries resulting from the use of the safer walkers. The costs were defined as the additional resource costs associated with making baby walkers safer. The study found that the stair-fall requirements were highly effective in reducing the risk of stair-fall injury, and that the benefits of the requirements substantially exceeded the costs. The expected net benefits (i.e., benefits minus costs) amounted to an average of about $169 per walker, over the walker's expected product life. Given current U.S. sales of about 600,000 baby walkers annually, the present value of the expected net benefits associated with 1 year's production amounts to over $100 million annually. A sensitivity analysis showed that the major findings were robust with respect to variations in underlying assumptions.

  16. Posaconazole after previous antifungal therapy with voriconazole for therapy of invasive aspergillus disease, a retrospective analysis.

    Science.gov (United States)

    Heinz, Werner J; Egerer, Gerlinde; Lellek, Heinrich; Boehme, Angelika; Greiner, Jochen

    2013-05-01

    Invasive aspergillosis is an important cause of morbidity and mortality in haematological patients. Current guidelines recommend voriconazole as first-line therapy. A change in class of antifungal agent is generally recommended for salvage therapy. The focus of this analysis was to assess if posaconazole is suitable for salvage therapy following voriconazole treatment. This was a retrospective investigation on patients with sequential antifungal therapy of posaconazole after voriconazole identified at four German hospitals. Response rates at 30 and 60 days following start of posaconazole application and toxicity of azoles by comparing liver enzymes and cholestasis parameters were evaluated. Data were analysed by descriptive statistics. Overall, the success rate was 72.2% [15 of 36 patients showed complete response (41.7%), 11 patients partial response (30.6%) at any time point], eight patients failed treatment and two were not evaluable. Mean laboratory values increased during voriconazole and decreased during posaconazole treatment: aspartate aminotransferase (increase: 31.9 U l(-1) vs. decrease: 19.6 U l(-1) ), alanine aminotransferase (32.4 U l(-1) vs. 19.8 U l(-1) ), gamma-glutamyl transferase (124.2 U l(-1) vs. 152.3 U l(-1) ) and alkaline phosphatase (71.5 U l(-1) vs. 40.3 U l(-1) ) respectively. No patient discontinued posaconazole therapy due to an adverse event. In this analysis posaconazole was a safe and effective antifungal salvage therapy in patients with prior administration of another triazole.

  17. Retrospective analysis of 140 cases of medullary thyroid carcinoma followed-up in a single institution

    Science.gov (United States)

    SIMÕES-PEREIRA, JOANA; BUGALHO, MARIA JOÃO; LIMBERT, EDWARD; LEITE, VALERIANO

    2016-01-01

    Familial cases of medullary thyroid carcinoma (MTC) may be diagnosed by genetic screening, while in sporadic tumors the diagnosis relies mainly on fine-needle aspiration cytology. The aim of the present study was to determine the demographic, clinical and pathological characteristics of MTC patients followed-up at the Portuguese Institute of Oncology Francisco Gentil (Lisbon, Portugal). For that purpose, a retrospective analysis of 140 MTC patients diagnosed between 1990 and 2010 was performed. The results indicated that patients with hereditary MTC (11.4%) were significantly younger than patients with sporadic MTC. Of the latter, 34.3% had no clinical suspicion of MTC prior to surgery. The sensitivity of cytology and calcitonin (CT) assay in diagnosing MTC were 51.3 and 98.7%, respectively. All familial index cases and 69.0% of sporadic cases presented with advanced stage disease at the time of diagnosis, while 73.0% of familial MTC detected by genetic/pentagastrin screening were diagnosed at the early stage of the disease. Biochemical cure (BC) was achieved in 39.7% of patients and, of these, only 6.5% relapsed. The 5 and 10-year survival rates were 79.3 and 73.6%, respectively. Age >45 years (P=0.026), advanced stage at diagnosis (P<0.001) and absence of BC (P<0.001) were predictors of a worse prognosis on univariate analysis. However, when the patients detected by genetic/pentagastrin screening were excluded from the analysis, age was no longer a prognostic factor, although disease stage remained a significant prognostic factor. On multivariate analysis, BC was the only factor with a significant impact on prognosis (P=0.031). In addition, the present study confirmed that the majority of patients were diagnosed at advanced stages, and CT determination was observed to be more sensitive than cytology to diagnose MTC. Patients at early stages were more prone to achieve BC, which was a favorable prognostic factor. To the best of our knowledge, the present study

  18. Remote sensing monitoring and analysis of dominant species of submerged vegetation in Taihu Lake over last 30 years%近30年太湖沉水植物优势种遥感监测及变化分析

    Institute of Scientific and Technical Information of China (English)

    王琪; 周兴东; 罗菊花; 陈冲

    2016-01-01

    Multi-temporal remote sensing image data over the periods from 1985 to 1986 , from 1995 to 1996 , from 2004 to 2006 , and from 2014 to 2015 were used to construct a classification tree ( CT ) model for aquatic vegetation. With consideration of the differences in phenological information of submerged vegetation in Taihu Lake, the succession of the dominant species of submerged vegetation in the lake over the last 30 years was studied. The overall accuracies and Kappa coefficients of the remote sensing classification results for the four periods were 64. 86% and 0. 59, 70. 83% and 0. 65, 63. 93% and 0. 50, and 64. 94% and 0. 60, respectively. The results show that Potamogeton malaianus has expanded from Dongshan Bay to Xishan Island, and from East Taihu Lake to South Taihu Lake from 1985 to 2015 . There was a declining trend in the growth of Vallisneria spiralis in the Zhushan and Meiliang bays. There was only one kind of submerged vegetation ( i. e. , Potamogeton orispus) in Meiliang Bay in recent years. No submerged vegetation was found in the central part of the lake. The submerged vegetation was widely distributed in East Taihu Lake, with the most species. The submerged vegetation has experienced the following four stages of succession in the last 30 years: Vallisneria spiralis-Potamogetonaceae, Potamogeton pusillus, Ceratophyllum Demersum-Elodea nuttalli, and Potamogetonaceae-Elodea nuttalli. Eutrophication and aquatic breeding are the main factors leading to the succession of submerged vegetations in Taihu Lake.%利用1985—1986年、1995—1996年、2004—2006年和2014—2015年多时相遥感影像数据,构建了水生植物分类决策树模型,结合沉水植物的生活史差异,研究太湖近30年沉水植物优势种的演替模式。4个时期的沉水植物遥感分类总体精度与 Kappa 系数依次为64.86%和0.59,70.83%和0.65,63.93%和0.50,64.94%和0.60。研究表明:1985—2015年马来眼子菜由东山湾向西山岛、东太湖向南

  19. 基于遥感的近30 a中国海岸线和围填海面积变化及成因分析%Analysis on changes in coastline and reclamation area and its causes based on 30-year satellite data in China

    Institute of Scientific and Technical Information of China (English)

    高志强; 刘向阳; 宁吉才; 芦清水

    2014-01-01

    Since the reform and open-door policy in 1978, China coastal zone has experienced huge changes under a large number of coastal projects. However, there are few studies on the whole China coastline change and reclamation evolution during the period. For this reason, China’s coastline and coastal reclamation change information were extracted from 1980 to 2010 period, from which four remote sensing images and the Chinese coastal survey data were used. In addition, Google Earth/Google Maps online remote sensing information was used as an auxiliary. Based on these, in-depth research on specific processes and driving forces of coastline change and reclamation evolution in the past 30 years were conducted. First, Chinese coastal zone was divided into nine regions combining with policy, economic, and natural factors as well as the administrative division. Then, we analyzed coastline change from five aspects which contained coastline length change, coastline change extent, coastline change area, coastline change direction and reasons of coastline change in combination with using two indicators:coastline change degree and coastline forward degree. Correspondingly, we also analyzed reclamation evolution from three aspects: reclamation added area, land use types of reclamation and reasons of reclamation evolution. The results demonstrated that China’s coastline length showed an increasing trend and a drastic change degree in the past 30 years. The change direction of China’s coastline has been promoting to the ocean and the trend became more and more obvious. Situations of coastline change varied with time and region. China’s coastline length increment and trend to ocean were most remarkable from year 2000 to 2010. It had the largest change area in the 1980s, while the smallest change area was found in the 1990s. Shanghai-Jiangsu and Jing-Jin- Tang had significant coastline changes while the changes of Guangxi province and Hainan province were rather mild. The minimum

  20. RADIATION CONDITIONS IN KALUGA REGION 30 YEARS AFTER CHERNOBYL NPP ACCIDENT

    Directory of Open Access Journals (Sweden)

    A. G. Ashitko

    2016-01-01

    Full Text Available The article describes radiation conditions in the Kaluga region 30 years after the Chernobyl NPP accident. The Chernobyl NPP accident caused radioactive contamination of nine Kaluga region territories: Duminichsky, Zhizdrinsky, Kuibyshevsky, Kirovsky, Kozelsky, Ludinovsky, Meshchovsky, Ulyanovsky and Hvastovichsky districts. Radioactive fallout was the strongest in three southern districts: Zhizdrinsky, Ulyanovsky and Hvastovichsky, over there cesium-137 contamination density is from 1 to 15Ci/km. According to the Russian Federation Government Order in 2015 there are 300 settlements (S in the radioactive contamination zone, including 14 settlements with caesium-137 soil contamination density from 5 to 15 Ci/ km2 and 286 settlements with the contamination density ranging from 1 to 5 Ci/km2. In the first years after the Chernobyl NPP accident in Kaluga region territories, contaminated with caesium-137, there were introduced restrictive land usage, were carried out agrochemical activities (ploughing, mineral fertilizer dressing, there was toughened laboratory radiation control over the main doze-forming foodstuff. All these measures facilitated considerable decrease of caesium-137 content in local agricultural produce. Proceeding from the achieved result, in 2002 there took place the transition to more tough requirements SanPiN 2.3.2.1078-01. Analysis of investigated samples from Zhizdrinsky, Ulyanovsky and Hvastovichsky districts demonstrated that since 2005 meat samples didn’t exceed the standard values, same for milk samples since 2007. Till the present time, the use of wild-growing mushrooms, berries and wild animals meat involves radiation issues. It was demonstrated that average specific activity of caesium-137 in milk samples keeps decreasing year after year. Long after the Chernobyl NPP accident, the main products forming internal irradiation doses in population are the wild-growing mushrooms and berries. Population average annual

  1. A randomized controlled 30 years follow up of three conventional resin composites in Class II restorations

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    2015-01-01

    three (one set) as similar as possible Class II restorations of moderate size.After cavity preparation, the three cavities were chosen at random to be restored with twochemical-cured (P10, Miradapt) and one light-cured resin composite (P30). A chemical-curedenamel bonding agent was applied after etching......Objective. The aim of this 30 year randomized controlled study was to evaluate, by intrain-dividual comparisons, the durability of three conventional resin composites in Class IIrestorations. Methods. Each of 30 participants, 21 female and 9 male (mean age 30 years, range 20–43),received at least...... of the enamel. The chemical-cured resincomposites were placed in bulk and the light-cured in increments. One operator placed 99restorations (33 sets). The restorations were evaluated with slightly modified USPHS crite-ria at baseline, 2, 3, 5, 10, 15, 20 and 30 years. Statistical analyses were performed by the...

  2. Neonatal injury at cephalic vaginal delivery: a retrospective analysis of extent of association with shoulder dystocia.

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    Cantekin Iskender

    Full Text Available PURPOSE: To describe the risk factors and labor characteristics of Clavicular fracture (CF and brachial plexus injury (BPI; and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia. METHODS: This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300 was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia. RESULTS: During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2% sustained permanent injury, whereas one neonate (4.5% with BPI following shoulder dystocia sustained permanent injury (p = 0.34. CONCLUSION: BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae.

  3. Performance curves of medical researchers during their career: analysis of scientific production from a retrospective cohort

    Science.gov (United States)

    Duclos, Antoine; Herquelot, Eléonore; Polazzi, Stéphanie; Malbezin, Muriel; Claris, Olivier

    2017-01-01

    Objectives To establish the pattern of change in individual scientific production over the career of medical researchers. Design Retrospective cohort based on prospectively collected data in a hospital information system. Setting Multicentre university hospital in France. Participants Two distinct populations of 1835 researchers (full professors vs non-academic physicians) having produced 44 723 publications between 1995 and 2014. Main outcome measures Annual number of publications referenced in Medline/PubMed with a sensitivity analysis based on publications as first/last author and in high impact journals. The individual volume of publications was modelled by age using generalised estimating equations adjusted for birth cohort, biomedical discipline and academic position of researchers. Results Averaged over the whole career, the annual number of publications was 5.28 (95% CI 4.90 to 5.69) among professors compared to 0.82 (95% CI 0.76 to 0.89) among non-academic physicians (pcareer (0.90, 95% CI 0.77 to 1.06). The non-academic physicians experienced a slower pace of learning curve at the beginning of their careers (42.38, 95% CI 25.37 to 70.81) followed by a smaller increase in the annual number of publications (1.29, 95% CI 1.11 to 1.51). Conclusions Compared to full professors, non-academic physicians had a poor capacity to publish, indicating a low productivity when medical doctors have limited time or little interest in undertaking research. This finding highlights the potential for rethinking the missions of medical doctors towards an enlargement of scientific prerogatives in favour of progress in global knowledge. PMID:28237957

  4. Retrospective and Prospective Decomposition Analysis of Chinese Manufacturing Energy Use, 1995-2020

    Energy Technology Data Exchange (ETDEWEB)

    Hasanbeigi, Ali [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Price, Lynn [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Fino-Chen, Cecilia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Lu, Hongyou [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group

    2013-01-15

    In 2010, China was responsible for nearly 20 percent of global energy use and 25 percent of energy-related carbon dioxide (CO2) emissions. Unlike most countries, China’s energy consumption pattern is unique because the industrial sector dominates the country’s total energy consumption, accounting for about 70 percent of energy use and 72 percent of CO2 emissions in 2010. For this reason, the development path of China’s industrial sector will greatly affect future energy demand and dynamics of not only China, but the entire world. A number of analyses of historical trends have been conducted, but careful projections of the key factors affecting China’s industry sector energy use over the next decade are scarce. This study analyzes industrial energy use and the economic structure of the Chinese manufacturing sector in detail. First, the study analyzes the energy use of and output from 18 industry sub-sectors. Then, retrospective (1995-2010) and prospective (2010-2020) decomposition analyses are conducted for these industrial sectors in order to show how different factors (production growth, structural change, and energy intensity change) influenced industrial energy use trends in China over the last 15 years and how they will do so over the next 10 years. The results of this study will allow policy makers to quantitatively compare the level of structural change in the past and in the years to come and adjust their policies if needed to move towards the target of less energy-intensive industries. The scenario analysis shows the structural change achieved through different paths and helps to understand the consequences of supporting or limiting the growth of certain manufacturing subsectors from the point of view of energy use and structural change. The results point out the industries that have the largest influence in such structural change

  5. A retrospective analysis of glycol and toxic alcohol ingestion: utility of anion and osmolal gaps

    Directory of Open Access Journals (Sweden)

    Krasowski Matthew D

    2012-01-01

    Full Text Available Abstract Background Patients ingesting ethylene glycol, isopropanol, methanol, and propylene glycol ('toxic alcohols' often present with non-specific signs and symptoms. Definitive diagnosis of toxic alcohols has traditionally been by gas chromatography (GC, a technique not commonly performed on-site in hospital clinical laboratories. The objectives of this retrospective study were: 1 to assess the diagnostic accuracy of the osmolal gap in screening for toxic alcohol ingestion and 2 to determine the common reasons other than toxic alcohol ingestion for elevated osmolal gaps. Methods Electronic medical records from an academic tertiary care medical center were searched to identify all patients in the time period from January 1, 1996 to September 1, 2010 who had serum/plasma ethanol, glucose, sodium, blood urea nitrogen, and osmolality measured simultaneously, and also all patients who had GC analysis for toxic alcohols. Detailed chart review was performed on all patients with osmolal gap of 9 or greater. Results In the study period, 20,669 patients had determination of serum/plasma ethanol and osmolal gap upon presentation to the hospitals. There were 341 patients with an osmolal gap greater than 14 (including correction for estimated contribution of ethanol on initial presentation to the medical center. Seventy-seven patients tested positive by GC for one or more toxic alcohols; all had elevated anion gap or osmolal gap or both. Other than toxic alcohols, the most common causes for an elevated osmolal gap were recent heavy ethanol consumption with suspected alcoholic ketoacidosis, renal failure, shock, and recent administration of mannitol. Only 9 patients with osmolal gap greater than 50 and no patients with osmolal gap greater than 100 were found to be negative for toxic alcohols. Conclusions Our study concurs with other investigations that show that osmolal gap can be a useful diagnostic test in conjunction with clinical history and physical

  6. Retrospective analysis of multidisciplinary therapy for locally advanced squamous cell carcinoma of the maxillary sinus

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    Yoshida, Hiroshi; Seo, Yuji; Nakajima, Kaori; Miyano, Takashi [Asahikawa Medical Univ., Hokkaido (Japan); Kikuchi, Yuzou [Kanazawa Univ. (Japan). School of Medicine

    2002-06-01

    The purpose of this study was to retrospectively investigate the efficacy of multidisciplinary therapy (concomitant radiotherapy and intra-arterial infusion of 5-fluorouracil (5-FU) followed by maxillectomy) in the treatment of squamous cell carcinoma of the maxillary sinus. We reviewed 71 patient records with locally advanced but respectable carcinoma of the maxillary sinus treated by means of multidisciplinary therapy between 1978 through 1997. The clinical T factor for these patients, according to the UICC definitions (1997), was 12 for T2, 46 for T3, and 13 for T4. Twelve patients were diagnosed as node-positive at initial presentation. Intra-arterial 5-FU was delivered via a superficial temporal artery in accordance with radiotherapy, and the cumulative 5-FU dose ranged from 2,900 mg to 5,250 mg (median 5,000 mg). The total radiotherapy dose ranged from 29 Gy to 48 Gy (median 48 Gy) with conventional fractionation. Patients underwent radical maxillectomy thereafter. The 5-year overall survival rate and disease-specific survival rate of all the patients were 58% and 68%, respectively. There was no significant correlation of clinical T factor or N factor with disease-specific survival on univariate and multivariate analysis. The overall treatment-related mortality rate was 3.7%. Radiation cataract later developed in all evaluable patients whose lenses were within the treatment volume. About a half of the operable T4 patients survived over 5 years by means of the above-mentioned multidisciplinary therapy. This multidisciplinary therapy should be compared to treatment with a combination of surgery and postoperative chemoradiotherapy. (author)

  7. Why the increase in under five mortality in Uganda from 1995 to 2000? A retrospective analysis

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    Ayiga Natal

    2011-09-01

    Full Text Available Abstract Background From 1995-2000 the under five mortality rate in Uganda increased from 147.3 to 151.5 deaths per 1000 live births and reasons for the increase were not clear. This study was undertaken to understand factors influencing the increase in under five mortality rate during 1995-2000 in Uganda with a view of suggesting remedial actions. Methods We performed a comparative retrospective analysis of data derived from the 1995 and the 2000 Uganda demographic and health surveys. We correlated the change of under five mortality rate in Uganda desegregated by region (central, eastern, north and western with change in major known determinants of under five mortality such social economic circumstances, maternal factors, access to health services, and level of nutrition. Results The increase in under five mortality rate only happened in western Uganda with the other 3 regions of Uganda (eastern, northern and central showing a decrease. The changes in U5MR could not be explained by changes in poverty, maternal conditions, level of nutrition, or in access to health and other social services and in the prevalence of HIV among women attending for ante-natal care. All these factors did not reach statistical significance (P > 0.05 using Pearson's correlation coefficient. Conclusion In order to explain these findings, there is need to find something that happened in western Uganda (but not other parts of the country during the period 1995-2000 and has the potential to change the under five mortality by a big margin. We hypothesize that the increase in under five mortality could be explained by the severe malaria epidemic that occurred in western Uganda (but not other regions in 1997/98.

  8. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Institute of Scientific and Technical Information of China (English)

    Fei Qi; Guo-Xin Zhang; Dan-Yang She; Zhi-Xin Liang; Ren-Tao Wang; Zhen Yang; Liang-An Chen

    2015-01-01

    Background:Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality,and there is no clear evidence that this is due to inappropriate antibiotic therapy.This study was to elucidate the clinical features,pathogens,therapy,and outcomes of HCAP,and to clarify the risk factors for drug-resistant pathogens and prognosis.Methods:Retrospective observational study among hospitalized patients with HCAP over 10 years.The primary outcome was 30-day all-cause hospital mortality after admission.Demographics (age,gender,clinical features,and comorbidities),dates of admission,discharge and/or death,hospitalization costs,microbiological results,chest imaging studies,and CURB-65 were analyzed.Antibiotics,admission to Intensive Care Unit (ICU),mechanical ventilation,and pneumonia prognosis were recorded.Patients were dichotomized based on CURB-65 (low-vs.high-risk).Results:Among 612 patients (mean age of 70.7 years),88.4% had at least one comorbidity.Commonly detected pathogens were Acinetobacter baumannii,Pseudomonas aeruginosa,and coagulase-negative staphylococci.Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%).Mean age,length of stay,hospitalization expenses,ICU admission,mechanical ventilation use,malignancies,and detection rate for P.aeruginosa,and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group.CURB-65 ≥3,malignancies,and mechanical ventilation were associated with an increased mortality.Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAR.Conclusion:Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach.CURB-65 ≥3,malignancies,and mechanical ventilation may result in an increased mortality.

  9. Retrospective analysis of suspected rabies cases reported at Bugando Referral Hospital, Mwanza, Tanzania

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    Humphrey D Mazigo

    2010-01-01

    Full Text Available Aims: The aim of this study was to determine the incidence of humans being bitten by rabies-suspected animals, and the victims′ adherence to post-exposure prophylaxis (PEP regimen. Materials and Methods: A retrospective analysis of data of victims treated at Bugando Medical Centre during the period 2002-2006 (n=5 years was done. Results: A total of 767 bite injuries inflicted by rabies-suspected animals were reported, giving a mean annual incidence of ~58 cases per 100,000 (52.5% males, 47.5% females. The proportion of children bitten was relatively higher than that of adults. All victims were treated by using inactivated diploid-cell rabies vaccine and were recommended to appear for the second and third doses. However, only 28% of the victims completed the vaccination regime. Domestic dogs were involved in 95.44% of the human bite cases, whereas cats (3.9%, spotted hyena (Crocuta crocuta (0.03%, vervet monkey (Cercopithecur aethiops (0.01% and black-backed jackal (0.01% played a minor role. The majority of rabies-suspected case reports were from Nyamagana district and occurred most frequently from June to October each year. Conclusions: In conclusion, this study revealed that incidences of humans being bitten by dogs suspected of rabies are common in Tanzania, involve mostly children, and victims do not comply with the prophylactic regimen. Rigorous surveillance to determine the status of rabies and the risk factors for human rabies, as well as formulation and institution of appropriate rabies-control policies, is required.

  10. Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

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    Ashley Branham, PharmD

    2010-01-01

    Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.

  11. Pancreatic Cancer in a Northern African Population: A Retrospective Analysis Spanning Two Decades

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    Feriel Sellam

    2008-09-01

    Full Text Available Background Pancreatic cancer has the highest mortality rate of all major cancers. 94% of pancreatic cancer patients will die within five years of diagnosis. Objective To study the epidemiological and pathological characteristics of pancreatic cancer in North African population over a period of twenty two years from 1991 to 2013. Patients and method This was an epidemiological descriptive study conducted in Sidi bel Abbes University Hospital (Western Algeria, Northern Africa. We made a retrospective analysis of records of patients diagnosed with pancreatic cancer and for this purpose the study period was sub-classified into two periods: 1991-2002 and 2003-2013. Results 264 patients aged between 16-96 years were diagnosed with pancreatic cancer; 107 females (40.5% and 157 males (59.5% were recorded between 1991 and 2013; with a sex ratio of 1.46, and age range 16–96 years (median 66.2. Ninety patients (34% were diagnosed with pancreatic cancer during the first period (1991-2002, and 147 patients (66% during the second one (2003 – 2013. A significant association was reported between male patients and their medical histories in the second period (p=0.012; 29% of those patients suffered from diabetes mellitus and 23% from high blood pressure. Another significant correlation was noted between male gender and TNM classification during the first period where p=0.047, mainly at M1 and T4 stages with respectively the rates of 26.3% and 19.3%. Conclusion Pancreatic cancer remains one of the deadliest cancers worldwide and even in developing countries.

  12. A retrospective analysis of endoscopic treatment outcomes in patients with postoperative bile leakage

    Science.gov (United States)

    Sayar, Suleyman; Olmez, Sehmus; Avcioglu, Ufuk; Tenlik, Ilyas; Saritas, Bunyamin; Ozdil, Kamil; Altiparmak, Emin; Ozaslan, Ersan

    2016-01-01

    OBJECTIVE: Bile leakage, while rare, can be a complication seen after cholecystectomy. It may also occur after hepatic or biliary surgical procedures. Etiology may be underlying pathology or surgical complication. Endoscopic retrograde cholangiopancreatography (ERCP) can play major role in diagnosis and treatment of bile leakage. Present study was a retrospective analysis of outcomes of ERCP procedure in patients with bile leakage. METHODS: Patients who underwent ERCP for bile leakage after surgery between 2008 and 2012 were included in the study. Etiology, clinical and radiological characteristics, and endoscopic treatment outcomes were recorded and analyzed. RESULTS: Total of 31 patients (10 male, 21 female) were included in the study. ERCP was performed for bile leakage after cholecystectomy in 20 patients, after hydatid cyst operation in 10 patients, and after hepatic resection in 1 patient. Clinical signs and symptoms of bile leakage included abdominal pain, bile drainage from percutaneous drain, peritonitis, jaundice, and bilioma. Twelve (60%) patients were treated with endoscopic sphincterotomy (ES) and nasobiliary drainage (NBD) catheter, 7 patients (35%) were treated with ES and biliary stent (BS), and 1 patient (5%) was treated with ES alone. Treatment efficiency was 100% in bile leakage cases after cholecystectomy. Ten (32%) cases of hydatid cyst surgery had subsequent cystobiliary fistula. Of these patients, 7 were treated with ES and NBD, 2 were treated with ES and BS, and 1 patient (8%) with ES alone. Treatment was successful in 90% of these cases. CONCLUSION: ERCP is an effective method to diagnose and treat bile leakage. Endoscopic treatment of postoperative bile leakage should be individualized based on etiological and other factors, such as accompanying fistula. PMID:28058396

  13. Deep vein thrombosis of the lower limbs: A retrospective analysis of doppler ultrasound findings

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    Sanjay M Khaladkar

    2014-01-01

    Full Text Available Background: Deep venous thrombosis (DVT of lower limbs is one of the most common cause for the majority of deaths caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. Most venous thrombi are clinically silent. B-mode and color Doppler imaging is needed for early diagnosis of DVT to prevent complications and sequalae of DVT. Aim and Objectives: The objectives of the following study were to evaluate the role of Doppler as an imaging modality in diagnosing DVT of lower limbs, to study the spectrum of findings on Doppler ultrasound in patients with DVT. Materials and Methods: Retrospective descriptive analysis of 78 patients of DVT diagnosed on Doppler. Results: Nearly 74% of the patients were males and 26% were females with majority belonging to fifth decade (26%. 75 (96.1% cases showed unilateral while 3 (3.9% cases showed bilateral lower limb involvement. In our study, predominant distribution of thrombus was found to be in above knee region with 69/78 (88.5% patients having thrombus in the superficial femoral vein. Popliteal vein was involved in 54/78 (69.2% patients. Complete thrombosis was observed in 54/78 (69% cases, while partial thrombosis was observed in 24/78 (31% cases. Subacute stage was seen in 42 cases (53.8%, acute stage in 23 cases (29.5% while chronic stage in 13 cases (16.7%. 71 cases (91% had multiple contiguous segmental involvement, whereas 7 cases (9% had isolated vein involvement. Conclusion: Color Doppler is useful in diagnosing DVT in symptomatic and at risk patients and provides a non-invasive method of investigation. It is also helpful in evaluating the site, extent and stage of thrombus.

  14. Double-J Versus External Ureteral Stents in Kidney Transplantation: A Retrospective Analysis

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    Vogel

    2015-07-01

    Full Text Available Background Kidney transplantation has long been recognized as the best available therapy for end stage kidney disease. Objectives This study aimed to compare outcomes of double-J versus percutaneous ureteral stent placement in renal transplantation. Patients and Methods A retrospective analysis was performed on data of renal transplantations performed at our institution in a 12-month period. In this period, external and double-J stents were used in parallel. Length of hospital stay and stent-associated complications were evaluated. Results In 76 kidney transplants, 43 external (group 1 and 33 double-J (group 2 urinary stents were used. No significant difference was observed in the number of urinary tract infections, ureteric stenosis or necrosis. The mean overall length of hospital stay was comparable in both groups (20.7 days in group 1 vs 19.3 days in group 2, P = 0.533. For patients without immunological complications, the hospital stay was significantly reduced using double-J stents (12.9 days in group 1, 10.8 days in group 2, P = 0.018. Leakage of the ureteroneocystostomy occurred in 6 out of 43 patients in group 1 (13.9%. No case of anastomotic insufficiency was observed in group 2 (P = 0.035. Macrohematuria was detected in 13 out of the 43 patients in group 1 (30.2%, compared to 3 out of 33 patients in group 2 (9.1%; P = 0.045. Conclusions This nonrandomized comparison of stent types in kidney transplantation supports the use of prophylactic double-J stents in terms of decreased ureteric complications and reduced length of hospital stay.

  15. Magnetic Resonance Imaging Features of Idiopathic Granulomatous Mastitis: A Retrospective Analysis

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    Poyraz

    2016-05-01

    Full Text Available Background Granulomatous mastitis is a rare and benign inflammatory breast disease that may clinically and radiologically mimic breast cancer. Objectives The aim of this study was to evaluate the features of idiopathic granulomatous mastitis (IGM on breast magnetic resonance imaging (MRI with mammographic and sonographic findings. Patients and Methods A retrospective analysis was conducted on 20 patients with IGM who had been diagnosed by needle core or excisional biopsy at a single institution between 2006 and 2012. All of the patients underwent MRI for suspicious breast findings prior to biopsy. MRI examinations were performed on a 1.5 T scanner. The MRI findings were evaluated in accordance with the breast imaging-reporting and data system (BI-RADS MRI lexicon established by the American College of Radiology. Results MRI detected a total of 29 lesions in the 20 patients. Fourteen of these lesions were seen as mass enhancements, with the remaining 15 identified as non-mass enhancements (NMEs. The median size of all lesions was 3.6 cm (range, 0.7 - 6.7 cm. The most frequently observed features were masses with a round shape (9 out of 14, 64%, smooth contour (11 out of 14, 78%, and a rim enhancement pattern (10 out of 14, 71%. The most common features of the 15 NME lesions were segmental distribution (6 out of 15, 40% and heterogeneous enhancement patterns (8 out of 15, 53%. The time-intensity curves of the dynamic studies showed benign type one signal intensity (persistent enhancement pattern in the majority of lesions (10 out of 20, 50%. Conclusion Our study suggests that breast MRI findings of IGM have a wide spectrum. Rim enhancement patterns are frequently seen on contrast enhanced images, but the imaging findings are nonspecific and cannot be used definitively to distinguish between benign and malignant lesions.

  16. Overt gastrointestinal bleeding in patients with acute myocardial infarction:retrospective analysis of risks and outcomes

    Institute of Scientific and Technical Information of China (English)

    Xinhong Guo; Yusheng Zhao; Jiayue Li; Deshui Wang; Qiao Xue; Wei Gao

    2008-01-01

    Overt gastrointestinal bleeding (GIB) is one of the noncardiac complications in patients with acute myocardial infarction (AMI).Identification of patients at increased risk of overt GIB could aid in targeting more aggressive treatment,and lead to improved outcomes.The aim of this study is to determine the frequency,risk factors,and prognostic significance of overt GIB in patients with AMI.Methods A retrospective review of the medical records of 1443 patients admitted to the Chinese PLA General Hospital with AMI was conducted.Charts were reviewed for clinical characteristics,possible precipitating factors and complications.Patients were categorized as having or not having overt GIB(GIB associated with hemodynamic changes or the need for transfusions).Results Twenty nine (2.0%) patients developed overt GIB within 30 days after AMI.Patients with overt GIB had higher 30-day mortality rate than those without (44.8% vs.9.9%,P < 0.001).Multivariate logistic regression analysis showed major determinants of in-hospital overt GIB secondary to AMI were gender of female (odds ratio 2.41,95% confidence interval [CI] 1.08 to 5.37),age=75 years (odds ratio 1.58,95% CI 1.13 to 2.20),prior history of AMI (odds ratio 2.28,95% CI 1.17 to 4.88),pneumonia (odds ratio 3.47,95% CI 1.50 to 8.03) and anemia at admission (odds ratio 2.37,95% CI 1.04 to 5.37).Conclusions In patients with AMI,overt GIB is associated with higher in-hospital mortality,and female sex,older age,prior AMI,pneumonia and anemia at admission are predictors of overt GIB during hospitalization.(J Geriatr Cardiol 2008;5:195-198)

  17. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis.

    Science.gov (United States)

    Sun, Eric C; Dixit, Anjali; Humphreys, Keith; Darnall, Beth D; Baker, Laurence C; Mackey, Sean

    2017-03-14

    Objectives To identify trends in concurrent use of a benzodiazepine and an opioid and to identify the impact of these trends on admissions to hospital and emergency room visits for opioid overdose.Design Retrospective analysis of claims data, 2001-13.Setting Administrative health claims database.Participants 315 428 privately insured people aged 18-64 who were continuously enrolled in a health plan with medical and pharmacy benefits during the study period and who also filled at least one prescription for an opioid.Interventions Concurrent benzodiazepine/opioid use, defined as an overlap of at least one day in the time periods covered by prescriptions for each drug. Main outcome measures Annual percentage of opioid users with concurrent benzodiazepine use; annual incidence of visits to emergency room and inpatient admissions for opioid overdose.Results 9% of opioid users also used a benzodiazepine in 2001, increasing to 17% in 2013 (80% relative increase). This increase was driven mainly by increases among intermittent, as opposed to chronic, opioid users. Compared with opioid users who did not use benzodiazepines, concurrent use of both drugs was associated with an increased risk of an emergency room visit or inpatient admission for opioid overdose (adjusted odds ratio 2.14, 95% confidence interval 2.05 to 2.24; Pbenzodiazepine/opioid use could reduce the risk of emergency room visits related to opioid use and inpatient admissions for opioid overdose by an estimated 15% (95% confidence interval 14 to 16).Conclusions From 2001 to 2013, concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and significantly contributed to the overall population risk of opioid overdose.

  18. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Hyun Jeong Kim

    Full Text Available BACKGROUND: Lactic acidosis is a common cause of high anion gap metabolic acidosis. Sodium bicarbonate may be considered for an arterial pH <7.15 but paradoxically depresses cardiac performance and exacerbates acidosis by enhancing lactate production. This study aimed to evaluate the cause and mortality rate of lactic acidosis and to investigate the effect of factors, including sodium bicarbonate use, on death. METHODS: We conducted a single center analysis from May 2011 through April 2012. We retrospectively analyzed 103 patients with lactic acidosis among 207 patients with metabolic acidosis. We used SOFA and APACHE II as severity scores to estimate illness severity. Multivariate logistic regression analysis and Cox regression analysis models were used to identify factors that affect mortality. RESULTS: Of the 103 patients with a mean age of 66.1±11.4 years, eighty-three patients (80.6% died from sepsis (61.4%, hepatic failure, cardiogenic shock and other causes. The percentage of sodium bicarbonate administration (p = 0.006, catecholamine use, ventilator care and male gender were higher in the non-survival group than the survival group. The non-survival group had significantly higher initial and follow-up lactic acid levels, lower initial albumin, higher SOFA scores and APACHE II scores than the survival group. The mortality rate was significantly higher in patients who received sodium bicarbonate. Sodium bicarbonate administration (p = 0.016 was associated with higher mortality. Independent factors that affected mortality were SOFA score (Exp (B = 1.72, 95% CI = 1.12-2.63, p = 0.013 and sodium bicarbonate administration (Exp (B = 6.27, 95% CI = 1.10-35.78, p = 0.039. CONCLUSIONS: Lactic acidosis, which has a high mortality rate, should be evaluated in patients with metabolic acidosis. In addition, sodium bicarbonate should be prescribed with caution in the case of lactic acidosis because sodium bicarbonate

  19. Greenhouse gas emissions in Europe: a retrospective trend analysis for the period 1990-2008

    Energy Technology Data Exchange (ETDEWEB)

    Borgan, A.; Gugele, B.; Haider, S. (Umweltbundesamt, Vienna (Austria)) (and others)

    2011-10-15

    This report presents a retrospective overview of the greenhouse gas (GHG) emission trends in Europe from 1990 to 2008, with a particular focus on the underpinning drivers and the influence of EU policies. The analysis is based on the combination of decomposition analyses to identify the respective influence of each identified driver and an overview of the main EU policies and their likely effects on these drivers. The period covered by the analysis stops in 2008. As a result, the analysis avoids the effects of the recent economic crisis on GHG emissions. This reinforces the conclusion on long-term emission drivers. The report covers the EU-27 and presents results for the other EEA member countries (Iceland, Liechtenstein, Norway, Switzerland and Turkey) and Croatia (EU candidate country together with Turkey) as far as data is available. The results can be summarized as: 1) Overall GHG emission trends. EU GHG emissions were reduced between 1990 and 2008. Most of the reductions took place in the 1990s, but emissions have also been decreasing every year from 2003 until the last year considered in this report, 2008. 2) Predominant drivers. For the most part, the GHG emission trends observed in the EU between 1990 and 2008 resulted from economic factors. However, EU policies, some of which were not directly targeting GHG emissions, as well as national policies by some front runner countries, also played a role in these trends. 3) Impacts of EU policies. Between 2000 and 2008, emission trends were more directly targeted by a range of energy and climate policies, e.g. the implementation of the European Climate Change programme. However, the steady increase in energy demand during this period - particularly electricity - outweighed the considerable EU-wide savings generated by energy efficiency improvements and the development of renewable energy. 4) Co-benefits. Taking example from the positive benefits on GHG emissions that resulted from the implementation of non

  20. Quantitative analysis of causes for temporal and spatial variation characteristics and evolution of potential evapotranspiration in Gansu Province during recent 30 years%近30年甘肃省潜在蒸散发时空变化特征及演变归因的定量分析

    Institute of Scientific and Technical Information of China (English)

    李耀军; 魏霞; 苏辉东

    2015-01-01

    蒸散发是地球系统水量平衡和能量平衡中的重要组成部分,研究潜在蒸散发的变化对于更好地理解气候变化对水文循环的影响及水资源配置具有重要意义。本文基于FAO推荐并修订的Penman-Monteith模型,利用1981-2010年甘肃省内及周边的32个气象站点的常规观测资料对甘肃近30年内潜在蒸散发的时空变化特征进行研究,并对潜在蒸散发对气象因子的敏感性及其敏感系数的空间分布进行分析,定量揭示了影响甘肃潜在蒸散发变化的主导因素。结果可为研究甘肃气候变化对水循环的影响、提高农业灌溉效率和调整水资源利用结构及优化配置水资源提供参考。%Evapotranspiration is an important part in the water and energy balance of earth's system.The research on the variation of potential evapotranspiration ( ETp ) is of great significance for a better under-standing of the impact of climate change on hydrological cycle and water resources allocation.Based on Penman-Monteith model recommended and revised by FAO,by use of meteorological data collected from 32 meteorological stations in or around Gansu,the paper analyzed the spatial and temporal variation char-acteristics of potential evapotranspiration in recent 30 years.Moreover,it analyzed the sensitivity of mete-orological factors to potential evapotranspiration and the spatial distribution of sensitive coefficient, and quantitatively reveal the dominant factor of ETp 's variation.The result can provide reference for studying the impact of climate change on hydrological cycle,improve agricultural irrigation efficiency,adjust utiliza-tion structure of water resources and optimizing the allocation of water resources in Gansu Province.

  1. [RETROSPECTIVE DATA ANALYSIS OF THE PATIENTS WITH INFLAMMATORY JOINT DISEASES TREATED WITH GOLIMUMAB IN CROATIA].

    Science.gov (United States)

    Anić, Branimir; Babić-Naglić, Ðurđica; Grazio, Simeon; Kehler, Tatjana; Kaliterna, Dusanka Martinović; Radoncić, Ksenija Mastrović; Morović-Vergles, Jadranka; Novak, Srđan; Prus, Visnja; Vlak, Tonko; Baresić, Marko

    2015-01-01

    Golimumab is a human monoclonal antibody which inhibits tumor necrosis factor-alpha (TNF-α) and is approved for the treatment of inflammatory arthritides (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis) when the conventional non-pharmacological and pharmacological therapies fail to cause remission or low disease activity. In this retrospective study there were included patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis who were treated in Croatia with golimumab, from June 2011 to June 2013. included and these retrospective data are compared with similar data from clinical trials and other available databases. Standard variables of disease activity and functional ability were observed. Results demonstrated significant efficacy of golimumab regarding lowring the disease activity and imrpving functional ability in pateints with these inflammatory rherumatic disease. In conclusion, in this retrospective study during two years treatment golimumab showed efficacy in decreasing disease activity and imrpove functional ability in patiemts with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.

  2. Analysis on livestock and poultry production and nitrogen pollution load of cultivated land during last 30 years in China%中国近30年畜禽养殖量及其耕地氮污染负荷分析

    Institute of Scientific and Technical Information of China (English)

    杨飞; 杨世琦; 诸云强; 王卷乐

    2013-01-01

      为准确掌握近年来中国畜禽养殖发展的区域差异及畜禽粪便对环境的污染威胁,该研究利用年平均增长率方法,揭示畜禽养殖量及其氮污染的增长率的区域差异和时序变化规律,分析耕地的畜禽污染负荷.结果表明,近些年中国畜禽养殖业发展迅速,各地区的猪、羊、家禽养殖量的年平均增长率都普遍较高,增幅甚至超过12%;牛和羊的年平均增长率的区域差异较大.畜禽养殖发展基本可分为3个阶段:稳步发展阶段(1980-1995年),全面发展阶段(1996-2006年),现代化发展阶段(2007年-至今).华北、华中、华南、西南地区畜禽氮污染产生量都较大,华北和东北各省的年平均增长率相对较高,其中河南、四川、山东三省的畜禽养殖的增幅较快、养殖量较大、耕地的氮污染负荷较重.全国平均单位耕地面积的畜禽氮污染负荷达138.13 kg/hm2,其中四川等6省市已达202.98 kg/hm2以上.该研究为全国和各省区农业发展规划和畜禽养殖结构调整提供参考.%In recent decades, China's livestock and poultry industry developed rapidly, and their wastes have become an important pollution source, and made a serious threat to China's environment. Due to the significant differences in natural conditions and economic development level in different provinces or regions, the scale and speed of livestock and poultry production show a large regional differences. Based on the statistical data of major livestock and poultry in recent 30 years of main provinces in China, we studied the spatial heterogeneity and temperal changes of livestock and poultry production and their annual growth rate, and further analzed their nitrogen pollution load per cultivated land area. The studied results show that, in recent years, China's livestock and poultry industry have developed rapidly, especially in the north and northeastern of China. The average annual growth rate of pigs, sheep

  3. Radiotherapy of spinal cord gliomas. A retrospective mono-institutional analysis

    Energy Technology Data Exchange (ETDEWEB)

    Corradini, Stefanie; Hadi, Indrawati; Ganswindt, Ute; Belka, Claus; Niyazi, Maximilian [University of Munich, Department of Radiation Oncology, Munich (Germany); Hankel, Vinzent [Marienhospital Stuttgart, Department of Radiation Oncology, Stuttgart (Germany); Ertl, Lorenz [Staedtisches Klinikum Muenchen Harlaching, Department of Radiology, Neuroradiology, and Nuclear Medicine, Munich (Germany); University of Munich, Department of Neuroradiology, Munich (Germany)

    2016-03-15

    Due to the rarity of spinal cord gliomas, no consensus has been reached regarding the optimal treatment strategy. The aim of the present retrospective study was to identify patient and tumor characteristics and to evaluate the effectiveness of radiotherapy within this setting. Patients diagnosed with spinal cord gliomas between 2003 and 2013 and treated at the Department of Radiation Oncology, University of Munich, were retrospectively analyzed. Overall survival was estimated with the Kaplan-Meier method and univariate analysis was performed by log-rank testing. A total of 16 patients were identified. The cohort consisted of seven primary spinal cord gliomas and eight cases of metastases of cerebral gliomas. Median follow-up was 42 months and median total radiation dose was 45.0 Gy. In all, 62.5 % of patients received a simultaneous chemotherapy with temozolomide. The median overall survival was 6 months (95% CI: 0-27.5 months). Surgical resection of the tumor was a significant predictor of improved survival, compared with radiotherapy alone (p = 0.001). Patients with the diagnosis of a primary spinal cord glioma survived significantly longer than those presenting with a metastatic deposit from a cerebral glioma (p < 0.001). A statistically significant dose-response relationship at dose levels of ≥ 45 Gy vs. < 45 Gy could be derived (p < 0.001). Simultaneous chemotherapy did not influence survival outcome. Despite the aggressive treatment in the present study, the prognosis for spinal cord gliomas was still poor, with a median overall survival of 6 months. To the best of our knowledge, this is the largest study reporting the results of simultaneous chemoradiation in spinal cord gliomas. A combined chemoradiation treatment seems feasible and can be considered as a new treatment option in the management of spinal cord gliomas. (orig.) [German] Das spinale Gliom stellt eine aeusserst seltene Entitaet dar. Aktuell besteht daher kein Konsensus ueber die optimale

  4. Retrospective and prospective analysis of policy incentives for wind power in Portugal

    Science.gov (United States)

    Pena Cabra, Ivonne A.

    been decommissioned despite being in operation for more than 20 years, favoring from new, detailed and hard-to-follow agreements in the legislation. All wind parks that are currently in operation have received feed-in tariffs since they connected to the grid, and are expected to keep receiving them at least until December 2019, and up to December 2036 - depending on year of connection and agreement under the most recent legislation (Diario da Republica 2013). The 2020 renewable energy goals in Portugal include having 6.8 GW of installed wind capacity, which implies the connection of 2 GW in the next years. If no further grid investments are made and wind capacity increases up to 100 MW to the connection point that we analyze, total annual electricity spill is likely to range the 20% to 40%. If the connection grid policy is designed to allow for wind spill, already 'occupied' connection points will be available to new entrants, lowering the total investment costs for new wind parks and increasing their profitability. This thesis is divided in three main parts: a first introductory section, a retrospective study of wind power in Portugal and a prospective analysis of the Portuguese wind power sector. The introductory section is a brief overview of the global renewable status, described in Chapter 1. Chapter 2 and Chapter 3 compile a retrospective study of wind power and the policies that have incentivized wind diffusion. We include in the discussion some references to the future wind power goals, but the results and policy recommendations are directed towards the existing connected wind power capacity. (Abstract shortened by UMI.).

  5. Susceptibility of Ph-positive all to TKI therapy associated with Bcr-Abl rearrangement patterns: a retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Yu Jing

    Full Text Available BACKGROUND: Tyrosine kinase inhibitors (TKIs have demonstrated success in the treatment of acute lymphoblastic leukemia (ALL in patients that express BCR-ABL rearrangements (Philadelphia chromosome [Ph]. The current study aimed to assess the efficacy of TKIs and prognostic factors in the treatment of adults with Ph+-ALL. METHODS: In this multicenter retrospective study, the relationship between Ph+-ALL and treatment outcomes among Chinese patients receiving TKI-containing induction/consolidation chemotherapy was examined. A total of 86 Ph+-ALL patients were included and followed for 3.85 (0.43-9.30 years. Overall survival (OS and event-free survival (EFS were analyzed. RESULTS: A total of 86 Ph+-ALL patients (40 females and 46 males; median age: 34.0 years were enrolled, including those with BCR/ABL transcripts 190 (n = 52, 210 (n = 25, and 230 (n = 2; BCR/ABL isoform determination was not available for 7 patients. Mortality was influenced by variable BCR/ABL transcripts and TKI administration, and BCR/ABL transcripts, hematopoietic stem cell transplantation (HSCT, and TKI administration were associated with the occurrence of events. The OS rate in the TKI administration group during steady state was significantly higher compared with those patients who did not receive TKI administration (P = 0.008, the EFS rate in the TKI administration group during steady state was significantly higher compared with those patients who did not receive TKIs (P = 0.012, and also higher than those with TKI salvage administration (P = 0.004. BCR/ABL transcripts 210 showed preferable OS and EFS compared with BCR/ABL transcripts 190 and 230 (P<0.05 for each. CONCLUSIONS: The susceptibility of Ph+-ALL to TKI associated with the patterns of BCR-ABL rearrangement is demonstrated for the first time, thus adding another risk-stratifying molecular prognostic tool for the management of patients with Ph+-ALL.

  6. Behaviour of the low degree terms of the Earth gravity field over the last 30 years

    Science.gov (United States)

    Biancale, R.; Lemoine, J.-M.; Reinquin, F.; Deleflie, F.; Ramillien, G.; Gégout, P.

    2012-04-01

    The GRACE mission has revealed since 2002 the recent evolution of the Earth's gravity field with a resolution down to 400 km, equivalent to degree and order 50 in spherical harmonics. Precise orbit computation for altimetric satellites can obviously gain by applying these variations, which are classically given, as in recent EIGEN models, as drifts and periodic terms (yearly and semi-yearly). However extrapolating these variations to pre-GRACE periods, mainly the drifts, can be problematic for orbit computation performances on former altimetric satellites. One option is to analyse older satellite data, in particular SLR data on geodetic satellites, in order to assess the very low degree variations of the gravity field and compare it to the GRACE determination. This can be done over the last 30 years, using for instance the Lageos and Lageos-2, Starlette and Stella satellites. The spherical harmonic degrees that can be accessed in this way are degrees 2 to 4. Additional information on degree 2 can be derived from the analysis of the Earth orientation parameters, pole coordinates and length of day (LOD), which have been observed over a long period with great accuracy by astrometric, satellite geodetic and extra-galactic means. Once corrected for atmospheric and oceanic load and velocity variations, the pole coordinates will principally bring information on the C(2,1) and S(2,1) coefficients, while the LOD will principally be connected with the C(2,0). Combining these two approaches allows a better observation of the temporal evolution of the gravity field over a long time span and a more realistic modelling of it for the precise orbit computation of past altimeter missions.

  7. Stereotactic surgery for refractory epilepsy complicated by mental disorders A retrospective case analysis

    Institute of Scientific and Technical Information of China (English)

    Yifang Wang; Aigang Xu; Qifu Tan; Zhengwei Wang; Dongsheng Jiao; Hao Zhu; Kaidong Liu

    2008-01-01

    BACKGROUND: Anti-epilepsy and anti-psychosis drugs have traditionally been used in the clinic to treat epilepsy complicated by mental disorders. However, there is still no effective therapy for refractory epilepsy patients suffering from persistent mental disorders. OBJECTIVE: To explore the therapeutic effects of stereotactie multi-element localization and multi-target radiofrequency ablation on patients with refractory primary epilepsy and mental disorders. DESIGN: A retrospective case analysis. SETTING: Department of Neurosurgery, the 454 Hospital of Chinese PLA. PARTICIPANTS: Between June and November 2004, 13 patients with refractory primary epilepsy complicated by persistent mental disorders were admitted to the Department of Neurosurgery, the 454 Hospital of Chinese PLA. The patient group consisted of nine males and four females, with an average age of 25 years (range 18-39 years), and a course of disease ranging 3-11 years. Diagnosis of mental disorders was in accordance with Chinese Classification of Mental Disorders. Written informed consent was obtained from all patients and their families, and the treatment protocol was approved by the Ethics Committee of the Hospital. METHODS: Under venous inhalation anesthesia, the disease targets, including bilateral corpus callosum, bilateral amygdala, and bilateral medial septal area, as well as unilateral Forel-H area, were coagulated by RFG-3CF radiofrequency thermocoagulation at 75-80 ℃ for 60-70 seconds. During thermocoagulation, the targets were identified using deep-brain microelectrodes and localized according to electrophysiology and electric resistance values. MAIN OUTCOME MEASURES: One year post-surgery, epileptic seizures were assessed on the basis of the Tan classification, and psychogenic (non-epileptic) seizures were evaluated using a 5-grade system. RESULTS: All enrolled 13 epileptic patients were included in the final analysis. The results of follow-up evaluations demonstrated that epilepsy was

  8. A retrospective analysis of the change in anti-malarial treatment policy: Peru

    Directory of Open Access Journals (Sweden)

    Vincent-Mark Arlene

    2009-04-01

    Full Text Available Abstract Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru. Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents, a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b engaging in collaborative teamwork among nationals and between nationals and international collaborators, c respect for and inclusion of district-level staff in all phases of the process, d reliance on high levels of technical and scientific knowledge, e use of standardized protocols to collect data, and f transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the

  9. A Retrospective Clinical Analysis of 216 Patients With Non-ST Segment Elevation Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Manish Pradhan; Shuxian Zhou; Juan Lei; Zesheng Liu

    2008-01-01

    Objectives To analyze the clinical characteristics of 216 patients with non-ST segment elevation myocardial infarc-tion (NSTEMI). Methods A retrospective analysis was used. Two hundred and sixteen NSTEMI patients were divid-ed into two groups: ①according to the age: age 178 μmol. L-1 group. Seven hundred and eighty six acute myocardial infarction (AMI) patients during the same period were divided into ST seg-ment elevation myocardial infarction (STEMI) group and NSTEMI group. Clinical characteristics of the patients in th e two groups were compared. Results ① The number of NSTEMI patients in age ≥65 years group is significantly grea-ter than that in age 178 μmol· L-1) and triple ves-sel disease. Fewer patients in this group received coronary artery angiography (CAG), percutaneous coronary interven-tion (PCI) and coronary artery bypass graft (CABG). More number of deaths in this group compared with the age 4 group is significantly greater than that in TIMI score 4 group comparing with TIMI score ≤4 group. ③ Obviously, more number of elderly patients, non-insulin dependant diabetes mellitus (NIDDM), patients with cardiac troponin T (CTnT) >3.0 ng · L-1 and deaths occurred in sCr > 178 μmol · L-1 group. @ STEMI and NSTEMI patients were compared in same time frame as follows: fewer NSTEMI patients and more elderly patients had no chest pain, NID-DM, hypertension, dyslipidemia, left main coronary artery (LMCA) disease while CTnT ≥3.0 ng· ml-1; fewer pa- tients with aneurysm (30 days) underwent CAG, PCI and CABG treatment. However, there were no significant differ-ences in smokers, patients with less than 50% stenosis in any vessel, 1 -3 vessel disease, acute left ventricle heart fail-ure, cardiogenic shock, serious arrhythmia and deaths. ⑤ The multivariate logistic regression analysis showed that death in NSTEMI was directly influenced by malignant arrhythmias with age ≥ 70 years. Conclusions Patients with NSTEMI were older, had more risk factors

  10. Complications of microvascular decompression in hemifacial spasm treatment Retrospective analysis of 156 cases

    Institute of Scientific and Technical Information of China (English)

    Yongfeng Sun; Guanghui Dai; Jun Yuan; Weidong Zhai; Jianwei Zhong; Tao Wang

    2008-01-01

    BACKGROUND: Microvascular decompression has become a well-accepted, safe method in the treatment of hemifacial spasms. However, postoperative complications exist and influence the prognosis of the disease.OBJECTIVE: This study aimed to analyze, by case review, the characteristics and regularity of microvascular decompression complications in the treatment of hemifacial spasm. DESIGN: Retrospective analysis.SETTING: Beijing General Group Hospital of the Chinese People's Armed Police Forces.PARTICIPANTS: A total of 156 patients with hemifacial spasm were admitted to the Department of Neurosurgery, Beijing General Group Hospital of the Chinese People's Armed Police Forces from June 2004 to June 2006 and recruited for this study. The patients, 57 males and 99 females, averaged 46 years of age (range 17-68-years old). All suffered from facial innervated muscular paroxysmal and recurrent contraction, which could not be controlled by consciousness. Electromyogram demonstrated waves of fibrillation and fasciculation. Prior to admission, all patients had received other treatments. Written informed consents for treatment were obtained from all patients. This protocol was approved by the Hospital’s Ethics Committee. METHODS: After anesthesia, a cranial bone pore was drilled below the connection of the lateral sinus and sigmoid sinus. Dura mater was dissected at the "⊥" shape and held in the air. Under microscopy, the flocculus cerebelli was lifted slightly up for convenient observation of the cerebellopontine angle. The mucous membrane was sharply separated. Corresponding vessels were identified at the root of the facial nerves and subsequently liberated and disassociated from the root exit zone. Suitably sized Teflon cotton was placed between the corresponding vessels and brain stem.MAIN OUTCOME MEASURES: Complications of microvascular decompression.RESULTS: All 156 patients participated in the final analysis. ① Postoperatively, 66 (42%) patients presented with obvious

  11. Recovering from 30 Years of War: Refugee Women and Children in Angola.

    Science.gov (United States)

    Women's Commission for Refugee Women and Children, New York, NY.

    After 30 years of war, Angola faces the challenge of creating a civil society. This report presents key findings of a visit to Angola, December 1-13, 1996, by the Women's Commission for Refugee Women and Children. The report describes conditions facing women and children affected by war in Angola, addresses the return process of refugees from…

  12. Studies Using Single-Subject Designs in Sport Psychology: 30 Years of Research

    Science.gov (United States)

    Martin, G. L.; Thompson, K.; Regehr, K.

    2004-01-01

    A prominent feature of behavior-analytic research has been the use of single-subject designs. We examined sport psychology journals and behavioral journals published during the past 30 years, and located 40 studies using single-subject designs to assess interventions for enhancing the performance of athletes and coaches. In this paper, we…

  13. Bullying in Childhood, Externalizing Behaviors, and Adult Offending: Evidence from a 30-Year Study

    Science.gov (United States)

    Fergusson, David M.; Boden, Joseph M.; Horwood, L. John

    2014-01-01

    This study examined the developmental processes linking childhood bullying to criminal offending in adulthood, using data from a 30-year longitudinal study. The linkages between bullying in childhood and three criminal offending outcomes in adulthood were estimated both before and after control for a range of confounding factors. A series of…

  14. Experimental study of cathodic protection of concrete from a 30 year old bridge

    NARCIS (Netherlands)

    Polder, R.B.; Nerland, O.C.

    1998-01-01

    An experimental study of cathodic protection (CP) was carried out with a conductive primer anode applied to specimens from a concrete bridge. The bridge was demolished after 30 years of service due to severe delaminations and reinforcement corrosion. Four specimens of approximately 1 m2 each were ma

  15. Leadership and Change in Schools: Personal Reflections over the Last 30 Years

    Science.gov (United States)

    Seashore, Karen R.

    2009-01-01

    The two fields of leadership studies and school change have increasingly converged over the last 30 years. This paper reviews the origins of the intersection, and the development of research themes in three areas: The role of leaders in shaping and using organizational culture, the agency of teachers in the change process, and the importance of…

  16. Reflections on 30 Years of AIDS—Part 1

    Centers for Disease Control (CDC) Podcasts

    2011-06-15

    Dr. Kevin DeCock, director of The Center for Global Health at CDC, reflects on 30 years of the AIDS epidemic.  Created: 6/15/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 6/16/2011.

  17. "Fear of Success" Revisited: A Replication of Matina Horner's Study 30 Years Later.

    Science.gov (United States)

    Engle, Jennifer

    This study updated and extended the classic "fear of success" study conducted by Matina Horner more than 30 years ago. Horner (1970) asked college students to respond to a scenario in which "Anne" or "John" is at the top of her/his medical school class. Based on the negative responses of students to "Anne,"…

  18. Early treatment of trans-tibial amputees: retrospective analysis of early fitting and elastic bandaging

    NARCIS (Netherlands)

    Velzen, van A.D.; Nederhand, M.J.; Emmelot, C.H.; IJzerman, M.J.

    2005-01-01

    This study investigates the effects of early fitting in trans-tibial amputees. The assumption is that compared to elastic bandaging, the use of a rigid dressing in early fitting will result in quicker wound healing and earlier ambulation. A retrospective file search was carried out in three differen

  19. Retrospective image-based gating of intracoronary optical coherence tomography: Implications for quantitative analysis

    NARCIS (Netherlands)

    K. Sihan (Kenji); C.P. Botha (Charl); F.H. Post (Frits); S. de Winter (Sebastiaan); N. Gonzalo (Nieves); E.S. Regar (Eveline); P.W.J.C. Serruys (Patrick); R. Hamers (Ronald); N. Bruining (Nico)

    2011-01-01

    textabstractAims: Images acquired of coronary vessels during a pullback of time-domain optical coherence tomography (OCT) are influenced by the dynamics of the heart. This study explores the feasibility of applying an in-house developed retrospective image-based gating method for OCT and the influen

  20. Radiation dose associated with local control in advanced anal cancer : Retrospective analysis of 129 patients

    NARCIS (Netherlands)

    Widder, Joachim; Kastenberger, Reinhard; Fercher, Elisabeth; Schmid, Rainer; Langendijk, Johannes A.; Dobrowsky, Werner; Poetter, Richard

    2008-01-01

    Background and purpose: To retrospectively analyse a large consecutive cohort of patients with anal cancer for treatment-related factors influencing local control and survival. Materials and methods: All patients referred for primary radiotherapy at Medical University of Vienna in 1990-2002 with ana

  1. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    Science.gov (United States)

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  2. Chinese specific characteristics of sporadic Creutzfeldt-Jakob disease: a retrospective analysis of 57 cases.

    Directory of Open Access Journals (Sweden)

    Wei Zhao

    Full Text Available OBJECTIVE: Sporadic Creutzfeldt-Jakob disease (sCJD is a fatal and transmissible neurodegenerative disorder. However, no studies have reported Chinese specific characteristics of sCJD. We aimed to identify differences in sCJD between Chinese patients and patients from other countries. METHODS: The data from 57 Chinese sCJD patients were retrospectively analyzed, including demographic data, clinical manifestations, laboratory examinations, electroencephalograms (EEGs, diffusion-weighted imaging (DWI scans, positron emission tomography (PET scans, and pathological results. RESULT: The disease was pathologically confirmed in 11 patients. 39 cases were diagnosed as probable sCJD, and 7 were possible. Of the total cases, 33 were male, and 24 were female. The onset age ranged from 36 to 75 years (mean: 55.5, median: 57. Disease onset before the age of 60 occurred in 57.9% of patients. The disease duration from onset to death ranged 5-22 months (mean: 11.6, median: 11, and 51.9% of patients died 7 to 12 months after disease onset. The majority of patients presented with sub-acute onset with progressive dementia. 3 of the 9 patients who took 14-3-3 protein analysis had positive results (33.3%. The sensitivity of EEG was 79.6% (43/54. For DWI and PET examinations, the sensitivities were 94% (47/50 and 94.1% (16/17, respectively. In seven patients who did not show typical hyper-intensities on the first DWI examination, abnormalities of hypo-metabolism in the cerebral cortex were clearly detected by PET. In 13 out of the 17 patients, PET detected extra abnormal regions in addition to the hyper-intense areas observed in DWI. CONCLUSION: This is the first study to indicate that Chinese sCJD patients have a much earlier onset age and a longer disease duration than other populations, which is most likely related to racial differences. The longer disease duration may also be a probable characteristic of Asian populations. PET had high sensitivity for the

  3. A Retrospective Analysis of Pressure Ulcer Incidence and Modified Braden Scale Score Risk Classifications.

    Science.gov (United States)

    Chen, Hong-Lin; Cao, Ying-Juan; Wang, Jing; Huai, Bao-Sha

    2015-09-01

    The Braden Scale is the most widely used pressure ulcer risk assessment in the world, but the currently used 5 risk classification groups do not accurately discriminate among their risk categories. To optimize risk classification based on Braden Scale scores, a retrospective analysis of all consecutively admitted patients in an acute care facility who were at risk for pressure ulcer development was performed between January 2013 and December 2013. Predicted pressure ulcer incidence first was calculated by logistic regression model based on original Braden score. Risk classification then was modified based on the predicted pressure ulcer incidence and compared between different risk categories in the modified (3-group) classification and the traditional (5-group) classification using chi-square test. Two thousand, six hundred, twenty-five (2,625) patients (mean age 59.8 ± 16.5, range 1 month to 98 years, 1,601 of whom were men) were included in the study; 81 patients (3.1%) developed a pressure ulcer. The predicted pressure ulcer incidence ranged from 0.1% to 49.7%. When the predicted pressure ulcer incidence was greater than 10.0% (high risk), the corresponding Braden scores were less than 11; when the predicted incidence ranged from 1.0% to 10.0% (moderate risk), the corresponding Braden scores ranged from 12 to 16; and when the predicted incidence was less than 1.0% (mild risk), the corresponding Braden scores were greater than 17. In the modified classification, observed pressure ulcer incidence was significantly different between each of the 3 risk categories (P less than 0.05). However, in the traditional classification, the observed incidence was not significantly different between the high-risk category and moderate-risk category (P less than 0.05) and between the mild-risk category and no-risk category (P less than 0.05). If future studies confirm the validity of these findings, pressure ulcer prevention protocols of care based on Braden Scale scores can

  4. Thalidomide-based multidisciplinary treatment for patients with advanced hepatocellular carcinoma: A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Yang-Yuan Chen; Hsu-Heng Yen; Kun-Ching Chou; Shun-Sheng Wu

    2012-01-01

    AIM: To evaluate the efficacy of thalidomide in combination with other therapies to treat patients with advanced hepatocellular carcinoma (HCC). METHODS: We performed a retrospective analysis of all patients with HCC who were treated with thalidomide for at least two months. The medical records of patients with HCC who were treated at our institution between April 2003 and March 2008 were reviewed. Image studies performed before and after treatment, tumor response, overall survival, and the decrease in α-fetoprotein (AFP) levels were evaluated. RESULTS: A total of 53 patients with HCC received either 100 or 200 mg/d of thalidomide. The patient population consisted of 9 women and 44 men with a median age of 61 years. Thirty patients (56.6%) were classified as Child-Pugh A, and 12 patients (22.6%) were classified as Child-Pugh B. Twenty-six patients had portal vein thrombosis (49.1%), and 25 patients had extrahepatic metastasis (47.1%). The median duration of thalidomide treatment was 6.0 mo. Six of the 53 patients achieved a confirmed response (11.3%), one achieved a complete response (1.9%) and 5 achieved a partial response (9.4%). The disease control rate (CR+PR+SD) was 28.3% (95% CI:17.8-42.4), and the median overall survival rate was 10.5 mo. The 1-and 2-year survival rates were 45% and 20%, respectively. Only one complete response patient showed an improved overall survival rate of 66.8 mo. Sixteen patients (30.2%) showed more than a 50% decrease in their serum AFP levels from baseline, indicating a better response rate (31.3%), disease control rate (43.8%), and overall survival time (20.7 mo). The therapy was well tolerated, and no significant toxicities were observed. CONCLUSION: Thalidomide was found to be safe for advanced HCC patients, demonstrating anti-tumor activity including response, survival, and AFP decreases of greater than 50% from baseline.

  5. Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

    Science.gov (United States)

    Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

    2014-01-01

    The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended.

  6. Clinical and pathological features of intracranial meningiomas in children: A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Kun Yang; Lisheng He; Linsun Dai; Jian Chen; Zhixiong Lin

    2006-01-01

    BACKGROUND:The attack of meningiomas has sex and age differences.Previous studies indicated that children and adult patients had different clinical and pathological features.Due to the limitation of conditions and technique of diagnosis and treatment,some clinical and pathological features of meningiomas in children should be further recognized.OBJECTIVE:To summarize the clinical and pathological features in 15 children with intracranial meningiomas.DESIGN:A retrospective case analysis.SETTING:The hospitals which the first author had been working in.PARTIClPANTS:Fifteen children with intracranial meningiomas were selected from the hospitals the first author had been working in from June 1996 to June 2006.There were 9 boys and 6 gids,aged 1.8-15 years,with an average of 9.8 years.The duration from attack to diagnosis was 1 month to 2.5 years,with an average of 13months.Inclusive criteria:①Clinically diagnosed,operated and confirmed pathologically;②≤15 years;③The children and their relatives were all informed and agree with the detection.METHODS:The clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment and pathological data were retrospectively summarized.Thirteen of 15 children with intracranial meningiomas were followed up by means of reexamination for 1-8 years.and the postoperative recurrence were observed.HAIN OUTCOME MEASURES:Clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment,pathological data,recurrence conditions of 1 to 8 years follow-up.RESULTS:Thirteen of the 15 children with intracranial meningiomas were involved in the analysis of results.and 2 lost to the follow-up. ①The main clinical manifestations at diagnosis were headache in 11 cases(73%,11/5),vomiting in 8 cases(53%,8/15),papilledema in 9 cases(60%,9/15),hypopsia in 6 cases (40%,6/15),epilepsy in 5 cases(33%,5,15).hemiplegia in 4 cases(27%,4/15),cranial

  7. 贵州省黔西南州燃煤型砷中毒30年防治概况分析%Analysis of the prevention and control of endemic arsenism in Qianxinan State of Guizhou Province in 30 years

    Institute of Scientific and Technical Information of China (English)

    周运书; 辛勇; 朱爱华; 程明亮; 吴君; 姚玉梅; 刘杰; 张信江; 沈建华; 袁华芳; 苏显荣

    2009-01-01

    Objective To summarize the prevention and control of endemic arsenism in Qianxinan state of Guizhou Province in 30 years,so as to provide scientific basis for prevention and control of arsenic poisoning. Methods According to the documentary information of endemic arsenism in Qianxinan state of Guizhou Province of 1976-2005.and the data from samples monitoring of published article,to discuss the general situation of prevention and control by time sequence.Results There were 3 large outbreaks in Xingren County in 1976.in Jiaole District in 1991,in Xingyi City and Anlong County in 1992-1994 with 877,1548 and 594 patients respcctively.The arsenic quantities of various areas of burning-coal were 3361,2130,352 and 2150 mg/kg,which were obviouslv above national standards(1 00 mg/kg).The arsenic quantities of samples were 1.34,1.34,0.71 and 0.39 mg/L in urine,and 53.50,53.50,58.60 and 12.60 mg/kg in hair.The national standards of the two samples were 0.17 mg/L and 0.28 mg/kg.The dead causes of 236 arsenism decedent were 45.3%(107/236)cancer,26.3% (62/236)hepatocirrhosis ascites,5.9%(14/230)lung-cardiopathy in 1992-2000.Other systemic damages were found.Conclusions Reducing the use of high-arsenic coal is crucial in prevention of endemic arsenism.Only the long-term mechanism is established and the strong prevention and control measures are formulated,the occurrence of endemic arsenism can be effectively controlled.%目的 总结分析贵州省黔西南州燃煤型砷中毒30年的防治工作,为进一步完善砷中毒的防治措施提供科学依据.方法 根据1976-2005年贵州省黔西南州流行病学调查材料和发表论文中的监测数据,按时间顺序对病区防治概况进行分析.结果 于1976年兴仁县、1991年交乐地区、1992-1994年兴义市和安龙县发生了3次燃煤型砷中毒流行,患病人数分别为877、1548、594人.各病区煤砷分别为3361、2130、352、2150 mg/kg,均超过国家标准(100 mg/kg);患者尿砷(1.34、1.34

  8. Clinical phenotypes of autoimmune polyendocrinopathycandidiasis-ectodermal dystrophy seen in the Northern Ireland paediatric population over the last 30 years.

    Science.gov (United States)

    Millar, Sarinda; Carson, Dennis

    2012-09-01

    Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), also known as autoimmune polyendocrinopathy syndrome type 1, is a rare autosomal recessive disorder with a variable and evolving phenotypic course. It is caused by mutations in the autoimmune regulator (AIRE) gene. APECED syndrome is diagnosed clinically by the presence of 2 from 3 major criteria; chronic mucocutaneous candidasis, primary hypoparathyroidism and primary adrenocortical insufficiency. Many of the patients develop all three before the age of 20 years. There is also a wide spectrum of other associated conditions including endocrine and non endocrine manifestations. This paper reviews the clinical phenotypes seen in the paediatric population of Northern Ireland during the last 30 years detailed from a retrospective review of clinical notes. Eight patients were identified with APECED and all patients were found to be homozygous for the c.964dell3 mutation. A wide clinical variation is apparent within APECED syndrome. Paediatricians should be vigilant of the diagnosis when they encounter any of the features described and consider the future development of associated diseases. In confirmed APECED syndrome, clinical and laboratory investigation is essential to initiate early treatment in the patient and other affected members of the family.

  9. Analysis of 1,545 Fractures of Facial Region—A Retrospective Study

    OpenAIRE

    Gaddipati, Rajasekhar; Ramisetti, Sudhir; Vura, Nandagopal; Reddy, K. Rajiv; Nalamolu, Bhargav

    2015-01-01

    Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused due to various etiologies. This is a retrospective epidemiological study, which was performed on patients with fractures in the maxillofacial region during a period of 2005 to 2013 at Mamata Dental College and Hospital, Khammam...

  10. Diabetic kidney disease patients on hemodialysis: a retrospective survival analysis across different socioeconomic groups

    OpenAIRE

    Vijayan, Madhusudan; Radhakrishnan, Saranya; Abraham, Georgi; Mathew, Milly; Sampathkumar, Krishnaswamy; Mancha, Nevin Philip

    2016-01-01

    Background Diabetic kidney disease is the leading cause of stage 5 chronic kidney disease (CKD) in India. Renal replacement therapy (RRT) is accessible to very few patients because of socioeconomic deprivation. We studied the effect of diabetes and socioeconomic status on the outcome of patients on maintenance hemodialysis (MHD). Methods We retrospectively analyzed the outcome of 897 patients (629 males/268 females; mean age ± standard deviation 48.69 ± 14.27 years) initiated on MHD from 2003...

  11. Retrospective analysis of 53 cases of medical supplies quality adverse event

    Directory of Open Access Journals (Sweden)

    Cheng-zu LUO

    2014-04-01

    Full Text Available Medical supplies are the basic material for medical work in the hospital, and in relation to the patient's life.This paper analyzed retrospectively 53 cases of medical supplies quality adverse event in our hospital from 2011 to 2012.Accordingly, it was discussed how to improve the whole quality control system of medical supplies, how to ensure clinical safety, and how to reduce the incidence of adverse events.

  12. A retrospective analysis of ectopic varices in gastrointestinal tract diagnosed by endoscopy

    Institute of Scientific and Technical Information of China (English)

    李楠

    2013-01-01

    Objective To understand the incidence,causes,clinical manifestations and treatment of ectopic varices (EV) in gastrointestinal (GI) tract.Methods GI endoscopic examinations were carried out in 99 783 patients from January 2004 to October 2012 in General Hospital of PLA.Sixty-four cases of ectopic varices in GI tract were discovered.The clinical manifestations of EV patients and treatment were analyzed retrospectively.The

  13. East Mediterranean region sickle cell disease mortality trial: retrospective multicenter cohort analysis of 735 patients.

    Science.gov (United States)

    Karacaoglu, Pelin Kardaş; Asma, Suheyl; Korur, Aslı; Solmaz, Soner; Buyukkurt, Nurhilal Turgut; Gereklioglu, Cigdem; Kasar, Mutlu; Ozbalcı, Demircan; Unal, Selma; Kaya, Hasan; Gurkan, Emel; Yeral, Mahmut; Sariturk, Çagla; Boga, Can; Ozdogu, Hakan

    2016-05-01

    Sickle cell disease (SCD), one of the most common genetic disorders worldwide, is characterized by hemolytic anemia and tissue damage from the rigid red blood cells. Although hydroxyurea and transfusion therapy are administered to treat the accompanying tissue injury, whether either one prolongs the lifespan of patients with SCD is unknown. SCD-related mortality data are available, but there are few studies on mortality-related factors based on evaluations of surviving patients. In addition, ethnic variability in patient registries has complicated detailed analyses. The aim of this study was to investigate mortality and mortality-related factors among an ethnically homogeneous population of patients with SCD. The 735 patients (102 children and 633 adults) included in this retrospective cohort study were of Eti-Turk origin and selected from 1367 patients seen at 5 regional hospitals. A central population management system was used to control for records of patient mortality. Data reliability was checked by a data supervision group. Mortality-related factors and predictors were identified in univariate and multivariate analyses using a Cox regression model with stepwise forward selection. The study group included patients with homozygous hemoglobin S (Hgb S) disease (67 %), Hb S-β(0) thalassemia (17 %), Hgb S-β(+) thalassemia (15 %), and Hb S-α thalassemia (1 %). They were followed for a median of 66 ± 44 (3-148) months. Overall mortality at 5 years was 6.1 %. Of the 45 patients who died, 44 (6 %) were adults and 1 (0.1 %) was a child. The mean age at death was 34.1 ± 10 (18-54) years for males, 40.1 ± 15 (17-64) years for females, and 36.6 ± 13 (17-64) years overall. Hydroxyurea was found to have a notable positive effect on mortality (p = 0.009). Mortality was also significantly related to hypertension and renal damage in a univariate analysis (p = 0.015 and p = 0.000, respectively). Acute chest syndrome

  14. Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

    Institute of Scientific and Technical Information of China (English)

    Jialiang Li; Chunjiang Yu

    2006-01-01

    AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH).METHODS: A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People's Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale (GOS) at 6 months after injury, and GOS scoring standard was 1-5 points (1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study).RESULTS: The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ② At admission, the Glasgow coma scale (GCS) scores were as follow: 13-15 scores (mild) in 10 cases,9-12 scores (moderate)in 20 cases, and 3-8 scores (severe) in 10 cases. Hemiplegia presented in 37 cases,aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within

  15. Revisiting 30 years of Biofunctionalization and Surface Chemistry of Inorganic Nanoparticles for Nanomedicine

    Directory of Open Access Journals (Sweden)

    João eConde

    2014-07-01

    Full Text Available In the last 30 years we have assisted to a massive advance of nanomaterials in material science. Nanomaterials and structures, in addition to their small size, have properties that differ from those of larger bulk materials, making them ideal for a host of novel applications. The spread of nanotechnology in the last years has been due to the improvement of synthesis and characterization methods on the nanoscale, a field rich in new physical phenomena and synthetic opportunities. In fact, the development of functional nanoparticles has progressed exponentially over the past two decades. This work aims to extensively review 30 years of different strategies of surface modification and functionalization of noble metal (gold nanoparticles, magnetic nanocrystals and semiconductor nanoparticles, such as quantum dots. The aim of this review is not only to provide in-depth insights into the different biofunctionalization and characterization methods, but also to give an overview of possibilities and limitations of the available nanoparticles.

  16. 30 years of reform and opening up:experience and characteristics

    Institute of Scientific and Technical Information of China (English)

    陈佳贵

    2008-01-01

    This year marks the 30th anniversary of China’s reform and opening-up program,which has brought about unprecedented achievements in the country’s three decades of rapid development. This issue contains three articles on the theme of this 30th anniversary,presenting insights on the past and present and prospects for the coming period. The current issue includes "China’s 30 years of reform and opening up:experiences and characteristics" by Prof. Chen Jiagui;"30 years of prosperity in China’s non-state economy" by Prof. Liu Yingqiu; and "The development of an open economy in China" by Prof. Pei Changhong. These articles evaluate the policies of the past three decades from different angles and looking at different facets,yet each with theoretical as well as practical signif icance. We believe that these historical reflections will steer China on an even more successful path of future reform and opening.

  17. Revisiting 30 years of Biofunctionalization and Surface Chemistry of Inorganic Nanoparticles for Nanomedicine

    Science.gov (United States)

    Conde, João; Dias, Jorge; Grazú, Valeria; Moros, Maria; Baptista, Pedro; De La Fuente, Jesús

    2014-07-01

    In the last 30 years we have assisted to a massive advance of nanomaterials in material science. Nanomaterials and structures, in addition to their small size, have properties that differ from those of larger bulk materials, making them ideal for a host of novel applications. The spread of nanotechnology in the last years has been due to the improvement of synthesis and characterization methods on the nanoscale, a field rich in new physical phenomena and synthetic opportunities. In fact, the development of functional nanoparticles has progressed exponentially over the past two decades. This work aims to extensively review 30 years of different strategies of surface modification and functionalization of noble metal (gold) nanoparticles, magnetic nanocrystals and semiconductor nanoparticles, such as quantum dots. The aim of this review is not only to provide in-depth insights into the different biofunctionalization and characterization methods, but also to give an overview of possibilities and limitations of the available nanoparticles.

  18. 30-year lidar observations of the stratospheric aerosol layer state over Tomsk (Western Siberia, Russia)

    Science.gov (United States)

    Zuev, Vladimir V.; Burlakov, Vladimir D.; Nevzorov, Aleksei V.; Pravdin, Vladimir L.; Savelieva, Ekaterina S.; Gerasimov, Vladislav V.

    2017-02-01

    There are only four lidar stations in the world which have almost continuously performed observations of the stratospheric aerosol layer (SAL) state over the last 30 years. The longest time series of the SAL lidar measurements have been accumulated at the Mauna Loa Observatory (Hawaii) since 1973, the NASA Langley Research Center (Hampton, Virginia) since 1974, and Garmisch-Partenkirchen (Germany) since 1976. The fourth lidar station we present started to perform routine observations of the SAL parameters in Tomsk (56.48° N, 85.05° E, Western Siberia, Russia) in 1986. In this paper, we mainly focus on and discuss the stratospheric background period from 2000 to 2005 and the causes of the SAL perturbations over Tomsk in the 2006-2015 period. During the last decade, volcanic aerosol plumes from tropical Mt. Manam, Soufrière Hills, Rabaul, Merapi, Nabro, and Kelut and extratropical (northern) Mt. Okmok, Kasatochi, Redoubt, Sarychev Peak, Eyjafjallajökull, and Grímsvötn were detected in the stratosphere over Tomsk. When it was possible, we used the NOAA HYSPLIT trajectory model to assign aerosol layers observed over Tomsk to the corresponding volcanic eruptions. The trajectory analysis highlighted some surprising results. For example, in the cases of the Okmok, Kasatochi, and Eyjafjallajökull eruptions, the HYSPLIT air mass backward trajectories, started from altitudes of aerosol layers detected over Tomsk with a lidar, passed over these volcanoes on their eruption days at altitudes higher than the maximum plume altitudes given by the Smithsonian Institution Global Volcanism Program. An explanation of these facts is suggested. The role of both tropical and northern volcanic eruptions in volcanogenic aerosol loading of the midlatitude stratosphere is also discussed. In addition to volcanoes, we considered other possible causes of the SAL perturbations over Tomsk, i.e., the polar stratospheric cloud (PSC) events and smoke plumes from strong forest fires. At least

  19. Eco-region dependent lengthening of vegetation period over the past 30 years in Europe

    Science.gov (United States)

    Garonna, I.; De Jong, R.; De Wit, A.; Mücher, C. A.; Schmid, B.; Schaepman, M. E.

    2013-12-01

    Land Surface Phenology (LSP) is the most direct representation of intra-annual dynamics of vegetated land surfaces as observed from satellite observations. As such, LSP plays a key role in understanding the terrestrial carbon budget, as well as the response of terrestrial ecosystems to environmental change. Various studies have highlighted significant increases in vegetation activity over time (i.e. greening) over Europe in recent decades (e.g. Stöckli and Vidale, 2004), associated both with climatic changes and with large-scale human interventions including land-use change (de Jong et al., 2013). In this study, we characterize LSP changes in Europe's eco-regions for the last 30 years. We used the latest version of the 8-km Global Inventory Modeling and Mapping Studies (GIMMS) Normalized Difference Vegetation Index dataset (third generation, or NDVI-3g) to retrieve LSP metrics for Europe for the last three decades (1982-2011). Each year of NDVI data was processed using the Harmonic Analysis of Time Series (HANTS) algorithm, producing smooth NDVI annual profiles on a pixel-by-pixel basis. In order to derive LSP metrics for each year, namely Start, End and Length of Growing Season, we selected the Midpoint-pixel local threshold method, based on the White et al. (2009) inter-comparison. A landscape-based stratification, using the European Landscape Classification (LANMAP) (Mücher et al., 2010) allowed us to examine LSP characteristics and trends for the different European eco-regions. We demonstrate significant shifts in LSP metrics over the study period, with a general lengthening of the growing season in Europe of approximately 0.4 days year-1. LSP trends varied significantly between eco-regions, and we discuss potential reasons for these spatially diverse trends. de Jong, R., et al. (2013), Spatial relationship between climatologies and changes in global vegetation activity, Global Change Biology, 19(6), 1953-1964. Mücher, C. A., J. A. Klijn, D. M. Wascher, and

  20. Cervical cancer screening among women aged 18-30 years - United States, 2000-2010.

    Science.gov (United States)

    2013-01-01

    Screening women for cervical cancer can save lives. However, among young women, cervical cancer is relatively rare, and too-frequent screening can lead to high costs and adverse events associated with overtreatment. Before 2012, cervical cancer screening guidelines of the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and U.S. Preventive Services Task Force (USPSTF) differed on age to start and how often to get screened for cervical cancer. In 2012, however, all three organizations recommended that 1) screening by Papanicolau (Pap) test should not be used for women aged <21 years, regardless of initiation of sexual activity, and 2) a screening interval of 3 years should be maintained for women aged 21-30 years. ACS and ACOG explicitly recommend against yearly screening. To assess trends in Pap testing before the new guidelines were introduced, CDC analyzed 2000-2010 data from the Behavioral Risk Factor Surveillance System (BRFSS) for women aged 18-30 years. CDC found that, among women aged 18-21 years, the percentage reporting never having been screened increased from 26.3% in 2000 to 47.5% in 2010, and the proportion reporting having had a Pap test in the past 12 months decreased from 65.0% to 41.5%. Among those aged 22-30 years, the proportion reporting having had a Pap test within the preceding 12 months decreased from 78.1% to 67.0%. These findings showed that Pap testing practices for young women have been moving toward the latest guidelines. However, the data also showed a concerning trend: among women aged 22-30 years, who should be screened every 3 years, the proportion who reported never having had a Pap test increased from 6.6% to 9.0%. More effort is needed to promote acceptance of the latest evidence-based recommendations so that all women receive the maximal benefits of cervical cancer screening.

  1. Reflections on 30 Years of AIDS—Part 2

    Centers for Disease Control (CDC) Podcasts

    2011-06-15

    Dr. James Curran, Dean of the Rollins School of Public Health and Co-Director of Emory’s Center for AIDS Research, and Dr. Harold Jaffe, CDC’s Associate Director for Science, reflect on 30 years of the AIDS epidemic.  Created: 6/15/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 6/20/2011.

  2. Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Jingu, Keiichi, E-mail: kjingu-jr@rad.med.tohoku.ac.jp [Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan); Tanabe, Takaya [Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata (Japan); Ariga, Hisanori; Umezawa, Rei; Ogawa, Yoshihiro; Takeda, Ken; Koto, Masashi; Sugawara, Toshiyuki; Kubozono, Masaki; Shimizu, Eiji; Abe, Keiko; Yamada, Shogo [Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan)

    2012-07-15

    Purpose: To analyze retrospectively the results of intraoperative radiotherapy (IORT) with or without external beam radiotherapy ({+-} EBRT) for localized pancreatic cancer in the past three decades and to analyze prognostic factors by multivariate analysis. Methods and Materials: Records for 322 patients with pancreatic cancer treated by IORT {+-} EBRT in Tohoku University Hospital between 1980 and 2009 were reviewed. One hundred ninety-two patients who had no distant organ metastases or dissemination at the time of laparotomy were enrolled in the present study. Results: Eighty-three patients underwent gross total resection (R0: 48 patients, R1: 35 patients), and 109 patients underwent only biopsy or palliative resection. Fifty-five patients underwent adjuvant EBRT, and 124 underwent adjuvant chemotherapy. The median doses of IORT and EBRT were 25 and 40 Gy, respectively. The median follow-up period was 37.5 months. At the time of the analysis, 166 patients had disease recurrence, and 35 patients had local failure. The 2-year local control (LC) and overall survival (OS) rates were 71.0% and 16.9%, respectively. Comparison of the results for each decade showed that OS was significantly improved decade by decade (2-year: 25.0% vs. 18.8% vs. 4.2%, p < 0.001). Multivariate analysis showed that degree of resection (R0-1 vs. R2, hazard ratio = 1.97, p = 0.001) and adjuvant chemotherapy (yes vs. no, hazard ratio = 1.54, p = 0.028) had significant impacts on OS. Late gastrointestinal morbidity of Common Terminology Criteria for Adverse Events version 3.0 grade 4 or 5 was observed in four patients. Conclusion: Excellent local control for pancreatic cancer with few cases of severe late toxicity was achieved by using IORT. OS of patients with pancreatic cancer treated by IORT {+-} EBRT improved significantly decade by decade. Multivariate analysis showed that degree of resection and adjuvant chemotherapy had significant impacts on OS.

  3. Ferimentos cervicais: análise retrospectiva de 191 casos Neck injuries: retrospective analysis of 191

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Von Bahten

    2003-10-01

    Full Text Available OBJETIVOS: Analisar a epidemiologia e a conduta nos ferimentos cervicais. MÉTODO: Foram analisados 487.128 prontuários de pacientes que ingressaram no Serviço de Emergência do Hospital Universitário Cajuru no período de 01/1996 a 06/2001. Destes, selecionaram-se 378 pacientes com ferimentos cervicais. Foram excluídos 153 que apresentavam lesões associadas e 14 por óbito no atendimento inicial. O estudo foi feito , assim, em 191 pacientes com les��es cervicais exclusivas. Avaliou-se a localização da ferida, o mecanismo de trauma, o comprometimento do platisma, sinais e sintomas, a hora de admissão e a conduta empregada. RESULTADOS: Cento e sessenta e quatro (86% pacientes eram masculinos. A média de idade foi de 28 anos (10-72. Noventa (47% ferimentos foram por arma de fogo (FAF e 88 (46% por arma branca (FAB. O principal horário de admissão foi entre 20 e 04 horas. Quanto à localização, 53% das lesões foram à esquerda, 45% à direita e 2% medianos; 36% em zona I, 55% em zona II e 9% em zona III. Em 101 o ferimento penetrou o platisma: cinqüenta e um (50% apresentaram sinais e sintomas clínicos e receberam conduta operatória. As lesões vasculares foram as mais encontradas (20. Houve 24 (47% cervicotomias não-terapêuticas. O tratamento conservador foi empregado em 41 (45% casos de acordo com os exames físico e complementares. CONCLUSÕES: Homens jovens são mais acometidos quanto aos ferimentos cervicais. Estes ocorrem mais freqüentemente na zona II, e a incidência dos FAF e FAB foi equivalente. É adequado um manejo mais seletivo em relação aos ferimentos cervicais, devendo o manejo da zona II adequar-se à disposição de recursos dos serviços de trauma.BACKGROUND: The study proposes to assess the demographics and management of neck injuries. METHODS: A retrospective review of 487.128 emergency department medical records from 01/1996 to 06/2001 was conducted. Out of the 378 patients selected for the analysis

  4. Gamma-knife for treating pituitary adenomas in 501 cases: Retrospective case analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OBJECTIVE: To analyze the effectiveness and complications of 501 cases with pituitary adenoma by using gamma-knife retrospectively.DESIGN: Case-analysis.SETTING: Gamma-knife Center, the 363 Hospital of Chinese PLA.PARTICIPANTS: A total of 501 cases were selected from Gamma-knife Center, the 363 Hospital of Chinese PLA from January 1997 to December 2002. All patients were certainly diagnosed with CT and MRI scanning. There were 186 males and 315 females. Their ages ranged from 15 to 84 years with the mean age of 39 years. All patients provided confirmed consent.METHODS: All 501 cases with pituitary adenomas were treated by gamma-knife or combined with operations: The average iso-dose curve was 50% (30% - 65%), peri-dose was 14 Gy and the average target number was 5.17. ① At 35 months after treatment, patients received follow-up including clinical symptoms,imaging symptoms and endocrine symptoms. ② Patients who received second gamma-knife treatment were analyzed and their complications were observed after operation.MAIN OUTCOME MEASURES: ① Follow-up results of clinical symptoms, image and endocrine indexes; ② second gamma-knife treatment; ③ postoperative complications.RESULTS: Among 501 accepted patients, 275 cases were involved in the follow up of clinical symptoms,154 in image symptoms and 98 in endocrine symptoms. ① Follow-up results of clinical symptoms, image and endocrine indexes: Follow up of clinical symptoms demonstrated that clinical symptoms of 169 cases were relieved, of 68 disappeared, and of 38 deteriorated. Follow-up of image symptoms indicated that pituitary tumor of 25 cases disappeared, of 84 shortened, of 42 not changed, and of 3 enlarged. Follow-up of endocrine symptoms suggested that endocrine of 50 cases was abnormal, of 29

  5. Magma at depth: A retrospective analysis of the 1975 unrest at Mount Baker, Washington, USA

    Science.gov (United States)

    Crider, Juliet G.; Frank, David; Malone, Stephen D.; Poland, Michael P.; Werner, Cynthia; Caplan-Auerbach, Jacqueline

    2011-01-01

    Mount Baker volcano displayed a short interval of seismically-quiescent thermal unrest in 1975, with high emissions of magmatic gas that slowly waned during the following three decades. The area of snow-free ground in the active crater has not returned to pre-unrest levels, and fumarole gas geochemistry shows a decreasing magmatic signature over that same interval. A relative microgravity survey revealed a substantial gravity increase in the ~30 years since the unrest, while deformation measurements suggest slight deflation of the edifice between 1981-83 and 2006-07. The volcano remains seismically quiet with regard to impulsive volcano-tectonic events, but experiences shallow (10 km) long-period earthquakes. Reviewing the observations from the 1975 unrest in combination with geophysical and geochemical data collected in the decades that followed, we infer that elevated gas and thermal emissions at Mount Baker in 1975 resulted from magmatic activity beneath the volcano: either the emplacement of magma at mid-crustal levels, or opening of a conduit to a deep existing source of magmatic volatiles. Decadal-timescale, multi-parameter observations were essential to this assessment of magmatic activity.

  6. A retrospective clinicopathological study on oral lichen planus and malignant transformation: Analysis of 518 cases

    OpenAIRE

    Shen, Zheng Yu; LIU Wei; Zhu, Lai Kuan; Feng, Jin Qiu; Tang, Guo Yao; Zhou, Zeng Tong

    2012-01-01

    Objective: To investigate the epidemiological and clinical characteristics of a relatively large cohort of patients with oral lichen planus (OLP) from eastern China. Study design: A total of 518 patients with histologically confirmed OLP in a long-term follow-up period (6 months-21.5 years) were retrospectively reviewed in our clinic. Results: Of the 518 patients, 353 females and 165 males were identified. The average age at diagnosis was 46.3 years (range 9-81 years) with the buccal mucosa b...

  7. Severe adverse events related to tattooing: An retrospective analysis of 11 years

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2012-01-01

    Full Text Available Background: The incidence of tattoos has been increased markedly during the last 20 years. Aims: To analyze the patient files for severe adverse medical reactions related to tattooing. Settings: Academic Teaching Hospital in South-East Germany. Materials and Methods: Retrospective investigation from March 2001 to May 2012. Results: The incidence of severe adverse medical reactions has been estimated as 0.02%. Infectious and non-infectious severe reactions have been observed. The consequences were medical drug therapies and surgery. Conclusions: Tattooing may be associated with severe adverse medical reactions with significant morbidity. Regulations, education and at least hygienic controls are tools to increase consumer safety.

  8. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Jalaludin, M A

    1993-10-01

    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

  9. Retrospective value analysis of decision support benefits from a production planning system for a brewery

    Directory of Open Access Journals (Sweden)

    H.W. Ittmann

    2003-12-01

    Full Text Available A decision support system for production planning in a brewing company was developed to assist with the planning of brewing, packaging and distribution of beer and to minimise production costs. Having been in operation for some time, the system has changed and adapted in a very dynamic environment. The system's present form and current use are discussed. Initial management approval for system development was based on faith rather than proper cost-benefit and value analyses. This paper aims at retrospectively highlighting these values and benefits with regard to supporting decision-making in the company.

  10. Retrospective Analysis of Abruptio Placentae Cases and Comparision of Normal Pregnancies

    Directory of Open Access Journals (Sweden)

    Ahmet Kale

    2005-01-01

    Full Text Available The aim of this study was to analyze of 94 abruptio placentae cases retrospectively during 1 years period.We evaluated of 94 abruptio placentae cases (group1 retrospectively during 5 years period in our clinic. Maternal age, parity, prepartum estimated gestasional week, birth weight, cesarean section ratio, hypertension pregnancies were evaluated and compared with 127 normal pregnancies (group2 who had given births . The ratio of abruptio placentae was 1.38% during five years period. Prepartum estimated mean gestasional week in group 1 was 32.0±3.3 and 15.35 % of women had pregnancy induced hypertension. Cesarean section was performed 81.91 % of cases. All of cesarean endications was abruptio placentae (p0.05. Mean 1.minute APGAR score was 3.02±1.10 in grup 1 and 6.80±2.5 in group 2 (p<0.001. Mean 5.minute APGAR score was 3.99 ± 1.17 in grup 1 and 8.42±1.50 in group 2 (p<0.001. Early neonatal mortality ratio was 69.14 %in group 1 and, %3.9 in group 2 (p<0.001.Abruptio placentae still remains as an important obstetric problem which is associated with a high perinatal mortality rate.

  11. Antituberculosis drug resistance patterns in two regions of Turkey: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Oymak Sema F

    2002-12-01

    Full Text Available Abstract Backround The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has recently received increased attention owing largely to the dramatic outbreaks of multi drug resistance tuberculosis (MDR-TB. Methods Patients residing in Zonguldak and Kayseri provinces of Turkey with, pulmonary tuberculosis diagnosed between 1972 and 1999 were retrospectively identified. Drug susceptibility tests had been performed for isoniazid (INH, rifampin (RIF, streptomycin (SM, ethambutol (EMB and thiacetasone (TH after isolation by using the resistance proportion method. Results Total 3718 patients were retrospectively studied. In 1972–1981, resistance rates for to SM and INH were found to be 14.8% and 9.8% respectively (n: 2172. In 1982–1991 period, resistance rates for INH, SM, RIF, EMB and TH were 14.2%, 14.4%, 10.5%, 2.7% and 2.9% (n: 683, while in 1992–1999 period 14.4%, 21.1%, 10.6%, 2.4% and 3.7% respectively (n: 863. Resistance rates were highest for SM and INH in three periods. MDR-TB patients constituted 7.3% and 6.6% of 1982–1991 and 1992–1999 periods (p > 0.05. Conclusion This study demonstrates the importance of resistance rates for TB. Continued surveillance and immediate therapeutic decisions should be undertaken in order to prevent the dissemination of such resistant strains.

  12. Schwannomas in the head and neck: retrospective analysis of 21 patients and review of the literature

    Directory of Open Access Journals (Sweden)

    Erwin Langner

    Full Text Available CONTEXT AND OBJECTIVE: Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. According to their cellularity, they can be subdivided into Antoni A or Antoni B types. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25% of the cases, and may be associated with Von Recklinghausen's disease. The present study retrospectively analyzed some data on this disease in the head and neck region and reviewed the literature on the subject. DESIGN AND SETTING: Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. METHODS: Data on 21 patients between 1980 and 2003 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and association with neurofibromatosis were evaluated. RESULTS: The patients' ages ranged from 16 to 72 years. Four patients had a positive past history of type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial and cervical plexuses, vagus nerve, sympathetic chain and lingual or recurrent laryngeal nerve. The nerve of origin was not identified in six cases. Tumor enucleation was performed in 16 patients; the other five required more extensive surgery. CONCLUSION: Schwannomas and neurofibromas both derive from Schwann cells, but are different entities. They are solitary lesions, except in Von Recklinghausen's disease. They are generally benign, and rarely recur. The recommended surgical treatment is tumor enucleation.

  13. Citicoline for acute ischemic stroke in Mexican hospitals: a retrospective postmarketing analysis.

    Science.gov (United States)

    Leon-Jimenez, C; Chiquete, E; Cantu, C; Miramontes-Saldana, M J; Andrade-Ramos, M A; Ruiz-Sandoval, J L

    2010-06-01

    Some neuroprotective agents have shown benefits in animal models, but disappointing results in humans. Citicoline is used in several countries as coadjuvant treatment in acute ischemic stroke (AIS) patients; however, there are no retrospective postmarketing surveillances on the experience of citicoline in Mexico. The aim of this study was to evaluate the correlation between citicoline exposure and functional outcome at discharge and at 30 and 90 days post-stroke, in a retrospective case-control design on systematic descriptive databases from three referral hospitals. Clinical records of 173 consecutively registered patients were analyzed, 86 of whom were treated with citicoline within the first 48 h after AIS and the remaining 87 were untreated, randomly selected controls matched for age (+/- 5 years), gender and NIHSS (+/- 1 point) at hospital admission. Pretreatment conditions were similar between groups. Compared with controls, exposure to citicoline was associated with a significantly lower 30-day mean and median modified Rankin score (in both, P citicoline was independently associated with a lower 90-day mortality risk (P = 0.047) and with fewer in-hospital complications (mainly infections and sepsis, P = 0.001). In this observational study, citicoline use was associated with a better functional status and lower rates of short-term mortality, possibly due to fewer in-hospital systemic complications. The putative benefits should be interpreted as clinical associations, since this is not a randomized, controlled clinical trial.

  14. Hotspots of Educational Technology in China in Recent 30 Years Based on Co-word Analysis and Bibliometric:A Case Study on 7 CSSCI Journals%中国教育技术学三十年研究热点与趋势--基于共词分析和文献计量方法

    Institute of Scientific and Technical Information of China (English)

    陈巧云; 李艺

    2013-01-01

    Under the social background of the constant development of information technology,how the field of educa-tional technology changes is one of the research focuses. Taking the papers in the field of educational technology pub-lished in 7 source journals of CSSCI as object,this paper carried out the statistical analysis,in order to understand and grasp the change of educational technology development. After the time evolution analysis of high frequency keywords, the paper pointed out that the development process of education technology research in China can be divided into three stages,namely the TVU education research stage (1988-1993),audio visual education stage (1994-2002)and in-formation technology education research stage (2003-2012). Researchers made factor analysis,cluster analysis and social network analysis by SPSS,and discussed the hotspots and research trends of educational technology field. The re-sults show that there are seven main aspects reflecting current research hotspots,namely teaching process,multimedia teaching,instructional design,network education,distance education,information technology education,and learning mode under network environment. Among them,instructional design and multimedia technology attracts most attention in the field of educational technology,while mobile learning,collaborative learning,network distance education,and education informatization may represent the development trend.%在信息技术不断发展的社会背景下,教育技术学研究如何变迁是本领域关注的焦点问题之一。本文对7本教育技术学领域CSSCI期刊近30年所刊发文章进行统计分析,以探讨这一时期教育技术学学科的变迁过程,从整体上理解和把握教育技术学研究的发展趋势。文章通过对高频关键词的时间演进分析,指出近30年来我国教育技术学研究热点可以分为电大教育研究阶段(1988-1993年)、电化教育研究阶段(1994-2002年)和

  15. SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Elguindi, S; Ezzell, G; Gagneur, J [Mayo Clinic Arizona, Phoenix, AZ (United States)

    2015-06-15

    Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.

  16. Usefulness of texture analysis in differentiating transient from persistent part-solid nodules(PSNs: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Sang Hwan Lee

    Full Text Available BACKGROUND: Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features. METHODS: This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed. RESULTS: Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05 C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9% showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%. (P =  0.004. CONCLUSION: Texture analysis of

  17. Prediction Research of Climate Change Trends over North China in the Future 30 Years

    Institute of Scientific and Technical Information of China (English)

    LIU Yanxiang; YAN Jinghui; WU Tongwen; GUO Yufu; CHEN Lihua; WANG Jianping

    2008-01-01

    A simulation of climate change trends over North China in the past 50 years and future 30 years was performed with the actual greenhouse gas concentration and IPCC SRES B2 scenario concentration by IAP/LASG GOALS 4.0 (Global Ocean-Atmosphere-Land system coupled model), developed by the State Key Laboratory of Numerical Modelling for Atmospheric Sciences and Geophysical Fluid Dynamics (LASG),Institute of Atmospheric Physics (IAP), Chinese Academy of Sciences (CAS). In order to validate the model,the modern climate during 1951-2000 was first simulated by the GOALS model with the actual greenhouse gas concentration, and the simulation results were compared with observed data. The simulation results basically reproduce the lower temperature from the 1960s to mid-1970s and the warming from the 1980sfor the globe and Northern Hemisphere, and better the important cold (1950-1976) and warm (1977-2000)periods in the past 50 years over North China. The correlation coefficient is 0.34 between simulations and observations (significant at a more than 0.05 confidence level). The range of winter temperature departures for North China is between those for the eastern and western China's Mainland. Meanwhile, the summer precipitation trend turning around the 1980s is also successfully simulated. The climate change trends in the future 30 years were simulated with the CO2 concentration under IPCC SRES-B2 emission scenario.The results show that, in the future 30 years, winter temperature will keep a warming trend in North China and increase by about 2.5℃ relative to climate mean (1960-1990). Meanwhile, summer precipitation will obviously increase in North China and decrease in South China, displaying a south-deficit-north-excessive pattern of precipitation.

  18. Accuracy of frozen section diagnosis: a retrospective analysis of 4785 cases

    DEFF Research Database (Denmark)

    Winther, Charlotte; Graem, Niels

    2011-01-01

    During a 1-year period 4785 intraoperative consultations were performed. The pathology reports were retrospectively reviewed to determine the accuracy of frozen section diagnosis in various tissue types. Skin for evaluation of section margins and axillary sentinel lymph nodes for evaluation...... of metastatic disease were most frequently sent for frozen section diagnosis. The number of discordant cases were 182, 178 were false negative and four were false positive. When frozen section diagnoses were compared with permanent section diagnoses, the overall diagnostic concordance was 95.1%. The number...... of deferred specimens was 57. The accuracy of frozen section diagnosis varied between tissue types, and axillary sentinel lymph nodes accounted for the greatest number of discordances. In conclusion, the frozen section diagnosis is a reliable method with varying concordance and deferral rates between tissue...

  19. Risk factors for intraocular penetration of caterpillar hair in Ophthalmia Nodosa: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Sengupta Sabyasachi

    2010-01-01

    Full Text Available We report risk factors associated with intraocular penetration of caterpillar hair seen at our institute from January 2005 to December 2007. Records of all patients with caterpillar hair induced ophthalmitis (CHIO were retrospectively reviewed for clinical characteristics, anatomic location of lodgment of the caterpillar hair, treatment methods, and outcomes. Out of a total of 544 cases of CHIO, 19 eyes (seven in the anterior chamber and 12 in the posterior segment experienced intraocular penetration (3.5%. The presence of deep intracorneal hair (80 cases, 14.7% was found to be the only risk factor for intraocular penetration ( P < 0.001. The removal of intracorneal hair was possible in only 29 out of 80 eyes (36% and this was associated with a significantly reduced risk of intraocular penetration ( P = 0.022. Patients with retained intracorneal hairs should be counseled regarding risk of intraocular penetration and closely followed up for at least six months.

  20. A Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Carpenter, Alberta [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-01-01

    This is the second in a series of reports exploring the costs, benefits, and other impacts of state renewable portfolio standards (RPS), both retrospectively and prospectively. This report focuses on the benefits and impacts of all state RPS programs, in aggregate, for the year 2013 (the most-recent year for which the requisite data were available). Relying on a well-vetted set of methods, the study evaluates a number of important benefits and impacts in both physical and monetary terms, where possible, and characterizes key uncertainties. The prior study in this series focused on historical RPS compliance costs, and future work will evaluate costs, benefits, and other impacts of RPS policies prospectively.

  1. THE INCIDENCE OF THYROID MALIGNANCY IN NODULAR GOITER: A RETROSPECTIVE ANALYSIS IN A MEDICAL COLLEGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Praveen Kumar

    2015-09-01

    Full Text Available The incidence of malignancy in nodular goiter has been found to vary from 4% to 17%. Our aim is to determine the incidence of malignancy in nodular goiter by doing the histopathological examination of thyroidectomy specimens. MATERIALS AND METHODS: This retrospective, observational study was carried out on patients who are undergone thyroidectomy for clinically diagnosed nodular goiter in Fr . Muller Medical College Hospital during 2012 - 2014 (3 yrs. All the operated specimens were subjected to a histopathological examination to determine the incidence of malignancy. RESULTS: Among the 258 nodular goitre cases which were studied, 21 (8.1% cases contained malignant foci. Among them, papillary carcinoma was the most common type of malignancy observed. CONCLUSION: The risk of malignancy in nodular goitre should not to be underestimated. Total/ Near - total thyroidectomy is the preferred operation. All the operated specimens should be sent for histopathological examination

  2. A retrospective analysis of possible triggers of Guillain-Barre syndrome.

    Science.gov (United States)

    Yang, Bing; Lian, Ying; Liu, Ying; Wu, Bing-Yun; Duan, Rui-Sheng

    2016-04-15

    Antecedent infections have been found to be the most common trigger for Guillain-Barre syndrome (GBS). In the present study, we retrospectively analyzed 36 adult patients with GBS and found that surgery, trauma and treatment with ganglioside were also common before the onset of GBS. The proportion of the axonal subtype of GBS in post-surgical/traumatic patients was higher than that in non-surgical/traumatic patients (P=0.013) in the present study. In conclusion, this study has shown that prior infection, surgery, trauma and ganglioside may be clinical contributors to the onset of GBS and raised the possibility that they may act synergistically as triggers for the development of GBS.

  3. The Private Communications of Magnetic Recording under Socialism (Retrospective Disco Analysis

    Directory of Open Access Journals (Sweden)

    Oleg Vladimir Sineokij

    2013-07-01

    Full Text Available The article analyzes the formation and development of a general model of rare sound records in the structure of institutions of a social communication. The author considers psychocomminicative features of the filophone communication as a special type of interaction in the field of entertainment. The author studied the causes and conditions of a tape subculture in the USSR. It is observed the dynamics of the disco-communication in limited information conditions from socialism till modern high-tech conditions.At the end of the article the author argues based achievements in the field of advanced technology systems, innovation revival in the industry of music-record. Hence, using innovative approaches in the study, the author sets out the basic concept of recording popular music as a special information and legal institution, in retrospect, the theory and practice of the future needs in the information society.

  4. Retrospective analysis of main and interaction effects in genetic association studies of human complex traits

    DEFF Research Database (Denmark)

    Tan, Qihua; Christiansen, Lene; Brasch-Andersen, Charlotte;

    2007-01-01

    BACKGROUND: The etiology of multifactorial human diseases involves complex interactions between numerous environmental factors and alleles of many genes. Efficient statistical tools are demanded in identifying the genetic and environmental variants that affect the risk of disease development....... This paper introduces a retrospective polytomous logistic regression model to measure both the main and interaction effects in genetic association studies of human discrete and continuous complex traits. In this model, combinations of genotypes at two interacting loci or of environmental exposure...... regression model can be used as a convenient tool for assessing both main and interaction effects in genetic association studies of human multifactorial diseases involving genetic and non-genetic factors as well as categorical or continuous traits....

  5. Interstitial inflammatory lesions of the pulmonary allograft: a retrospective analysis of 2697 transbronchial biopsies

    DEFF Research Database (Denmark)

    Burton, C.M.; Iversen, M.; Carlsen, J.

    2008-01-01

    of 2697 biopsies were evaluated corresponding to a mean of 6+/-2 (median 8) completed schedules per patient. Diffuse alveolar damage (DAD) was the second most common histological finding within the first 2 weeks after transplantation. The peak prevalence of bronchiolitis obliterans organizing pneumonia......, incidence and possible associations between commonly identified inflammatory and fibrotic lesions in the pulmonary allograft. METHODS: Retrospective chart review of all transbronchial biopsies performed within the first 2 years of 299 lung-transplanted patients in the period 1996 to 2006. RESULTS: A total.......0001, respectively). Acute cellular rejection was not associated with DAD, and patients with lymphocytic bronchiolitis were not more likely to demonstrate features of organizing pneumonia (DAD or BOOP). CONCLUSIONS: Histologic findings of ACR, lymphocytic bronchiolitis, BOOP, and interstitial pneumonitis were...

  6. Laparoscopic Sacropexy: A Retrospective Analysis of the Subjective Outcome in 310 Cases

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    B. Bojahr

    2012-01-01

    Full Text Available Background and Objective. The aim of this study was to assess the subjective outcome following laparoscopic sacropexy. Methods. We performed a retrospective cohort study among women treated for descensus with laparoscopic sacropexy between January 2000 and December 2007. 310 patients received questionnaires during followup assessing major pre- and postoperative symptoms and overall satisfaction. Results. 214 (69% patients responded to the questionnaire. Mean followup was 24.5 months. The number of patients with back or lower abdominal pain, foreign body sensation in the vagina and prolapse-related symptoms, urinary symptoms, vaginal and bladder infections, and the need for pessary usage decreased significantly postsurgically. Bowel symptoms increased slightly but not significantly. Two years after surgery, nearly 2 thirds of the women were satisfied or very satisfied with the outcome. Conclusion. Laparoscopic sacropexy is an effective treatment of descensus, with favorable or satisfactory subjective outcomes.

  7. Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis

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    Soresi, M.; Bonfissuto, G.; Magliarisi, C.; Riili, A.; Terranova, A.; Di Giovanni, G.; Bascone, F.; Carroccio, A.; Tripi, S.; Montalto, G. E-mail: gmontal@unipa.it

    2003-05-01

    AIM: To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance. MATERIALS AND METHODS: One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound. RESULTS: Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened ({chi}{sup 2} MH=74.3; p<0.0001). CONCLUSION: Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.

  8. Comparison of Infection Rates Among Critically Ill Patients Per Their Route of Nutrition: A Retrospective Analysis

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    Esra Ozayar

    2013-10-01

    Full Text Available Aim: Infection is an important problem in intensive care units (ICU which is a complication of nutritional support. In our institution, we aimed to determine the differences in infection rates of patients who were supported with parenteral nutrition (PN and enteral + parenteral nutrition (EN+PN combination retrospectively. Material and Method: In this study, we enrolled 156 patients from January 1, 2011 to Agust 1, 2011. There were 88 patients in the parenteral nutrition group (Group 1 and 68 patients in the enteral+ parenteral nutrition group (Group 2. On all 156 patients, retrospective chart reviews were performed and biweekly culture results were recorded. Specifically, soft tissue infections, skin infections, catheter related blood stream infections, pneumonia and urinary tract infections were recorded. HI (hospital infection incidences and incidence densities were also calculated in both groups. Results: There were 16 recorded infections in 16 patients among Group 1. These were 4 cases of catheter related blood stream infections, 4 cases of pneumonia, 3 cases of urinary tract infections and 5 cases of soft tissue infections. In group 2, 8 patients showed signs of infection. These were, 4 cases catheter related blood stream infections, 2 cases of soft tissue infections and 2 cases of urinary tract infections. There were no reported pneumonia cases in group 2. Discussion: According to our results, with the exception of catheter related blood stream infections, infection numbers declined within the group of combination of enteral and parenteral nutrition group than parenteral nutrition group alone, but the results were not statistically significant. The intolerance to enteral nutrition can increase the cost of stay, mainly due to increased length of stay as a result of increased infection rates. We would recommend a combination nutrition regimen in such a similar situation, in order to decrease infection rates.

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

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    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.

  10. Orbital Extension of a Giant Ethmoidal Sinus Osteoma in a 30-Year-old Female

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    Esmat Karbassi

    2013-03-01

    Full Text Available Introduction: Osteoma is a benign tumor rarely found in the paranasal sinuses.   Case Report: A 30-year-old female presented with an 8-month history of proptosis of the right eye that was progressing slowly. She was diagnosed with ethmoid osteoma and managed with collaborative surgery at the ophthalmology and otolaryngology departments. After surgery, the patient suffered visual loss that was managed medically. The surgical steps and protocol used for safe removal are discussed in the report.    Conclusion: Management of a giaint osteoma extending to orbital tissue needs meticulous dissection through open approach and collaborative surgery by otolaryngologist and ophtalmologist

  11. 30 years of Physics Education Research at the University of Washington

    Science.gov (United States)

    Shaffer, Peter S.

    2017-01-01

    Over the past 30 years, members of the UW Physics Education Group have examined student learning in courses serving a wide range of populations. Most of the focus has been on elementary, middle, and high school teachers and students in introductory university physics courses, but more recently, the effort has expanded to include physics majors in upper-division courses on quantum mechanics and electrodynamics. In general, the group has taken a practical approach that focuses on identifying instructional strategies that are effective at promoting conceptual understanding and student reasoning ability. Examples will be drawn from across these courses to illustrate common themes and connections.

  12. Effect size and power in assessing moderating effects of categorical variables using multiple regression: a 30-year review.

    Science.gov (United States)

    Aguinis, Herman; Beaty, James C; Boik, Robert J; Pierce, Charles A

    2005-01-01

    The authors conducted a 30-year review (1969-1998) of the size of moderating effects of categorical variables as assessed using multiple regression. The median observed effect size (f(2)) is only .002, but 72% of the moderator tests reviewed had power of .80 or greater to detect a targeted effect conventionally defined as small. Results suggest the need to minimize the influence of artifacts that produce a downward bias in the observed effect size and put into question the use of conventional definitions of moderating effect sizes. As long as an effect has a meaningful impact, the authors advise researchers to conduct a power analysis and plan future research designs on the basis of smaller and more realistic targeted effect sizes.

  13. ANALYSIS OF MATERNAL MORTALITY IN A TERTIARY CARE C ENTRE: A 5 YRS RETROSPECTIVE STUDY

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    Shabana

    2013-03-01

    Full Text Available ABSTRACT: AIMS : This study aimed to study the determinants, commo n causes and possible prevention of maternal mortality. MATERIALS AND METHODS: Maternal mortalities in Department of Obstetrics and gynecology, Gandhi medi cal college, Sultania Zanana Hospital, Bhopal during 5 year period from Jan 2007- Dec 2011 were studied. The individual records of all maternal deaths occurring during the study peri od of 5 years were extracted from patient’s case notes and hospital record registers. Total deli veries for the period were extracted from the delivery registers. RESULTS : In the year 2007-2011 total live births were 43,68 3 of which 338 mothers died giving cumulative maternal mortality r atio of 773.75 per 1,00,000 live births. Among 338 total maternal deaths, the maximum deaths were in the age group 20-30 years (88.16%.The death rate of mothers from rural areas was higher (65.68%.The highest number of maternal death occurred among multigravidae (46. 74% . A total of 91.72% of maternal death occurred in unbooked patients. Most were referred patients (74.55%. Most of them were illiterate (61.8%.76.62% patients died within 24 ho urs of admission.33.13% women died in antenatal period while 64.49% died in postnatal perio d. Direct obstetric causes of death accounted for 76.03% of all maternal deaths. Among the direct causes 39.64% died due to hypertensive disorder of pregnancy, 18.93% due to hem orrhage. Indirect causes accounted for 23.96% in which anemia (8.57%, malaria (3.55% hepa titis (2.66% were the leading causes . CONCLUSIONS : This study has shown higher maternal mortality du e to being a tertiary care hospital based study where more complicated and refe rred cases are admitted. Most maternal deaths can be prevented by providing care at grass r oot level, linkage between primary, secondary and tertiary care, strengthening of refer ral services and instituting emergency obstetric services.

  14. Maternal dioxin exposure and pregnancy outcomes over 30 years of follow-up in Seveso.

    Science.gov (United States)

    Wesselink, Amelia; Warner, Marcella; Samuels, Steven; Parigi, Aliza; Brambilla, Paolo; Mocarelli, Paolo; Eskenazi, Brenda

    2014-02-01

    Animal evidence suggests an association between exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and adverse pregnancy outcomes. Epidemiologic studies report inconsistent results, but are limited by narrow range of exposure, small sample size, and lack of a biologic measure of highest lifetime exposure. On July 10, 1976, a chemical explosion in Seveso, Italy resulted in the highest known residential exposure to TCDD. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort of TCDD exposure and reproductive health. Individual-level TCDD was measured in serum collected soon after the explosion. After 20years of follow-up, we found no association between maternal TCDD in 1976 serum or estimated at pregnancy and spontaneous abortion (SAB), fetal growth, or gestational length. Here, we present an updated analysis of TCDD exposure and adverse pregnancy outcomes from a subsequent follow-up of the SWHS cohort in 2008-2009. SWHS women had 1211 post-explosion pregnancies through the 2008-2009 follow-up. We found no association between TCDD estimated at pregnancy and SAB, fetal growth, or gestational length. However, we found a non-significant inverse association between maternal 1976 serum TCDD and birthweight (adjusted β=-22.8, 95% CI: -80.1, 34.6). The association was stronger among first post-explosion births, but remained non-significant (adjusted β=-47.7, 95% CI: -107.3, 11.9). SWHS is the first study to be able to consider two potentially relevant measures of TCDD exposure: highest lifetime dose and in utero. Our results, although non-significant, suggest that highest dose may be more relevant in epidemiologic studies of TCDD and pregnancy outcomes.

  15. Global dataset of biogenic VOC emissions calculated by the MEGAN model over the last 30 years

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    K. Sindelarova

    2014-04-01

    Full Text Available The Model of Emissions of Gases and Aerosols from Nature (MEGANv2.1 together with the Modern-Era Retrospective Analysis for Research and Applications (MERRA meteorological fields were used to create a global emission dataset of biogenic volatile organic compounds (BVOC available on a monthly basis for the time period of 1980–2010. This dataset is called MEGAN-MACC. The model estimated mean annual total BVOC emission of 760 Tg (C yr−1 consisting of isoprene (70%, monoterpenes (11%, methanol (6%, acetone (3%, sesquiterpenes (2.5% and other BVOC species each contributing less than 2%. Several sensitivity model runs were performed to study the impact of different model input and model settings on isoprene estimates and resulted in differences of up to ±17% of the reference isoprene total. A greater impact was observed for a sensitivity run applying parameterization of soil moisture deficit that led to a 50% reduction of isoprene emissions on a global scale, most significantly in specific regions of Africa, South America and Australia. MEGAN-MACC estimates are comparable to results of previous studies. More detailed comparison with other isoprene inventories indicated significant spatial and temporal differences between the datasets especially for Australia, Southeast Asia and South America. MEGAN-MACC estimates of isoprene, α-pinene and group of monoterpenes showed a reasonable agreement with surface flux measurements at sites located in tropical forests in the Amazon and Malaysia. The model was able to capture the seasonal variation of isoprene emissions in the Amazon forest.

  16. Clostridium difficile 30 years on: what has, or has not, changed and why?

    Science.gov (United States)

    Gerding, Dale N

    2009-03-01

    The report of clindamycin-associated colitis in 1974 by Tedesco et al. [Ann Intern Med 81: 429-33] stimulated an intense search for the cause of this severe complication of antibiotic use. The search culminated in early 1978 in the publication of a series of papers within 3 months that identified the causative agent as Clostridium difficile and its accompanying toxins. Thirty years later we are in the midst of a resurgence of C. difficile infection (CDI) in North America and Europe that is greater than ever previously reported and for which morbidity and mortality appear to be higher than ever seen in the past. The purpose of this review is to highlight the discoveries of the past 30 years that, in my view, have brought us to our current level of understanding of the pathogenesis, prevention and treatment of CDI, and to suggest why a disease thought to be managed so well 30 years ago could now be causing more morbidity and mortality than ever before. In the 21st century the focus should be on better understanding the relationship between the C. difficile organism and the host at the mucosal level, so that biotherapeutic and vaccine strategies for the prevention of CDI can be developed.

  17. Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis

    DEFF Research Database (Denmark)

    Runström, B; Hallböök, O; Nyström, P O;

    2013-01-01

    AIM: To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula. MATERIAL AND METHODS: Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals. RESULTS: In all, 96...... (87%) of the 110 fistulae healed and 92 (91%) patients survived. A total of 9 patients with unhealed fistula died. Multivariate analysis revealed jaundice as an independent factor for both death and failed closure and operation without anastomosis as an independent positive factor for healing. Failure...... rate was lower after an operation with stoma without anastomosis (6 of 43, 14%) than after an operation with anastomosis (30 of 89, 34%) p = 0.0213. Of the 36 instances with unhealed fistula, 13 (36%) could be ascribed to inadvertent bowel lesions at the reconstructive operation. In addition...

  18. Cancers in the TREAT Asia HIV Observational Database (TAHOD: a retrospective analysis of risk factors

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    Petoumenos Kathy

    2010-12-01

    Full Text Available Abstract Background This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer. Methods TREAT Asia HIV Observational Database (TAHOD sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs, and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR and unrelated (NADC-IUR. Results A total of 617 patients were included in this study: 215 cancer cases and 402 controls from 13 sites. The majority of cancer cases were male (71%. The mean age (SD for cases was 39 (10.6, 46 (11.5 and 44 (13.7 for ADCs, NADC-IURs and NADCs-IR, respectively. The majority (66% of cancers were ADCs (16% Kaposi sarcoma, 40% non-Hodgkin's lymphoma, and 9% cervical cancer. The most common NADCs were lung (6%, breast (5% and hepatocellular carcinoma and Hodgkin's lymphoma (2% each. There were also three (1.4% cases of leiomyosarcoma reported in this study. In multivariate analyses, individuals with CD4 counts above 200 cells/mm3 were approximately 80% less likely to be diagnosed with an ADC (p Conclusions The spectrum of cancer diagnoses in the Asia region currently does not appear dissimilar to that observed in non-Asian HIV populations. One interesting finding was the cases of leiomyosarcoma, a smooth-muscle tumour, usually seen in children and young adults with AIDS, yet overall quite rare. Further detailed studies are required to better describe the range of cancers in this region, and to help guide the development of screening programmes.

  19. Bibliometric analysis of research on regenerative periodontal surgery during the last 30 years

    Science.gov (United States)

    Gutiérrez-Vela, María M.; Díaz-Haro, Ana; Berbel-Salvador, Sonia; Lucero-Sánchez, Aldo; Cutando-Soriano, Antonio

    2012-01-01

    Objectics: The evolution of research activity during the last thirty years on regenerative periodontal surgery is studied. Results: A small number of authors are highly productive with more than 10 publications on the subject each. 79,6% of authors have only produced one article on the subject. The co-authorship average is of 2,68 authors per paper, with a collaboration between 2 and 6 authors. Main journals on the field of regenerative periodontal surgery are Journal of Periodontology and Journal of Clinical Periodontology, which are ranked 14th and 1st in their category according to the Journal Citations Reports. The most used language is English, followed by Japanese and Italian, Spanish occupying the eighth position. Conclusions: A significant increase on scientific literature is observed, similar to the one Dentistry has had. A reduced number of authors account for most production. In the same token, there is a scarce professionalization of researchers in this field, where most of the authors are occasional. On the other hand, there are two very specialized journals on this topic. Key words:Bibliometrics, scientometrics periodontal regeneration, surgical periodontal treatment, scientific literature, scopus, scientific output. PMID:24558535

  20. Spinal shape analysis in 1,020 healthy young adults aged from 19 to 30 years

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    Jakub Krejčí

    2016-03-01

    Full Text Available Background: A number of studies on diseased spine have been published; however, there is a relative paucity of studies investigating spine shape characteristics in healthy populations. Such characteristics are needed for diagnostics of spine disorders and assessment of changes in the spinal shape that may have been caused by influence of the modern life style or intensive sport activity. Objective: The aim of the study was to determine characteristics of the spine shape in a large sample of healthy young adults. Methods: Population cross-sectional study. A non-radiographic surface method (system DTP-3 was used for the assessment of spine shape in the sagittal and frontal planes. A total of 1,020 participants (440 men, 580 women took part in the study, their mean (± SD age was 21.8 ± 1.9 years (range 19.1-29.7 for men and 21.9 ± 1.8 years (range 19.3-29.7 for women. All data were checked for normality and are presented as means, standard deviations, ranges, skewness, and kurtosis. Differences between the sexes were assessed with the two-sample t-test. Results: The average sagittal spinal shape was C3 - 12.9° - C7 - 43.0° - T10 - 27.1° - L5 for men and C3 - 12.1° - C6 - 44.5° - T11 - 34.1° - L5 for women. Men showed a significantly smaller thoracic kyphosis and lumbar lordosis curvatures than women. The average curvature due to the lateral deviation in the frontal plane was 6.1° for both sexes, the curvature was larger than 10° in 9.1% of men and 8.8% of women. We found left lateral deviation in 72.5% of men and in 63.6% of women. Conclusions: The study provides characteristics of the spine shape in a large sample of healthy young adults. Such characteristics should be part and parcel of determining the cut-off level for physiological spinal shape. Based on the results of the study, we suggest a lateral deviation of 10° as the maximum for a curvature to be still considered non-pathological.

  1. Bibliometric analysis of research on regenerative periodontal surgery during the last 30 years

    OpenAIRE

    Gutiérrez Vela, María del Mar; Díaz Haro, Ana; Berbel Salvador, Sonia; Lucero Sánchez, Aldo; Robinson García, Nicolás; Cutando Soriano, Antonio

    2012-01-01

    Objectics: The evolution of research activity during the last thirty years on regenerative periodontal surgery is studied. Results: A small number of authors are highly productive with more than 10 publications on the subject each. 79,6% of authors have only produced one article on the subject. The co-authorship average is of 2,68 authors per paper, with a collaboration between 2 and 6 authors. Main journals on the field of regenerative periodontal surgery are Journal of Periodontology and Jo...

  2. Title I and Student Achievement: A Meta-Analysis of 30 Years of Test Results.

    Science.gov (United States)

    Borman, Geoffrey D.; D'Agostino, Jerome V.

    Title I of the Elementary and Secondary Education Act was implemented in 1965 to provide financial assistance to state and local education agencies to meet the special needs of educationally disadvantaged children. Federal funding supports a variety of supplemental services that share the collective purpose of improving educational opportunities…

  3. Interstitial cystitis: a retrospective analysis of treatment with pentosan polysulfate and follow-up patient survey.

    Science.gov (United States)

    Waters, M G; Suleskey, J F; Finkelstein, L J; Van Overbeke, M E; Zizza, V J; Stommel, M

    2000-03-01

    To evaluate the efficacy and safety of pentosan polysulfate sodium (PPS) in relieving symptoms of interstitial cystitis, the authors retrospectively reviewed charts of 260 patients in whom interstitial cystitis had been diagnosed. Subsequently, they conducted a follow-up phone interview or mail survey of those patients who were treated with PPS to investigate changes in the patients' symptoms, adverse effects, and change in quality of life. The control group consisted of patients whose interstitial cystitis had been diagnosed at cystoscopy and had a duration of at least 1 year and who had taken at least one or more oral medications for their symptoms. The average length of treatment was 9.3 months among the 27 subjects on PPS therapy. The mean length of time that they had diagnosed interstitial cystitis was 35.63 months and 48.78 months for the PPS-treated and control groups, respectively, with no statistically significant difference. Changes in frequency, urgency, and pain were greater in the treatment group and statistically significant (P = .11, P = .49, and P = .004, respectively). No change occurred in the rate of nocturia in the PPS-treated group compared with that in the control group. Symptoms of both groups improved over time, but improvement was statistically significantly greater in the treatment group (P = .001) over the treatment interval. The most common side effect attributable to PPS was diarrhea in 15% of subjects. Pentosan proved to be an efficacious option for reducing the debilitating symptoms of interstitial cystitis.

  4. Langerhans cell histiocytosis: a retrospective analysis in a Korean tertiary hospital from 2003 to 2012.

    Science.gov (United States)

    Kwon, Soon Hyo; Choi, Jae Woo; Kim, Hyo Jin; Youn, Sang Woong

    2013-10-01

    Epidemiological study of Langerhans cell histiocytosis (LCH) has been limited due to its rarity and multisystemic involvement. The aim of this study was to investigate the epidemiological features of LCH via the clinical data warehouse (CDW). Clinical data of 30 LCH patients from the all departments of a tertiary referral hospital between 2003 and 2012 were analyzed retrospectively by searching the CDW. The male-to-female ratio was 2.8:1. The age of onset ranged 7 days to 57 years with a median of 13 years. Of the patients, 36.7% presented initial symptoms before the age of 10 years. The involved organs at diagnosis were: bone (66.7%), skin (16.7%), lungs (13.3%) and lymph node (3.3%). For all of the 30 cases, there were 31 disease sites because of a single case of multisystemic disease involving both skin and bone. Of the 96.7% of patients with single-system disease, 69.0% had bony involvement. This study elucidated the clinical features of LCH from all the departments of a tertiary hospital via the CDW, which suggests a potential role of the CDW as a new epidemiological approach for rare diseases.

  5. Anticlockwise swirl of mesenteric vessels: A normal CT appearance, retrospective analysis of 200 pediatric patients

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    Sodhi, Kushaljit S., E-mail: sodhiks@gmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Bhatia, Anmol, E-mail: anmol_bhatia26@yahoo.co.in [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Saxena, Akshay K., E-mail: fatakshay@yahoo.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Rao, Katragadda L.N., E-mail: klnrao@hotmail.com [Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Menon, Prema, E-mail: menonprema@hotmail.com [Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India)

    2014-04-15

    Objective: The counterclockwise rotation of the SMV on SMA is a normal and non-specific finding, which results in an incomplete swirl formation on CT scans. However, it has a potential to be misinterpreted as ‘midgut volvulus’ resulting in serious clinical implications. The study was done to determine the frequency and degree of counterclockwise rotation of the SMV on SMA on CT in normal otherwise asymptomatic pediatric patients undergoing CT scan. Methods: In this IRB approved study, we retrospectively analyzed abdominal CT scan examinations of 200 consecutive pediatric patients (age range of 11 days to 18 years), which were performed for different clinical indications over a period of 10 months. They were evaluated for the absence or presence and degree of counterclockwise rotation of the mesenteric vessels. Results: Of the 200 patients, 128 (64%) patients showed no clockwise or anticlockwise rotation of mesenteric vessels. Counterclockwise rotation of SMV on SMA was seen in 72 (36%) patients. Further, the degree of rotation of vessels was also calculated, based on the criteria proposed by the authors. Conclusions: The counterclockwise rotation of SMV on SMA gives an appearance of mesenteric whirlpool in otherwise normal mesenteric vessels and can be misinterpreted as midgut volvulus. It is a normal CT appearance and is due to a variation in branching pattern of mesenteric vessels. Awareness of this normal branching pattern of mesenteric vessels is important to avoid an inadvertent laparotomy.

  6. Diagnosis and surgical treatment of renal hydatid disease: a retrospective analysis of 30 cases.

    Directory of Open Access Journals (Sweden)

    Mulati Rexiati

    Full Text Available Echinococcosis (CE is an infection which is caused by the larval stage of a tapeworm and is endemic in stockbreeding regions of developing countries. The kidney is the most commonly affected organ in the urinary tract. However, reports on renal hydatid disease are limited in the literature, and usually there are no specific clinical characteristics and promising operative methods. The purpose of this study is to assess the most appropriate surgical technique for the patient with urinary tract CE. We retrospectively analyzed thirty patients with renal hydatid cysts who received different surgical treatments in the urology department of the First Affiliated Hospital of Xinjiang Medical University from February 1985 to April 2010. Twenty patients were males and ten were females. The diagnostic accuracy was 74%, 87.5%, and 66.6% respectively by using of ultrasound, CT, and laboratory tests. Thirty patients were followed up for 1-15 years after surgery. One patient experienced a recurrence of renal CE. The ultrasound, CT, and immunological tests are an important means of diagnosis. The surgical treatment principle of renal hydatid should be based on residual renal function, hydatid cyst size, number, location, and surgical techniques to determine the surgical plan to retain the renal function.

  7. Propofol Infusion Syndrome: A Retrospective Analysis at a Level 1 Trauma Center

    Directory of Open Access Journals (Sweden)

    James H. Diaz

    2014-01-01

    Full Text Available Objectives. The propofol infusion syndrome (PRIS, a rare, often fatal, condition of unknown etiology, is defined by development of lipemic serum, metabolic acidosis, rhabdomyolysis, hepatomegaly, cardiac arrhythmias, and acute renal failure. Methods. To identify risk factors for and biomarkers of PRIS, a retrospective chart review of all possible PRIS cases during a 1-year period was conducted at a level 1 trauma hospital in ICU patients over 18 years of age receiving continuous propofol infusions for ≥3 days. Additional study inclusion criteria included vasopressor support and monitoring of serum triglycerides and creatinine. Results. Seventy-two patients, 61 males (84.7% and 11 females (15.3%, satisfied study inclusion criteria; and of these, 3 males met the study definition for PRIS, with 1 case fatality. PRIS incidence was 4.1% with a case-fatality rate of 33%. The mean duration of propofol infusion was 6.96 days. A positive linear correlation was observed between increasing triglyceride levels and infusion duration, but no correlation was observed between increasing creatinine levels and infusion duration. Conclusions. Risk factors for PRIS were confirmed as high dose infusions over prolonged periods. Increasing triglyceride levels may serve as reliable biomarkers of impending PRIS, if confirmed in future investigations with larger sample sizes.

  8. The specialising or sampling debate: a retrospective analysis of adolescent sports participation in the UK.

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    Bridge, Matthew W; Toms, Martin R

    2013-01-01

    Whether young people should specialise in one competitive sport at an early age, or pursue a wider range of sports during adolescence is a topic of some debate (Baker, Cobley, & Fraser-Thomas, 2009) and is fundamental within sports policy and coaching practice. The purpose of this retrospective recall study was to identify whether early specialisation or sporting diversification (sampling) throughout childhood and adolescence can influence performance levels prior to adulthood. An online questionnaire was used to collect the sport participation histories of 1006 UK sports people, which were then compared with the developmental framework provided by the Developmental Model of Sport Participation (DMSP, Côté & Fraser-Thomas, 2007). A significant association between the number of sports participated in at the ages of 11, 13, and 15 and the standard of competition between 16 and 18 years was found. Individuals who competed in three sports aged 11, 13, and 15 were significantly more likely to compete at a national compared with club standard between the ages of 16 and 18 than those who practised only one sport. The findings reported here provide some empirical support for the sampling performance pathway DMSP model in a UK context.

  9. RETROSPECTIVE ANALYSIS: TO ENHANCE PATIENT SAFETY BY MINIMIZING MEDICATION ERRORS IN TERTIARY CARE CARDIAC HOSPITAL

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    Lal Sukhbir

    2012-09-01

    Full Text Available To identify and measure the frequency of medication errors, to understand the causes for errors and best strategies to decrease medication errors rate in a cardiac hospital New Delhi. The Retrospective study of 137 case files, was undertaken to find out the medication errors in new drugs to be included in hospital formulary and to study policy compliances,for the period of a month, February 2010.We studied 137 patient files and Medication error related were reported most often at the stages of prescription- 32 cases(23.35%, 12 administration errors(8.75%, 9 documentation errors(6.56%, 7 transcription errors (5.1%. This study has demonstrated a whole range of different types of errors in different phases of medication use and documentation process. We have seen that handwritten prescriptions are associated with large number of errors. A combined effort is required by the physician’s, managerial staff, nursing staff and educational interventions to improve patient safety in hospital.KEY WORDS:

  10. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control.

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    Emilio Mezzenga

    Full Text Available The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system.

  11. Clinic-Based Retrospective Analysis of Psychopharmacology for Behavior in Fragile X Syndrome

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    Elizabeth Berry-Kravis

    2012-01-01

    Full Text Available Fragile X syndrome (FXS is associated with behavior that limits functioning, including distractibility, hyperactivity, impulsivity, hyperarousal, anxiety, mood dysregulation, and aggression. Medication response and side effect data were reviewed retrospectively for 257 patients (age 14±11 years, range 4–60 years, 203 M, 54 F attending an FXS clinic. Treatment success rates were defined as the percentage of positive response in the form of documented clinical report of improvement in the behavior(s being targeted over at least a 6-month period on the medication, without side effects requiring medication discontinuance, while failures were defined as discontinuance of medication due to lack of clinical effectiveness or side effects. Success rate for treatment of targeted behaviors with trials of individual medications was 55% for stimulants, 53% for antidepressants, 62% for alpha2-agonists, and 54% for antipsychotics. With sequential trials of different medications in the same class, success rate improved to 73–77%. Side effect-related failures were highest for antipsychotics. Systematic psychopharmacologic intervention targeted to behavioral symptoms appears helpful in the majority of patients with FXS.

  12. Sedation of children for auditory brainstem response using ketamine-midazolam-atropine combination - a retrospective analysis.

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    Bocskai, Tímea; Németh, Adrienne; Bogár, Lajos; Pytel, József

    2013-12-01

    Authors investigated sedation quality in children for auditory brainstem response testing. Two-hundred and seventy-six sedation procedures were retrospectively analyzed using recorded data focusing on efficacy of sedation and complications. Intramuscular ketamine-midazolam-atropine combination was administered on sedation preceded by narcotic suppository as pre-medication. On using the combination vital parameters remained within normal range, the complication rate was minimal. Pulse rate, arterial blood pressure and pulse oxymetry readings were stable, hypoventilation developed in 4, apnoea in none of the cases, post-sedation agitation occurred in 3 and nausea and/or vomiting in 2 cases. Repeated administration of narcotic agent was necessary in a single case only. Our practice is suitable for the sedation assisting hearing examinations in children. It has no influence on the auditory brainstem testing, the conditions necessary for the test can be met entirely with minimal side-effects. Our practice provides a more lasting sedation time in children during the examination hence there is no need for the repetition of the narcotics.

  13. Simultaneous pancreas-kidney transplantation in a single center:10-year retrospective analysis

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    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.

  14. Analysis of the pattern of maxillofacial fractures in north western of Iran: A retrospective study

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    Mesgarzadeh Ali

    2011-01-01

    Full Text Available Background : Maxillofacial fractures can lead to substantial long-term functional, esthetic and psychological complications. Aim : The aim of this study is to evaluate these injuries in a Turkish Iranian population. Materials and Methods : A retrospective study of 170 patients with 210 maxillofacial fractures admitted to the emergency department of a central referral emergency hospital in the area over a 5 year period is presented. Patients′ data included demographic information, etiology, site and associated injuries and complications. Results : Road traffic accident was the commonest cause (40% and the age group of 21-30 comprised the biggest group (30%. Mandibular fractures outnumbered midface fractures (150vs.60. Ramus (21.5% and zygoma (26.5% were the commonest fracture regions respectively in mandible and midface. Male: female ratio was 3.8:1 Almost half of patients (46% had sustained associated injuries most of which was soft tissue laceration of the face (17.5%. 22 patient (13% had associated complication and the hemorrhage was the commonest form of that (9%. Conclusion : It seems that road traffic accidents continue to be the leading cause of maxillofacial fractures and there is an urgent need to implement enhanced regulations and monitoring on motor vehicular traffic.

  15. Sternal Insufficiency Fractures of Post-menopausal Women:Retrospective Analysis of 17 Cases

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    Zhe-yuan Huang; Bi-long Yi; Hao-yuan Liu

    2012-01-01

    Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures (SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough (5 cases),dyspnoea (3 cases),breathlessness (3 cases),and wheeze (2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease (7 cases),rheumatoid arthritis (3 cases),systemic lupus erythematosus (1 case),asthma (1 case),and thoracic vertebral fracture (13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.

  16. Long-term patterns of dental attendance and caries experience among British adults: a retrospective analysis.

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    Aldossary, Arwa; Harrison, Victoria E; Bernabé, Eduardo

    2015-02-01

    There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long-term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥ 16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular-attenders) based on their responses to three questions on lifetime dental-attendance patterns. The association between dental-attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio-economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long-term dental attendance and caries experience was found in adjusted models. Former and never regular-attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular-attenders. No differences in DMFT or its components were found between current and always regular-attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses.

  17. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  18. Acquired hemophilia a: retrospective analysis of 49 cases from a single Chinese hemophilia center.

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    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%.

  19. Maternal Tetanus at the University College Hospital in Ibadan Nigeria: A 15-Year Retrospective Analysis

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    OA Roberts; IO Morhason-Bello; BO Adedokun; AO Adekunle

    2008-01-01

    Objective To determine the characteristics of women with maternal tetanus, pattern of presentation and outcome of management.Methods A total of 19 women were managed with maternal tetanus between 1990 and 2005 from the University College Hospital in Ibadan Nigeria. A retrospective study was performed. The medical records of all women managed as a case of maternal tetanus were retrieved from the central record department of the hospital The pattern of presentation, characteristics of women, the duration of hospital admission, tetanus toxoid immunization, and outcome of care were measured.Results The records of 18 women managed were analyzed. The mean age at presentation was 25.2±5.3 years. The patients were mostly single, nulliparous and had primary school education. The maternal tetanus cases seen mainly complicated induced abortion while 5 and 2 other cases were due to childbirth complication and leg wound respectively. The portal of entry of the remaining 3 cases could not be ascertained.None of the patient managed had complete immunization schedule. The average duration of admission was 11.2±6. 7 d. Five women had intensive care with 3 of them requiring ventilatory support. The case fatality rate was 66. 7%. The only factor that significantly improved survival was presence of generalized spasm at presentation (P=0. 006) Conclusion The occurrence of maternal tetanus is a reflection of low quality of health care delivery and lack or inefficient routine immunization coverage in any community.

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

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    陈晋峰; 张力建; 刘静贤

    2003-01-01

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

  1. A Three years retrospective analysis of agents isolated from cerebrospinal fluid in a University Hospital

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    Barış Otlu

    2012-03-01

    Full Text Available Objectives: In this study, we aimed to investigate the agents which were isolated from cerebrospinal fluid (CSF samples in our hospital for three years, retrospectively.Materials and methods: The CSF samples, which were sent our laboratory, of the patients those had presumptive diagnosis of meningitis between September 2008 and September 2011 were included into the study. Isolated bacteria were identified with conventional methods, biochemical tests and/or Phonix (BD, US kits. Antimicrobial susceptibility of the strains were investigated according to Clinical Laboratory Standards Institute (CLSI recommendations.Results: 11 Streptococcus pneumoniae, 8 Klebsiella pneumoniae, 7 Pseudomonas aeruginosa, 7 Acinetobacter baumannii, 5 Escherichia coli, 4 Enterococcus spp., 2 Enterobacter spp., 25 Coagulase-negative staphylococcus, 1 Morganella morganii, 2 Neisseria meningitidis, 1 Brucella spp., and 1 Candida albicans were isolated (overall n:74; 5.2% from total 1408 CSF samples. In susceptibility test, 2 S.pneumonia was found as penicillin-resistant, and one E.coli and two K.pneumoniae were found as extended spectrum of beta-lactamase producers. Additionally, carbapenem resistance was detected in three A.baumannii and one P.aeruginosa strains.Conclusion: Determination of agent profile and antimicrobial resistance pattern from different localizations and patients’ groups will help to improve protective and therapeutic health policies.

  2. Associations of education with 30 year life course blood pressure trajectories: Framingham Offspring Study

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    Xiao Yongling

    2011-02-01

    Full Text Available Abstract Background Education is inversely associated with cardiovascular disease incidence in developed countries. Blood pressure may be an explanatory biological mechanism. However few studies have investigated educational gradients in longitudinal blood pressure trajectories, particularly over substantial proportions of the life course. Study objectives were to determine whether low education was associated with increased blood pressure from multiple longitudinal assessments over 30 years. Furthermore, we aimed to separate antecedent effects of education, and other related factors, that might have caused baseline differences in blood pressure, from potential long-term effects of education on post-baseline blood pressure changes. Methods The study examined 3890 participants of the Framingham Offspring Study (mean age 36.7 years, 52.0% females at baseline from 1971 through 2001 at up to 7 separate examinations using multivariable mixed linear models. Results Mixed linear models demonstrated that mean systolic blood pressure (SBP over 30 years was higher for participants with ≤12 vs. ≥17 years education after adjusting for age (3.26 mmHg, 95% CI: 1.46, 5.05 in females, 2.26 mmHg, 95% CI: 0.87, 3.66 in males. Further adjustment for conventional covariates (antihypertensive medication, smoking, body mass index and alcohol reduced differences in females and males (2.86, 95% CI: 1.13, 4.59, and 1.25, 95% CI: -0.16, 2.66 mmHg, respectively. Additional analyses adjusted for baseline SBP, to evaluate if there may be educational contributions to post-baseline SBP. In analyses adjusted for age and baseline SBP, females with ≤12 years education had 2.69 (95% CI: 1.09, 4.30 mmHg higher SBP over follow-up compared with ≥17 years education. Further adjustment for aforementioned covariates slightly reduced effect strength (2.53 mmHg, 95% CI: 0.93, 4.14. Associations were weaker in males, where those with ≤12 years education had 1.20 (95% CI: -0

  3. Pulmonary embolism excluded acute coronary syndrome by coronarography: a retrospective analysis

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    LIU Chun-ping; LI Jun-xia; NIU Li-li; CHEN Hang-wei; TAN Bo; WANG Ya-ping

    2012-01-01

    Background Pulmonary embolism (PE) is often mistaken as acute coronary syndromes (ACS) because of the considerable overlap in their clinical features.We evaluated the factors causing misdiagnosis of PE as ACS and factors that differentiate PE from ACS to improve the diagnosis efficacy of PE.Methods The medical records of 22 consecutive PE patients,between 2001 and 2010,who were initially suspected of ACS were retrieved.ACS was ruled out by coronary artery angiography before a definite diagnosis of PE was given.Twenty-two contemporary cases of ACS matched by age and sex were recruited as controls.Clinical manifestations,electrocardiograms (ECG),and biomarkers of these patients were reviewed retrospectively.The factors causing misdiagnosis of PE as ACS and factors differentiating PE from ACS were evaluated.Results We found two leading causes of misdiagnosis of PE as ACS.One is that PE can resemble ACS in several clinical aspects (symptoms and signs,ECG findings,plasma cardiac troponin I,and D-dimer).The other is the insufficient recognition of PE by clinicians.Risk factors for venous thromboembolism (VTE),especially deep venous thrombosis (DVT),together with signs of PE,such as unexplained dyspnea or hypoxemia,and right ventricular pressure overload on ECGs are valuable in differentiating the two diseases.Conclusions Differentiation between PE and ACS is sometimes challenging.Adequate awareness of the risk factors for VTE and the signs of PE are crucial in the diagnosis of PE.

  4. Retrospective analysis of the clinical behavior of oral hairy leukoplakia in 215 HIV-seropositive patients

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    Daniela Assis do VALE

    Full Text Available Abstract Oral manifestations are common findings in human immunodeficiency virus (HIV infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL is strongly associated with HIV infection demonstrating its relationship with the individual’s immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4% patients. Most were men in the fourth decade of life, 171 (79.5% and 112 (52,1% respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68% patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%. The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI. OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.

  5. Caspofungin as antifungal prophylaxis in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation: a retrospective analysis

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    Döring Michaela

    2012-07-01

    Full Text Available Abstract Background Pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT often receive intravenous liposomal amphotericin B (L-AmB as antifungal prophylaxis. There are no guidelines for antifungal prophylaxis in children in this situation. Caspofungin (CAS, a broad-spectrum echinocandin, could be an effective alternative with lower nephrotoxicity than L-AmB. Methods We retrospectively analyzed the safety, feasibility, and efficacy of CAS in our center, and compared the results with L-AmB as antifungal monoprophylaxis in pediatric patients undergoing HSCT. 60 pediatric patients received L-AmB (1 or 3 mg/kg bw/day and another 60 patients received CAS (50 mg/m2/day as antifungal monoprophylaxis starting on day one after HSCT. The median ages of patients receiving L-AmB and CAS were 7.5 years and 9.5 years, respectively. Results No proven breakthrough fungal infection occurred in either group during the median treatment period of 23 days in the L-AmB group and 24 days in the CAS group. One patient receiving CAS developed probable invasive aspergillosis. During L-AmB treatment, potassium levels significantly decreased below normal values. Patients treated with L-AmB had more drug-related side effects and an increased need for oral supplementation with potassium, sodium bicarbonate and calcium upon discharge as compared with the CAS group. CAS was well-tolerated and safe in this cohort of immunocompromised pediatric patients, who underwent high-dose chemotherapy and HSCT. Conclusion Prophylactic CAS and L-AmB showed similar efficacy in this biggest cohort of pediatric patients after allogeneic HSCT reported, so far. A prospective randomized trial in children is warranted to allow for standardized guidelines.

  6. A retrospective analysis of reported errata in five leading medical journals in 2012

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    Vijaya R. Bhatt

    2014-11-01

    Full Text Available Background: Although medical publications are frequently used as the source of information, the prevalence of errata remains unclear. The objective of this study was to examine peer-review and publication processes of medical journals as well as to determine the occurrence of reported errata in medical journals and timeliness in identifying and correcting errata. Methods: Five medical journals, New England Journal of Medicine, Annals of Internal Medicine, British Medical Journal, Journal of American Medical Association, and Lancet, were evaluated. The characteristics of these journals were obtained from editors’ survey. All these journals report errata noted in their prior publications. We retrospectively analyzed all errata reported from January 1, 2012, to December 31, 2012. The mean number of reported errata per issue, the most common errata, and the mean time to report errata were calculated. Results: The journals had high impact factors (14–51, received 3,200 to more than 15,000 submissions in 2012, and utilized two or more external reviewers and usually two or more editors for any accepted articles. All the journals edited the accepted articles, including references, figures, and tables for style. A mean of 1.3 articles with ≥1 errata was reported per issue (a total of 306 articles with errata in 226 issues. Errata in author's information, numeric errata, and errata in the figures and tables were the most common errata. The mean time to report the errata was 122 days. Conclusion: The high-impact journals, with extensive pre-publication review, reported relatively few errata per issue. The delay in reporting errata needs further exploration.

  7. Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

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    Xiao-ming CHENG

    2011-02-01

    Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

  8. [Retrospective analysis for 104 cases of early-stage Hodgkin's Lymphoma treated with different modality therapies].

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    Du, Ting-Ting; Xiao, Xiu-Bin; Su, Hang; Da, Yong; Chen, Xin-Lin; Zhong, Kai-Li; Zhao, Shi-Hua; Lu, Yun; Wang, Shuang; Zhang, Wei-Jing

    2012-04-01

    This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin's Lymphoma. 104 cases of early-stage Hodgkin's Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed, including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group, and the long-term efficacy and toxicity of two therapy modalities were evaluated. The results showed that the median survival time of 104 cases was 85.42 months, the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4 and 71.4 respectively (P = 0.924); the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4 and 96.4 respectively (P = 0.779); the 5-year overall survival (OS) rates in the 2 groups were 89.5 and 89.1 respectively, and the 8-year OS rates of the 2 groups were 81.3 and 70.6. No statistical difference was found in above-mentioned 2 groups. Moreover, the 5-year progression free survival (PFS) rates of these 2 groups were 84.2 and 69.0 (P = 0.04), and 8-year PFS rates of these 2 groups were 80.0 and 55.5 (P = 0.04) respectively, the 5-year relapse rates of these 2 groups were 28.1 and 45.6 (P = 0.023) respectively. It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin's Lymphoma, but there is no difference in the overall survival rate between the 2 groups.

  9. Analysis of 1,545 Fractures of Facial Region—A Retrospective Study

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    Gaddipati, Rajasekhar; Ramisetti, Sudhir; Vura, Nandagopal; Reddy, K. Rajiv; Nalamolu, Bhargav

    2015-01-01

    Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused due to various etiologies. This is a retrospective epidemiological study, which was performed on patients with fractures in the maxillofacial region during a period of 2005 to 2013 at Mamata Dental College and Hospital, Khammam, India. A total of 1,015 patients with 1,545 fractures were referred for treatment to department of oral and maxillofacial injuries surgery, of Mamata Dental College and Hospital, with a mean age of 31.19. The ratio of males (859):females (156) is 5.5:1. Injuries caused by motorbike injuries (34.9%) are highest. The highest frequency of fractures caused by various reasons is seen more in third decade (39%). Mandible (43.81%) is the most common fracture site in the face. Among soft tissue injuries most commonly seen are lacerations (43%). This study differentiates the etiological factors causing facial trauma in several age groups. Results of this study suggest outcomes indicate that more reliance on individual transport on motor vehicles has increased the frequency of facial bone fractures. Regardless of age, motor vehicle accidents were high in all age groups except the first decade of life and above 60 years of age when traffic accidents dominated. Thus effectiveness of current preventive measures is to be assessed, followed by instituting new guidelines for prevention and inflexible traffic rules shall be levied. More epidemiological surveys can, if encouraged to measure the frequency of fractures, better the world. PMID:26576235

  10. Breast cancer receptor status assessment and clinicopathological association in Nigerian women: A retrospective analysis

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    Makanjuola SBL

    2014-08-01

    Full Text Available Background: Breast cancer markers are becoming increasingly important in breast cancer research due to their impact on prognosis, treatment and survival. The present retrospective study was carried out to quantify the proportion of estrogen (ER, progesterone (PR, and human epithelial receptor 2 (HER2 expressions and their association with tumour grade, age, and tumour size in breast cancer patients in Nigeria. Materials and methods: The paraffin embedded tissue sections were analysed for breast cancer markers using monoclonal antibody SP1 for ER and SP2 for PR and polyclonal antibody ErbB2 for HER2. Results: A total of 286 breast cancer paraffin wax tissue sections were analysed for ER, PR and HER2 expression. Of all the tissue samples examined, 20 (7% were ER-positive, 6 (2.1% were PR-positive, 11 (3.8% were HER2-positive whereas 248 (87% were triple-negative breast carcinoma. ER- and PR-positivity was associated with early grade I and II tumours (P 50mm (P < 0.0001. Conclusion: A small proportion of Nigerian women with breast cancer are ER/PR-positive which are associated with less aggressive, better prognosis and benefit from endocrine therapy. An even smaller proportion of patients with aggressive tumors were HER2-posivite but responsive to Herceptin treatment. Unfortunately, a very high proportion of cases were triple-negative which is associated with very aggressive tumours and no targeted treatment, which may explain the high mortality rates from breast cancer in Nigeria.

  11. Childhood hospitalisation for otitis media in Western Australia: A 10-year retrospective analysis

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    Nicholas Liu

    2016-04-01

    Full Text Available Background The aim of this study was to assess the prevalence of hospitalisation for otitis media across the different risk indicators for Western Australian children (less than 15 years old over a 10-year period. Method This retrospective population-based study used the deidentified detailed data of children under the age of 15 years, hospitalised for otitis media (OM, as determined by principal diagnosis (ICD-10AM and obtained from the Western Australian (WA Hospital Morbidity Dataset for 10 financial years from 1999–2000 to 2008–2009. Various risk indicators, including age, gender, Indigenous status, insurance status, hospital area, hospital type, and length of stay were also analysed. Results Out of 26,294 cases of in-hospital care, Indigenous children comprised 4.7 per cent (n=1,226, while the non-Indigenous children comprised 95.3 per cent (n=25,068. The majority of the children, nearly 98.8 per cent, were admitted for chronic OM. The children were grouped into three age groups, namely, 0–4 years, 5–9 years, and 10–14 years. Nearly two-thirds of all cases were in the 0–4-year age group. Significantly more non-Indigenous (51 per cent than Indigenous children (2 per cent had private health insurance. The hospitalisation rates were directly proportional between the number of Indigenous children living in the area and the increasing remoteness of the area along with greater socioeconomic disadvantage. There were 24 per cent more cases from very remote areas compared to highly accessible areas, and there were 60 per cent more cases from the most disadvantaged socioeconomic category, compared with the least disadvantaged category, for Indigenous children. Conclusion These data depict the variations in prevalence of otitis media hospitalisations within the community, as affected by various risk indicators.

  12. Anterior chamber depth and refractive change in late postoperative capsular bag distension syndrome: a retrospective analysis.

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    Min Kyu Yang

    Full Text Available To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS.Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes.Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00-0.90. ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034, equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068.Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS.

  13. Wide spetcrum mutational analysis of metastatic renal cell cancer: a retrospective next generation sequencing approach.

    Science.gov (United States)

    Fiorentino, Michelangelo; Gruppioni, Elisa; Massari, Francesco; Giunchi, Francesca; Altimari, Annalisa; Ciccarese, Chiara; Bimbatti, Davide; Scarpa, Aldo; Iacovelli, Roberto; Porta, Camillo; Virinder, Sarhadi; Tortora, Giampaolo; Artibani, Walter; Schiavina, Riccardo; Ardizzoni, Andrea; Brunelli, Matteo; Knuutila, Sakari; Martignoni, Guido

    2017-01-31

    Renal cell cancer (RCC) is characterized by histological and molecular heterogeneity that may account for variable response to targeted therapies. We evaluated retrospectively with a next generation sequencing (NGS) approach using a pre-designed cancer panel the mutation burden of 32 lesions from 22 metastatic RCC patients treated with at least one tyrosine kinase or mTOR inhibitor. We identified mutations in the VHL, PTEN, JAK3, MET, ERBB4, APC, CDKN2A, FGFR3, EGFR, RB1, TP53 genes. Somatic alterations were correlated with response to therapy. Most mutations hit VHL1 (31,8%) followed by PTEN (13,6%), JAK3, FGFR and TP53 (9% each). Eight (36%) patients were wild-type at least for the genes included in the panel.A genotype concordance between primary RCC and its secondary lesion was found in 3/6 cases. Patients were treated with Sorafenib, Sunitinib and Temsirolimus with partial responses in 4 (18,2%) and disease stabilization in 7 (31,8%). Among the 4 partial responders, 1 (25%) was wild-type and 3 (75%) harbored different VHL1 variants. Among the 7 patients with disease stabilization 2 (29%) were wild-type, 2 (29%) PTEN mutated, and single patients (14% each) displayed mutations in VHL1, JAK3 and APC/CDKN2A. Among the 11 non-responders 7 (64%) were wild-type, 2 (18%) were p53 mutated and 2 (18%) VHL1 mutated.No significant associations were found among RCC histotype, mutation variants and response to therapies. In the absence of predictive biomarkers for metastatic RCC treatment, a NGS approach may address single patients to basket clinical trials according to actionable molecular specific alterations.

  14. Trends in healthcare utilization among older Americans with colorectal cancer: A retrospective database analysis

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    Earle Craig C

    2009-12-01

    Full Text Available Abstract Background Analyses of utilization trends (cost drivers allow us to understand changes in colorectal cancer (CRC costs over time, better predict future costs, identify changes in the use of specific types of care (eg, hospice, and provide inputs for cost-effectiveness models. This retrospective cohort study evaluated healthcare resource use among US Medicare beneficiaries diagnosed with CRC between 1992 and 2002. Methods Cohorts included patients aged 66+ newly diagnosed with adenocarcinoma of the colon (n = 52,371 or rectum (n = 18,619 between 1992 and 2002 and matched patients from the general Medicare population, followed until death or December 31, 2005. Demographic and clinical characteristics were evaluated by cancer subsite. Resource use, including the percentage that used each type of resource, number of hospitalizations, and number of hospital and skilled nursing facility days, was evaluated by stage and subsite. The number of office, outpatient, and inpatient visits per person-year was calculated for each cohort, and was described by year of service, subsite, and treatment phase. Hospice use rates in the last year of life were calculated by year of service, stage, and subsite for CRC patients who died of CRC. Results CRC patients (mean age: 77.3 years; 44.9% male used more resources than controls in every category (P Conclusion Use of hospice care among CRC decedents increased substantially over the study period, while other resource use remained generally steady. Our findings may be useful for understanding CRC cost drivers, tracking trends, and forecasting resource needs for CRC patients in the future.

  15. Cumulative ionizing radiation exposure in patients with end stage kidney disease: a 6-year retrospective analysis.

    LENUS (Irish Health Repository)

    Coyle, Joe

    2011-08-13

    OBJECTIVE: To quantify cumulative exposure to ionizing radiation in patients with end stage kidney disease (ESKD). To investigate factors which may be independently associated with risk of high cumulative effective dose (CED). MATERIALS AND METHODS: The study had local institutional review board ethical approval. We conducted a retrospective study of 394 period prevalent ESKD patients attending a single tertiary referral centre between 2004 and 2009. Patient demographics were obtained from case records. Details of radiological investigations were obtained from the institutional radiology computerized database. CED was calculated using standard procedure specific radiation levels. High exposure was defined as CED > 50 mSv, an exposure which has been reported to increase cancer mortality by 5%. Data were compared using Pearson χ(2) and Mann-Whitney U test or Kruskal-Wallis tests. RESULTS: 394 patients were followed for a median of 4 years (1518 patient years follow-up). Of these 63% were male. Seventeen percent of patients had a CED of >50 mSv. Computed tomography (CT) accounted for 9% of total radiological studies\\/procedures while contributing 61.4% of total study dose. Median cumulative dose and median dose per patient year were significantly higher in the hemodialysis (HD) group (15.13 and 5.79 mSv, respectively) compared to the post-transplant group (2.9 and 0.52 mSv, respectively) (P < 0.001). CONCLUSION: ESKD patients are at risk of cumulative exposure to significant levels of diagnostic radiation. The majority of this exposure is imparted as a result of CT examinations to patients in the HD group.

  16. Therapeutic plasma exchange in patients with neurological diseases: multicenter retrospective analysis.

    Science.gov (United States)

    Kaya, Emin; Keklik, Muzaffer; Sencan, Mehmet; Yilmaz, Mehmet; Keskin, Ali; Kiki, Ilhami; Erkurt, Mehmet Ali; Sivgin, Serdar; Korkmaz, Serdal; Okan, Vahap; Doğu, Mehmet Hilmi; Unal, Ali; Cetin, Mustafa; Altuntaş, Fevzi; Ilhan, Osman

    2013-06-01

    Therapeutic plasma exchange (TPE), is a procedure, changing pathologic substances in the plasma of patients with replacement fluid. TPE has an increasing list of indications in recent years such as neurological, connective tissue, hematological, nephrological, endocrinological and metabolic disorders. We report our multicenter data about therapeutic plasma exchange in patients with neurological diseases. Six University Hospitals' aphaeresis units medical records about neurologic diseases were reviewed retrospectively. Hundred and fifteen patients and 771 TPE sessions from six aphaeresis units' were included to this study. Of the 115 patients, 53 (46%) were men and 62 (54%) were women. The median age was 50 (range: 5-85) years. Of these patients 58.3% were Guillain-Barre syndrome (GBS), 17.4% were acute disseminated encephalomyelitis (ADEM), 10.4% were chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), 7% were multiple sclerosis, 6.1% were myasthenia gravis (MG) and 0.9% were Wilson disease (WD). The median number of TPE sessions per patient was 5 (range 1-72). Human albumin was used as a replacement fluid in 66% and fresh frozen plasma was used in 34% of cases. TPE was done through central venous catheters in 66%, and peripheral venous access in 34% of patients. Some complications were seen in patients (18.3%) during TPE sessions. These complications were, complications related to catheter placement procedure (8.7%), hypotension (3.5%), hypocalcaemia (3.5%) and allergic reactions (1.7%). The complication ratios were 2.7% in total 771 TPE procedures. TPE procedure was terminated in 6% of sessions depending on these complications. Overall responses to TPE were noted in 89.5% of patients. In conclusion; Therapeutic plasma exchange is an effective treatment option in several neurologic diseases.

  17. Analysis of gingival biopsies in the Gujarati population: A retrospective study

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    Bhari Sharanesha Manjunatha

    2014-01-01

    Full Text Available Background: Biopsy is an important diagnostic tool used in the diagnosis of lesions ranging from simple non-neoplastic, tumor-like lesions to malignancies, and is often the only way to diagnose oral lesions and diseases. The gingiva is the most common site for some kind of irritation or low-grade injury, resulting in localized overgrowths that are considered to be reactive and non-neoplastic lesions. This aim of this study is to analyze the frequency and distribution of gingival lesions in the Gujarati population. Materials and Methods: In this retrospective study, gingival biopsies submitted for a period of five years were included. Microscopic slides of all the cases were reviewed by two observers for confirmation of the diagnosis. Results: Among the 106 cases of gingival biopsies, the most frequent category of lesions encountered was the non-neoplastic category, which accounted for 73.58% of the cases. Both benign and malignant neoplasms constituted 26.42% of the cases. Among the non-neoplastic lesions, Pyogenic granuloma was the most frequent lesion (38.46%, followed by fibrous hyperplasia (20.51%, inflammatory hyperplasia (19.23%, and Epulis (8.97%. Neoplasms accounted for 26.42% of the gingival biopsies (92.85% benign and 7.15% malignant. Among the benign neoplastic lesions, Fibroma (30.76% and Fibrolipoma (26.92% were the most frequent, followed by peripheral ossifying fibroma (23.08% and peripheral giant cell granuloma (11%. Conclusion: It is difficult to compare studies carried out in various countries due to differences in people′s attitudes toward oral health and the accessibility of various population groups to biopsy services. Nevertheless, this study has provided some information about the frequency and distribution of biopsied gingival lesions in the Gujarati population over a period of five years.

  18. Retrospective analysis of old-age colitis in the Dutch inflammatory bowel disease population

    Institute of Scientific and Technical Information of China (English)

    Muhammed Hadithi; Marcel Cazemier; Gerrit A Meijer; Elisabeth Bloemena; Richel J Felt-Bersma; Chris J Mulder; Stephan GM Meuwissen; Amado Salvador Pe(n)a; Adriaan A van Bodegraven

    2008-01-01

    AIM:To describe the characteristics of Dutch patients with chronic.inflammatory bowel disease (IBD) first diagnosed above 60 years of age-a disease also known as old-age colitis (OAC) and to highlight a condition that has a similar appearance to IBD,namely segmental colitis associated with diverticular disease (SCAD).METHODS:A retrospective longitudinal survey of patient demographic and clinical characteristics,disease characteristics,diagnostic methods,management and course of disease was performed.The median follow-up period was 10 years.RESULTS:Of a total of 1100 IBD patients attending the Department of Gastroenterology,59 (5%) [median age 82 years (range 64-101);25 male (42%)] were identified.These patients were diagnosed with ulcerative colitis (n = 37,61%),Crohn's disease (n = 14,24%),and indeterminate colitis (n = 8,15%).Remission was induced in 40 (68%) patients within a median interval of 6 mo (range 1-21) and immunosuppressive therapy was well tolerated.Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis,namely SCAD instead of IBD in five (8%) patients.CONCLUSION:OAC is not an infrequent problem for the gastroenterologist,and should be considered in the evaluation of older patients with clinical features suggestive of IBD.Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD,when diagnosing IBD in the presence of diverticulosis coll.

  19. Ventilator-Associated Pneumonia and Causative Microorganisms in Intensive Care Unit: A Two Year Retrospective Analysis

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    Onur Palabıyık

    2016-12-01

    Full Text Available Objective: Ventilator-associated pneumonia (VAP is the most common nosocomial infection in the intensive care units (ICUs. It causes prolonged hospital stay and increases mortality. In this study, we aimed to investigate the rate of VAP, causative microorganisms, and their antibiotic susceptibilities in anaesthesiology and reanimation ICU (ARICU. Material and Method: This retrospective study included patients who were admitted to 12-bed ARICU between January 2013 and December 2014. The detection of VAP was done according to Centers for Disease Control and Prevention criteria. The rate of VAP, VAP ratio, and ventilator utilization ratio (VUR were calculated according to guidelines of Turkish National Infection Surveillance Control Group. Endotracheal aspiration samples were collected and cultivated. The identification of the isolates was performed by using VITEK-2 automated system. Antibiotic susceptibilities were determined by the disc diffusion method according to the Clinical and Laboratory Standards Institute criteria. Results: VAP was determined in 16 of 359 patients who required invasive mechanic ventilation for longer than 48 hours and hospitalized in ARICU. VUR was 65%, VAP ratio was 4.5% and the rate of VAP was 3.3 per 1000 ventilator days. Seventeen microorganisms were isolated from endotracheal aspiration samples, including Acinetobacter baumannii (n=6, Pseudomonas aeruginosa (n=4, methicillin-resistant Staphylococcus aureus (n=4, Klebsiella pneumoniae, Enterobacter cloacae and Serratia marcescens. The most sensitive antibiotics for microorganisms are listed as follows; Acinetobacter baumannii: colistin, Pseudomonas aeruginosa: amikacin, carbapenems; Methicillin-resistant Staphylococcus aureus: linezolid, teicoplanin, vancomycin, trimethoprim sulfamethoxazole; Klebsiella and Enterobacteriaceae species: carbapenems, trimethoprim sulfamethoxazole, gentamicin. Conclusion: Intermittent analyses and antibiotic susceptibilities of VAP

  20. Minor head injury in anticoagulated patients: a 6-year retrospective analysis in an emergency department

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    Alessandro Riccardi

    2014-05-01

    Full Text Available The appropriate management of minor head injury (MHI in patients receiving oral anticoagulant (OAC is unclear. In this retrospective study, we focused on elderly patients (>65 years treated with OAC, presented to our emergency department with MHI between 2004 and 2010. Three hundred and six patients with MHI were taking OAC: we documented 7.19% hemorrhages at the first computed tomography (C; 18.19% deaths; 50.1% spontaneous reabsorptions; 22.73% deteriorations of intracranial bleeding without surgical intervention (for clinical comorbidity, and 4.55% neurosurgical interventions. We documented a second positive CT scan in 2 patients (1.51% who had no symptoms and remained asymptomatic during observation. In both cases, intracranial bleeding resolved spontaneously. The mean international normalized ratio (INR value was 2.26, higher in the group of patients with bleeding (2.74 than in the group without bleeding (2.19. We found a significant increased risk in patients with posttraumatic loss of consciousness [odds ratio (OR 28.3], diffuse headache (OR 14.79, vomiting (OR 14.2 and neurological signs (OR 5.27. We did not reach significance in patients with post-traumatic amnesia. Our data confirm the need for a CT scan of any patients on OAC with MHI. None of our patients developed any symptoms or signs during observation, and only 2 patients developed an intracranial hemorrhage in the second CT scan with a favorable evolution. Our data need to be confirmed with an observational study, but we suggest that the second CT could be reserved for patients developing symptoms and signs during observation. We also underline the role of the INR in the stratification of risk.

  1. Percutaneous endoscopic gastrostomy (PEG) using a novel large-caliber introducer technique kit: a retrospective analysis

    Science.gov (United States)

    Toh Yoon, Ezekiel Wong; Yoneda, Kaori; Nakamura, Shinya; Nishihara, Kazuki

    2016-01-01

    Background and study aims: Percutaneous endoscopic gastrostomy (PEG) using the introducer technique is not only useful in patients with upper digestive tract stenosis but has been shown to reduce peristomal infection. In this study, we evaluated the safety and utility of a novel large-caliber introducer PEG kit (using 20 Fr size tube) compared with a push kit of similar size. Patients and methods: One hundred and thirty-six patients who received PEG at our hospital between January 2014 and December 2015 were retrospectively analyzed. Baseline characteristics, laboratory biomarkers, hemodynamic changes, postoperative adverse events and clinical outcomes with both kits were compared. Results: The new introducer PEG kit was used in 61 patients while the remaining 75 patients received tube placement using a push technique PEG kit. Except for the prevalence of dementia, which was lower in the introducer PEG kit group, baseline characteristics were similar in both groups. Tube placements were 100 % successful with both PEG kits and there were no significant differences in the change of postoperative hemodynamic or laboratory biomarkers. The Introducer PEG kit group experienced fewer incidence of feeding-related aspiration pneumonia (8.2 % vs. 24 %, P = 0.02), lower peristomal infection scores (1.2 vs. 1.6, P < 0.01), shorter postoperative length of stay (16 days vs. 23.7 days, P = 0.01) and fewer deaths at day 60 (3.3 % vs. 16 %, P = 0.02). Conclusions: Gastrostomy using the new large-caliber introducer PEG kit is safe and produced non-inferior (with some favourable) results when compared to the push technique using similar size tubes. PMID:27652307

  2. Neuropathological and genetic correlates of survival and dementia onset in synucleinopathies: a retrospective analysis

    Science.gov (United States)

    Irwin, David J.; Grossman, Murray; Weintraub, Daniel; Hurtig, Howard I.; Duda, John E.; Xie, Sharon X.; Lee, Edward B.; Van Deerlin, Vivianna M.; Lopez, Oscar L.; Kofler, Julia K.; Nelson, Peter T.; Jicha, Gregory A.; Woltjer, Randy; Quinn, Joseph F.; Kaye, Jeffery; Leverenz, James B; Tsuang, Debby; Longfellow, Katelan; Yearout, Dora; Kukull, Walter; Keene, C. Dirk; Montine, Thomas J.; Zabetian, Cyrus P.; Trojanowski, John Q.

    2016-01-01

    Background There exists great heterogeneity in patient survival and the time interval between motor symptom and dementia onset (MDI) across Lewy body spectrum disorders (LBSD). The goal of this study is to identify genetic and pathological findings that have the strongest association with these features of clinical heterogeneity in LBSD. Methods In this retrospective study, we examined symptom onset, and genetic and neuropathological data from a cohort of LBSD patients with autopsy-confirmed α-synucleinopathy (as of Oct 1, 2015) recruited from 5 clinical research centres in 5 cities in the USA. Using histopathology techniques and markers, we assessed the burden of tau neurofibrillary tangles, neuritic plaques, α-synuclein inclusions, and other pathologic changes in cortical regions using averaged ordinal scores and genotyped cases for variants associated with LBSD. We evaluated the time interval from onset of motor symptoms to dementia (MDI) and overall survival in groups with varying levels of co-morbid Alzheimer’s disease pathology (AD) according to current National Institute on Aging–Alzheimer’s Association neuropathological criteria and used multivariate regression to control for age at death and gender. Findings This study included 213 patients who had been followed to autopsy and met inclusion criteria of clinical LBSD with autopsy-confirmed α-synculeinopathy. Patient groups were characterized by no (n=49,23%), low-level (n=56,26%), intermediate-level (n=45,21%) or high-level (n=63,30%) AD neuropathology. Across groups of increasing levels of AD neuropathology, there were higher cerebral α-synuclein scores, shorter MDI, and shorter disease duration (pdiagnostic criteria which use reliable biomarkers for AD neuropathology in LBSD should help identify the most appropriate patients for clinical trials of emerging therapies targeting tau, amyloid-beta or α-synuclein, and stratify them by level of AD neuropathology. Funding NIH (NIA/NINDS). PMID

  3. Spectrum of Lesions Affecting the Renal Pelvis and Pelviureteric Junction: A 13-Year Retrospective Analysis

    Science.gov (United States)

    Kini, Hema; Suresh, Pooja Kundapur; Guni, Laxman Prabhu Gurupur; Bhat, Shaila; Kini, Jyoti Ramanath

    2016-01-01

    Introduction Both, the renal pelvis and the ureter, are affected by developmental, reactive and neoplastic disorders, though rare in incidence. Aim This series of cases were analysed to study the clinicopathological characteristics of the common and comparatively rare lesions involving the renal pelvis and pelviureteric junction. Materials and Methods A retrospective collection of 476 nephrectomies and pelviureteric junction resections, received over a period of 13 years from 2001 to 2013 was done. The patients’ clinical details were obtained and the histopathological findings reviewed. The lesions were classified into non-neoplastic and neoplastic categories. Results Primary involvement of the renal pelvis and pelviureteric junction was seen in 105 of 476 specimens. The mean age was 54.5 years with a male to female ratio of 2.2:1. The non-neoplastic lesions accounted for 76.2% of cases with a majority being pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy (68.6%) causing hydronephrosis. Urothelial carcinomas were encountered in 20% of the cases. A majority of the urothelial carcinomas were infiltrative (81%) and high grade (71%) tumours. Conclusion Renal pelvis, a conduit to propel urine, can be the site for numerous disorders. Non-neoplastic lesions were more common than neoplasms. Pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy was the commonest lesion in our study. In the neoplastic category, urothelial carcinoma was most common. However, rare lesions such as hamartomatous fibroepithelial polyp, Von Brunn’s nests, flat urothelial hyperplasia and intramuscular haemangioma of upper ureter at the pelviureteric junction were encountered along with occasional cases of tuberculosis and squamous cell carcinomas. PMID:27042468

  4. Acneiform Eruption and Other Dermatologic Side Effects Induced by Targeted Cancer Therapy: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Kurtuluş Didem Yazganoğlu

    2012-06-01

    Full Text Available Background and Design: Epidermal growth factor receptor (EGFR inhibitors may cause different adverse cutaneous reactions including acneiform (pustular, papulopustular eruption. Rarely, other specific targeted cancer therapy agents may cause similar pustular eruptions. The aim of this study was to evaluate the adverse skin reactions, mainly acneiform eruptions caused by these chemotherapeutic agents. Material and Methods: We retrospectively analyzed the data of 23 patients who developed acneiform eruption due to chemotherapeutic agents between May 2007 and April 2011. The drugs causing acneiform eruption, clinical features of eruption, other associated dermatologic adverse reactions and the treatment modalities used for the acneiform reaction were noted. Results: EGFR inhibitors such as erlotinib and cetuximab were the main drugs causing acneiform eruption in 21 patients. Everolimus and bevacizumab in combination with irinotecan were responsible in two patients. The eruption occurred on the face in all patients. The trunk, neck and the scalp were other affected body parts in some patients. The periorbital area on the face was generally spared. Xerosis and paronychia were the main associated adverse cutaneous reactions. Trichomegaly was another finding in two patients. The patients, who could have been followed, responded to topical or systemic antibiotics, or some medications for acne vulgaris/rosacea. Chemotherapy could be continued in all patients. Conclusion: Dermatologists need to know the specific eruptions occurring with chemotherapy drugs, especially EGFR inhibitors in order to develop the best approach without discontinuation of cancer therapy. Acneiform eruptions due to chemotherapeutics are most commonly seen on the face sparing periorbital area. Other reactions including mainly xerosis, paronychia and trichomegaly can also occur.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  6. Neurological effects of white spirit: Contribution of animal studies during a 30-year period

    DEFF Research Database (Denmark)

    Nielsen, Gunnar Damgård; Lund, Søren Peter; Ladefoged, Ole

    2006-01-01

    , but the neurophysiological tests showed adverse effects at this level. Fourth, neurophysiological methods may be more sensitive than histopathological, neurobehavioural and neurochemical methods. Overall, white spirit with a high and a low content of aromatics showed no overt difference in long-term effects in animals......Numerous studies have suggested that long-term occupational exposure to white spirit may cause chronic toxic encephalopathy (WHO 1996). This review summarizes the chronic nervous system effects of white spirit in animal studies during a 30-year period. First, routine histopathology was consistently...... unable to reveal adverse peripheral or central nervous system effects after inhalation of white spirit. Second, neurobehavioural studies in animals showed no adverse effect after inhalation of white spirit with a high content of aromatics in contrast to what was found with products with a low content...

  7. 30-Year Satellite Record Reveals Accelerated Arctic Sea Ice Loss, Antarctic Sea Ice Trend Reversal

    Science.gov (United States)

    Cavalieri, Donald J.; Parkinson, C. L.; Vinnikov, K. Y.

    2003-01-01

    Arctic sea ice extent decreased by 0.30 plus or minus 0.03 x 10(exp 6) square kilometers per decade from 1972 through 2002, but decreased by 0.36 plus or minus 0.05 x 10(exp 6) square kilometers per decade from 1979 through 2002, indicating an acceleration of 20% in the rate of decrease. In contrast to the Arctic, the Antarctic sea ice extent decreased dramatically over the period 1973-1977, then gradually increased, with an overall 30-year trend of -0.15 plus or minus 0.08 x 10(exp 6) square kilometers per 10yr. The trend reversal is attributed to a large positive anomaly in Antarctic sea ice extent observed in the early 1970's.

  8. A case of lupus vulgaris with rare localization diagnosed 30 years after onset.

    Science.gov (United States)

    Laudańska, H; Reduta, T; Zalewski, G; Chodynicka, B

    2011-01-01

    Cutaneous tuberculosis (tuberculosis cutis) is one of the extrapulmonary forms of tuberculosis, which may affect the skin only or co-exist with tuberculosis of other organs, particularly the lungs. We describe a case of lupus vulgaris in a 72-year-old male patient with a single lesion localized on his lower extremity, developing for 30 years before correct diagnosis and previously treated with topical steroids. Bacillus infection in other organs was not detected. Diagnosis of tuberculosis was made based on personal history, clinical picture, hypersensitivity to tuberculin, histopathology and polymerase chain reaction. A multidrug therapy with rifampicin, isoniazid and pyrazinamide resulted in regression of the lesion. The common lack of knowledge about the clinical picture of cutaneous tuberculosis causes its late diagnosis and treatment.

  9. Post-gastrectomy patients need to be followed up for 20-30 years

    Institute of Scientific and Technical Information of China (English)

    Frank I. Tovey; Michael Hobsley

    2000-01-01

    AIM To investigate the incidence andmanagement of nutritional deficiencies followinga gastrectomy.METHODS A gastrectomy population of 227patients in London was followed up for 30 years after operation to detect and treat nutritional deficiencies.RESULTS By the end of the first decade iron deficiency was the commonest problem. Vitamin B12 deficiency became more important in the second decade. During the third decade both reached equal prevalence, being found in some 90% of the female and 70% of the male residual population. Vitamin D deficiency was a lesser problem, reaching its climax in the second decade. Overall, all women fared worse than men.CONCLUSION The importance of long-term follow-up of gastrectomy patients for iron,Vitamin B12 and Vitamin D deficiencies is emphasised.

  10. Recurrent diplopia over a 30-year period: natural history of a Lewis and Sumner syndrome.

    Science.gov (United States)

    Lefaucheur, Romain; Bouwyn, Jean Paul; Wallon, David; Bedat-Millet, Anne-Laure; Ahtoy, Patrick; Perot, Guillaume; Hannequin, Didier; Maltête, David

    2012-06-01

    We described the case of a patient with recurrent episodes of isolated diplopia over the last 30 years. On her last event, neurological examination revealed not only a right third and sixth cranial nerves involvement, but also a right peripheral facial palsy and a motor weakness on the left ulnar territory. Electrophysiological nerves motor conduction study revealed a conduction block on the left ulnar nerve and a less severe on the right ulnar nerve. Asymmetrical upper limb sensorimotor weakness combined with conduction block and cranial nerves palsy led to a diagnosis of Lewis and Sumner syndrome (LSS). This case is unusual by the presentation of the disease and is, to our knowledge the longer natural disease course of LSS reported. Moreover, it suggests that the recurrent diplopia variant may represent a separate entity with a good prognosis even in absence of invasive treatment.

  11. Isotretinoin: dose, duration and relapse. What does 30 years of usage tell us?

    Science.gov (United States)

    Rademaker, Marius

    2013-08-01

    With 30 years of clinical use, it is appropriate to review the use of isotretinoin. We now understand that retinoids influence cellular growth, differentiation, morphogenesis and apoptosis, inhibit tumour promotion and malignant cell growth, exert immuno-modulatory actions and alter cellular cohesiveness. This has expanded the indications of isotretinoin from just acne and rosacea to a wide range of inflammatory and malignant skin disorders. While the standard dose of 0.5 to 1 mg/kg per day for 4 months to a cumulative dose of 120-140 mg/kg per day has served us well in the management of acne vulgaris, there is emerging evidence that much lower dosages (as low as 5 mg/day) are just as effective but have significantly fewer adverse effects. Relapse of acne vulgaris continues to be a problem but we are beginning to recognise that this is related less to the cumulative dose and more to the length of sebaceous gland suppression. Other factors important for relapse include a macrocomedonal pattern of acne, smoking and age, both younger (under 14 years) and older (over 25 years). After 30 years of use, we now understand why isotretinoin is such an effective drug. Not only does it clear acne in almost all patients, long-term remission can be achieved in 70-80% of patients with a single course. Important changes in the use of isotretinoin include using a lower daily dose for a longer period of time. New indications continue to emerge, particularly as a potential treatment for both intrinsic and extrinsic (photo) aging. Teratogenicity however, remains a very significant concern.

  12. A Bibliographic Study of Drug Abuse Research during last 30 years in Iran

    Directory of Open Access Journals (Sweden)

    Afarin Rahimi Movaghar

    2009-05-01

    Full Text Available In the last decades, the produced science has been significantly increased in the field of drug abuse, globally. The objective of this study was to assess the bibliographic aspects of the science produced in Iran on drug abuse in the last 30 years. All scientific papers published from Iran in a 30-year period (1973-2002 in national as well as international scientific journals were assessed for this study. These papers are indexed in the database for Iranian Mental Health Researches, called IranPsych. The total number of 218 papers on drug and drug abuse were found and assessed by six psychiatrists and psychologists with good inter-rater reliability. About half of these papers were published in the last two years. About half of the papers have been published in the Persian medical journals. One-third have been published in international journals. Overall, 449 authors contributed to the 218 published papers from whom 80 percent had only one paper. Half of the papers were written by only 15 authors (3.3 percent. Most of the authors were Medical Doctors and from Medical Universities. None of the researches was received financial support from pharmacologic industries. This study shows that in recent years, the increase in the publication of the researches conducted on drug abuse has been significant. Nevertheless, according to the high prevalence of drug abuse problem in Iran and improvements in the scientific, as well as executive structures, the whole scientific output is insignificant. The findings guide us to a more systematic approach toward training of researchers and promotion of resaerch in this area. Moreover, more active involvement of social scientists and publication of their research findings are recommended.

  13. Effect of different combinations of physiotherapy treatment approaches on functional outcomes in stroke patients: A retrospective analysis

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    Bryan Ping Ho Chung, MSc in Health Care

    2014-06-01

    Full Text Available This retrospective study compared the functional outcomes among stroke patients who had received rehabilitation based on different physiotherapy treatment approaches. The participants were divided into three groups according to the physiotherapist in charge of their treatment. The primary treatment approaches applied in Group A, Group B, and Group C were the functional approach, the Bobath approach, and the motor learning approach, respectively. For each participant, the Berg's Balance Scale score, the Modified Barthel Index, and the Modified Rivermead Mobility Index were compared among these three groups prior to and after the stroke rehabilitation programme. Within-group analysis showed that Group A, Group B, and Group C participants had a statistically significant improvement in their Modified Barthel Index (p  0.05. In summary, this study showed that different combinations of treatment approaches may induce similar improvement in functional outcomes after stroke rehabilitation.

  14. Relationship of Extreme Chromosomal Instability with Long-term Survival in a Retrospective Analysis of Primary Breast Cancer

    DEFF Research Database (Denmark)

    Roylance, Rebecca; Endesfelder, David; Gorman, Patricia

    2011-01-01

    methods, such as centromeric FISH, aimed at determining the variation around the modal number of two or more chromosomes within individual tumor nuclei. Here, we document the frequency of tumor CIN by dual centromeric FISH analysis in a retrospective primary breast cancer cohort of 246 patients...... with survival outcome. Results: There was increased CIN and clonal eterogeneity in ER-negative compared with ER-positive breast cancer. Consistent with a negative impact of CIN on cellular fitness, extreme CIN in ER-negative breast cancer was an independent variable associated with improved long-term survival......Background: Chromosomal instability (CIN) is thought to be associated with poor prognosis in solid tumors; however, evidence from preclinical and mouse tumor models suggest that CIN may paradoxically enhance or impair cancer cell fitness. Breast cancer prognostic expression signature sets, which...

  15. Retrospective analysis of role of interstitial brachytherapy using template (MUPIT in locally advanced gynecological malignancies

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    Nandwani Pooja

    2007-01-01

    Full Text Available Aim : The aim of this retrospective study was to assess treatment outcomes for patients with locally advanced gynecological malignancies being treated with interstitial brachytherapy using Martinez universal perineal interstitial template (MUPIT and to study the acute and late sequelae and survival after treatment by this technique. Materials and Methods : Ninety seven patients untreated with histopathological confirmation of carcinoma of cervix (37 vault (40 and vagina (20 were treated by combination of external beam RT (EBRT using megavoltage irradiation to pelvis to dose of 4000-5000 cGy followed by interstitial brachytherapy using MUPIT between September 2001 to March 2005. Median age was 46 years. Only those patients who were found unsuitable for conventional brachytherapy or in whom intracavitatory radiotherapy was found to be unlikely to encompass a proper dose distribution were treated by interstitial template brachytherapy using MUPIT application and were enrolled in this study. The dose of MUPIT was 1600-2400 cGy in 4-6# with 400 cGy /# and two fractions a day with minimum gap of six hours in between two fractions on micro-HDR. Criteria for inclusion of patients were as follows: Hb minimum 10 gm/dl, performance status - 70% or more (Karnofsy scale, histopathological confirmation FIGO stage IIB-IIIB (excluding frozen pelvis. Results : Among the 97 patients studied, 12 patients lost to follow-up and hence they were excluded from the study. Follow-up of rest of the patients was then done up to September 2006. The duration of follow-up was in the range of 20-60 months. Parameters studied were local control rate, complication rate, mortality rate and number of patients developing systemic metastasis. Local control was achieved in 56/85 (64.7% and complication rate was 15/85 (17.6%. Local control was better for nonbulky tumors compared bulky tumors irrespective of stage of disease. Local control was better in patients with good regression of

  16. A retrospective analysis of characteristics of visual field damage in patients with Leber's hereditary optic neuropathy.

    Science.gov (United States)

    Ran, Ruijin; Yang, Shuo; He, Heng; Ma, Shiqi; Chen, Zhiqi; Li, Bin

    2016-01-01

    The objective of this study is to investigate the characteristics and the evolution of visual field damage caused by Leber's hereditary optic neuropathy (LHON) and to provide clinical data for the diagnosis of LHON. Parameters of visual field in 32 consecutive patients (49 eyes) with LHON who were confirmed by genetic diagnostic tests were retrospectively measured within 1 week, between three to six months, and at six months after onset. Visual field defects revealed central scotoma in 26 eyes (53.1 %), paracentral scotoma in 12 eyes (24.5 %), ceco-central defects in 6 eyes (12.2 %), blind spot enlargenment in 3 eyes (6.1 %), quadrantanopia in 2 eyes (4.1 %) within 1 week after onset. After 3 to 6 months, ceco-central defects were detected in 22 eyes (44.9 %), central isopter constriction in 10 eyes (20.4 %), hemianopia or quadrantanopia in 5 eyes (10.2 %), central scotoma in 4 eyes (8.2 %), and paracentral scotoma in 1 eye (2.0 %). After 6 months, central isopter constriction was observed in 18 eyes (36.7 %), diffuse defects in 21 eyes (42.9 %), ceco-central defects in 3 eyes (6.1 %), hemianopia or quadrantanopia in 5 eyes (10.2 %), and central scotoma in 2 eyes (4.1 %). LHON at different stages was characterized by different focal visual field defects: visual field defects in LHON patients within 1 week after onset were mostly central or paracentral scotoma, which was enlarged around the ceco-central defect, or connected to form a blind spot after 3-6 months. Diffuse and central isopter constriction defects were usually developed after 6 months. Damages firstly appeared in papillomacular bundle and gradually expanded outward. These characteristics of visual field defects reported in this study might provide a clinical basis for better diagnosis of LHON.

  17. Morphologic patterns and imaging features of intracranial hemangiopericytomas: a retrospective analysis

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    Pang HP

    2015-08-01

    Full Text Available Haopeng Pang,1 Zhenwei Yao,1 Yan Ren,1 Guobing Liu,2 Jiawen Zhang,1 Xiaoyuan Feng1 1Department of Radiology, Affiliated Huashan Hospital of Fudan University, People’s Republic of China; 2Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China Objectives: Hemangiopericytomas (HPCs are rare intracranial tumors. Their differential diagnosis using computed tomography (CT and magnetic resonance imaging (MRI is difficult because of similarities in morphologic features with other intracranial tumors and meningiomas. Methods: We retrospectively analyzed the clinical data and CT and MRI findings of 32 patients diagnosed with HPCs via histopathology. We evaluated the location, shape, morphologic patterns, density, and signal intensity of the tumors and classified them into four types. Results: The number of tumors analyzed was 32; 29 were supratentorial and three were infratentorial. Eighteen tumors were lobular, while 14 were oval in shape. Further, 28 tumors had cystic areas, and 16 had signal-void vessels. Among the 20 tumors that had been scanned by MRI; eleven showed isointensity, eight slight hyperintensity, and one slight hypointensity on T1-weighted image. Moreover, 12 showed isointensity, and eight showed slight hyperintensity on T2-weighted image and T2-weighted-fluid-attenuated-inversion recovery. Diffusion-weighted images showed isointensity (9/13 or slight hyperintensity (4/13. Of the 15 tumors scanned by contrast-enhanced MRI, one showed poor enhancement; six, moderate enhancement; and eight, intense enhancement. Only one tumor exhibited the “dural tail” sign. Moreover, calcification was observed in just one tumor on CT imaging (1/22. All tumors (5/5 showed intense enhancement on CT angiography, whereas some exhibited dual blood supply (2/5. Conclusion: We conclude that tumors present outside the brain parenchyma, with isointense to slightly intense regions on MRI scans, oval

  18. Curettage of benign bone tumors and tumor like lesions: A retrospective analysis

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    Zile Singh Kundu

    2013-01-01

    Full Text Available Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm cm and the mean volume of the lesions was 34.89 cm 3 (range 0.94-194.52 cm 3 . The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm 3 were found to have higher incidence of complications. Conclusion: This study

  19. Rhino-Orbito-Cerebral Mucormycosis. A Retrospective Analysis of Clinical Features and Treatment Outcomes

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    Nithyanandam Suneetha

    2003-01-01

    Full Text Available Objective: The conventional management of rhino-orbito-cerebral (ROC mucormycosis includes control of metabolic abnormality, administration of amphotericin B and surgery that spans simple sinus clearance, radical debridement and orbital exenteration. Recent literature includes anecdotal descriptions of successful treatment with conservative management of involved orbits. We evaluated the clinical features and outcome of treatment for the different stages of ROC mucormycosis. Method: In this retrospective case series, 34 case records of patients with a histopathological diagnosis of ROC mucormycosis treated between 1992 and 2000 were reviewed. Three clinical stages and three treatment groups were identified. Patients with limited sino-nasal disease (Clinical stage I underwent sino-nasal debridement (Treatment group A. Patients with limited rhino-orbital disease (Clinical stage II underwent either sino-nasal debridement alone (Treatment group A or orbital exenteration in addition to sino-nasal debridement (Treatment group B. Patients with rhino-orbito-cerebral disease (Clinical stage III did not undergo any surgical procedure (Treatment group C. Thirty-three patients received intravenous amphotericin B. Outcome for each group was measured as "Treatment success" (disease free, stable patient with metabolic abnormality under control and "Treatment failure" (progression of disease with worsening general condition or mortality due to the disease. Results: Uncontrolled diabetes in 30 (88.2% of 34 patients was the commonest underlying disease and 16 (53.3% of 30 diabetics had ketoacidosis. Chronic renal failure (n = 4, hepatic disease (n = 3 and idiopathic thrombocytopenia (n = 1 were the other underlying diseases. Eleven patients had stage I disease, 16 patients had stage II disease and seven patients had stage III disease. All 11 patients with stage I disease received treatment A; of 16 patients with stage II disease, 7 received treatment A and the

  20. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis

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    Christian Hierholzer

    2011-01-01

    Full Text Available Background: Two major therapeutic principles can be employed for the treatment of distal femoral fractures: retrograde intramedullary (IM nailing (RN or less invasive stabilization on system (LISS. Both operative stabilizing systems follow the principle of biological osteosynthesis. IM nailing protects the soft-tissue envelope due to its minimally invasive approach and closed reduction techniques better than distal femoral locked plating. The purpose of this study was to evaluate and compare outcome of distal femur fracture stabilization using RN or LISS techniques. Materials and Methods: In a retrospective study from 2003 to 2008, we analyzed 115 patients with distal femur fracture who had been treated by retrograde IM nailing (59 patients or LISS plating (56 patients. In the two cohort groups, mean age was 54 years (17-89 years. Mechanism of injury was high energy impact in 57% (53% RN, 67% LISS and low-energy injury in 43% (47% RN, 33% LISS, respectively. Fractures were classified according to AO classification: there were 52 type A fractures (RN 31, LISS 21 and 63 type C fractures (RN 28, LISS 35; 32% (RN and 56% (LISS were open and 68% (RN and 44% (LISS were closed fractures, respectively. Functional and radiological outcome was assessed. Results: Clinical and radiographic evaluation demonstrated osseous healing within 6 months following RN and following LISS plating in over 90% of patients. However, no statistically significant differences were found for the parameters time to osseous healing, rate of nonunion, and postoperative complications. The following complications were treated: hematoma formation (one patient RN and three patients LISS, superficial infection (one patient RN and three patients LISS, deep infection (2 patients LISS. Additional secondary bone grafting for successful healing 3 months after the primary operation was required in four patients in the RN (7% of patients and six in the LISS group (10% of patients

  1. Retrospective analysis of pesticide metabolites in urine using liquid chromatography coupled to high-resolution mass spectrometry.

    Science.gov (United States)

    López, Antonio; Dualde, Pablo; Yusà, Vicent; Coscollà, Clara

    2016-11-01

    A comprehensive retrospective analysis of pesticide metabolites in urine was developed, using liquid chromatography coupled to Orbitrap high-resolution mass spectrometry (UHPLC-HRMS) that includes both post-run target (suspect screening) and non-target screening. An accurate-mass database comprising 263 pesticide metabolites was built and used for the post-run screening analysis. For non-target analysis, a "fragmentation-degradation" relationship strategy was selected. The proposed methodology was applied to 49 real urine samples from pregnant women. In the post-target analysis 26 pesticide metabolites were tentatively identified, 8 of which (2-diethylamino-6-methyl-pyrimidinol; 3-ketocarbofuran; 4,6-dimethoxy-2-pyrimidinamine; 4-hydroxy-2-isporopyl-6-methylpyrimidine; diethyl malate; diethyl maleate; N-(2-Ethyl-6-methylphenyl)-2-hydroxyacetamide and propachlor oxanilic acid ) were confirmed using analytical standards. Likewise, one unknown degradation product, methyl-N-phenylcarbamate was elucidated in the non-target screening. Finally, the real urine samples were grouped according to their origin applying a metabolomic approach.

  2. 198例成年人心瓣膜病超声心动图检查的回顾性分析%Retrospective Analysis of Echocardiography Data of 198 Adult Patients with Valvular Heart Diseases

    Institute of Scientific and Technical Information of China (English)

    胡小娟; 胡智安; 韩鄂辉; 吕志红; 柯建梅

    2015-01-01

    为探讨黄石地区30岁以上的成年人心脏瓣膜病的发病率情况、发病原因及经胸超声心动图显像特点,回顾性分析了近2年来到黄石市中心医院就诊的年龄>30岁、诊断为心脏瓣膜病的患者的经胸超声心动图资料. 比较不同年龄组心脏瓣膜病的发生率,差异有统计学意义(P<0. 05),尤其是60岁以上,其发病率明显增高;且最常受累的瓣膜是主动脉瓣,差异有统计学意义 (P<0. 01);心脏瓣膜病的发病原因中以退行心脏瓣膜病最为常见. 经胸超声心动图检查可直接观察心脏瓣膜病患者瓣膜的形态、结构,判断瓣膜的狭窄及反流程度,能进行定性与定量评价,可为临床提供完善的诊疗方案.%Objective:To discuss the incidence, etiological and the ultrasonographic features of valvular heart diseases in adult patients( over 30 years old) in huangshi. Method:A retrospective analysis of the echocardio-graphy data of patients( over 30 years old) with VHD in Huangshi Central Hospital in recent two years. Re-sults:among different age groups,the occurrence of valvular heart diseases was compared,the difference was statistically significant(P<0. 05),especially for those over 60 years old,the incidence rate increased signifi-cantly. And the valve most frequently involved in valvular heart diseases was aortic valve,the difference was statistically significant(P<0. 01). In the etiology of valvular heart diseases,senile degenerative heart valvular disease( SDHVD) is the most common one. Conclusion:valvular heart diseases,valve shape and structure,can directly be observed by echocardiography, it can also demonstrate valvular stenosis and reflux and can be qualitative and quantitative evaluation,which can provide complete diagnosis and treatment plan for clinical work.

  3. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis

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    Siddiqui A

    2016-05-01

    Full Text Available Asad Siddiqui,1 Andrew Tse,2 James E Paul,3 Peter Fitzgerald,4 Bernice Teh,51Department of Anesthesia, University of Toronto, Toronto, 2Department of Anesthesia, University of Ottawa, Ottawa, 3Department of Anesthesia, 4Department of Surgery, McMaster University, Hamilton, Ontario, Canada; 5Canterbury Anesthetic Services, Victoria, Australia Introduction: Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children's hospital, in patients undergoing the Nuss procedure. Methods: Seventy-two pediatric patients were identified as having been treated with one of three epidural regimens for postoperative pain management following the Nuss procedure: Group A (n=12 received 0.125% bupivacaine and 5 µg/mL fentanyl, Group B (n=21 received 0.125% bupivacaine and 10 µg/mL hydromorphone, and Group C (n=39 received 0.1% ropivacaine and 20 µg/mL hydromorphone. Our primary outcome was maximal daily pain scores (numerical rating scale 0–10, with an analytical focus on postoperative day 1 scores. The primary outcome was analyzed using linear regression. The secondary outcomes included the length of stay, side-effect profiles as reflected by the number of treatments for nausea and pruritus, pain scores according to epidural site insertion, occurrence of breakthrough pain, and presence of severe pain throughout their hospital stay. Secondary outcomes were analyzed using linear or

  4. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis

    Science.gov (United States)

    Siddiqui, Asad; Tse, Andrew; Paul, James E; Fitzgerald, Peter; Teh, Bernice

    2016-01-01

    Introduction Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure) is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children’s hospital, in patients undergoing the Nuss procedure. Methods Seventy-two pediatric patients were identified as having been treated with one of three epidural regimens for postoperative pain management following the Nuss procedure: Group A (n=12) received 0.125% bupivacaine and 5 µg/mL fentanyl, Group B (n=21) received 0.125% bupivacaine and 10 µg/mL hydromorphone, and Group C (n=39) received 0.1% ropivacaine and 20 µg/mL hydromorphone. Our primary outcome was maximal daily pain scores (numerical rating scale 0–10), with an analytical focus on postoperative day 1 scores. The primary outcome was analyzed using linear regression. The secondary outcomes included the length of stay, side-effect profiles as reflected by the number of treatments for nausea and pruritus, pain scores according to epidural site insertion, occurrence of breakthrough pain, and presence of severe pain throughout their hospital stay. Secondary outcomes were analyzed using linear or logistic regression adjusted for pain scores at baseline. The criterion for statistical significance was set a priori at alpha =0.05. Results Group A had significantly higher day-1 pain scores (score 5.42/10) than Group B (4.52/10; P=0.030) and Group C (4.49/10; P=0.015) after adjusting for baseline pain and age. No significant difference in maximum daily

  5. 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

  6. Postoperative radiotherapy of patients with thymic epithelial tumors (TET). A retrospective analysis of outcome and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Haefner, Matthias Felix; Roeder, Falk; Sterzing, Florian; Krug, David; Koerber, Stefan A.; Debus, Juergen [Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg (Germany); German Cancer Research Center (dkfz), Clinical Cooperation Unit Radiation Oncology, Heidelberg (Germany); Kappes, Jutta [University of Heidelberg, Department of Pneumology, Thoraxklinik Heidelberg, Heidelberg (Germany); Hoffmann, Hans [University of Heidelberg, Department of Thoracic Surgery, Thoraxklinik Heidelberg, Heidelberg (Germany); Slynko, Alla [German Cancer Research Center (dkfz), Biostatistics, Heidelberg (Germany); Bischof, Marc [Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg (Germany); SLK-Kliniken Heilbronn, Department of Radiation Oncology, Heilbronn (Germany)

    2014-08-26

    The purpose of this study was to evaluate postoperative radiotherapy regarding outcome and toxicity in patients with thymic epithelial tumors (TET) after surgery. We retrospectively analyzed medical records of 41 patients with TET treated with postoperative radiotherapy at our institution between 1995 and 2012. The impact of prognostic factors (e.g., Masaoka stage, histological subtype) was investigated and radiation-related toxicity was assessed. Median age was 59.8 years and median follow-up was 61 months. In 24.4 %, TETs were associated with paraneoplastic syndromes. The 5-year overall survival (OS) was 89.5 % and the 5-year disease-free survival (DFS) was 88.9 %. Masaoka stage had a significant impact on OS (p = 0.007). Locally limited stages I + II had a 5-year OS of 100 % compared to 80 % for stage III and 66.7 % for stage IV. The 5-year DFS was excellent with 100 % for both WHO groups A/AB/B1 and B2, respectively, and significantly (p = 0.005) differed from B3/C-staged patients with a 5-year DFS of 63.6 %. Resection status, paraneoplastic association, radiation dose, or tumor size did not influence survival. There were no high-grade acute or late side effects caused by radiotherapy. Masaoka stage has a significant impact on OS as WHO type has on DFS in patients with TETs after surgery and adjuvant irradiation. Postoperative radiotherapy with doses around 50 Gy is safe and not likely to cause high-grade toxicity. Further prospective trials are necessary to separate patient subgroups that benefit from radiotherapy from those that do not. (orig.) [German] Die vorliegende Studie hatte zum Ziel, die postoperative Radiotherapie von Patienten nach Resektion einer Thymusneoplasie epithelialen Ursprungs (Thymom, Thymuskarzinom, ''thymic epithelial tumors'', TET) hinsichtlich prognostischer Relevanz und Nebenwirkungsprofil zu beurteilen. Wir analysierten retrospektiv die medizinischen Krankenakten von 41 Patienten mit TET, die zwischen 1995 und

  7. Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis.

    Science.gov (United States)

    Wöhrer, Stefan; Kiesewetter, Barbara; Fischbach, Julia; Müllauer, Leonhard; Troch, Marlene; Lukas, Julius; Mayerhoefer, Marius E; Raderer, Markus

    2014-08-01

    We have performed a retrospective analysis of all patients with extragastric mucosa-associated lymphoid tissue (MALT) lymphoma treated at our institution to compare the efficacy of first-line therapeutic modalities including surgery, radiation, systemic therapy, and antibiotics. One hundred eighty-five patients with extragastric MALT lymphoma with a median age of 63 (interquartile range (IQR) 50-74) years and a median follow-up time of 49 (IQR 18-103) months were retrospectively analyzed. Time to progression and time to next therapy were used as surrogate endpoints for efficacy. Patients having either surgery (100 %), chemo/immunotherapy (85.5 %), or radiation (80 %) had significantly (p = 0.01) higher response rates than patients treated with antibiotics (33.3 %). Patients who were irradiated had significantly more progressive disease, but also the longest follow-up time. Stage, elevated LDH, anemia, elevated beta-2 microglobulin, plasmacytic differentiation, monoclonal gammopathy, or autoimmune disease did not influence the rate of disease progression nor did complete remission or partial remission from initial therapy influence time to and rate of progression. There was no significant difference in the median time to progression (p = 0.141), but the estimated time to progression (p = 0.023) as well as the estimated time to next therapy (p = 0.021) was significantly different among the various cohorts favoring surgery, chemo/immunotherapy, and radiation. Our results suggest extragastric MALT lymphoma as a potential systemic disease irrespective of initial stage. Radiation, surgery, and chemo/immunotherapy seem to be equally effective in achieving remissions and prolonged progression free survivals, but a curative potential is questionable. Localized MALT lymphomas affecting the thyroid gland or the lungs have excellent long-term progression-free survivals with surgical treatment only.

  8. A Retrospective Analysis of Maxillofacial Trauma in Shiraz, Iran: a 6-Year- Study of 768 Patients (2004-2010

    Directory of Open Access Journals (Sweden)

    Arabion HR.

    2014-03-01

    Full Text Available Statement of Problem: Information about etiology and incidence of maxillofacial trauma is important for prevention and appropriate treatments of such injuries. Purpose: The purpose of this retrospective study was to conduct an analysis of maxillofacial injuries transferred and/or referred to the department of maxillofacial Surgery at Chamran emergency hospital, Shiraz, over a 6-year-period with special reference to age, gender, occupation, date, type, site, etiology and clinical management. Materials and Method: The data for this study were collected and reviewed retrospec-tively from the records and radiographs of 768 patients who were treated for maxillofacial trauma in the department of maxillofacial surgery at the Shiraz Chamran Emergency Hospital, Iran, between 2004 and 2010. Results: A total of 730 of the subjects were the patients with fractures of the facial skeleton. The mean age was 26.6± 12.6 years, ranging from 2 to 81 years. Traffic accident was the most frequent etiological factor of maxillofacial fractures irrespective of gender (69.9% for men and 54.2% for women, whereas the second most frequent cause of injuries was falling down (9.8% for men and 21.5% for women .The other etiologies were assault (5.2%, sport related injuries (1.3% and firearm injuries (1%. Regarding the head injuries in patients with maxillofacial fractures, brain contusion was seen in 227(29.6% patients and 13.5% of patients had lacerations in the facial soft tissue. The monthly distribution peaked in October, with 81 cases (10.5%, which seems to have been due to schools opening. The next highest incidence was in December, with 80 cases (10.4%, probably because of the changing weather's effect on road traffic. Conclusion: Isolated mandibular fracture due to the road traffic accident was the most common type of maxillofacial injuries in the city of Shiraz.

  9. Allometric scaling of marbofloxacin, moxifloxacin, danofloxacin and difloxacin pharmacokinetics: a retrospective analysis.

    Science.gov (United States)

    Cox, S K

    2007-10-01

    The purpose of this study was to examine the allometric analyses of marbofloxacin, moxifloxacin, danofloxacin and difloxacin using pharmacokinetic data from the literature. The parameters of interest (half-life, clearance and volume of distribution) were correlated across species as a function of body weight using an allometric approach (Y = aWb). Results of the allometric analysis indicated similarity between clearance and volume of distribution as they relate to body weight for all drugs. The elimination half-life was independent of body mass for all fluoroquinolones except moxifloxacin. Results of the analysis suggest that allometric scaling can be used as a tool for predicting pharmacokinetic parameters for fluoroquinolones.

  10. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

    Directory of Open Access Journals (Sweden)

    Danilo Manuel Cerqueira Costa

    2013-07-01

    Full Text Available Objective: To evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis. Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others. Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14% cases presented changes after the second analysis, as follows: nephrolithiasis (10%, steatosis (3%, adrenal nodule (0.7% and cholelithiasis (0.3%. Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis.

  11. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Danilo Manuel Cerqueira; Salvadori, Priscila Silveira; Monjardim, Rodrigo da Fonseca; Bretas, Elisa Almeida Sathler; Torres, Lucas Rios; Caldana, Rogerio Pedreschi; Shigueoka, David Carlos; Medeiros, Regina Bitelli; D' ippolito, Giuseppe, E-mail: giuseppe_dr@uol.com.br [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Departamento de Diagnostico por Imagem

    2013-06-15

    Objective: to evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis. (author)

  12. National Library of Medicine Celebrates 30 Years of Progress and Charts the Future | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. National Library of Medicine Celebrates 30 Years of Progress and ... me to imagine a world without the National Library of Medicine." Photo courtesy of NIH NLM Director ...

  13. Retrospective analysis of 25 children with Takayasu's arteritis%儿童多发性大动脉炎25例回顾性分析

    Institute of Scientific and Technical Information of China (English)

    李亚男; 李善玉; 刘丽

    2011-01-01

    Objective To explore the clinical feature of children with Takayasn's arteritis (TA), and to analyze the relevant treatment methods and prognosis. Methods Retrospective analysis was performed on the clinical manifestations of 25 children with TA, and the process of treatment and prognosis. Results In this study, the ratio of male to female was 8 : 17, and the average onset age was ( 10.8 ± 3.0) years old. The most common TA type was 1 (56.0%), and the initial symptoms included headache, convulsions, fatigue, protcinuria, etc. All children had high blood pressure and 19 cases had lo (Tubercle bacillus) injection, 22 cases received cortjcosterojcis, and/or eveiophos-pharnide treatment All patient's condition relieved, but 16 patients had recurrence. Three cases received interventional therapy, no stenosis happened again. Conclusions For children, especially adolescent children with headache and high blood pressure as the main clinical manifestation, the diagnosis of TA should be kept in mind, TA in children is often caused by tuberculosis infection, therefore, early diagnosis and treatment of tuberculosis infection can effectively prevent the occurrence of TA. Drug treatment have a higher recurrence rate, interventional therapy can effectively improve ischemic symptoms.%目的 探讨儿童多发性大动脉炎(TA)的临床特征,分析相关治疗方法和转归.方法回顾性分析25例儿童多发性大动脉炎患儿的临床表现、治疗过程及预后.结果 患儿发病年龄为(10.8±3.0)岁,男女比为8:17.TA临床分型中以Ⅲ型最多(56.0%),常以头痛、抽搐、乏力、蛋白尿等为首发症状,25例患儿均有高血压,其中19例有结核感染.22例患儿接受糖皮质激素和(或)环磷酰胺治疗后病情缓解,其中16例出现复发;3例患儿接受血管内介入治疗,效果良好,未再出现狭窄.结论 儿童尤其是青春期以头痛、高血压为主要表现时需注意多发性大动脉炎可能.儿童多发性大动脉

  14. Factors driving mortality and growth at treeline: a 30-year experiment of 92 000 conifers.

    Science.gov (United States)

    Barbeito, Ignacio; Dawes, Melissa A; Rixen, Christian; Senn, Josef; Bebi, Peter

    2012-02-01

    Understanding the interplay between environmental factors contributing to treeline formation and how these factors influence different life stages remains a major research challenge. We used an afforestation experiment including 92 000 trees to investigate the spatial and temporal dynamics of tree mortality and growth at treeline in the Swiss Alps. Seedlings of three high-elevation conifer species (Larix decidua, Pinus mugo ssp. uncinata, and Pinus cembra) were systematically planted along an altitudinal gradient at and above the current treeline (2075 to 2230 m above sea level [a.s.l.]) in 1975 and closely monitored during the following 30 years. We used decision-tree models and generalized additive models to identify patterns in mortality and growth along gradients in elevation, snow duration, wind speed, and solar radiation, and to quantify interactions between the different variables. For all three species, snowmelt date was always the most important environmental factor influencing mortality, and elevation was always the most important factor for growth over the entire period studied. Individuals of all species survived at the highest point of the afforestation for more than 30 years, although mortality was greater above 2160 m a.s.l., 50-100 m above the current treeline. Optimal conditions for height growth differed from those for survival in all three species: early snowmelt (ca. day of year 125-140 [where day 1 is 1 January]) yielded lowest mortality rates, but relatively later snowmelt (ca. day 145-150) yielded highest growth rates. Although snowmelt and elevation were important throughout all life stages of the trees, the importance of radiation decreased over time and that of wind speed increased. Our findings provide experimental evidence that tree survival and height growth require different environmental conditions and that even small changes in the duration of snow cover, in addition to changes in temperature, can strongly impact tree survival and

  15. Retrospective detection of exposure to organophosphorus anti-cholinesterases: Mass spectrometric analysis of phosphylated human butyrylcholinesterase

    NARCIS (Netherlands)

    Fidder, A.; Hulst, A.G.; Noort, D.; Ruiter, R. de; Schans, M.J. van der; Benschop, H.P.; Langenberg, J.P.

    2002-01-01

    In this paper a novel and general procedure is presented for detection of organophosphate-inhibited human butyrylcholinesterase (HuBuChE), which is based on electrospray tandem mass spectrometric analysis of phosphylated nonapeptides obtained after pepsin digestion of the enzyme. The utility of this

  16. "Studies in Higher Education" 1976-2013: A Retrospective Using Citation Network Analysis

    Science.gov (United States)

    Calma, Angelito; Davies, Martin

    2015-01-01

    This paper provides a citation network analysis of the publications in "Studies in Higher Education" from 1976 to 2013 inclusive. This represents the entire history of the journal to date. It analyses the most published authors, most cited authors and most discussed topics using keywords. 1056 articles were taken from Web of…

  17. Health informatics research in Australia: retrospective analysis using PubMed

    Directory of Open Access Journals (Sweden)

    Kumara Mendis

    2007-01-01

    Discussion Australian HI publications in PubMed increased consistently throughout the period 1970-2005, which is on a par with world trends in HI publications. In Australia, most HI publications are in general medical journals. Lack of consistency in author names and failure to include the country name and even the state are the main obstacles to PubMed bibliometric analysis.

  18. A retrospective appreciation of Willard Day's contributions to radical behaviorism and the analysis of verbal behavior

    Science.gov (United States)

    Moore, Jay

    1991-01-01

    Willard Day's contributions to radical behaviorism are grouped under three headings: (a) an emphasis on the distinction between radical and methodological behaviorism; (b) an emphasis on the interpretation, rather than the prediction and control, of behavior; and (c) an emphasis on the analysis of verbal behavior as a natural, ongoing phenomenon. The paper suggests that the contributions above are listed in ascending order of significance. PMID:22477632

  19. Sudden infant death syndrome in Korea: a retrospective analysis of autopsy-diagnosed cases.

    Science.gov (United States)

    Yoo, Seong Ho; Kim, Angela Julie; Kang, Shin-Mong; Lee, Han Young; Seo, Joong-Seok; Kwon, Tae Jung; Yang, Kyung-Moo

    2013-03-01

    This study aimed to elucidate the demographic and sleeping environmental factors associated with sudden infant death syndrome (SIDS) in Korea. The autopsy reports of all SIDS cases reported to the National Forensic Service and Seoul National University College of Medicine between 1996 and 2008 were reviewed for data collection and analysis to identify the risk factors for SIDS. Analysis of the 355 SIDS cases reported within the study period revealed that of the 168 (47.3%) cases for which sleeping position before death had been reported, 75 (44.7%) cases had occurred after placement in prone or side position. Of the 204 (57.5%) cases for which bed-sharing situation had been reported, 121 (59.3%) deaths had occurred during bed-sharing, of which 54 (44.6%) infants were under 3 months of age, a significantly younger age than that of the non-bed-sharing cases (P = 0.0279). Analysis of the results indicated no tendency toward an increase or decrease in the use of a prone or side position. Rather, there was a statistically significant increasing trend for bed-sharing over the study period (OR, 1.087; 95% CI, 1.004-1.177; P = 0.04). These findings indicate the need for nationwide educational programs promoting a safe sleeping environment to enhance SIDS prevention.

  20. Divergent Arctic-Boreal Vegetation Changes between North America and Eurasia over the Past 30 Years

    Directory of Open Access Journals (Sweden)

    Arindam Samanta

    2013-05-01

    Full Text Available Arctic-Boreal region—mainly consisting of tundra, shrub lands, and boreal forests—has been experiencing an amplified warming over the past 30 years. As the main driving force of vegetation growth in the north, temperature exhibits tight coupling with the Normalized Difference Vegetation Index (NDVI—a proxy to photosynthetic activity. However, the comparison between North America (NA and northern Eurasia (EA shows a weakened spatial dependency of vegetation growth on temperature changes in NA during the past decade. If this relationship holds over time, it suggests a 2/3 decrease in vegetation growth under the same rate of warming in NA, while the vegetation response in EA stays the same. This divergence accompanies a circumpolar widespread greening trend, but 20 times more browning in the Boreal NA compared to EA, and comparative greening and browning trends in the Arctic. These observed spatial patterns of NDVI are consistent with the temperature record, except in the Arctic NA, where vegetation exhibits a similar long-term trend of greening to EA under less warming. This unusual growth pattern in Arctic NA could be due to a lack of precipitation velocity compared to the temperature velocity, when taking velocity as a measure of northward migration of climatic conditions.

  1. The virtual brain: 30 years of video-game play and cognitive abilities

    Directory of Open Access Journals (Sweden)

    Andrew James Latham

    2013-09-01

    Full Text Available Forty years have passed since video-games were first made widely available to the public and subsequently playing games has become a favourite past-time for many. Players continuously engage with dynamic visual displays with success contingent on the time-pressured deployment, and flexible allocation, of attention as well as precise bimanual movements. Evidence to date suggests that both brief and extensive exposure to video-game play can result in a broad range of enhancements to various cognitive faculties that generalize beyond the original context. Despite promise, video-game research is host to a number of methodological issues that require addressing before progress can be made in this area. Here an effort is made to consolidate the past 30 years of literature examining the effects of video-game play on cognitive faculties and, more recently, neural systems. Future work is required to identify the mechanism that allows the act of video-game play to generate such a broad range of generalized enhancements.

  2. 30 Years on Selected Issues in the Prevention of HIV among Persons Who Inject Drugs

    Directory of Open Access Journals (Sweden)

    D. C. Des Jarlais

    2013-01-01

    Full Text Available After 30 years of extensive research on human immunodeficiency virus (HIV among persons who inject drugs (PWID, we now have a good understanding of the critical issues involved. Following the discovery of HIV in 1981, epidemics among PWID were noted in many countries, and consensus recommendations for interventions for reducing injection related HIV transmission have been developed. While high-income countries have continued to develop and implement new Harm Reduction programs, most low-/middle-income countries have implemented Harm Reduction at very low levels. Modeling of combined prevention programming including needle exchange (NSP and antiretroviral therapy (ARV suggests that NSP be given the highest priority. Future HIV prevention programming should continue to provide Harm Reduction programs for PWID coupled with interventions aimed at reducing sexual transmission. As HIV continues to spread in low- and middle-income countries, it is important to achieve and maintain high coverage of Harm Reduction programs in these locations. As PWID almost always experience multiple health problems, it will be important to address these multiple problems within a comprehensive approach grounded in a human rights perspective.

  3. International Standards for Properties and Performance of Advanced Ceramics - 30 years of Excellence

    Science.gov (United States)

    Jenkins, Michael G.; Salem, Jonathan A.; Helfinstine, John; Quinn, George D.; Gonczy, Stephen T.

    2016-01-01

    Mechanical and physical properties/performance of brittle bodies (e.g., advanced ceramics and glasses) can be difficult to measure correctly unless the proper techniques are used. For three decades, ASTM Committee C28 on Advanced Ceramics, has developed numerous full-consensus standards (e.g., test methods, practices, guides, terminology) to measure various properties and performance of a monolithic and composite ceramics and coatings that, in some cases, may be applicable to glasses. These standards give the "what, how, how not, why, why not, etc." for many mechanical, physical, thermal, properties and performance of advanced ceramics. Use of these standards provides accurate, reliable, repeatable and complete data. Involvement in ASTM Committee C28 has included users, producers, researchers, designers, academicians, etc. who write, continually update, and validate through round robin test programmes, more than 45 standards in the 30 years since the Committee's inception in 1986. Included in this poster is a pictogram of the ASTM Committee C28 standards and how to obtain them either as i) individual copies with full details or ii) a complete collection in one volume. A listing of other ASTM committees of interest is included. In addition, some examples of the tangible benefits of standards for advanced ceramics are employed to demonstrate their practical application.

  4. Recurrent ectopic pancreatitis of the jejunum and mesentery over a 30-year period

    Institute of Scientific and Technical Information of China (English)

    John CT Wong; Charlotte Robinson; Edward C Jones; Alison Harris; Charles Zwirewich; Robert Wakefield; Richard K Simons; Eric M Yoshida

    2011-01-01

    BACKGROUND: Ectopic pancreas is defined as pancreatic tissue found outside its usual anatomical position, with no ductal or vascular communication with the native pancreas. We describe a case of ectopic pancreas of the small bowel and mesentery causing recurrent episodes of pancreatitis, initially suspected on computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), and confirmed on histological review of the resection. METHODS: A 67-year-old woman presented with clinical symptoms and biochemical evidence of pancreatitis. She had similar episodes over the past 30 years with unrevealing investi-gations, and was concluded to have idiopathic pancreatitis. She underwent CT and MRCP, with findings suggestive of ectopic pancreas, a diagnosis confirmed on histology of the resection. RESULTS: MRCP identified a mass in the proximal small bowel mesentery isointense to the native pancreas, with a small duct draining into a proximal jejunal loop. The resected specimen consisted of normal parenchyma with lobulated acinar tissue with scattered islets of Langerhans, an occasional ductular structure, and admixed areas of adipose tissue. The patient remained asymptomatic with normal biochemistry six months post-operatively. CONCLUSION: In an individual with abdominal pain, elevated serum amylase/lipase, but imaging findings of a normal native pancreas, ectopic pancreatitis should be considered, and can be evaluated by CT and MRCP.

  5. Paraganglioma, neuroblastoma, and a SDHB mutation: Resolution of a 30-year-old mystery.

    Science.gov (United States)

    Schimke, R Neil; Collins, Debra L; Stolle, Catherine A

    2010-06-01

    Familial paraganglioma/pheochromocytoma (PGL/PCC) is genetically heterogenous with mutations in three of the four subunits of the heterotetrameric mitochondrial complex II enzyme succinate dehydrogenase (SDH) being causally responsible for the majority of cases. In addition to PGL/PCC an array of non-paraganglial tumors have been described in affected individuals. We present a 30-year follow-up on the family of a deceased patient who synchronously developed malignant neuroblastoma (NBL), PCC, and renal cell carcinoma (RCC). Other family members with late onset disease have come to our attention, and molecular study revealed a mutation in the SDHB gene. Despite the embryologic relationship, NBL has been seen in only two previous patients with familial PGL/PCC, both with deletions of the SDHB gene. Review of the literature suggests the lack of a reported association between NBL and familial PGL/PCC may be an ascertainment bias. We further suggest that study of the SDH genes in NBL survivors who develop secondary solid tumors, particularly RCC, may correct this bias, and provide for more effective and comprehensive tumor screening in this patient population.

  6. Noncancer mortality based on the Hiroshima Atomic Bomb survivors registry over 30 years, 1968-1997

    Energy Technology Data Exchange (ETDEWEB)

    Kasagi, Keiko [Hiroshima Univ. (Japan). Research Inst. for Radiation Biology and Medicine

    2002-04-01

    The relation of radiation exposure with noncancer mortality was examined on 44,514 atomic bomb survivors (17,935 males, 26,579 females, and mean age 22.8{+-}15.7 yrs at the time of bombing) registered at Research Institute for Radiation Biology and Medicine, Hiroshima University, based on mortality follow-up over 30 years, 1968-1997. Noncancer mortality was significantly related to radiation dose with relative risk of 1.06 at 1 Sv radiation dose, although weaker than the dose response in solid cancer mortality. The significant dose responses were observed especially in circulatory disease, stroke and urinary organ disease, and suggestive dose response in pneumonia. The temporal pattern in dose response by age at the time of bombing indicated that the relative risk of noncancer mortality was higher with follow-up period, which is contrary to a decreasing dose response in solid cancer mortality with follow-up period. The tendency was remarkable in those survivors younger at the time of bombing. These findings suggest that the significant radiation risk observed in noncancer mortality might increase as the proportion of younger survivors among atomic bomb survivors increases. (author)

  7. [Spatiotemporal variation of soil pH in Guangdong Province of China in past 30 years].

    Science.gov (United States)

    Guo, Zhi-Xing; Wang, Jing; Chai, Min; Chen, Ze-Peng; Zhan, Zhen-Shou; Zheng, Wu-Ping; Wei, Xiu-Guo

    2011-02-01

    Based on the 1980s' soil inventory data and the 2002-2007 soil pH data of Guangdong Province, the spatiotemporal variation of soil pH in the Province in past 30 years was studied. In the study period, the spatial distribution pattern of soil pH in the Province had less change (mainly acidic), except that in Pearl River Delta and parts of Qingyuan and Shaoguan (weak alkaline). The overall variation of soil pH was represented as acidification, with the average pH value changed from 5.70 to 5.44. Among the soil types in the Province, alluvial soil had an increased pH, lateritic red soil, paddy soil, and red soil had a large decrement of pH value, and lime soil was most obvious in the decrease of pH value and its area percentage. The soil acidification was mainly induced by soil characteristics, some natural factors such as acid rain, and human factors such as unreasonable fertilization and urbanization. In addition, industrialization and mining increased the soil pH in some areas.

  8. From Energy Audits to Home Performance: 30 Years of Articles in Home Energy Magazine

    Energy Technology Data Exchange (ETDEWEB)

    Meier, Alan

    2014-08-11

    Home Energy Magazine has been publishing articles about residential energy efficiency for 30 years. Its goal has been to disseminate technically reliable and neutral information to the practitioners, that is, professionals in the business of home energy efficiency. The articles, editorials, letters, and advertisements are a kind of window on the evolution of energy conservation technologies, policies, and organizations. Initially, the focus was on audits and simple retrofits, such as weatherstripping and insulation. Instrumentation was sparse sometimes limited to a ruler to measure depth of attic insulation and a blower door was exotic. CFLs were heavy, awkward bulbs which might, or might not, fit in a fixture. Saving air conditioning energy was not a priority. Solar energy was only for the most adventurous. Thirty years on, the technologies and business have moved beyond just insulating attics to the larger challenge of delivering home performance and achieving zero net energy. This shift reflects the success in reducing space heating energy and the need to create a profitable industry by providing more services. The leading edge of the residential energy services market is becoming much more sophisticated, offering both efficiency and solar systems. The challenge is to continue providing relevant and reliable information in a transformed industry and a revolutionized media landscape.

  9. A 30 Year Old Man with Fever and Indolent Soft Tissue Masses

    Directory of Open Access Journals (Sweden)

    Wissam Zaeeter

    2010-01-01

    Full Text Available Problem statement: Multifocal Skeletal Tuberculosis (MSTB is a rare presentation of skeletal tuberculosis. The indolent nature of this condition often leads to delayed or missed diagnosis, sometimes with devastating consequences for the patient. In order to provide meaningful clinical information and to highlight pitfalls in diagnosis of MFST, we present a case of MSTB. A review of this condition is included for broader coverage. Approach: A 30 year old immune-competent male patient with a 1 year history of indolent soft tissue masses on the chest wall overlying the sternum and the ribs. CAT scan of the chest showed multiple lytic bony lesions involving the ribs, sternum and vertebrae that mimicked metastatic cancer. Fine needle aspiration of the lesion revealed AFB and granulomas. Culture of the aspirated material grew mycobacterium tuberculosis and a diagnosis of MSTB was made. Results: A diagnosis of MSTB was made and anti-tuberculous therapy was initiated. Conclusion: This case indicated that multi-focal skeletal tuberculosis may develop in immune-competent patients without overt pulmonary involvement. From our experience along with previously reported data, MSTB should be suspected in patients from endemic areas who present with multiple skeletal bony lesions. Appropriate management and therapy are essentials for cure and to prevent complications.

  10. The SLC28 (CNT) and SLC29 (ENT) nucleoside transporter families: a 30-year collaborative odyssey.

    Science.gov (United States)

    Young, James D

    2016-06-15

    Specialized nucleoside transporter (NT) proteins are required for passage of nucleosides and hydrophilic nucleoside analogues across biological membranes. Physiologic nucleosides serve as central salvage metabolites in nucleotide biosynthesis, and nucleoside analogues are used as chemotherapeutic agents in the treatment of cancer and antiviral diseases. The nucleoside adenosine modulates numerous cellular events via purino-receptor cell signalling pathways. Human NTs are divided into two structurally unrelated protein families: the SLC28 concentrative nucleoside transporter (CNT) family and the SLC29 equilibrative nucleoside transporter (ENT) family. Human CNTs are inwardly directed Na(+)-dependent nucleoside transporters found predominantly in intestinal and renal epithelial and other specialized cell types. Human ENTs mediate bidirectional fluxes of purine and pyrimidine nucleosides down their concentration gradients and are ubiquitously found in most, possibly all, cell types. Both protein families are evolutionarily old: CNTs are present in both eukaryotes and prokaryotes; ENTs are widely distributed in mammalian, lower vertebrate and other eukaryote species. This mini-review describes a 30-year collaboration with Professor Stephen Baldwin to identify and understand the structures and functions of these physiologically and clinically important transport proteins.

  11. Radiation induced skin cancer the chest wall 30 years later from breast cancer operation

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Kouji; Togawa, Tamotsu; Hasegawa, Takeshi; Matsunami, Hidetoshi; Ikeda, Tsuneko [Matsunami General Hospital, Kasamatsu, Gifu (Japan); Matsuo, Youichi

    1998-10-01

    This paper describes the skin cancer on the frontal chest wall induced by postoperative irradiation 30 years later from mastectomy. The patients was a 62-year-old woman, who received mastectomy of the right breast cancer (invasive ductal carcinoma, comedo type) at 31 years old, and received the postoperative radiotherapy of total 11,628 rad over 38 times. On the first medical examination in author`s hospital, the patient had an ulcer of about 10 cm diameter and was diagnosed the radiation induced skin cancer (well differentiated squamous cell carcinoma) in the biopsy. Because of the general condition of the patient was extremely bad and the skin cancer had highly developed, the excision was thought to be impossible. The radiotherapy (16 Gy) and combined local chemotherapy by OK 432 and Bleomycin were performed. In spite of the short term treatment, these therapies were effective on the reduction of the tumor size and the hemostasis, and brought the patient the improvement of QOL. The general condition of the patient improved to be stable and she recovered enough to go out from the hospital for 6 months. After 10 months, she showed anorexia and dyspnea and died after about 1 year from the admission. The present case is extremely rare, and it is required the radical therapy like the excision of chest wall at early stage. (K.H.)

  12. Primary health care development: where is Nepal after 30 years of Alma Ata Declaration?

    Science.gov (United States)

    Karkee, R; Jha, N

    2010-01-01

    The year 2008 has witnessed the global conversation to return to tenets of Alma-Ata and to review its 30 years of journey. We reviewed Nepal's journey on Primary Health Care development: policy formulation, structure development, progress and constraints. Though Nepal has institutionalised the PHC approach in health policy, strategy and health care delivery system, this has not been effectively translated into actions, and the results are mixed. Nepal has gained impressive achievements in selective primary health care markers: 45.43% maternal mortality and 62.34% child mortality reduction during 1990-2005. But gain in comprehensive health care markers is not impressive: 18.7% Skilled Birth Attendant (4% in poorest quintile and 45% in richest quintile), 39% having access to improved sanitation and 55.7% of females are literate as compared to males. Socio-political environment until recently was not favourable for comprehensive primary health care, allowing limited health sector decentralisation and community empowerment. Health activities were focussed more on selective health care strategy in the form of disease control, immunisation, vitamin A supplementation, oral rehydration solution use and contraceptive use. Nepal's rural hilly geography posed great challenge on logistic supply, communication and retention of health workers rendering public health centres of low quality with negative perceptions of consumers. Nepal is on the pathway to build equitable comprehensive primary health care.

  13. A glimpse into 30 years of struggle against prostitution by the women's liberation movement in Norway.

    Science.gov (United States)

    Strøm, Agnete

    2009-11-01

    The Women's Front of Norway has worked against prostitution for 30 years. In 2008 a law criminalizing the purchase of a sexual act was passed in Norway. This article describes the struggle and the main actors in lobbying for the law. In the 1980s, we raised awareness of prostitution and trafficking in women in a study of the pornography industry, and targeted sex tourist agencies organizing trips to the Philippines and Thailand. In the 1990s, our members in trade unions got their unions to take a stand against prostitution and against legalizing prostitution as "work". In 2006, the Norwegian Confederation of Trade Unions Congress supported a law criminalizing the buyer of a sexual act; this had a strong impact on the centre-left coalition Government. We invited leaders of the Coalition Against Trafficking in Women to Norway to meet parliamentarians and trade unionists, and kept up the pressure. From the start, the focus was on ensuring that the situation for women in prostitution was ameliorated. Our demands have been for better social services and job training. Street prostitution, especially in Oslo, has been curbed, and a growth in the indoor market has not been reported. Our next task is participating in the awareness campaign "Buying Sex is not a Sport" in connection with the Soccer World Cup, South Africa, 2010.

  14. How are qualitative methods used in diabetes research? A 30-year systematic review.

    Science.gov (United States)

    Hennink, Monique M; Kaiser, Bonnie N; Sekar, Swathi; Griswold, Emily P; Ali, Mohammed K

    2017-02-01

    We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. We conducted a systematic review of National Library of Medicine, EMBASE, and Web of Science electronic databases to identify original research articles that used qualitative methods to study diabetes between 1980 and 2011. We identified 554 eligible articles and categorised these by geographic region, year of publication, study population, study design, research question, qualitative data collection methods, and journal type. Results show low use of qualitative methods in diabetes research over the past 30 years. The majority of articles (75%) reported using substantive qualitative research, while mixed-methods research has remained underutilised. Eighty-five per cent of articles reported studies conducted in North America or Europe, with few studies in developing countries. Most articles reported recruiting clinic-based populations (58%). Over half (54%) of research questions focused on patient experience and 24% on diabetes management. Qualitative methods can provide important insights about socio-cultural aspects of disease to improve disease management. However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations.

  15. Retrospective analysis of prognostic factors for sixty osteosarcoma patients with local recurrence

    Institute of Scientific and Technical Information of China (English)

    Jingjing Sha; Weixiang Qi; Haiyan Hu; Yuanjue Sun; Zan Shen; Yang Yao

    2013-01-01

    Objective: The aim of this study was to identify prognostic factors and imply the appropriate management for lo-cal recurrent osteosarcoma. Methods: The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010. The mean followed-up time for these patients was 49.1 months (range 13 to 143 months). The factors of age, gender, tumor site, tumor size, surgical procedure, neoadjuvant chemotherapy, frequency of primary postoperative adjuvant chemotherapy, lung metastasis, metastasis of other sites (except for lung) and treatment after local recurrence were selected as the measurements for this analysis. Kaplan-Meier method was used to measure the overall survival and post-recurrence survival. The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test. The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival. Results: The median post-recurrence survival and overall survival of 60 patients were 32 months (95% confidence interval: 16.2-47.8) and 55 months (95% confidence interval: 39.3–70.7) respectively. The 2- and 3-year cumulative survival rates were 81.7% and 55.4%, respectively. The Log-rank univariate analysis showed that age, gender, tumor size, metastasis of other sites (except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence (P 0.05). Conclusion: The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site (except for lung) and the treatment after local recurrence. The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.

  16. Retrospective analysis of hepatitis C infected patients treated through an integrated care model

    Science.gov (United States)

    Levin, James M; Dabirshahsahebi, Shabnam; Bauer, Mindy; Huckins, Eric

    2016-01-01

    AIM To determine if our health system’s integrated model reflects sustained virologic response (SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions. METHODS Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through March 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat (ITT) analysis. Inclusion criteria consisted of both treatment naïve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype (GT) or METAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction interventions. RESULTS At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir (SOF)/ledipasvir (LDV), 8 SOF/LDV and ribavirin (RBV), 7 SOF and Simeprevir (SMV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue (41.4%), headache (28.6%), nausea (18.1%), and diarrhea (8.3%). No serious adverse effects were reported. CONCLUSION Dean Health System’s integrated care model successfully managed patients being treated for hepatitis C virus (HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes

  17. Retrospective analysis of energy use and conservation trends: 1972-1982. Appendix

    Energy Technology Data Exchange (ETDEWEB)

    Adams, R.C.; Belzer, D.B.; Fang, J.M.; Imhoff, K.L.; Lax, D.H.; Moe, R.J.; Roop, J.M.; Wusterbarth, A.R.

    1985-06-01

    This appendix contains the detailed documentation corresponding to the end-use sectoral analyses presented in the main report. The data and methods used to calculate alternative scenarios for estimating energy savings in four economic sectors are provided in this volume. Appendix A contains the detailed documentation for the residential sector analysis. The methodology used to prepare estimates of building energy savings in the commercial sector is provided in Appendix B. Finally, Appendices C and D discuss the data and explain the analytical techniques used to derive estimates of energy savings in the industrial and transportation sectors, respectively. 9 refs., 14 figs., 86 tabs.

  18. [Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

    Science.gov (United States)

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

    The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

  19. Second allogeneic transplantation for relapse of malignant disease: retrospective analysis of outcome and predictive factors by the EBMT.

    Science.gov (United States)

    Ruutu, T; de Wreede, L C; van Biezen, A; Brand, R; Mohty, M; Dreger, P; Duarte, R; Peters, C; Garderet, L; Schönland, S; Gratwohl, A; Niederwieser, D; de Witte, T; Kröger, N

    2015-12-01

    In patients treated with allogeneic stem cell transplantation (SCT) for malignant disease who suffer from a relapse after the transplantation, the role of second allogeneic SCT is often uncertain. In a retrospective analysis, 2632 second allogeneic transplantations carried out for a relapse after the first transplantation were analyzed to define indications and identify predictive factors. Fifteen percent of the patients remained relapse-free until 5 years after the second SCT. Patients with CML had a better survival than patients with other diseases. In a multivariate analysis, factors associated with better survival were low disease burden, longer remission duration after the first transplantation, longer interval between the transplantations, younger age, absence of grade II-IV acute GvHD or chronic GvHD after the first transplantation, and later year of transplantation. The European Society for Blood and Marrow Transplantation risk score predicted the outcome. Using the same donor as in the first transplantation vs another donor had no predictive value for survival. Sibling donor was a favorable predictive factor. In conclusion, second allogeneic SCT offers a reasonable option especially for young patients with a long remission after the first transplantation and a low disease burden. The present findings do not support the usefulness of changing the donor for the second transplantation.

  20. A retrospective content analysis of studies on factors constraining the implementation of health sector reform in Ghana.

    Science.gov (United States)

    Sakyi, E Kojo

    2008-01-01

    Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation.

  1. An Unprecedented High Incidence of Leptospirosis in Futuna, South Pacific, 2004 - 2014, Evidenced by Retrospective Analysis of Surveillance Data.

    Directory of Open Access Journals (Sweden)

    Denis Massenet

    Full Text Available Futuna is a small Polynesian island in the South Pacific with a population of 3,612 in 2013. The first human leptospirosis case was confirmed in 1997. Active surveillance started in 2004. Cases were confirmed by PCR or real time PCR, or by serology using MAT or a combination of IgM-ELISA and MAT. A retrospective analysis of surveillance data shows that the disease was endemic with a mean annual incidence of 844 cases per 100,000 over an 11-year period from 2004 to 2014. An epidemic peak as high as 1,945 cases per 100,000 occurred in 2008. Serogroup Australis was predominant until 2007, Icterohaemorrhagiae was dominant afterwards. Cluster analysis revealed different hot spots over time. Lifestyle habits, such as walking barefoot in irrigated taro fields or pig pens probably contributed to contamination from the swine and rodent reservoirs to humans. Severe forms were rare, and the case fatality rate was 0.5%. The medical community and general population were aware of leptospirosis and rapid treatment with amoxycillin was the main treatment, probably contributing to this low fatality rate.

  2. Retrospective analysis of a listeria monocytogenes contamination episode in raw milk goat cheese using quantitative microbial risk assessment tools.

    Science.gov (United States)

    Delhalle, L; Ellouze, M; Yde, M; Clinquart, A; Daube, G; Korsak, N

    2012-12-01

    In 2005, the Belgian authorities reported a Listeria monocytogenes contamination episode in cheese made from raw goat's milk. The presence of an asymptomatic shedder goat in the herd caused this contamination. On the basis of data collected at the time of the episode, a retrospective study was performed using an exposure assessment model covering the production chain from the milking of goats up to delivery of cheese to the market. Predictive microbiology models were used to simulate the growth of L. monocytogenes during the cheese process in relation with temperature, pH, and water activity. The model showed significant growth of L. monocytogenes during chilling and storage of the milk collected the day before the cheese production (median increase of 2.2 log CFU/ml) and during the addition of starter and rennet to milk (median increase of 1.2 log CFU/ml). The L. monocytogenes concentration in the fresh unripened cheese was estimated to be 3.8 log CFU/g (median). This result is consistent with the number of L. monocytogenes in the fresh cheese (3.6 log CFU/g) reported during the cheese contamination episode. A variance-based method sensitivity analysis identified the most important factors impacting the cheese contamination, and a scenario analysis then evaluated several options for risk mitigation. Thus, by using quantitative microbial risk assessment tools, this study provides reliable information to identify and control critical steps in a local production chain of cheese made from raw goat's milk.

  3. A retrospective economic analysis of the Ontario red fox oral rabies vaccination programme.

    Science.gov (United States)

    Shwiff, S A; Nunan, C P; Kirkpatrick, K N; Shwiff, S S

    2011-05-01

    Ontario initiated a red fox (Vulpes vulpes) oral rabies vaccination (ORV) programme in 1989. This study utilized a benefit-cost analysis to determine if this ORV programme was economically worthwhile. Between 1979 and 1989, prior to ORV baiting, the average annual human post-exposure treatments, positive red fox rabies diagnostic tests and indemnity payments for livestock lost to rabies were 2248, 1861 and $246,809, respectively. After baiting, from 1990 to 2000, a 35%, 66% and 41% decrease in post-exposure treatments, animal rabies tests and indemnity payments was observed, respectively. These reductions were viewed as benefits of the ORV programme, whereas total costs were those associated with ORV baiting. Multiple techniques were used to estimate four different benefit streams and the total estimated benefits ranged from $35,486,316 to $98,413,217. The annual mean ORV programme cost was $6,447,720, with total programme costs of $77,372,637. The average benefit-cost ratios over the analysis period were .49, 1.06, 1.27 and 1.36, indicating overall programme efficiency in three of the four conservative scenarios.

  4. Associations between safety culture and employee engagement over time: a retrospective analysis.

    Science.gov (United States)

    Daugherty Biddison, Elizabeth Lee; Paine, Lori; Murakami, Peter; Herzke, Carrie; Weaver, Sallie J

    2016-01-01

    With the growth of the patient safety movement and development of methods to measure workforce health and success have come multiple modes of assessing healthcare worker opinions and attitudes about work and the workplace. Safety culture, a group-level measure of patient safety-related norms and behaviours, has been proposed to influence a variety of patient safety outcomes. Employee engagement, conceptualised as a positive, work-related mindset including feelings of vigour, dedication and absorption in one's work, has also demonstrated an association with a number of important worker outcomes in healthcare. To date, the relationship between responses to these two commonly used measures has been poorly characterised. Our study used secondary data analysis to assess the relationship between safety culture and employee engagement over time in a sample of >50 inpatient hospital units in a large US academic health system. With >2000 respondents in each of three time periods assessed, we found moderate to strong positive correlations (r=0.43-0.69) between employee engagement and four Safety Attitudes Questionnaire domains. Independent collection of these two assessments may have limited our analysis in that minimally different inclusion criteria resulted in some differences in the total respondents to the two instruments. Our findings, nevertheless, suggest a key area in which healthcare quality improvement efforts might be streamlined.

  5. Time to wean after tracheotomy differs among subgroups of critically ill patients: Retrospective analysis in a mixed medical/surgical intensive care unit

    NARCIS (Netherlands)

    A.J.W.J. van der Lely; D.P. Veelo; D.A. Dongelmans; J.C. Korevaar; M.B. Vroom; M.J. Schultz

    2006-01-01

    OBJECTIVE: To determine the time to wean from mechanical ventilation and time spent off the ventilator per day after tracheotomy in critically ill patients in a 28-bed mixed medical and surgical intensive care unit (ICU) in Amsterdam, Netherlands. METHODS: We conducted a retrospective analysis of co

  6. CHRISTMAS 2015 : THE PUBLICATION GAME Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H.; Tijdink, Joeri K.; Otte, Wim

    2015-01-01

    Objective To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. Design Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. Methods The yearly frequencies of positive, negative, and neutr

  7. Assisted reproductive technology in India: A 3 year retrospective data analysis

    Directory of Open Access Journals (Sweden)

    Narendra Malhotra

    2013-01-01

    Full Text Available Assisted reproductive technology (ART has grown by leaps and bounds in the last few years. India has one of the highest growths in the ART centers and the number of ART cycles performed every year. Very soon India will be the leader in the world of ART in terms of a number of cycles. With the advances of technology and availability of techniques even in tier II and tier III cities our country, the results still vary dramatically. There is no standardization of protocols and reporting is very inadequate. Furthermore, there are only ART guidelines and no law still exists. Our first and the biggest challenge is to document the tremendous work being done in India and on the basis of analysis of this work, a proper registry can be made and guidance given to all on standardization and improvement. This is the 8 th edition of National ART Registry of India being presented and analyzed.

  8. Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds.

    Science.gov (United States)

    Muñoz, E; Argüelles, D; Areste, L; Miguel, L San; Prades, M

    2008-03-08

    The medical records of 468 horses that underwent 490 exploratory laparotomies for the correction of gastrointestinal diseases were reviewed to search for differences between Andalusian horses and other breeds. The seasonal distribution of surgical colics and their outcome and complications were also investigated. Bivariant analysis was used to compare the horses' age, gender and breed with the type of surgery, the bowel affected and the type of colic, and all these variables were compared in relation to euthanasia during surgery, complications, short-term survival and seasonal distribution. A total of 405 horses survived the surgery and 329 were discharged from the hospital. Horses less than one year old had better short-term survival than older horses. Andalusian horses suffered more inguinal hernias than the other breeds and were more prone to suffer laminitis as a complication. Colic surgery and inguinal hernias were also more common in the summer.

  9. Retrospective Analysis of NIST Standard Reference Material 1450, Fibrous Glass Board, for Thermal Insulation Measurements.

    Science.gov (United States)

    Zarr, Robert R; Heckert, N Alan; Leigh, Stefan D

    2014-01-01

    Thermal conductivity data acquired previously for the establishment of Standard Reference Material (SRM) 1450, Fibrous Glass Board, as well as subsequent renewals 1450a, 1450b, 1450c, and 1450d, are re-analyzed collectively and as individual data sets. Additional data sets for proto-1450 material lots are also included in the analysis. The data cover 36 years of activity by the National Institute of Standards and Technology (NIST) in developing and providing thermal insulation SRMs, specifically high-density molded fibrous-glass board, to the public. Collectively, the data sets cover two nominal thicknesses of 13 mm and 25 mm, bulk densities from 60 kg·m(-3) to 180 kg·m(-3), and mean temperatures from 100 K to 340 K. The analysis repetitively fits six models to the individual data sets. The most general form of the nested set of multilinear models used is given in the following equation: [Formula: see text]where λ(ρ,T) is the predicted thermal conductivity (W·m(-1)·K(-1)), ρ is the bulk density (kg·m(-3)), T is the mean temperature (K) and ai (for i = 1, 2, … 6) are the regression coefficients. The least squares fit results for each model across all data sets are analyzed using both graphical and analytic techniques. The prevailing generic model for the majority of data sets is the bilinear model in ρ and T. [Formula: see text] One data set supports the inclusion of a cubic temperature term and two data sets with low-temperature data support the inclusion of an exponential term in T to improve the model predictions. Physical interpretations of the model function terms are described. Recommendations for future renewals of SRM 1450 are provided. An Addendum provides historical background on the origin of this SRM and the influence of the SRM on external measurement programs.

  10. The association between diabetes related medical costs and glycemic control: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Barron John

    2006-01-01

    Full Text Available Abstract Background The objective of this research is to quantify the association between direct medical costs attributable to type 2 diabetes and level of glycemic control. Methods A longitudinal analysis using a large health plan administrative database was performed. The index date was defined as the first date of diabetes diagnosis and individuals had to have at least two HbA1c values post index date in order to be included in the analyses. A total of 10,780 individuals were included in the analyses. Individuals were stratified into groups of good (N = 6,069, fair (N = 3,586, and poor (N = 1,125 glycemic control based upon mean HbA1c values across the study period. Differences between HbA1c groups were analyzed using a generalized linear model (GLM, with differences between groups tested by utilizing z-statistics. The analyses allowed a wide range of factors to affect costs. Results 42.1% of those treated only with oral agents, 66.1% of those treated with oral agents and insulin, and 57.2% of those treated with insulin alone were found to have suboptimal control (defined as fair or poor throughout the study period (average duration of follow-up was 2.95 years. Results show that direct medical costs attributable to type 2 diabetes were 16% lower for individuals with good glycemic control than for those with fair control ($1,505 vs. $1,801, p Conclusion Almost half (44% of all patients diagnosed with type 2 diabetes are at sub-optimal glycemic control. Evidence from this analysis indicates that the direct medical costs of treating type 2 diabetes are significantly higher for individuals who have fair or poor glycemic control than for those who have good glycemic control. Patients under fair control account for a greater proportion of the cost burden associated with antidiabetic prescription drugs.

  11. A Retrospective Perinatal Data Analysis of Immigrant and German Women from Representative Birth Cohorts at the Virchow Hospital, Berlin

    Science.gov (United States)

    Armbrust, R.; von Rennenberg, R.; David, M.

    2016-01-01

    Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospitalʼs birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin. χ2 tests and Fisherʼs exact test were used for significance testing (significance level p episiotomy, higher grade perineal tears and severe postpartum haemorrhage did not differ between the groups. There were however significant differences in the use of uterine stimulants, analgesics in labour and both local and regional anaesthesia, with women of Turkish origin and other immigrants receiving anaesthesia less, but oxytocin more often. Rooming-in was more common among German primipara and multipara from 1984 onwards. Discussion: This retrospective analysis of three historical birth cohorts showed significant differences in perinatal care between German and immigrant women, presumably reflecting deficits in care. It seems remarkable that this trend has not changed over a time span of three decades despite a continuous increase in immigration and acculturation. A “research paradox”, however, remains: Despite these increasing rates, there are no current or older, prospective or systematic studies of obstetric care in immigrants. PMID:27904165

  12. Gastric leptomeningeal carcinomatosis: Multi-center retrospective analysis of 54 cases

    Institute of Scientific and Technical Information of China (English)

    Sung Yong Oh; Su-Jin Lee; Jeeyun Lee; Suee Lee; Sung-Hyun Kim; Hyuk-Chan Kwon; Gyeong-Won Lee; Jung Hun Kang; In Gyu Hwang; Joung-Soon Jang; Ho Yeong Lim; Young Suk Park; Won Ki Kang; Hyo-Jin Kim

    2009-01-01

    AIM: To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis (LMC) of gastric cancer.METHODS: We analyzed 54 cases of cytologically con- firmed gastric LMC at four institutions from 1994 to 2007.RESULTS: The male-to-female ratio was 32:22, and the patients ranged in age from 28 to 78 years (median,48.5 years). The majority of patients had advanced disease at initial diagnosis of gastric cancer. The clinical or pathologic tumor, node and metastasis stage of the primary gastric cancer was Ⅳ in 38 patients (70%).The median interval from diagnosis of the primary malignancy to the diagnosis of LMC was 6.3 mo, ranging between 0 and 73.1 mo. Of the initial endoscopic findings for the 45 available patients, 23 (51%) of the patients were Bormann type Ⅲ and 15 (33%) patients were Bormann type Ⅳ. Pathologically, 94% of cases proved to be poorly differentiated adenocarcinomas.Signet ring cell component was also observed in 40% of patients. Headache (85%) and nausea/vomiting (58%) were the most common presenting symptoms of LMC. A gadolinium-enhanced magnetic resonance imaging was conducted in 51 patients. Leptomeningeal enhancement was noted in 45 cases (82%). Intrathecal (IT) chemotherapy was administered to 36 patientsprimarily methotrexate alone (61%), but also in combination with hydrocortisone/± Ara-C (39%). The median number of IT treatments was 7 (range, 1-18). Concomitant radiotherapy was administered to 18 patients,and concomitant chemotherapy to seven patients. Seventeen patients (46%) achieved cytological negative conversion. Median overall survival duration from the diagnosis of LMC was 6.7 wk (95% CI: 4.3-9.1 wk). In the univariate analysis of survival duration, hemoglobin,IT chemotherapy, and cytological negative conversion showed superior survival duration ( P = 0.038, P = 0.010, and P = 0.002, respectively). However, in our multivariate analysis, only cytological negative conversion was predictive of

  13. Contrasting population trends of piscivorous seabirds in the Pribilof Islands: A 30-year perspective

    Science.gov (United States)

    Byrd, G.V.; Schmutz, J.A.; Renner, H.M.

    2008-01-01

    The Pribilof Islands provide nesting habitat for one of the largest concentrations of piscivorous seabirds in the North Pacific region. Pribilof breeding populations of black-legged and red-legged kittiwakes (Rissa tridactyla and Rissa brevirostris), and common and thick-billed murres (Uria aalge and Uria lomvia) are supported by a highly productive marine food web. Productivity and temperature in this area are influenced by winter sea ice that frequently reaches its maximum extent near the Pribilofs. Although St. George and St. Paul islands, the two largest of the Pribilof group, are situated only 60 km apart, St. George is within 25 km of the shelf break, but St. Paul is approximately 90 km away. In contrast, the local contribution of sea ice-edge productivity in the spring is frequently closer to St. Paul than to St. George. Central place foraging piscivorous seabirds nesting at St. Paul and St. George are likely differentially affected by the relative contributions of the shelf break and ice-edge environments based on juxtaposition. Within the past decade or so, sea ice in the Bering Sea has failed to reach the vicinity of the Pribilofs in some years, and predictions of warming in the future suggest the possibility that direct effects of the ice on the immediate Pribilof environment will be reduced. To evaluate the response of kittiwakes and murres on the two islands to conditions in their foraging environments, we examined population trends over the past 30 years based on data from the seabird monitoring program conducted by the Alaska Maritime National Wildlife Refuge and others. Spatial differences in trends have been more consistent than differences among species, with populations at St. Paul having more enduring declines than those at St. George. At St. George, black-legged kittiwakes and common murres have remained stable. Red-legged kittiwakes and thick-billed murres both declined, but began to rebound in the late 1980s, such that in 2005 population

  14. Evaluating Frequency, Diagnostic Quality, and Cost of Lyme Borreliosis Testing in Germany: A Retrospective Model Analysis

    Directory of Open Access Journals (Sweden)

    I. Müller

    2012-01-01

    Full Text Available Background. Data on the economic impact of Lyme borreliosis (LB on European health care systems is scarce. This project focused on the epidemiology and costs for laboratory testing in LB patients in Germany. Materials and Methods. We performed a sentinel analysis of epidemiological and medicoeconomic data for 2007 and 2008. Data was provided by a German statutory health insurance (DAK company covering approx. 6.04 million members. In addition, the quality of diagnostic testing for LB in Germany was studied. Results. In 2007 and 2008, the incident diagnosis LB was coded on average for 15,742 out of 6.04 million insured members (0.26%. 20,986 EIAs and 12,558 immunoblots were ordered annually for these patients. For all insured members in the outpatient sector, a total of 174,820 EIAs and 52,280 immunoblots were reimbursed annually to health care providers (cost: 2,600,850€. For Germany, the overall expected cost is estimated at 51,215,105€. However, proficiency testing data questioned test quality and standardization of diagnostic assays used. Conclusion. Findings from this study suggest ongoing issues related to care for LB and may help to improve future LB disease management.

  15. Risk factors for central venous catheter-related thrombosis in children: a retrospective analysis.

    Science.gov (United States)

    Chen, Kai; Agarwal, Arnav; Tassone, Maria Cristina; Shahjahan, Nadia; Walton, Mark; Chan, Anthony; Mondal, Tapas

    2016-06-01

    Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines. Data on clinical and catheter-related risk factors were collected from patient charts. Statistical analysis using Pearson's χ tests, independent samples t-test, and odds ratios were used to assess potential risk factors for thrombosis. Neither insertion site (subclavian vein or otherwise), left- vs. right-sided insertion, nor catheter type were significant risk factors for thrombosis. There were no thrombotic events reported at the superior vena cava (SVC)-right atrium junction and no significant differences in thrombotic risk with initial tip placement in the SVC-right atrium junction vs. the SVC, right atrium, or inferior vena cava. Acute lymphoblastic leukaemia was a major clinical risk factor for thrombosis. Tip movement was common and may have been an important factor in the development of CVC-related thrombi. Prospective studies can yield insight into the role of follow-up imaging in the prevention of catheter-related thrombosis in children.

  16. Acute Fatty Liver of Pregnancy: A Retrospective Analysis of 56 Cases

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    Yan-Ping Zhang

    2016-01-01

    Results: The initial symptoms varied considerably, with nausea and vomiting (13/56, 23% being the most common. Liver-function indexes were remarkable, including elevated levels of serum alanine aminotransferase (262.16 ± 281.71 U/L, aspartate aminotransferase (260.98 ± 237.91 U/L, lactic dehydrogenase (1011.76 ± 530.34 U/L, and direct bilirubin (85.59 ± 90.02 μmol/L. Coagulation disorders were indicated by abnormal levels of fibrinogen (245.95 ± 186.11 mg/dL, D-dimer (2.46 ± 4.01 mg/L, and fibrin degradation products (43.62 ± 48.71 mg/L. The main maternal complications were hypoproteinemia (75%, coagulopathy (54%, and acute renal failure (39%. Multivariate logistic regression analysis identified prothrombin time (PT; odds ratio [OR] = 1.558, 95% confidence interval [CI] =1.248–1.946, PORCIP= 0.009 as risk factors. The perinatal infant death rate was related to gestational age at delivery (ORCI PORCI PORCI PConclusions: Nausea and vomiting may be the most common symptoms of AFLP. Indexes of liver dysfunction and coagulation disorders should also be considered. PT and INR are risk factors for fatal complications in patients with AFLP, and perinatal mortality is linked to the level of fibrin degradation products. Timely delivery is crucial to controlling the development of AFLP.

  17. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

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    Kadry, Bassam; Press, Christopher D; Alosh, Hassan; Opper, Isaac M; Orsini, Joe; Popov, Igor A; Brodsky, Jay B; Macario, Alex

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  18. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis

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    Bassam Kadry

    2014-08-01

    Full Text Available Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI in patients undergoing total hip arthroplasty (THA with different components of operating room (OR time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  19. Retrospective analysis of post-mortem findings in 1,444 aged donkeys.

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    Morrow, L D; Smith, K C; Piercy, R J; du Toit, N; Burden, F A; Olmos, G; Gregory, N G; Verheyen, K L P

    2011-01-01

    The aim of this study was to describe and report the prevalence of conditions found at necropsy examination of UK donkeys. Records from 1,444 donkeys over a 7-year period were included in the analysis. Sixty-one categories of post-mortem finding were identified from 9,744 observations. The four most prevalent conditions noted were dental disorder (78.7%), vascular disease other than aneurysm (60.9%), arthritis (55.4%) and foot disorder (44.8%). Gastric ulceration was found in 42% of the donkeys and gastrointestinal impaction in 18.6%. The most frequent combination of two post-mortem findings in the same animal was arthritis and dental disorder. The most common disorders were associated with age, body weight and/or body condition post mortem and, for some disorders, gender. For many of the post-mortem findings, crude associations were found between the presence of one finding and the odds of also having certain other post-mortem findings. This study is the first to summarize all conditions noted at necropsy examination for a large group of donkeys. The findings increase knowledge of diseases and conditions of this species and may be useful when investigating the relevance of various pathological conditions in the live animal.

  20. CAN FUTURE STUDIES TRULY PREDICT THE FUTURE? A RETROSPECTIVE ANALYSIS OF TWO APPROACHES

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    Renata Fernandes Galhanone

    2012-01-01

    Full Text Available Futures Studies are one valuable tool to help businesses develop their Strategic Planning, in their ability to point out environment-induced changes in company policies, goals and actions. Companies and their leaders may discover energies and resources when they achieve a holistic, long range worldview, which helps them foresee, plan for and deal with the changes that will affect their future. The aim of this article is to examine the currentness of two exemplars of Futures Studies with distinct methods: a quantitative study analyzed by Mario Henrique Simonsen, and a qualitative futurology essay by Alvin Toffler based on the analysis of social, economic, technological and political trends and phenomena. A bibliographical research on secondary macroeconomic and sociocultural data supplied evidences for the projected trends. Based on this, the limitations of projection-based methods are discussed, as well as the advantages of using a qualitative or mixed approach when forecasts are made for the long term. It is worth reinforcing that the purpose of Futures Studies is not to predict with absolute precision how tomorrow will be like, but to produce indications so that adequate strategic decisions can be made today in an uncertain and turbulent environment.

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

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    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.

  2. Survival nomogram for curatively resected Korean gastric cancer patients: multicenter retrospective analysis with external validation.

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    Bang Wool Eom

    Full Text Available A small number of nomograms have been previously developed to predict the individual survival of patients who undergo curative resection for gastric cancer. However, all were derived from single high-volume centers. The aim of this study was to develop and validate a nomogram for gastric cancer patients using a multicenter database.We reviewed the clinicopathological and survival data of 2012 patients who underwent curative resection for gastric cancer between 2001 and 2006 at eight centers. Among these centers, six institutions were randomly assigned to the development set, and the other two centers were assigned to the validation set. Multivariate analysis using the Cox proportional hazard regression model was performed, and discrimination and calibration were evaluated by external validation.Multivariate analyses revealed that age, tumor size, lymphovascular invasion, depth of invasion, and metastatic lymph nodes were significant prognostic factors for overall survival. In the external validation, the concordance index was 0.831 (95% confidence interval, 0.784-0.878, and Hosmer-Lemeshow chi-square statistic was 3.92 (P = 0.917.We developed and validated a nomogram to predict 5-year overall survival after curative resection for gastric cancer based on a multicenter database. This nomogram can be broadly applied even in general hospitals and is useful for counseling patients, and scheduling follow-up.

  3. Retrospective analysis of third-line chemotherapy in advanced non-small cell lung cancer

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    Ali Murat Tatli

    2015-01-01

    Results: A total of 72 patients who had received third-line or higher chemotherapy were included in the analysis. The median age of patients was 49 years (range 41-76, and there were 13 (18.1% women and 59 (81.9% men. Estimated median survival was 26 months. Moreover, overall survival was significantly longer in patients for whom disease control was achieved after second-line chemotherapy compared to those with disease progression (34 vs. 17 months, respectively. Survival after third-line treatment was significantly longer in the group with Eastern Cooperative Oncology Group (ECOG performance status 0-1 at the beginning of third-line therapy compared to patients with a status of 2-3. Conclusions: In patients with advanced stage NSCLC, administration of third-line and higher systemic chemotherapy may be associated with increase in overall survival. Furthermore, greater increases in overall survival were also observed in patients for whom disease control was achieved after second-line therapy and in those with ECOG performance status of 0-1 before third-line treatment.

  4. Changes in physical fitness and nutritional status of schoolchildren in a period of 30 years (1980-2010

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    Gerson Luis de Moraes Ferrari

    2015-12-01

    Full Text Available Objective: To analyze and compare the changes in physical fitness according to the nutritional status and gender of schoolchildren during a period of 30 years (1980-2010. Methods: Four cross-sectional evaluations were performed every 10 years in a period of 30 years from 1978 to 1980 (baseline, 1988-1990 (10 years, 1998-2000 (20 years and 2008-2010 (30 years. The sample consisted of 1291 schoolchildren (188 in baseline, 307 in 10 years; 375 in 20 years; 421 in 30 years of 10 and 11 years old. The variables assessed were: body weight (kg, height (cm, upper limb strength (ULS; kg, lower limb strength (LLS; cm, agility (seconds and velocity (seconds. Schoolchildren were classified as normal weight and overweight according to World Health Organization reference of body mass index for age and gender. Comparisons among periods applied ANOVA followed by Bonferroni test, with a significance level set at of p<0.01. Variation between baseline and 30 years was assessed by the percentage delta. Seven different percentile values were presented for each variable. Results: In eutrophic boys and girls, mean values of ULS (−16.7%; −3.2%, agility (−1.5%; −1.6% decreased significantly after 30 years (p<0.001. In the overweight boys and girls, only the average ULS (−15.5%; −12.5% decreased significantly over time (p<0.001. After 30 years, the ULS percentile changed in boys. Conclusions: The decline in physical fitness was greater in schoolchildren with normal weight than in those with overweight.

  5. Spontaneus bilateral pedicle fracture 30 years after Harrington Instrumentation for idiopathic scoliosis: a case report

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    Obid Peter

    2012-01-01

    Full Text Available Abstract Introduction Spontaneous fractures of the spine are a common entity. They usually occur in older people with osteoporosis. This case is presented on account of its rarity. To the best of the authors' knowledge only one case of an osteoporotic pedicle fracture after Harrington Instrumentation has been described before. Case presentation We report the case of a 46-year-old Caucasian woman who underwent surgery due to idiopathic scoliosis with a Harrington Instrumentation (T4 to L3 30 years ago. During the operation she was infected with hepatitis C while receiving erythrocyte concentrates and has suffered from liver cirrhosis since then. She presented with a sudden pain in her lower back and paraesthesia in both her legs but no other neurological symptoms. A computed tomography scan showed a bilateral pedicle fracture of L3 and an additional compression fracture of L4. In the first session we performed a dorsal stabilization with massive intraoperative bleeding and a postoperative failure of liver synthesis. In a second session an additional ventral augmentation was done. After the second operation she developed a hepatorenal syndrome. Both operations left the patient in a very critical state which led to a prolonged stay in the intensive care and rehabilitation unit. At her 12-month follow-up visit, she was free of complaints. Conclusion The un-physiological load of the spine after Harrington Instrumentation can lead to osteoporosis due to inactivity even in younger patients. Although these implants are not used anymore one should keep this possibility in mind when dealing with patients who have received Harrington rods in surgical procedures.

  6. A continuing 30-year decline in water quality of Jiaojiang Estuary, China

    Institute of Scientific and Technical Information of China (English)

    Chun-ye Wang; Bin Zhou; Bei Huang

    2015-01-01

    A quantitative description of a long-term series of aquatic environmental factors and their spatial distributions was generated using measured data from the Jiaojiang Estuary from 1982 to 2011. The aquatic environmental factors included suspended matter, salinity, and nutrients. Based on these factors, the aquatic ecosystem health in the Jiaojiang Estuary over the last 30 years was analyzed. The results indicated that the suspended matter concentration in the estuary was mainly affected by the amounts of suspended sediment and solid waste, with the value fluctuating over a long period, and the range of high concentration expanded continually;the salinity was mainly affected by precipitation and surface water resources, showing an overall decreasing trend, and the region with low salinity moved seaward and toward the reclamation areas;and the nutritional status, mainly affected by discharge of industrial wastewater and domestic sewage, was satisfactory in the 1980s and 1990s, but the status became severe in recent years. Reclamation had a great influence on these three factors: high reclamation strength led to a significant increase in the suspended matter concentration and a deterioration of the nutritional status, and the reclamation rate was negatively related with the salinity in the estuary. There was a significant positive correlation between the health status of the aquatic ecosystem and salinity, with a correlation coefficient of 0.93. The correlation coefficient between the health status and nutritional status was ?0.71, while the correlation between the suspended matter concentration and health status was not as significant as that of the other two factors. The dynamics of the aquatic environment could be divided into four stages: sustainable health from the 1980s to the 1990s, continued deterioration from 2000 to 2003, improvement from 2004 to 2005, and secondary deterioration from 2006 to 2011. The Jiaojiang Estuary is faced with imminent environmental

  7. A continuing 30-year decline in water quality of Jiaojiang Estuary, China

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    Chun-ye WANG

    2015-01-01

    Full Text Available A quantitative description of a long-term series of aquatic environmental factors and their spatial distributions was generated using measured data from the Jiaojiang Estuary from 1982 to 2011. The aquatic environmental factors included suspended matter, salinity, and nutrients. Based on these factors, the aquatic ecosystem health in the Jiaojiang Estuary over the last 30 years was analyzed. The results indicated that the suspended matter concentration in the estuary was mainly affected by the amounts of suspended sediment and solid waste, with the value fluctuating over a long period, and the range of high concentration expanded continually; the salinity was mainly affected by precipitation and surface water resources, showing an overall decreasing trend, and the region with low salinity moved seaward and toward the reclamation areas; and the nutritional status, mainly affected by discharge of industrial wastewater and domestic sewage, was satisfactory in the 1980s and 1990s, but the status became severe in recent years. Reclamation had a great influence on these three factors: high reclamation strength led to a significant increase in the suspended matter concentration and a deterioration of the nutritional status, and the reclamation rate was negatively related with the salinity in the estuary. There was a significant positive correlation between the health status of the aquatic ecosystem and salinity, with a correlation coefficient of 0.93. The correlation coefficient between the health status and nutritional status was −0.71, while the correlation between the suspended matter concentration and health status was not as significant as that of the other two factors. The dynamics of the aquatic environment could be divided into four stages: sustainable health from the 1980s to the 1990s, continued deterioration from 2000 to 2003, improvement from 2004 to 2005, and secondary deterioration from 2006 to 2011. The Jiaojiang Estuary is faced with

  8. Congenital lobar emphysema: 30-year case series in two university hospitals

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    Daniele Cristina Cataneo

    2013-06-01

    Full Text Available OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years. All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those. No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months, and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective.

  9. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise.

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    Lawn, Joy E; Rohde, Jon; Rifkin, Susan; Were, Miriam; Paul, Vinod K; Chopra, Mickey

    2008-09-13

    In this paper, we revisit the revolutionary principles-equity, social justice, and health for all; community participation; health promotion; appropriate use of resources; and intersectoral action-raised by the 1978 Alma-Ata Declaration, a historic event for health and primary health care. Old health challenges remain and new priorities have emerged (eg, HIV/AIDS, chronic diseases, and mental health), ensuring that the tenets of Alma-Ata remain relevant. We examine 30 years of changes in global policy to identify the lessons learned that are of relevance today, particularly for accelerated scale-up of primary health-care services necessary to achieve the Millennium Development Goals, the modern iteration of the "health for all" goals. Health has moved from under-investment, to single disease focus, and now to increased funding and multiple new initiatives. For primary health care, the debate of the past two decades focused on selective (or vertical) versus comprehensive (horizontal) delivery, but is now shifting towards combining the strengths of both approaches in health systems. Debates of community versus facility-based health care are starting to shift towards building integrated health systems. Achievement of high and equitable coverage of integrated primary health-care services requires consistent political and financial commitment, incremental implementation based on local epidemiology, use of data to direct priorities and assess progress, especially at district level, and effective linkages with communities and non-health sectors. Community participation and intersectoral engagement seem to be the weakest strands in primary health care. Burgeoning task lists for primary health-care workers require long-term human resource planning and better training and supportive supervision. Essential drugs policies have made an important contribution to primary health care, but other appropriate technology lags behind. Revitalisng Alma-Ata and learning from three

  10. A 30-year history of earthquake crisis communication in California and lessons for the future

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    Jones, L.

    2015-12-01

    The first statement from the US Geological Survey to the California Office of Emergency Services quantifying the probability of a possible future earthquake was made in October 1985 about the probability (approximately 5%) that a M4.7 earthquake located directly beneath the Coronado Bay Bridge in San Diego would be a foreshock to a larger earthquake. In the next 30 years, publication of aftershock advisories have become routine and formal statements about the probability of a larger event have been developed in collaboration with the California Earthquake Prediction Evaluation Council (CEPEC) and sent to CalOES more than a dozen times. Most of these were subsequently released to the public. These communications have spanned a variety of approaches, with and without quantification of the probabilities, and using different ways to express the spatial extent and the magnitude distribution of possible future events. The USGS is re-examining its approach to aftershock probability statements and to operational earthquake forecasting with the goal of creating pre-vetted automated statements that can be released quickly after significant earthquakes. All of the previous formal advisories were written during the earthquake crisis. The time to create and release a statement became shorter with experience from the first public advisory (to the 1988 Lake Elsman earthquake) that was released 18 hours after the triggering event, but was never completed in less than 2 hours. As was done for the Parkfield experiment, the process will be reviewed by CEPEC and NEPEC (National Earthquake Prediction Evaluation Council) so the statements can be sent to the public automatically. This talk will review the advisories, the variations in wording and the public response and compare this with social science research about successful crisis communication, to create recommendations for future advisories

  11. 30 years of upper air soundings on board of R/V POLARSTERN

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    Driemel, Amelie; Loose, Bernd; Grobe, Hannes; Sieger, Rainer; König-Langlo, Gert

    2016-06-01

    The research vessel and supply icebreaker POLARSTERN is the flagship of the Alfred-Wegener-Institut in Bremerhaven (Germany) and one of the infrastructural pillars of German Antarctic research. Since its commissioning in 1982, POLARSTERN has conducted 30 campaigns to Antarctica (157 legs, mostly austral summer), and 29 to the Arctic (94 legs, northern summer). Usually, POLARSTERN is more than 300 days per year in operation and crosses the Atlantic Ocean in a meridional section twice a year. The first radiosonde on POLARSTERN was released on the 29 December 1982, 2 days after POLARSTERN started on its maiden voyage to the Antarctic. And these daily soundings have continued up to the present. Due to the fact that POLARSTERN has reliably and regularly been providing upper air observations from data sparse regions (oceans and polar regions), the radiosonde data are of special value for researchers and weather forecast services alike. In the course of 30 years (29 December 1982 to 25 November 2012) a total of 12 378 radiosonde balloons were started on POLARSTERN. All radiosonde data can now be found at König-Langlo (2015, doi:10.1594/PANGAEA.810000). Each data set contains the directly measured parameters air temperature, relative humidity and air pressure, and the derived altitude, wind direction and wind speed. 432 data sets additionally contain ozone measurements.Although more sophisticated techniques (meteorological satellites, aircraft observation, remote-sensing systems, etc.) have nowadays become increasingly important, the high vertical resolution and quality of radiosonde data remains paramount for weather forecasts and modelling approaches.

  12. CT imaging, then and now: a 30-year review of the economics of computed tomography.

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    Stockburger, Wayne T

    2004-01-01

    The first computed tomography (CT) scanner in the US was installed in June 1973 at the Mayo Clinic in Rochester, MN. By the end of 1974, 44 similar systems had been installed at medical facilities around the country. Less than 4 years after the introduction of CT imaging in the US, at least 400 CT systems had been installed. The practice of pneumoencephalography was eliminated. The use of nuclear medicine brain scans significantly diminished. At the time, CT imaging was limited to head studies, but with the introduction of contrast agents and full body CT systems the changes in the practice of medicine became even more significant. CT imaging was hailed by the US medical community as the greatest advance in radiology since the discovery of x-rays. But the rapid spread of CT systems, their frequency of use, and the associated increase in healthcare costs combined to draw the attention of decision-makers within the federal and state governments, specifically to establish policies regarding the acquisition and use of diagnostic technologies. Initially, CT imaging was limited to neurological applications, but in the 30 years since its inception, capabilities and applications have been expanded as a result of the advancements in technology and software development. While neurological disorders are still a common reason for CT imaging, many other medical disciplines (oncology, emergency medicine, orthopedics, etc.) have found CT imaging to be the definitive tool for diagnostic information. As such, the clinical demand for CT imaging has steadily increased. Economically, the development of CT imaging has been one of success, even in the face of governmental action to restrict its acquisition and utilization by healthcare facilities. CTimaging has increased the cost of healthcare, but in turn has added unquantifiable value to the practice of medicine in the US.

  13. [Tubulo-villous rectal tumours. Results of surgical resection in relation to histotype (30 years' experience)].

    Science.gov (United States)

    Carditello, Antonio; Milone, Antonino; Paparo, Domenica; Anastasi, Giuliana; Mollo, Francesco; Stilo, Francesco

    2004-01-01

    Adenomas of the rectum are frequently found during endoscopic examination. We report on our 30 years of experience with the treatment of tubulo-villous adenomas based on histotype. Between 1971 and 2001, 104 villous tumours of the rectum were treated surgically. The patients' average age was 65 years. These were sessile tumours in 69% of cases, pedunculated in 17.5% and flowing tumours in 13.5%. The mean tumour size was 3 cm. They were associated with colon cancer in 15% of cases and with polyadenoma in 10%. They were located in the rectum within 0 to 6 cm of the anal margin in half the cases. These tumours were treated by local excision in 74 cases and by wide excision in 30 cases. The malignant potential of the tumours was 30%, including 10% invasive malignancy. There were no surgical fatalities, but a 6% medical fatality rate was registered. There was a 20% complication rate related to the surgical technique. Twenty patients were lost to follow-up. Out of 84 villous tumours, monitored over a mean survival period of 6.5 years, there were 24 recurrences: 18 underwent endoscopic excision and in 6 cases a wide resection. The various tumour resection techniques and the operative indications of variable difficulty are presented. It would seem, at present, that total resection of the rectum with a colo-anal anastomosis is the best treatment for large flowing villous tumours occupying almost the entire rectum. Thorough preoperative examination and the mastering of various surgical procedures should allow the most suitable choice of treatment for each individual case.

  14. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors

    Science.gov (United States)

    El Khateeb, Sara M.; Abu-Hammad, Osama; Fadel, Hani; Dar-Odeh, Najla

    2017-01-01

    Aims and Objectives: To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. Materials and Methods: The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. Results: A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). Conclusions: A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend. PMID:28316945

  15. Identifying gender-preferred communication styles within online cancer communities: a retrospective, longitudinal analysis.

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    Kathleen T Durant

    Full Text Available BACKGROUND: The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. METHODS AND FINDINGS: We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P = <0.0001, breast P = 0.0089, prostate P = 0.0021. Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01. Typically a male patient communicates with more members than a female patient (Ovarian forum P = 0.0406, Breast forum P = 0.0013. A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P = 0.00406, breast forum P = 0.00013, prostate forum P = .0.0003. CONCLUSION: The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication

  16. Retrospective analysis of mortality and Candida isolates of 75 patients with candidemia: a single hospital experience

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    Hirano R

    2015-07-01

    Full Text Available Ryuichi Hirano,1 Yuichi Sakamoto,2 Kumiko Kudo,1 Motoki Ohnishi31Department of Pharmacy, Aomori Prefectural Central Hospital, Aomori, Japan; 2Laboratory Medicine and Blood transfusion, Aomori Prefectural Central Hospital, Aomori, Japan; 3General Medicine, Aomori Prefectural Central Hospital, Aomori, JapanAbstract: The mortality rate for candidemia is approximately 30%–60%. However, prognostic factors in patients with candidemia have not yet been elucidated in detail. The aim of the present study was to analyze prognostic factors for candidemia using the mortality rate and Candida isolates of patients with candidemia. Seventy-five patients with candidemia were analyzed between January 2007 and December 2013. The main outcome of this study was the 30-day mortality rate after the diagnosis of candidemia. The acute physiology and chronic health evaluation II score (APACHE II score was measured in 34 patients (45.3%. Odds ratios (ORs for death due to candidemia were analyzed using a multivariate stepwise logistic regression analysis. Twenty (26.6% patients died within 30 days of being diagnosed with candidemia. Non-survivors had a significantly higher APACHE II score (n=7, mean; 18.9±4.5 than that of survivors (n=27, mean; 14.0±5.0. Advanced age (OR =1.1, 95% confidence interval =1.01–1.23, P=0.04 was a significant risk factor for a high mortality rate, whereas removal of a central venous catheter (OR =0.03, 95% confidence interval =0.002–0.3, P=0.01 was associated with a lower mortality rate. Seventy-six Candida spp. were isolated from blood cultures: Candida albicans 28 (36.8%, Candida parapsilosis 23 (30.2%, Candida guilliermondii 16 (21.0%, Candida glabrata four (5.2%, Candida tropicalis two (2.6%, and Candida spp. three (3.9% that could not be identified. C. parapsilosis was the most frequently isolated species in younger patients (<65 years, whereas C. albicans was the most frequently isolated in elderly patients (≥65 years

  17. Identifying Gender-Preferred Communication Styles within Online Cancer Communities: A Retrospective, Longitudinal Analysis

    Science.gov (United States)

    Durant, Kathleen T.; McCray, Alexa T.; Safran, Charles

    2012-01-01

    Background The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. Methods and Findings We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate) dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P = <0.0001, breast P = 0.0089, prostate P = 0.0021). Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01). Typically a male patient communicates with more members than a female patient (Ovarian forum P = 0.0406, Breast forum P = 0.0013). A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P = 0.00406, breast forum P = 0.00013, prostate forum P = .0.0003). Conclusion The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication preference studies

  18. Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis.

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    Aye Thida

    Full Text Available BACKGROUND: The outcomes from an antiretroviral treatment (ART program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. METHODS: A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up; a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. RESULT: The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84% patients were retained in ART program: 750 (7% were lost to follow-up and 909 (9% died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. CONCLUSION: High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings.

  19. Prognostic value of preoperative absolute lymphocyte count in recurrent hepatocellular carcinoma following thermal ablation: a retrospective analysis

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    Li X

    2014-10-01

    Full Text Available Xin Li, Zhiyu Han, Zhigang Cheng, Jie Yu, Xiaoling Yu, Ping Liang Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, People's Republic of China Purpose: To investigate the prognostic value of preoperative absolute lymphocyte count (ALC in recurrent hepatocellular carcinoma (RHCC following thermal ablation. Materials and methods: We retrospectively analyzed the relationship between preoperative ALC and the clinicopathologic factors and long-term prognosis in 423 RHCC patients who underwent curative thermal ablation. Correlation analysis, receiver operating characteristic (ROC calculation, Kaplan–Meier curves, and multivariate regression were used for statistical analysis. Results: The median time to recurrence was 12 months for RHCC patients after thermal ablation. On multivariate Cox regression analysis, preoperative ALC was an independent risk factor for cancer recurrence, along with tumor differentiation and α-fetoprotein level. ALC ≥1.64×109/L defined by ROC calculation was associated with prolonged survival (area under the curve 0.741, P<0.001. Patients with ALC ≥1.64×109/L showed a mean survival of 20.2 months versus 11.6 months for patients with ALC <1.64×109/L (P<0.001. Patients were stratified into high and low groups according to ALC status. After excluding the basic parameters between groups, the 1- and 3-year recurrence rates in the high group were 20.9% and 29.5%, respectively, which were significantly lower than those of the low group (58.4% and 71.9%, respectively; P<0.001. The recurrence-free survival rates in the two groups analyzed by Kaplan–Meier curves were significantly different (P<0.001. Conclusion: Preoperative ALC is a powerful prognostic factor for RHCC recurrence after thermal ablation, which suggests that maintaining a high ALC in RHCC patients might improve cancer outcomes. Keywords: absolute lymphocyte count, recurrent hepatocellular carcinoma, thermal ablation, recurrence  

  20. Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas

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    Höltje, J.; Bonk, F.; Anstadt, A.; Terborg, C.; Pohlmann, C.; Urban, P. P.; Brüning, R.

    2015-01-01

    Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours). Results. A slight hemorrhagic infarction (HI1) was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1) was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3) or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone. PMID:26640710

  1. Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas

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    J. Höltje

    2015-01-01

    Full Text Available Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours. Results. A slight hemorrhagic infarction (HI1 was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1 was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3 or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone.

  2. Combination antibiotic therapy versus monotherapy for Pseudomonas aeruginosa bacteraemia: a meta-analysis of retrospective and prospective studies.

    Science.gov (United States)

    Hu, Yangmin; Li, Leiqing; Li, Wenlu; Xu, Huimin; He, Ping; Yan, Xiaofeng; Dai, Haibin

    2013-12-01

    The choice of antibiotic monotherapy or combination therapy to treat Pseudomonas aeruginosa bacteraemia is controversial. The aim of this review was to compare both types of therapy to determine which delivers the best outcome for P. aeruginosa bacteraemia. We systematically searched electronic bibliographic databases, including PubMed, Ovid EMBASE and The Cochrane Library, for clinical studies that compared combination therapy with monotherapy in the treatment of P. aeruginosa bacteraemia. Eligible articles were analysed using Stata(®)/SE software v.12.0. Stratification analysis was conducted by study design and treatment type. Publication bias was assessed using Begg's funnel plot and Egger's test. Ten studies (eight retrospective and two prospective) involving 1239 patients were analysed. We found no difference between combination therapy and monotherapy when the data were combined (odds ratio = 0.89, 95% confidence interval 0.57-1.40; P = 0.614) or when data were analysed in subgroups. Neither combination therapy nor monotherapy treatment appears to have a significant effect on mortality rates in patients with P. aeruginosa bacteraemia. Further studies evaluating the effects of combination therapy or monotherapy in more specialised cases, such as when encountering a multidrug-resistant organism, are necessary.

  3. Retrospective analysis of patients with carcinoma cervix in a rural/semi-urban setting in Western India

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    Ranvijay Singh

    2016-01-01

    Full Text Available Objectives: To compare the presentation of cervical cancer and the treatment modalities received by the patients at a semi-urban/rural area of Western India with that of published literature from urban centers. Materials and Methods: We conducted a retrospective analysis of patients with cervical cancer who presented at a semi-urban/rural cancer center between 2010 and 2013. A total of 141 patients with the median age of 51 years (25-81 were studied. The demographic and clinical variables included age, annual family income, profession, comorbidities, baseline hemoglobin, prior screening, clinical stage, treatment administered, and complications. The pathological variables included tumor type and grade. Results: In our study, all patients presented with vaginal bleeding. Majority of the patients (51 patients, 37.7% had Stage 3B disease. Since majority presented at later stages (Stage 3B, chemotherapy-radiotherapy was the most common treatment modality used in our population. On histopathology, 127 patients (90% had squamous cell carcinoma while 14 patients (10% had adenocarcinoma. In 96 patients (68%, the tumor grade was not known while it was a high, intermediate, and low grade in 6 (4%, 18 (13%, and 21 (15% patients, respectively. The follow-up data of our study were not adequate; hence, the long-term survival results could not be presented. Conclusion: Patients in rural India setting present at later stages which could be improved by creating awareness, improving their personal hygiene, and adequate screening.

  4. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases.

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    Fujiwara, Masayuki; Kamikonya, Norihiko; Odawara, Soichi; Suzuki, Hitomi; Niwa, Yasue; Takada, Yasuhiro; Doi, Hiroshi; Terada, Tomonori; Uwa, Nobuhiro; Sagawa, Kosuke; Hirota, Shozo

    2015-05-01

    The purpose of the present study was to determine the risk factors for developing thyroid disorders based on a dose-volume histograms (DVHs) analysis. Data from a total of 116 consecutive patients undergoing 3D conformal radiation therapy for head and neck cancers was retrospectively evaluated. Radiation therapy was performed between April 2007 and December 2010. There were 108 males and 8 females included in the study. The median follow-up term was 24 months (range, 1-62 months). The thyroid function was evaluated by measuring thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels. The mean thyroid dose, and the volume of thyroid gland spared from doses ≥10, 20, 30 and 40 Gy (VS10, VS20, VS30 and VS40) were calculated for all patients. The thyroid dose and volume were calculated by the radiotherapy planning system (RTPS). The cumulative incidences of hypothyroidism were 21.1% and 36.4% at one year and two years, respectively, after the end of radiation therapy. In the DVH analyses, the patients who received a mean thyroid dose hypothyroidism. The univariate analyses showed that the VS10, VS20, VS30 and VS40 were associated with the risk of hypothyroidism. Hypothyroidism was a relatively common type of late radiation-induced toxicity. A mean thyroid dose of 30 Gy may be a useful threshold for predicting the development of hypothyroidism after radiation therapy for head and neck cancers.

  5. Epidemiology of Foot and Mouth Disease in Ethiopia: a Retrospective Analysis of District Level Outbreaks, 2007-2012.

    Science.gov (United States)

    Jemberu, W T; Mourits, M C M; Sahle, M; Siraw, B; Vernooij, J C M; Hogeveen, H

    2016-12-01

    This study aimed at determining the incidence, distribution, risk factors, and causal serotypes of foot and mouth disease (FMD) outbreaks in Ethiopia based on 5 years of retrospective outbreak data (September 2007 until August 2012). District level outbreak data were collected from 115 randomly selected districts using a questionnaire administered to district animal health officers. The national incidence of FMD outbreaks during the study period was 1.45 outbreaks per five district years. Outbreaks were geographically widespread affecting all major regional states in the country and were more frequent in the central, southern, and southeastern parts of the country. Neither long-term nor seasonal trends were observed in the incidence of outbreaks. A mixed effects logistic regression analysis revealed that the type of production system (market oriented system versus subsistence systems), presence of a major livestock market and/or route, and adjacency to a national parks or wildlife sanctuary were found to be associated with increased risk of outbreaks in the districts. FMD virus serotypes O, A, SAT 2, and SAT 1 were identified as the causal serotypes of the outbreaks during the study period. Whereas O was the dominant serotype, SAT 2 was the serotype that showed increase in relative frequency of occurrence. The estimated incidence of outbreaks is useful in assessing the economic impacts of the disease, and the identified risk factors provide important knowledge to target a progressive FMD control policy for Ethiopia.

  6. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis

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    PASSOS Luciana Neves

    2000-01-01

    Full Text Available We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients and 1991 (33 patients. There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71, related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm³ and blood lymphocytes lower than 350/mm³. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

  7. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis.

    Science.gov (United States)

    Passos, L N; Araújo Filho, O F; Andrade Junior, H F

    2000-01-01

    We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm3 and blood lymphocytes lower than 350/mm3. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

  8. Clinicopathological Characteristics of Mucinous Breast Cancer: A Retrospective Analysis of a 10-Year Study.

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    Lei Lei

    Full Text Available Mucinous breast carcinoma (MC is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features.We identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN metastases, estrogen receptor (ER, progesterone receptor (PR and human epidermal growth factor receptor-2 (HER2 status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC, IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital.We identified 48 cases of pure mucinous carcinoma (PMC and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases and those with main mixed mucinous breast carcinoma (mMMC, 19 cases. pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted between the patients

  9. Re-irradiation for painful heel spur syndrome. Retrospective analysis of 101 heels

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    Hautmann, M.G.; Koelbl, O. [University of Regensburg, Department of Radiotherapy, Regensburg (Germany); Neumaier, U. [MVZ Neumaier and Kollegen, Private Clinic for Radiotherapy, Regensburg (Germany)

    2014-03-15

    Painful heel spur syndrome is a common disease with a lifetime prevalence of approximately 10 %. One of the most effective treatment options is radiotherapy. Many authors recommend a second or third series of radiation for recurrent pain and partial or no response to the initial treatment. As the results of re-irradiation have not been systematically analyzed the aim of this study was to document the results of repeated radiation treatment and to identify patients who could benefit from this treatment. The analysis was performed on patients from 2 German radiotherapy institutions and included 101 re-irradiated heels. Pain was documented with the numeric rating scale (NRS) and carried out before and directly after each radiation therapy as well as for the follow-up period of 24 months. The median age of the patients was 56 years with 30.1 % male and 69.9 % female patients. Pain was caused by plantar fasciitis in 72.3 %, Haglund's exostosis in 15.8 % and Achilles tendinitis in 11.9 %. Repeated radiation was indicated because the initial radiotherapy resulted in no response in 35.6 % of patients, partial response in 39.6 % and recurrent pain in 24.8 %. A significant response to re-irradiation could be found. For the whole sample the median NRS pain score was 6 before re-irradiation, 2 after 6 weeks and 0 after 12 and 24 months. Of the patients 73.6 % were free of pain 24 months after re-irradiation. All subgroups, notably those with no response, partial response and recurrent pain had a significant reduction of pain. Re-irradiation of painful heel spur syndrome is an effective and safe treatment. All subgroups showed a good response to re-irradiation for at least 24 months. (orig.) [German] Der schmerzhafte Fersensporn ist eine der haeufigsten Erkrankungen unter den Fusssyndromen. Die Lebenszeitpraevalenz liegt bei etwa 10 %. Eine der wirkungsvollsten Therapieoptionen stellt die Strahlentherapie dar. Dabei beschreiben viele Autoren die Durchfuehrung einer

  10. Retrospective Analysis of Recent Flood Events With Persistent High Surface Runoff From Hydrological Modelling

    Science.gov (United States)

    Joshi, S.; Hakeem, K. Abdul; Raju, P. V.; Rao, V. V.; Yadav, A.; Diwakar, P. G.; Dadhwal, V. K.

    2014-11-01

    /locations with probable flooding conditions. These thresholds were refined through iterative process by comparing with satellite data derived flood maps of 2013 and 2014 monsoon season over India. India encountered many cyclonic flood events during Oct-Dec 2013, among which Phailin, Lehar, and Madi were rated to be very severe cyclonic storm. The path and intensity of these cyclonic events was very well captured by the model and areas were marked with persistent coverage of high runoff risk/flooded area. These thresholds were used to monitor floods in Jammu Kashmir during 4-5 Sep and Odisha during 8-9 Aug, 2014. The analysis indicated the need to vary the thresholds across space considering the terrain and geographical conditions. With respect to this a sub-basin wise study was made based on terrain characteristics (slope, elevation) using Aster DEM. It was found that basins with higher elevation represent higher thresholds as compared to basins with lesser elevation. The results show very promising correlation with the satellite derived flood maps. Further refinement and optimization of thresholds, varying them spatially accounting for topographic/terrain conditions, would lead to estimation of high runoff/flood risk areas for both riverine and drainage congested areas. Use of weather forecast data (NCMWRF, (GEFS/R)), etc. would enhance the scope to develop early warning systems.

  11. Risk factors for stillbirths at universty of Maiduguri teaching hospital, Maiduguri, Nigeria: A cross-sectional retrospective analysis

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    B M Audu

    2009-01-01

    Full Text Available Background:Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Data on birth outcomes are Important for planning maternal and child health care services in developing countries. There is little or no literature on the stillbirth rate in north-eastern Nigeria. This may be the first study to serve as the baseline data in Maiduguri. Objective:This study aimed at determining the prevalence and identifying the risk factors contributing to foetal demise. Study design:A cross-sectional retrospective analysis of stillbirth among women delivering in UMTH over a-4 year period, from January 2001 to December 2004. Method:The Case records of 7996 women that delivered in UMTH over the study period were retrieved and the trend of the stillbirth experiences followed up retrospectively, and relevant information with special reference to socio-demographic characteristics, clinical risk factors for stillbirth and type of stillbirth obtained and analyzed. Results:There was a total of 179 stillbirths among the 7996 deliveries giving the institutional prevalence of 22/1000 deliveries. Macerated stillbirths with no obvious congenital malformation predominated (OR: 10.89; CI: 6.51-31.80, accounting for 52.5%, while fresh stillbirths (OR: 5.81; CI: 3.77-11.87, accounted for 47.5%. Most of the risk factors (63.7% for stillbirths were present ante partum such as multiparity (OR: 2.88; CI: 1.47-6.09, lack of antenatal care (OR: 1.91; CI: 0.92-2.05, maternal literacy level (OR: 2.82; Cl: 1.44-5.41, hypertension, pre-eclampsia and eclarnpsia disease complex (χ 2 =15.12; P-value =0.006; while intra partum risk factors contributed 36.3% with SVD as a mode of delivery, the leading risk factor (χ 2 = 23.79; & P-value 0.000. Conclusion:The prevalence of stillbirth is high and is predominantly associated with ante partum risk factors. In our setting, antenatal care should be considered as the cornerstone in the prevention of

  12. Discharge, water temperature, and water quality of Warm Mineral Springs, Sarasota County, Florida: A retrospective analysis

    Science.gov (United States)

    Metz, Patricia A.

    2016-09-27

    characterized by a slight-green color, with varying water clarity, low dissolved oxygen (indicative of deep groundwater), and a hydrogen sulfide odor. Water-quality samples detected ammonium-nitrogen and nitrates, but at low concentrations. The drinking water standard for nitrate adopted by the U.S. Environmental Protection Agency is 10 milligrams per liter, measured as nitrogen. Water samples collected at spring vents by divers on April 29, 2015, had concentrations of 0.9 milligram per liter nitrate-nitrogen at vent A and 0.04–0.05 milligram per liter at vents B, C, and D. Typically, the water clarity is highest in the morning (about 30 feet Secchi depth) and often decreases throughout the day.Analysis of existing data provided some insight into the hydrologic processes affecting Warm Mineral Springs; however, data have been sparsely and discontinuously collected since the 1940s. Continuous monitoring of hydrologic characteristics such as discharge, water temperature, specific conductance, and water-quality indicators, such as nitrate and turbidity (water clarity), would be valuable for monitoring and development of models of spring discharge and water quality. In addition, water samples could be analyzed for isotopic tracers, such as strontium, and the results used to identify and quantify the sources of groundwater that discharge at Warm Mineral Springs. Groundwater flow/transport models could be used to evaluate the sensitivity of the quality and quantity of water flowing from Warm Mineral Springs to changes in climate, aquifer levels, and water use.

  13. Historical data reveal 30-year persistence of benthic fauna associations in heavily modified waterbody

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    Ruth Callaway

    2016-08-01

    Full Text Available Baseline surveys form the cornerstone of coastal impact studies where altered conditions, for example through new infrastructure development, are assessed against a temporal reference state. They are snapshots taken before construction. Due to scarcity of relevant data prior to baseline surveys long-term trends can often not be taken into account. Particularly in heavily modified waterbodies this would however be desirable to control for changes in anthropogenic use over time as well as natural ecological variation. Here, the benthic environment of an industrialized embayment was investigated (Swansea Bay, Wales, UK where it is proposed to build a tidal lagoon that would generate marine renewable energy from the tidal range. Since robust long-term baseline data was not available, the value of unpublished historical benthos information from 1984 by a regional water company was assessed with the aim to improve certainty about the persistence of current benthic community patterns. A survey of 101 positions in 2014 identified spatially discrete benthic communities with areas of high and low diversity. Habitat characteristics including sediment properties and the proximity to a sewage outfall explained 17-35% of the variation in the community structure. Comparing the historical information from 1984 with 2014 revealed striking similarity in the benthic communities between those years, not just in their spatial distribution but also to a large extent in the species composition. The 30-year-old information confirmed spatial boundaries of discrete species associations and pinpointed a similar diversity hotspot. A group of five common species was found to be particularly persistent over time (Nucula nitidosa, Spisula elliptica, Spiophanes bombyx, Nephtys hombergii, Diastylis rathkei. According to the Infauna Quality Index (IQI linked to the EU Water Framework Directive (WFD the average ecological status for 2014 was ‘moderate’, but eleven samples

  14. Pichia anomala J121: a 30-year overnight near success biopreservation story.

    Science.gov (United States)

    Schnürer, Johan; Jonsson, Anders

    2011-01-01

    Thirty years ago, the ascomycetous yeast Pichia anomala strain J121 was isolated from moist wheat grain stored under conditions of restricted air access. Early observations indicated that an inverse relationship existed between mould and P. anomala colony forming units in grain. This yeast strain was later found to have strong antifungal properties in laboratory, pilot and farm studies with high-moisture wheat under malfunctioning airtight storage. P. anomala had the highest inhibitory activity of 60 yeast species evaluated against the mould Penicillium roqueforti. It also demonstrated strong inhibitory effects against certain Gram-negative bacteria. P. anomala J121 possesses a number of physiological characteristics, i.e. capacity to grow under low pH, low water activity and low oxygen tension and ability to use a wide range of carbon and nitrogen sources, enabling it to act as an efficient biopreservative agent. The biocontrol effect in grain was enhanced by addition of glucose, mainly through formation of the volatile antimicrobial ethyl acetate. Animal feeding trials with P. anomala J121 inoculated grains, fed to chickens and beef cattle, demonstrated that mould control observed in vitro in small scale laboratory experiments could be extended to large scale farm trials. In addition, no adverse effects on animal weight gain, feed conversion, health or behaviour were observed. We have now studied P. anomala J121 biology, ecology and grain preservation ability for 30 years. Over this period, more than 40 scientific publications and five PhD theses have been written on different aspects of this yeast strain, extending from fundamental research on metabolism, genetics and molecular biology, all the way to practical farm-scale level. In spite of the well documented biopreservative ability of the yeast, it has to date been very difficult to create the right constellation of technical, agricultural and biotechnical industries necessary to reach a commercial launch of a

  15. The National Tumor Association Foundation (ANT: A 30 year old model of home palliative care

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    Bonazzi Valeria

    2010-06-01

    Full Text Available Abstract Background Models of palliative care delivery develop within a social, cultural, and political context. This paper describes the 30-year history of the National Tumor Association (ANT, a palliative care organization founded in the Italian province of Bologna, focusing on this model of home care for palliative cancer patients and on its evaluation. Methods Data were collected from the 1986-2008 ANT archives and documents from the Emilia-Romagna Region Health Department, Italy. Outcomes of interest were changed in: number of patients served, performance status at admission (Karnofsky Performance Status score [KPS], length of participation in the program (days of care provided, place of death (home vs. hospital/hospice, and satisfaction with care. Statistical methods included linear and quadratic regressions. A linear and a quadratic regressions were generated; the independent variable was the year, while the dependent one was the number of patients from 1986 to 2008. Two linear regressions were generated for patients died at home and in the hospital, respectively. For each regression, the R square, the unstandardized and standardized coefficients and related P-values were estimated. Results The number of patients served by ANT has increased continuously from 131 (1986 to a cumulative total of 69,336 patients (2008, at a steady rate of approximately 121 additional patients per year and with no significant gender difference. The annual number of home visits increased from 6,357 (1985 to 904,782 (2008. More ANT patients died at home than in hospice or hospital; this proportion increased from 60% (1987 to 80% (2007. The rate of growth in the number of patients dying in hospital/hospice was approximately 40 patients/year (p 40 increased. Mean days of care for patients with KPS > 40 exceeded mean days for patients with KPS Conclusions The ANT home care model of palliative care delivery has been well-received, with progressively growing numbers

  16. Mortality of IgA nephropathy patients: a single center experience over 30 years.

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    Hajeong Lee

    Full Text Available Research on the prognosis of IgA nephropathy (IgAN has focused on renal survival, with little information being available on patient survival. Hence, this investigation aimed to explore long-term patient outcome in IgAN patients. Clinical and pathological characteristics at the time of renal biopsy were reviewed in 1,364 IgAN patients from 1979 to 2008. The outcomes were patient death and end stage renal disease (ESRD progression. Overall, 71 deaths (5.3% and 277 cases of ESRD (20.6% occurred during 13,916 person-years. Ten-, 20-, and 30-year patient survival rates were 96.3%, 91.8%, and 82.7%, respectively. More than 50% patient deaths occurred without ESRD progression. Overall mortality was elevated by 43% from an age/sex-matched general population (GP (standardized mortality ratio [SMR], 1.43; 95% confidence interval [CI], 1.04-1.92. Men had comparable mortality to GP (SMR, 1.22; 95% CI, 0.82-1.75, but, in women, the mortality rate was double (SMR, 2.17; 95% CI, 1.21-3.57. Patients with renal risk factors such as initial renal dysfunction (estimated glomerular filgration rate <60 ml/min per 1.73 m(2; SMR, 1.70; 95% CI, 1.13-2.46, systolic blood pressure ≥ 140 mmHg (SMR, 1.88; 95% CI, 1.19-2.82 or proteinuria ≥ 1 g/day (SMR, 1.66; 95% CI, 1.16-2.29 had an elevated mortality rate. Patients with preserved renal function, normotension, and proteinuria <1 g/day, however, had a similar mortality rate to GP. When risk stratification was performed by counting the number of major risk factors present at diagnosis, low-risk IgAN patients had a mortality rate equal to that of GP, whereas high-risk patients had a mortality rate higher than that of GP. This investigation demonstrated that overall mortality in IgAN patients was higher than that of GP. Women and patients with renal risk factors had a higher mortality than that of GP, Therefore, strategies optimized to alleviate major renal risk factors are warranted to reduce patient mortality.

  17. A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme

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    Green, Stuart A; Honeybourne, Emmi; Chalkley, Sylvia R; Price, Geraint; Bell, Derek; Green, John

    2015-01-01

    Objectives This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis. Design Observational, retrospective discriminant analysis. Setting 2 London community mental health services that provide psychological therapies for common mental disorders including anxiety and depression. Participants A total of 7388 patients attended the services between February 2009 and May 2012, of which 4393 (59%) completed therapy, or there was an agreement to end therapy, and were included in the study. Primary and secondary outcome measures Different combinations of the clinical outcome scores for anxiety Generalised Anxiety Disorder-7 and depression Patient Health Questionnaire-9 were used to construct different treatment outcomes. Results The predictive models were able to assign a positive or negative clinical outcome to each patient based on 5 independent pre-treatment variables, with an accuracy of 69.4% and 79.3%, respectively: initial severity of anxiety and depression, ethnicity, deprivation and gender. The number of sessions attended/missed were also important factors identified in recovery. Conclusions Predicting whether patients are likely to have a positive outcome following treatment at entry might allow suitable modification of scheduled treatment, possibly resulting in improvements in outcomes. The model also highlights factors not only associated with poorer outcomes but inextricably linked to prevalence of common mental disorders, emphasising the importance of social determinants not only in poor health but also poor recovery. PMID:25995234

  18. CAN A SPECIFIC NECK STRENGTHENING PROGRAM DECREASE CERVICAL SPINE INJURIES IN A MEN'S PROFESSIONAL RUGBY UNION TEAM? A RETROSPECTIVE ANALYSIS

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    Robert Naish

    2013-09-01

    Full Text Available Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009 or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009. However, a significant (p = 0.03 reduction in the number of match injuries was evident from 2007-2008 (n = 11 to 2008-09 (n = 2. Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes

  19. Further potential savings attributable to maximum generic substitution of antidepressants in South Africa: A retrospective analysis of medical claims

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    Jan H.P. Serfontein

    2010-03-01

    Full Text Available The main objective of the study was to calculate potential cost savings that could have been generated by maximum generic substitution of antidepressants within the private health care sector of South Africa from 2004 to 2006. Data on computerised medicine claims of patients receiving one or more antidepressants during three consecutive years (i.e. 2004, 2005 and 2006 were elicited from a South African pharmaceutical benefit management company. The total study population consisted of 292 071 items (N = 5 982 869 on 273 673 prescriptions (N = 5 213 765 at a total cost of R56 183 697.91(N = R1 346 210 929.00. A quantitative, retrospective drug utilisation review was conducted, and data were analysed using the Statistical Analysis System® programme. Potential cost savings were computed for criteria-eligible substances in the study population. Generic medicine constituted 58.7% (N = 292 071 of all antidepressants claimed, at a total cost of 28.2% (N = R1 346 210 929.00of all incurred costs. With total substitution of the average price of all criteria-eligible innovators, a potential saving of 9.3% (N = R56 183 697.91 of the actual antidepressant cost over the study period was calculated. In developing countries with limited health care resources, generic medicines can be cost-saving treatment alternatives.

    Opsomming

    Die hoofmikpunt van hierdie studie was om die potensiële kostebesparing te bereken wat deur maksimale generiese vervanging van antidepressante in die Suid-Afrikaanse private gesondheidsorgsektor tussen 2004 en 2006 teweeggebring sou kon word. Data oor gerekenariseerde eise vir medisyne van pasiënte wat een of meer antidepressante gedurende die studietydperk ontvang het (d.i. 2004, 2005 en 2006 is van ʼn Suid-Afrikaanse maatskappy wat farmaseutiese voordele bestuur, verkry. Die totale studiepopulasie het bestaan uit 292 071 items (N = 5 982 869van 273 673 voorskrifte (N = 5 213 765 teen ʼn totale koste van R56

  20. A 30-year perspective on psychosocial issues in lung cancer: how lung cancer "Came out of the Closet".

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    Weiss, Talia; Weinberger, Mark; Schwerd, Arielle M; Holland, Jimmie

    2012-11-01

    Psychological responses to lung cancer have changed over the past 30 years as perceptions of the disease have changed. Previously seen as a fatal diagnosis, it is now regarded as a cancer whose treatment is increasingly effective as the science of the disease advances. The stigma of smoking is diminishing as more is learned about genetic factors and as more nonsmokers are diagnosed. Support groups are now widely available. The increasing social support and greater knowledge of lung cancer provide a more supportive environment in which patients cope with lung cancer today compared with 30 years ago.

  1. Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up.

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    Shuming Li

    Full Text Available Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain.We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI, numerical pain rating scale (NPRS, and active cervical range of motion (CROM. The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3-5 times without rotation.A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53, a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4-11. At 12 months after the treatment, both NPRS and NDI were significantly lower [3 (0, 9 vs. 7 (5, 10

  2. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

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    Diego Pozza

    2015-09-01

    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.