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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. "JTPE": A 30-Year Retrospective of Published Research

    Science.gov (United States)

    Rhoades, Jesse L.; Woods, Amelia M.; Daum, David N.; Ellison, Douglas; Trendowski, Thomas N.

    2016-01-01

    This case study presents an examination of 30 years of "Journal of Teaching in Physical Education" ("JTPE") research. The purpose of this study was to provide a retrospective view of "JTPE" and its contribution to the field of physical education. In this effort the current study employed citation analysis, co-author…

  4. Lunokhod 2 - A retrospective Glance after 30 Years

    Science.gov (United States)

    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

  5. 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.

  6. 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…

  7. 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...

  8. MEAD retrospective analysis report

    OpenAIRE

    Hasager, Charlotte Bay; CARSTENSEN J.; Frohn, L. M.; Gustafson, B.; Brandt, J.; Conley, D.; Geernaert, G.; Henriksen, P.; C. A. Skjøth; Johnsson, M.

    2003-01-01

    The retrospective analysis investigates links between atmospheric nitrogen deposition and algal bloom development in the Kattegat Sea from April to September 1989-1999. The analysis is based on atmospheric deposition model results from the ACDEP model,hydrodynamic deep-water flux results, phytoplankton abundance observations from Danish and Swedish marine monitoring stations and optical satellite data. Approximately 70 % of the atmospheric deposition consists of wet depostion of highly episod...

  9. 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.

  10. The Relationship of Housing and Population Health: A 30-Year Retrospective Analysis

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    Jacobs, David E.; Wilson, Jonathan; Dixon, Sherry L.; Smith, Janet; Evens, Anne

    2008-01-01

    Objective We analyzed the relationship between health status and housing quality over time. Methods We combined data from two nationally representative longitudinal surveys of the U.S. population and its housing, the National Health and Nutrition Examination Survey and the American Housing Survey, respectively. We identified housing and health trends from approximately 1970 to 2000, after excluding those trends for which data were missing or where we found no plausible association or change i...

  11. 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.

  12. 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…

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Anthropometric Analysis of Faces and Heads of 18 to 30-Year Old Persians and its Comparison with Caucasian Ethnic Group

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    Mohammad Reza Farahvash M.D.

    2011-06-01

    Full Text Available Background: Anthropometric facial analysis and quantitative measurements are useful methods for diagnosis, as well as planning in plastic surgery. The literature is replete with numerous related studies, few of which are about the Iranian population. This study was conducted to determine the average facial proportions of Iranians and compare it with that of Caucasians. Methods: This cross-sectional study was conducted on a convenient sample of 212 Iranians (male=108, female=104 aged 18-30 years who did not have any previous major facial surgery or trauma and their past two generations were Iranian. Measurements between facial landmarks were determined and compared with Caucasians with Student and one sample t-tests (P<0.05, 95% CI. Results: The intercanthal (en-en and eye widths (ex-en/R, forehead height 2 (tr-n, trichion-endocanthion (tr-en and nasofacial and nasofrontal angles were not significantly different between the participating men and women but other facial measurements were significantly different (Р<0.05. The head (ft-ft, eye (ex-en/R/L and nose widths (al-al and upper face height (n-sto, nasofrontal angle and nasal tip protrusion in the study population were not significantly different from Caucasians. The upper lip (sn-sto, lower face (sn-gn and forehead heights (tr-n and nasofacial angle of the female participants were not significantly different from Caucasian women but other facial measurements were significantly different (Р<0.05.Conclusion: Most facial anthropometric measurements of Iranian subjects were significantly different from those of Caucasians. More precise studies with larger sample sizes are warranted to reach a common conclusion on the facial anthropometric similarities or differences between the two populations.

  15. Retrospective analysis of fatal falls.

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    Thierauf, Annette; Preuss, Johanna; Lignitz, Eberhard; Madea, Burkhard

    2010-05-20

    Fatal falls are frequent and inhomogeneous events and affect every age. The criminalistic classification can often only be done on the basis of extensive investigations and the autopsy results. We retrospectively surveyed 291 cases of fatal falls on which a post-mortem examination had been carried out in the institutes of Forensic Medicine in Bonn and Greifswald. In large part, these cases are falls from height (n=123) and ground-level falls (n=122). These are compared to fatal falls down a stairs (n=46); the analysis is confined to injuries to the cranium. In ground-level falls the injury pattern in falls under the influence of alcohol differs from that of falls with no alcohol in the case history: all injuries are seen in higher relative frequency in casualties after the consumption of alcohol. In falls from height, the previous consumption of alcohol did not influence the injury pattern; the intracranial traumas are seen in decreasing frequency with increasing heights. The aim of this retrospective analysis is to present injury patterns and influencing factors like fall heights and alcohol for the different kinds of falls on the basis of our collective and to demonstrate similarities and differences between the subgroups. PMID:20176452

  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. 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

  19. 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.

  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. 30 Years,Open Wisely

    Institute of Scientific and Technical Information of China (English)

    Wang Ting

    2009-01-01

    @@ Over the 30 years,since the Reform and Opening-up, to the outside world, Chinese foreign trade has inreased from 20.6 billion USD in 1978 to 2.17 trilliion USD in 2007,up by 105 times, with an average annual growth of 17.4%.

  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. Atmosphere and Counseling Get High Grades (Momentum 30-Year Retrospective).

    Science.gov (United States)

    Sorensen, Terri

    2000-01-01

    Asserts that Catholic schools have fewer problems such as teen pregnancy, sex, drugs, and alcohol, but that there needs to be more information provided to students on sex education. States that a great deal of tutoring and counseling are provided for students in Catholic institutions, and that students are treated with more care. (CW)

  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. Outcome in acromegaly: A retrospective analysis

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    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.

  7. LARYNGEAL MALIGNANCY: A RETROSPECTIVE DESCRIPTIVE ANALYSIS

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    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

  8. 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.

  9. Retrospective analysis of stoma-related complications

    OpenAIRE

    İsmet Özaydın; Ali Kemal Taşkın; Abdulkadir İskender

    2013-01-01

    Objective: One of the few factors, that affect life of peoplehave stoma negatively, are complications developing intissues where placed stomas or near stomas. We aimedto evaluate the stoma practices performed frequently inour clinic.Methods: Between January 2008 and December 2011,the records of 96 patients who had stoma retrospectively.Factors indication for stoma, emergency procedure, preoperativestoma, type of stoma and complications sitingrecorded.Results: Ninety-six stoma patients were ex...

  10. Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950–1979)

    Science.gov (United States)

    Afari-Dwamena, Nana Ama; Li, Ji; Chen, Rusan; Feinleib, Manning; Lamm, Steven H.

    2016-01-01

    Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10–934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3–59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL) unit risk estimates for lung cancer were lower than those in US EPA (2010). Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3–59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100–150 µg/L. PMID:27382373

  11. Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950–1979

    Directory of Open Access Journals (Sweden)

    Hamid Ferdosi

    2016-01-01

    Full Text Available Background. To examine whether the US EPA (2010 lung cancer risk estimate derived from the high arsenic exposures (10–934 µg/L in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3–59 µg/L. Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL unit risk estimates for lung cancer were lower than those in US EPA (2010. Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3–59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100–150 µg/L.

  12. Adolescent ovarian masses: A retrospective analysis.

    Science.gov (United States)

    Gupta, Bindiya; Guleria, Kiran; Suneja, Amita; Vaid, Neelam B; Rajaram, Shalini; Wadhwa, Neelam

    2016-05-01

    A retrospective study was conducted to review incidence, clinical practice, surgical management and histology of adolescent ovarian masses in order to audit and improve future practices. Complete hospital records of all adolescents between 10 and 20 years who had undergone surgery for ovarian masses were analysed between November 2006 to 2014. Parameters analysed were age, clinical features, diagnosis, operative procedure and histopathology. Ninety-four patients were included in the study and among them, 37 had non-neoplastic masses, 30 had benign neoplasms while 27 had malignant tumors. The main clinical presentations were abdominal pain (54%) and abdominal mass (41%). Dermoid was the most common benign neoplasm while germ cell tumor was the most common malignant mass; dysgerminoma being the commonest (68%). Malignancy was more common in early adolescence (12 ± 4.8 years) while non-neoplastic masses were seen more frequently in late adolescence (17.7 ± 2.2 years). There was a fair correlation between ultrasound and histopathological diagnosis. PMID:26789784

  13. 30 years of squeezed light generation

    DEFF Research Database (Denmark)

    Andersen, Ulrik Lund; Gehring, Tobias; Marquardt, Christoph;

    2016-01-01

    Squeezed light generation has come of age. Significant advances on squeezed light generation have been made over the last 30 years—from the initial, conceptual experiment in 1985 till today’s top-tuned, application-oriented setups. Here we review the main experimental platforms for generating...... quadrature squeezed light that have been investigated in the last 30 years....

  14. 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.

  15. 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.

  16. Technical development of industry for 30 years

    International Nuclear Information System (INIS)

    This book mentions the history for 30 years since 1979 on industrial technology, which records change of system and environment of industrial technology development, like economical and social environment, industrial technology policy, support system on technical development and enterprise institute, assignment for future and product of industrial technology by field such as electric electronic, information and communications, machine material and fiber chemistry, and the way which Korea industrial technology association walked on.

  17. Familial Papillary Thyroid Carcinoma: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Thomas J. McDonald

    2011-01-01

    Full Text Available Background. Whether or not the familial form of papillary thyroid carcinoma is more aggressive than the sporadic form of the disease remains controversial. Methods. To explore this question and whether or not increased aggressiveness is more apparent in families with multiple affected members, we performed a chi square by trend analysis on our patients clinical and pathologic data comparing: first degree families with three or more affected members versus first degree families with two affected members versus sporadic cases of papillary thyroid carcinoma. Results. No statistically significant trends were seen for any presenting surgical pathology parameter, age at presentation, length of follow-up or gender distribution. The familial groups exhibited significant trends for higher rates of reoperation (P=0.05 and/or requiring additional radioactive iodine therapy (P=0.03, distant metastases (P=0.003 and deaths (P=0.01. These aggressive features were most apparent in certain families with three or more affected members. Conclusions. Using the chi square by trend analysis, a significant trend was seen for the familial form of papillary thyroid cancer to possess more aggressive features than the sporadic disease. Prompt recognition of the familial nature of the disease may provide earlier diagnosis and treatment in similarly affected family members.

  18. 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.

  19. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  20. 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.

  1. A retrospective analysis of 772 patients with hallux limitus.

    Science.gov (United States)

    Grady, John F; Axe, Timothy M; Zager, Emil J; Sheldon, Lori A

    2002-02-01

    In this retrospective analysis of 772 patients with symptomatic hallux limitus, 428 patients (55%) were successfully treated with conservative care alone; of these 428 patients, 362 (84%) were treated with orthoses. Corticosteroid injections and a change in shoes allowed 24 patients (6% of conservatively treated patients) and 42 patients (10%), respectively, to have less discomfort and return to previous activity levels. Overall, 47% of the patients in this analysis were successfully treated with orthoses. Surgical procedures were performed on 296 patients (38% of all patients) who did not respond to conservative care. In this analysis, 48 of the patients (6% of all patients) who did not respond to conservative care either refused surgery or were not surgical candidates. These data are intended to provide podiatric physicians with expected outcomes for conservative care of hallux limitus. The etiology, symptoms, conservative management, and surgical treatments of hallux limitus and hallux rigidus are also reviewed. PMID:11847262

  2. Gastric cancer in young people under 30 years of age: worse prognosis, or delay in diagnosis?

    International Nuclear Information System (INIS)

    Gastric cancer is an aggressive disease with nonspecific early symptoms. Its incidence and prognosis in young patients has shown considerable variability. Our objective was to retrospectively study patients from our institution aged <30 years with gastric carcinoma. The study was undertaken to describe the experience of gastric cancer in this population, and to demonstrate its specific clinical and pathological characteristics. We reviewed the cases of histologically confirmed gastric cancer between 1985 and 2006 at the Instituto Nacional de Cancerología of Mexico (INCan); emphasis in our review was placed on clinical presentation, diagnostic and therapeutic intervention, pathology, and the results. Thirty cases of gastric carcinoma were reviewed. The patients’ median age was 27 years (range, 18–30 years) and the male:female ratio was 1:1. Gastric cancer exhibits different behavior in patients aged, 30 years, but delay in diagnosis and the tumor’s behavior appear to be the most important factors in prognosis of the disease

  3. Retrospective analysis of 88 patients with pancreatic duct stone

    Institute of Scientific and Technical Information of China (English)

    Jian-Shui Li; Zhao-Da Zhang; Yong Tang; Rong Jiang

    2007-01-01

    BACKGROUND:Pancreatic duct stone is a rare disease, but there appears to be a rising trend in its incidence in recent years. Its pathogenesis remains unknown. The causes, diagnosis and treatment of pancreatic duct stone are reviewed through a retrospective analysis of the cases treated in our hospital. METHODS:The medical records of 88 patients with pancreatic duct stone treated in West China Hospital, Sichuan University from January 1, 1998 to November 30, 2004 were analyzed retrospectively in terms of clinical characteristics, diagnosis and treatment. RESULTS:Epigastric pain was the most common symptom in the 88 patients with an average age of 45.44±6.72 years. Various other symptoms were also observed. Eighty-one patients were subjected to B-ultrasonography, 51 to CT, and 47 to magnetic resonance cholangiopancreatography (MRCP). Fifty-six patients (63.64%) were operated on, 25 (28.41%) were treated with Chinese and Western medicine, and 7 (7.95%) abandoned treatment. Chronic pancreatitis was pathologically conifrmed in all patients undergoing operation. CONCLUSIONS: B-ultrasonography is the ifrst choice to check for pancreatic duct stone, while MRCP proves instructively useful for the diagnosis and treatment. Chronic pancreatitis is the most important cause of pancreatic duct stone, but whether there is not a direct correlation between stone formation and alcohol abuse needs further study in China. Surgery is the most curative method for pancreatic duct stone patients with severe symptoms or suspected pancreatic carcinoma, while individual treatment is emphasized, and microtraumatic surgery may be a developing option for treating pancreatic stone.

  4. Spinal cord gliomas: A multi-institutional retrospective analysis

    International Nuclear Information System (INIS)

    Purpose: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. Patients and Methods: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. Results: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). Conclusion: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS

  5. 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

  6. Pregnancy associated nasopharyngeal carcinoma: A retrospective case-control analysis of maternal survival outcomes

    International Nuclear Information System (INIS)

    Background: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. Methods: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010. Results: The median age of both groups was 30 years (range, 23–35 years); median follow-up for all patients was 70 months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p = 0.72), distant metastasis-free survival (79% vs. 76%, p = 0.77), loco-regional relapse-free survival (97% vs. 91%, p = 0.69) and disease-free survival (69% vs. 74%, p = 0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. Conclusion: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC

  7. PAPAYYA THERAPY FOR CHRONICULCER: A RETROSPECTIVE C OHORTANDA META: ANALYSIS

    Directory of Open Access Journals (Sweden)

    Gopal Rao

    2015-09-01

    Full Text Available SUMMARY BACKGROUND/OBJECTIVE: Papayya wound therapy (PWT has been used in various wounds including diabetic foot ulcers, venous leg ulcers, pressure ulcers, and acute surgical wounds. However, the efficiency of PWT therapy has been controversial. We therefore conduct ed a cohort study and a meta - analysis to assess PWT effects. METHODS: A retrospective cohort study was performed in diabetic foot ulcer (DFU patients who were treated with PWT or conventional wound ther apy (CWT i n Mahatma Gandhi Memorial Hospital Warangal Telan gana State India. The Kaplan - Meier curve was applied to estimate the healing probability. A meta - analysis was performed to pool our study with four previous cohort studies identified from Medline a nd Scopus. RESULTS: The estimated incidence of wound healing was 5.7/100 (95% CI: 4.49, 7.32 patients - week, and the median time to healing was 14 weeks. The hazard ratio (HR of wound healing . W as 7.87 times significantly higher in the PWT than the CWT (p< 0.001 after adjusting for d uration and size of ulcers, ankle brachial index (ABI, and glycated haemoglobin (HbA1c. Meta - analysis was applied and suggested that the treatment effects were moderately heterogeneous {Chi - square Z 6.18 [degrees of freedom (d . f. Z 4]; p Z 0.186; I2 Z 35.2%}, with the pooled risk ratio (RR of 1.77 [95% confidence intervals (CI Z 1.01, 3.11], i.e., the chance of wound healing was 2 0% significantly higher with PWT than CWT. The average costs of d epartment of Surgery, Mahatma Gandhi Memorial Hospital Warangal Telangana State India.

  8. 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.

  9. [Retrospective analysis of nursing records at a specialized unit].

    Science.gov (United States)

    Ochoa-Vigo, Kattia; Pace, Ana Emilia; dos Santos, Claudia Benedita

    2003-01-01

    This is a retrospective longitudinal study conducted in a Specialized Unit in the interior of Brazil. It aimed at verifying differences in nursing records with regard to how to document the care provided to patients in three periods related to the implementation of the Nursing process. Data were collected from 20% of the records of patients aged over 15 years who were randomly selected according to proportional distribution. Such data were fully transcribed in an instrument constructed for this purpose and classified according to the proposals of the referential. The Binomial Test was used for analysis with a significance level of 0.05%. The results showed a tendency to improvement of the records as to writing intellection and complete description of the signs/symptoms in the second period. It was concluded that there was a difference between the initial and the pre-implementation periods, which expresses the need to review the way the Nursing Process must be developed as a responsibility of the whole nursing team. PMID:12852295

  10. 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.

  11. 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.

  12. Odontoid fractures: A retrospective analysis of 53 cases

    Directory of Open Access Journals (Sweden)

    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  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. The ALMA assembly, integration, and verification project: a retrospective analysis

    Science.gov (United States)

    Lopez, B.; Knee, L. B. G.; Jager, H.; Whyborn, N.; McMullin, J.; Murowinski, R.; Peck, A.; Corder, S.

    2014-08-01

    The Atacama Large Millimeter/submillimeter Array (ALMA) is a joint project between astronomical organizations in Europe, North America, and East Asia, in collaboration with the Republic of Chile. ALMA consists of 54 twelve-meter antennas and 12 seven-meter antennas operating as an aperture synthesis array in the (sub)millimeter wavelength range. Assembly, Integration, and Verification (AIV) of the antennas was completed at the end of the year 2013, while the final optimization and complete expansion to validate all planned observing modes will continue. This paper compares the actually obtained results of the period 2008-2013 with the baselines that had been laid out in the early project-planning phase (2005-2007). First plans made for ALMA AIV had already established a two-phased project life-cycle: phase 1 for setting up necessary infrastructure and common facilities, and taking the first three antennas to the start of commissioning; and phase 2 focused on the steady state processing of the remaining units. Throughout the execution of the project this lifecycle was refined and two additional phases were added, namely a transition phase between phases 1 and 2, and a closing phase to address the project ramp-down. A sub-project called Accelerated Commissioning and Science Verification (ACSV) was carried out during the year 2009 in order to provide focus to the whole ALMA organization, and to accomplish the start-of-commissioning milestone. Early phases of CSV focused on validating the basic performance and calibration. Over time additional observing modes have been validated as capabilities expanded both in hardware and software. This retrospective analysis describes the originally presented project staffing plans and schedules, the underlying assumptions, identified risks and operational models, among others. For comparison actual data on staffing levels, the resultant schedule, additional risks identified and those that actually materialized, are presented. The

  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 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

  18. 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

  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. Over 30 years of successful collaboration between JINR and INFN

    International Nuclear Information System (INIS)

    A short account of the successful 30-year long collaboration between the INFN section of Turin and the JINR Laboratory of Nuclear Problems is presented. Results obtained are discussed together with future plans

  1. Analysis on pattern changes and traits of rural residential areas during 30 years in Three Gorges Reservoir Area%三峡库区近30a农村居民点格局变化与特征分析

    Institute of Scientific and Technical Information of China (English)

    周伟; 曹银贵; 王静; 袁春

    2011-01-01

    the purpose of this paper is to analyze on pattern changes and traits of rural residential areas during 30 years in Three Gorges Reservoir Area, and provide the basis for rational use of rural residential areas and potential mining. Apply of combining of the methods of qualitative and quantitative analyses, analyze on the changing rules from the whole to the local. The results are that, 1) Rural residential areas are located surrounding the urban areas, and distributed along the river bank, while rural residential areas are small in the middle and downstream area. 2) The increasing of rural residential areas is due to occupying cultivated land, forestry land and grassland, and rural residential areas occupying cultivated land is gradually reducing because of the policy of cultivated land protection. 3) Regional differences are relatively large about rural residential area changes, and the scale is enlarging from scattering to concentrating, the compact degree is relatively low, the potential of intensive use is large. The conclusion is that the research can understand the structure and changing traits of rural residential areas.%为了了解三峡库区农村近30 a农村居民点用地的格局与变化特征,为农村居民点用地的合理利用、潜力挖掘提供基础.在研究中主要采用了定性描述与定量分析相结合的方法,分析了三峡库区从整体到局部的农村居民点用地的变化规律.研究结果表明:三峡库区农村居民点多分布在城市的周边地区,并且沿河岸分布;农村居民点对耕地占用的依赖性逐渐减轻;农村居民点用地变化区域差异比较大,农村居民点的规模在逐渐扩大,由居住分散逐渐向居住集中发展,农村居民点紧凑度相对较低,集约利用的潜力较大.此项研究可以较好地了解三峡库区农村居民点用地结构与变化规律.

  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. Complications in lumbar spine surgery: A retrospective analysis

    OpenAIRE

    Luca Proietti; Laura Scaramuzzo; Giuseppe R Schiro; Sergio Sessa; Carlo A Logroscino

    2013-01-01

    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 Metho...

  4. 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.

  5. Decadal trends of global precipitation in the recent 30 years

    Science.gov (United States)

    Li, Xiaofan; Zhai, Guoqing

    2015-04-01

    In this study, the decadal trends of global precipitation are calculated and compared using the CMAP, GPCP and NCEP/NCAR reanalysis monthly precipitation data over the past 30 years from 1979 to 2008. The major results include the followings: (1) The decadal trend of annually and globally averaged precipitation depends on a decreasing trend for the CMAP data, a flat trend for GPCP data, and an increasing trend for the reanalysis data. (2) The analysis of horizontal distributions of differences in temporally averaged precipitation between the second (1993-2008) and the first (1979-1993) 15 years shows that the decreasing trend in the CMAP data is associated with the reduction in precipitation over the oceans. The further analysis of difference in zonally averaged precipitation rate reveals the increased precipitation rate in both the Tropics and mid-latitudes. The reduction in precipitation over the oceans is significantly weaker in the GPCP data than in the CMAP data, which shows the flat trend in the global GPCP data. The increasing trend of global precipitation average for the reanalysis data is associated with the increase in precipitation off the equator as well as in the mid-latitudes. (3) The further analysis of precipitation statistics reveals that the decreasing trend for the CMAP data is associated with the reduction in high precipitation. The flat trend for the global GPCP data corresponds to the offset between the decrease in low precipitation and the increase in high precipitation. The increasing trend for the reanalysis data is related to the increase in high precipitation.

  6. Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward.

    Science.gov (United States)

    Mounsey, K E; Murray, H C; King, M; Oprescu, F

    2016-08-01

    Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations. In this paper, we describe key findings from a retrospective review of scabies outbreaks reported in the literature over the past 30 years. We undertook this review to gain insights into the impact of institutional outbreaks, the burden in terms of attack rates, economic costs, treatment trends, the types of index cases and outbreak progression. We found 84 reports over 30 years, with outbreaks most frequently reported in aged care facilities (n = 40) and hospitals (n = 33). On average, scabies outbreaks persisted for 3 months, and the median attack rate was 38%. While 1% lindane was once the most commonly employed acaricide, 5% permethrin and oral ivermectin are increasingly used. Crusted scabies represented the index case for 83% of outbreaks, and scabies was misdiagnosed in 43% outbreaks. The frequency of reported scabies outbreaks has not declined consistently over time suggesting the disease is still highly problematic. We contend that more research and practice emphasis must be paid to improve diagnostic methods, surveillance and control, health staff education and management of crusted scabies to prevent the development of scabies outbreaks in institutional settings. PMID:27019288

  7. 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...

  8. 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

  9. 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.

  10. 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.

  11. [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.

  12. 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.

  13. Historical Lassa fever reports and 30-year clinical update.

    Science.gov (United States)

    Macher, Abe M; Wolfe, Martin S

    2006-05-01

    Five cases of Lassa fever have been imported from West Africa to the United States since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. Vertigo in this patient has persisted for 30 years. PMID:16704848

  14. Historical Lassa Fever Reports and 30-year Clinical Update

    OpenAIRE

    Macher, Abe M.; Martin S. Wolfe

    2006-01-01

    Five cases of Lassa fever have been imported from West Africa to the United States since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. Vertigo in this patient has persisted for 30 years.

  15. Historical Lassa Fever Reports and 30-year Clinical Update

    Science.gov (United States)

    Wolfe, Martin S.

    2006-01-01

    Five cases of Lassa fever have been imported from West Africa to the United States since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. Vertigo in this patient has persisted for 30 years. PMID:16704848

  16. 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.

  17. [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.

  18. Childhood intussusception in Uzbekistan: Analysis of retrospective surveillance data

    Directory of Open Access Journals (Sweden)

    Flem Elmira

    2011-03-01

    Full Text Available Abstract Background Estimates of baseline incidence of childhood intussusception could help safety monitoring after the introduction of rotavirus vaccines. We studied the incidence of intussusception in Uzbekistan, a GAVI-fund eligible state in Central Asia. Methods We retrospectively reviewed intussusception cases in children Results Over a 5-year study period, 67 confirmed cases were identified, of which 67% were boys. The median age was 12 months, and no seasonal trend in the distribution of cases was observed. The diagnostic methods used included abdominal radiography (87% and ultrasonography (57%. Intussusception reduction by air enema was successful in 33 (49% patients and 34 (50% cases underwent surgery. A total of 4 deaths occurred, including 3 deaths in infants aged 0-6 months. The median length of hospital stay was 7.3 (range 0-37 days. The incidence of intussusception is estimated at 23 (95% CI 13.6-32.4 cases per 100,000 child-years, corresponding to approximately 237 cases annually. Conclusions This is the first study to estimate the incidence of childhood intussusception prior to the introduction of the rotavirus vaccination in Uzbekistan. A prospective surveillance system using a standardized case definition is needed in order to better examine the occurrence of intussusception in developing countries.

  19. Monitoring operating room turnaround time: a retrospective analysis.

    Science.gov (United States)

    Scagliarini, Michele; Apreda, Mariarosaria; Wienand, Ulrich; Valpiani, Giorgia

    2016-04-18

    Purpose - Operating room (OR) turnaround time is a key process indicator for hospital business management: delays lead to a reduced surgical interventions per day with a consequent increase in costs and decrease in efficiency. The purpose of this paper is to increase understanding by assessing the process' steady-state behaviour and identifying changes that indicate either improvement or deterioration in quality. Design/methodology/approach - With this purpose, the authors retrospectively applied Shewhart control charts and exponentially weighted moving average control charts to data extracted from an hospital information system. Findings - The results showed that statistical process control is able to identify steady-state behaviour process and to detect positive or negative changes in process performance. In particular the authors detected a deterioration in the process performance coinciding with the change in the operating room patient transfer staff. Practical implications - This study showed that statistical quality control is a valuable tool for monitoring performance indicators. Currently, hospital managers are designing an OR dashboard which also includes the control charts. Originality/value - The paper highlights the control chart application to organizational indicators allowing an objective OR system performance assessment. PMID:27120511

  20. 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.

  1. 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

  2. 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.

  3. RETROSPECTIVE CLINICAL ANALYSIS OF STILL BIRTH AND NEONATAL DEATHS

    Directory of Open Access Journals (Sweden)

    Uttam

    2014-03-01

    Full Text Available : OBJECTIVE: Aim was to evaluate clinical and associated risk factors for still births and neonatal deaths at tertiary health care centre. METHODS: A retrospective analytical study of new born at birth conducted at tertiary health care centre for three consecutive years. Demographic variables, status of new born at birth, NICU care and neonatal causes of death were analyzed. RESULTS: There were 1072,990,995 births for 2011, 2012, and 2013 year respectively Still births were 30, 36 and 41 and newborn deaths were 15,8,15 for three consecutive years. Mean age of mother was 25.35 yrs standard deviation 4.4. 82 % of still births were preterm. Maximum 67% of still births birth weight was less than 1.5 kg. NICU admission included 51% full term neonate, 44% preterm and 5% post term neonate. Maximum (51% NICU admissions neonatal birth weight was less < 1.5 kg.79% of dead neonates were preterm. Life threatening congenital defects was seen in 26%. Cause of death birth asphyxia 37% hyaline membrane disease 15%. CONCLUSION: Statistically significant mean gestational age of baby with mother was 38.26 weeks (SD 2.260, NICU neonates 36.70 weeks (SD 3.3 and still births 31.34 weeks (SD 4.6. Maternal urinary tract infection, Hypertensive diseases, diabetes mellitus were major reasons for stillbirths. Neonatal mortality from 26% reduced to 8% with increasing birth weight. Major neonatal deaths are because of birth asphyxia, congenital defects. Low Birth Weight and prematurity were overlapping factor for neonatal death. Still birth rate was 35; perinatal mortality rate was 44/1000 live births. Early neonatal mortality rate & Total neonatal mortality rate was 12 /1000 live births each

  4. Sinus retrospective analysis of surgeries in a hospital school

    Directory of Open Access Journals (Sweden)

    Carvalho, Thiago Bittencourt Ottoni de

    2010-12-01

    Full Text Available Introduction: The ENT is a medical specialty that covers 4.4% of all doctors in São Paulo, with a variety of surgical procedures distributed between pharynx, nose, ear and larynx. Knowing the profile of a reference service in otolaryngology allows for a better organization, scaling the volume of care and surgeries, providing better training to the student and resident physician. Objective: To describe the profile of sinonasal surgery and patients to them in the department of otolaryngology and head and neck surgery at a teaching hospital. Method: We conducted a cohort study of cross-sectional retrospective study with review of 872 charts of patients undergoing surgery Sinus between January 2006 and December 2008. Used questionnaires, seeking sex, age, surgical diagnosis and surgery. Results: Of 872 patients studied, 45.4% were female and 54.6% male, ranging in an age group 40-80 years (mean 29.8 years. The main surgical diagnoses were: nasal septum deviation (n=457, nasal deformity after trauma (n=287, enlarged turbinates (n=153, rhinosinusal polyposis (n=73, chronic sinusitis (n=32. Among the most frequently performed surgical procedures include: septoplasty (n=388, rhinoplasty (n=215, FESS (n=131, intra-turbinal cauterization (n=114, reconstructive rhinoplasty (n=73, turbinectomy (n=43, turbinoplasty (n=55. It is emphasized that patients may have received more than one surgical diagnosis and realized more than one surgery, depending on the alert. Conclusion: We present the volume and diversity of Sinus surgeries performed in our department, contributing to the scarce scientific literature on this type of case.

  5. Earth's surface water change over the past 30 years

    Science.gov (United States)

    Donchyts, Gennadii; Baart, Fedor; Winsemius, Hessel; Gorelick, Noel; Kwadijk, Jaap; van de Giesen, Nick

    2016-09-01

    Earth's surface gained 115,000 km2 of water and 173,000 km2 of land over the past 30 years, including 20,135 km2 of water and 33,700 km2 of land in coastal areas. Here, we analyse the gains and losses through the Deltares Aqua Monitor -- an open tool that detects land and water changes around the globe.

  6. 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.

  7. 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 ...

  8. Merkel Cell Carcinoma Analysis of Outcomes: A 30-Year Experience.

    Directory of Open Access Journals (Sweden)

    Evan Liang

    Full Text Available Merkel cell carcinoma (MCC is an aggressive cutaneous malignancy with poor prognosis. Limited data exists to guide treatment decisions. Here we report on our institutional experience and outcomes treating patients with MCC.A database search (1984-2014 of patients treated at the University of Wisconsin Hospital and Clinics was used to identify patients with histologically confirmed MCC. Patient, tumor, and treatment characteristics were examined via review of medical records. Statistical analyses were performed to assess outcomes and associated prognostic factors.A total of 87 patients with MCC were identified with a median follow-up of 17 months (mean: 38, range: 0-210 months. Two and five-year overall survival rates were 53.9% and 32.8%, respectively. Recurrence was documented in 31.0% of patients (85.2% locoregional, 48.1% distant and 33.3% both. Patients with a history of immunosuppression exhibited significantly worse survival (hazard ratio, 2.01; 95% CI, 1.1-3.7 when compared to immune-competent individuals. The head and neck region was the most common location of primary lesion (N=49 followed by the extremities (N=31. Upper extremity primaries predicted significantly better overall survival (hazard ratio, 0.48; 95% CI, 0.23-0.99 while lower extremity primaries did not have significantly better results (hazard ratio, 0.5; 95% CI, 0.21-1.2 in comparison to head and neck site of primary. Nodal involvement (hazard ratio, 2.95; 95% CI, 1.5-5.79 was also a negative prognostic factor associated with poor overall survival when compared with clinically node negative patients. Primary tumor size > 2 cm (hazard ratio, 1.76; 95% CI, 0.91-3.4 was not associated with survival.This study highlights the role of various factors in determining prognosis of Merkel cell carcinoma; history of immunosuppression, nodal involvement, and head/neck primary predicted worse overall survival. These findings suggest that improvements in both distant and locoregionally directed therapies might play an important role in control of MCC and identify areas for future study.

  9. 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

  10. 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

  11. Long term prognosis of women with breast cancer in New Zealand: study of survival to 30 years.

    OpenAIRE

    Hibberd, A. D.; Horwood, L J; Wells, J.E.

    1983-01-01

    The long term prognosis of women with breast cancer was studied by analysing retrospectively the 30 year survival of 2019 women with histologically proved breast cancer recorded at the National Cancer Registry in New Zealand between 1950 and 1954. Excess mortality rates for successive five year survival cohorts were calculated from the survival data. From the total cohort the excess mortality rate fell rapidly during the first 10 years and then became low after 20 years. There were no signifi...

  12. 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...... 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...

  13. THE EVANGELICAL-LUTHERAN COMMUNITY IN AZERBAIJAN: A RETROSPECTIVE ANALYSIS

    OpenAIRE

    Zeinalova, Sudaba

    2007-01-01

    This article looks at the life of the Protestant religious community in Azerbaijan, studies the history of how the German population that formed the foundation of the Protestant, Evangelical-Lutheran community migrated to Azerbaijan, and sheds light on the activity of the Lutheran church. A scientific analysis of the ethnoconfessional diversity that exists today in Azerbaijan reconfirms the peace-loving and respectful attitude of the Azerbaijani people toward different cultures, and the tradi...

  14. Financial analysis of potential retrospective premium assessments under the Price-Anderson system

    International Nuclear Information System (INIS)

    Ten representative nuclear utilities have been analyzed over the period 1981 to 1983 to evaluate the effects of three levels of retrospective premiums on various financial indicators. This analysis continues and expands on earlier analyses prepared as background for deliberations by the US Congress for possible extension or modification of the Price-Anderson Act

  15. 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

  16. 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

  17. Trends in global monsoon area and precipitation over the past 30 years

    Science.gov (United States)

    Hsu, Pang-chi; Li, Tim; Wang, Bin

    2011-04-01

    The analysis of the GPCP and CMAP datasets during the past 30 years (1979-2008) indicates that there are consistent increasing trends in both the global monsoon area (GMA) and the global monsoon total precipitation (GMP). This positive monsoon rainfall trend differs from previous studies that assumed a fixed global monsoon domain. Due to the increasing trends in both the GMA and GMP, a global monsoon intensity (GMI) index, which measures the global monsoon precipitation amount per unit area, is introduced. The GMI measures the strength of the global monsoon. Our calculations with both the GPCP and CMAP datasets show a consistent downward trend in the GMI over the past 30 years. This decreasing trend is primarily attributed to a greater percentage increase in the GMA than in the GMP. A further diagnosis reveals that the decrease of the GMI is primarily attributed to the land monsoon in the GPCP, but to the oceanic monsoon in the CMAP.

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

    OpenAIRE

    Barbara Pieretti; Marco Moretti; Maria Rita Sadori; Daniela Sbrozzi; Annamaria Masucci; Lucia Finaurini; Simonetta Gasperoni

    2013-01-01

    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...

  19. Expectant Management of Vestibular Schwannoma: A Retrospective Multivariate Analysis of Tumor Growth and Outcome

    OpenAIRE

    Hughes, Mark; Skilbeck, Christopher; Saeed, Shakeel; Bradford, Robert

    2011-01-01

    We conducted a retrospective observational study to assess the consequences of conservative management of vestibular schwannoma (VS). Data were collected from tertiary neuro-otological referral units in United Kingdom. The study included 59 patients who were managed conservatively with radiological diagnosis of VS. The main outcome measures were growth rate and rate of failure of conservative management. Multivariate analysis sought correlation between tumor growth and (i) demographic feature...

  20. [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

    2016-01-01

    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.

  1. Albumin Administration in Patients With Spontaneous Bacterial Peritonitis at a Tertiary Hospital: A Retrospective Clinical Analysis

    OpenAIRE

    Padmavathi Mali; Rajan Kanth; Sudheer Muduganti

    2015-01-01

    Purpose: Albumin is recommended for the treatment of spontaneous bacterial peritonitis (SBP) in patients at high risk for mortality. We assessed adherence to guidelines for administration of albumin for SBP in clinical practice at a private tertiary care hospital. Methods: A retrospective clinical analysis of all cases of SBP diagnosed at a tertiary referral center from January 1, 2006, to December 31, 2012, was performed. Patients were identified electronically and manually validated. Th...

  2. [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

    2016-01-01

    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. PMID:26732713

  3. RETROSPECTIVE ANALYSIS OF WOUND CHARACTERISTICS AND TETANUS DEVELOPMENT IN CAPTIVE MACAQUES

    OpenAIRE

    Springer, Danielle A.; Phillippi-Falkenstein, Kathrine; Smith, Gary

    2009-01-01

    Traumatic wounds and access to outdoor enclosures containing soil contribute to development of tetanus in non-human primates. A retrospective matched case-control study was conducted at a primate center to evaluate these factors by analysis of medical records of animals sustaining traumatic injuries during a three year study period: 31 macaques with traumatic injuries and a clinical diagnosis of tetanus were selected as cases and 62 macaques with traumatic injuries and no diagnosis of tetanus...

  4. 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...

  5. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    OpenAIRE

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surg...

  6. Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis

    OpenAIRE

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    Objective: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfected women requiring hysterectomy to explore if endometritis may be common among these patients.Methods: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgic...

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

    International Nuclear Information System (INIS)

    In April 2003, Nuclear Fuel Transport Co., Ltd. (NFT) marked the 30th 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. 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.

  9. Management of hypertrophic pylorus stenosis with ultrasound guided single shot epidural anaesthesia - A retrospective analysis of 20 cases

    OpenAIRE

    Willschke, Harald; Machata, Anette-Marie; Rebhandl, Winfried; Benkoe, Thomas; Kettner, Stephan C; Brenner, Lydia; Marhofer, Peter

    2010-01-01

    Abstract Aim: To retrospectively describe the performance of ultrasound guided thoracic epidural anaesthesia under sedation for anaesthesia management of open pyloromyotomy. Background: Anaesthesia management for hypertrophic pylorus stenosis is usually performed under general anaesthesia with tracheal intubation. Only a few publications describe avoidance of tracheal intubation in infants by using spinal or caudal anaesthesia. The present retrospective analysis describes the pe...

  10. 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.

  11. 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.

  12. Hypophosphatemia. From retrospective analysis to the analysis of the potential role of phosphatemia in panic disorders

    Directory of Open Access Journals (Sweden)

    Alessandro Riccardi

    2010-09-01

    Full Text Available The detection of a low serum phosphate level is not unusual in an Emergency Department, especially in clinical conditions linked to hyperventilation and subsequent respiratory alkalosis, asthma, sepsis, severe pain, anxiety. Symptoms of hypophosphatemia are typically not specific when the imbalance is not particularly severe, but if hyphophosphatemia does not resolve rhabdomyolisis, hemolysis, decreased tissue oxygenation and respiratory failure can be observed. Only recently some authors have pointed out that the level of serum phosphate in patient with anxiety and panic disorders can give information on the severity of the attacks as well on the clinical course of the disease. In a retrospective analysis on 599 case of hypophosphatemia observed in our ED, the percentage of case of panic disorders was particularly high among patients with lower phosphatemia. Therefore, we decided to examine this aspect closely, assessing if the determination of serum phosphate could be useful in the management of panic attacks at first approach in emergency room. Our observation are consistent with the statement that hypophosphatemia is one of the main clinical aspect of panic attack, and strongly support the hypothesis that hypophosphatemia correlates with the most severe symptoms of panic attack and should be itself considered as one of the most important aspect of this syndrome. Serum phosphate levels appear to mirror its clinical course, and can be used in the clinical setting of an Emergency Department, for the confirmation of a diagnosis of anxiety-panic disorder and as marker of the response to therapy

  13. 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.

  14. 30 years of lymph node pathology: biomarkers and other advances.

    Science.gov (United States)

    Ramsay, Alan D

    2013-03-01

    Over the last 30 years there has been a massive change in both the clinical and pathologic aspects of malignant lymphomas. Pathologists are now able to evaluate cellular phenotypes and lineages of tumor cells using a wide variety of biomarkers and molecular techniques. The ability to identify tumor cell phenotypes has revolutionized the classification of lymphomas, leading to an internationally agreed system based on the reliable recognition of specific clinico-pathologic entities. The World Health Organization classification combines clinical features, histomorphology, immunohistochemistry, and molecular and genetic marker data to precisely categorize lymphomas. On the clinical front the increasing use of needle core biopsies has made it easier and quicker to obtain tissue samples, and the development of (18)F-fluorodeoxyglucose positron emission tomography has revolutionized the assessment of patients both at presentation and after treatment. To improve overall outcomes for lymphoma patients there have been advances in the UK organization of cancer services. Cancer networks have been established, often with network multidisciplinary team meetings, and new diagnoses of lymphoma are reviewed on a network basis by pathologists specializing in the field. National and supranational quality control systems are in place for immunohistochemistry and for molecular techniques and multicenter clinical trials provide information about the efficacy of treatment regimens. The outcome of these advances is that a patient presenting in 2012 with suspected lymphoma can expect to be biopsied rapidly, to receive an accurate pathologic diagnosis by an expert hematopathologist, which will include prognostic marker information, and to have comprehensive disease assessment and discussion by a multidisciplinary team before embarking on the most appropriate treatment for his or her clinical situation. PMID:23417072

  15. TORUS2015: The AGN unification scheme after 30 years

    Science.gov (United States)

    Gandhi, P.; Hoenig, S. F.

    2015-09-01

    The torus paradigm has proved to be remarkably successful at unifying the observed zoo of active galaxy (AGN) classes, despite having many manifest holes. The field is still data-driven with novel observational results at multiple wavelengths emerging rapidly. We are only now beginning to map out the structure of dusty gas feeding and obscuring AGN, and to model its evolution in galaxy growth. But these have also brought out several apparently contradictory results which must hold the key to future progress. As we celebrate 30 years of the paradigm, this is the perfect time to draw together our current knowledge and reassess the state of the field. This will be an international workshop at the University of Southampton, UK, with the objective of laying out the major challenges to the field and paving future research directions. Our hope is to facilitate plenty of informal discussions between multiwavelength observers and theorists, addressing some key issues: * What is the main driver in the unification scheme? What are the roles of orientation, mass accretion rate and feedback? * What is the nature and structure of gas and dust in the torus? Do we have a self-consistent picture across multiple wavelengths? * How critical is the role of the torus as an interface between small nuclear scales and large galactic scales? Does galaxy evolution necessarily require tori? * How close are we to self-consistently simulating nuclear activity including AGN feeding and nuclear star-formation? Workshop Rationale The three themes of accretion, orientation, and evolution will be covered through invited and solicited contributions. Different to other conferences, we are building each session around some key papers that have shaped the field or those with great future potential to do so. We specifically pit competing ideas against each other to help painting a realistic picture of the state-of-the-art. Each session will end with discussion rounds delving into important future

  16. Short-term geriatric assessment units: 30 years later

    Directory of Open Access Journals (Sweden)

    Leduc Nicole

    2010-06-01

    Full Text Available Abstract Background The increasing number of hospitalized elderly persons has greatly challenged decision makers to reorganize services so as to meet the needs of this clientele. Established progressively over the last 30 years, the short-term Geriatric Assessment Unit (GAU is a specialized care program, now implemented in all the general hospital centres in Quebec. Within the scope of a broader reflection upon the appropriate care delivery for elderly patients in our demographic context, there is a need to revisit the role of GAU within the hospital and the continuum of care. The objective of this project is to describe the range of activities offered by Quebec GAU and the resources available to them. Methods In 2004, 64 managers of 71 GAU answered a mail questionnaire which included 119 items covering their unit's operation and resources in 2002-2003. The clinical and administrative characteristics of the clientele admitted during this period were obtained from the provincial database Med-Echo. The results were presented according to the geographical location of GAU, their size, their university academic affiliation, the composition of their medical staff, and their clinical care profile. Results Overall, GAU programs admitted 9% of all patients aged 65 years and older in the surveyed year. GAU patients presented one or more geriatric syndromes, including dementia. Based on their clientele, three distinct clinical care profiles of GAU were identified. Only 19% of GAU were focused on geriatric assessment and acute care management; 23% mainly offered rehabilitation care, and the others offered a mix of both types. Thus, there was a significant heterogeneity in GAU's operation. Conclusions The GAU is at the cutting edge of geriatric services in hospital centres. Given the scarcity of these resources, it would be appropriate to better target the clientele that may benefit from them. Standardizing and promoting GAU's primary role in acute care must

  17. 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

  18. 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.

  19. 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...

  20. 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.)

  1. Linking Land Surface Phenology and Growth Limiting Factor Shifts over the Past 30 Years

    Science.gov (United States)

    Garonna, I.; Schenkel, D.; de Jong, R.; Schaepman, M. E.

    2015-12-01

    The study of global vegetation dynamics contributes to a better understanding of global change drivers and how these affect ecosystems and ecological diversity. Land-surface phenology (LSP) is a key response and feedback of vegetation to the climate system, and hence a parameter that needs to be accurately represented in terrestrial biosphere models [1]. However, the effects of climatic changes on LSP depend on the relative importance of climatic constraints in specific regions - which are not well understood at global scale. In this study, we analyzed a Phenology Reanalysis dataset [2] to evaluate shifts in three climatic drivers of phenology at global scale and over the last 30 years (1982-2012): incoming radiation, evaporative demand and minimum temperature. As a first step, we compared LAI as modeled from these three factors (LAIre) to remotely sensed observations of LSP (LAI3g, [3]) over the same time period. As a second step, we examined temporal trends in the climatic constraints at Start- and End- of the Growing Season. There was good agreement between phenology metrics as derived form LAI3g and LAIre over the last 30 years - thus providing confidence in the climatic constraints underlying the modeled data. Our analysis reveals inter-annual variation in the relative importance of the three climatic factors in limiting vegetation growth at Start- and End- of the Growing Season over the last 30 years. High northern latitudes, as well as northern Europe and central Asia, appear to have undergone significant changes in dominance between the three controls. We also find that evaporative demand has become increasingly limiting for growth in many parts of the world, in particular in South America and eastern Asia. [1] Richardson, A.D. et al. Global Change Biology 18, 566-584 (2012). [2] Stöckli, R. et al. J. Geophys. Res 116, G03020 (2011). [3] Zhu, Z. et al. Remote Sensing 5, 927-948 (2013).

  2. Prevalence, Impact, and Adjustments of Measurement Error in Retrospective Reports of Unemployment: An Analysis Using Swedish Administrative Data.

    OpenAIRE

    Pina Sanchez, Jose Maria

    2014-01-01

    In this thesis I carry out an encompassing analysis of the problem of measurement error in retrospectively collected work histories using data from the “Longitudinal Study of the Unemployed”. This dataset has the unique feature of linking survey responses to a retrospective question on work status to administrative data from the Swedish Register of Unemployment. Under the assumption that the register data is a gold standard I explore three research questions: i) what is the prevalence of and ...

  3. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    OpenAIRE

    Rief, Harald; Bischof, Marc; Bruckner, Thomas; Welzel, Thomas; Askoxylakis, Vasileios; Rieken, Stefan; Lindel, Katja; Combs, Stephanie; Debus, Jürgen

    2013-01-01

    Background The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. Methods The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. Re...

  4. 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

  5. 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.

  6. 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.

  7. The long history of REI Conference: The first 30 years

    International Nuclear Information System (INIS)

    An analysis of the REI Conference evolution from the first, in 1981, to the last, 2009, REI-15, is reported, considering the contributions in the different topics, as fundamental processes, materials, nanosystem and application and revisiting some invited talks and presentations. Historical information concerning some Universities, which organized REI-Conferences, are introduced in the exposition.

  8. Effects of Radiotherapy in the treatment of multiple myeloma: a retrospective analysis of a Single Institution

    International Nuclear Information System (INIS)

    Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie & Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of at least one and up to 6 bony lesions at different times. In order to evaluate the effect of local radiotherapy on pain relief and bone recalcification a uni- and multivariate analysis was performed using a binary logistic regression model to correct for multiple measurements. Complete information on dose, fractionation and volume of radiotherapy was available from 81 patients treated in 136 target volumes for pain relief, and from 69 patients treated in 108 target volumes for recalcification. Total radiation doses varied between 8 Gy to 50 Gy (median dose 25 Gy in 2.5 Gy fractions, 5 times a week). Radiotherapy resulted in complete local pain relief in 31% and partial local pain relief in 54% of the patients. In the univariate analysis, higher total radiation doses (p = 0.023) and higher age (p = 0.014) at the time of radiotherapy were significantly associated with a higher likelihood of pain relief, whereas no significant association was detected for concurrent systemic treatment, type and stage of myeloma and location of bone lesions. The same variables were independent predictors for pain relief in the multivariate analysis. Recalcification was observed in 48% of irradiated bone lesions. In the uni- and multivariate analysis higher radiation doses were significantly associated (p = 0.048) with an increased likelihood of recalcification. Side effects of radiotherapy were generally mild. Higher total biological radiation doses were associated with better pain relief and recalcification in this

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

    Science.gov (United States)

    Abed, Firas M.

    2016-01-01

    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. PMID:27168995

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

    International Nuclear Information System (INIS)

    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.)

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

    Science.gov (United States)

    Abed, Firas M; Dark, Michael J

    2016-01-01

    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. PMID:27168995

  12. 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.

  13. 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.

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

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1999-01-01

    In design practice a process where a satisfactory solution is created within limited resources and time is required. However, since the design process is not well understood, research into how engineering designers actually solve design problems is needed. As a contribution to that end a research...... 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...

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.)

  1. The 30-year evolution of airway pressure release ventilation (APRV).

    Science.gov (United States)

    Jain, Sumeet V; Kollisch-Singule, Michaela; Sadowitz, Benjamin; Dombert, Luke; Satalin, Josh; Andrews, Penny; Gatto, Louis A; Nieman, Gary F; Habashi, Nader M

    2016-12-01

    Airway pressure release ventilation (APRV) was first described in 1987 and defined as continuous positive airway pressure (CPAP) with a brief release while allowing the patient to spontaneously breathe throughout the respiratory cycle. The current understanding of the optimal strategy to minimize ventilator-induced lung injury is to "open the lung and keep it open". APRV should be ideal for this strategy with the prolonged CPAP duration recruiting the lung and the minimal release duration preventing lung collapse. However, APRV is inconsistently defined with significant variation in the settings used in experimental studies and in clinical practice. The goal of this review was to analyze the published literature and determine APRV efficacy as a lung-protective strategy. We reviewed all original articles in which the authors stated that APRV was used. The primary analysis was to correlate APRV settings with physiologic and clinical outcomes. Results showed that there was tremendous variation in settings that were all defined as APRV, particularly CPAP and release phase duration and the parameters used to guide these settings. Thus, it was impossible to assess efficacy of a single strategy since almost none of the APRV settings were identical. Therefore, we divided all APRV studies divided into two basic categories: (1) fixed-setting APRV (F-APRV) in which the release phase is set and left constant; and (2) personalized-APRV (P-APRV) in which the release phase is set based on changes in lung mechanics using the slope of the expiratory flow curve. Results showed that in no study was there a statistically significant worse outcome with APRV, regardless of the settings (F-ARPV or P-APRV). Multiple studies demonstrated that P-APRV stabilizes alveoli and reduces the incidence of acute respiratory distress syndrome (ARDS) in clinically relevant animal models and in trauma patients. In conclusion, over the 30 years since the mode's inception there have been no strict

  2. [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.

  3. 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.

  4. 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

  5. Ultratrace LC-MS/MS analysis of segmented calf hair for retrospective assessment of time of clenbuterol administration in Agriforensics.

    Science.gov (United States)

    Duvivier, Wilco F; van Beek, Teris A; Meijer, Thijs; Peeters, Ruth J P; Groot, Maria J; Sterk, Saskia S; Nielen, Michel W F

    2015-01-21

    In agriforensics, time of administration is often debated when illegal drug residues, such as clenbuterol, are found in frequently traded cattle. In this proof-of-concept work, the feasibility of obtaining retrospective timeline information from segmented calf tail hair analyses has been studied. First, an ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) hair analysis method was adapted to accommodate smaller sample sizes and in-house validated. Then, longitudinal 1 cm segments of calf tail hair were analyzed to obtain clenbuterol concentration profiles. The profiles found were in good agreement with calculated, theoretical positions of the clenbuterol residues along the hair. Following assessment of the average growth rate of calf tail hair, time of clenbuterol administration could be retrospectively determined from segmented hair analysis data. The data from the initial animal treatment study (n = 2) suggest that time of treatment can be retrospectively estimated with an error of 3-17 days. PMID:25537490

  6. 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.

  7. Multiyear Serological Surveillance of Notifiable Influenza A Viruses in Belgian Poultry: A Retrospective Analysis.

    Science.gov (United States)

    Marché, Sylvie; Houdart, Philippe; van den Berg, Thierry; Lambrecht, Bénédicte

    2015-12-01

    Surveillance of notifiable avian influenza (NAI) virus is mandatory in European member states, and each year a serological survey is performed to detect H5 and H7 circulation in poultry holdings. In Belgium, this serological monitoring is a combination of a stratified and a risk-based approach and is applied to commercial holdings with more than 200 birds. Moreover, a competitive nucleoprotein (NP) ELISA has been used as first screening method since 2010. A retrospective analysis of the serological monitoring performed from 2007 through 2013 showed sporadic circulation of notifiable low-pathogenicity avian influenza (LPAI) viruses in Belgian holdings with a fluctuating apparent flock seroprevalence according to years and species. Overall, the highest apparent flock seroprevalence was detected for the H5 subtype in domestic Anatidae, with 20%-50% for breeding geese and 4%-9% for fattening ducks. Positive serology against non-H5/H7 viruses was also observed in the same species with the use of the IDScreen influenza A antibody competition ELISA kit (ID-vet NP ELISA), and confirmed by isolation of H2, H3, H6, and H9 LPAI viruses. Among Galliformes, the apparent flock seroprevalence was lower, ranging between 0.3% and 1.3%. Circulation of notifiable LPAI viruses was only observed in laying hens with a similar seroprevalence for H5 and H7. Based on ID-vet NP ELISA results, no circulation of LPAI viruses, regardless the subtype, was observed in breeding chickens and fattening turkeys. Retrospectively, the use of an ELISA as first-line test not only reduced the number of hemagglutination inhibition tests to be performed, but also gave a broader evaluation of the prevalence of LPAI viruses in general, and might help to identify the most at-risk farms.

  8. Multiyear Serological Surveillance of Notifiable Influenza A Viruses in Belgian Poultry: A Retrospective Analysis.

    Science.gov (United States)

    Marché, Sylvie; Houdart, Philippe; van den Berg, Thierry; Lambrecht, Bénédicte

    2016-05-01

    Surveillance of notifiable avian influenza (NAI) virus is mandatory in European member states, and each year a serological survey is performed to detect H5 and H7 circulation in poultry holdings. In Belgium, this serological monitoring is a combination of a stratified and a risk-based approach and is applied to commercial holdings with more than 200 birds. Moreover, a competitive nucleoprotein (NP) ELISA has been used as first screening method since 2010. A retrospective analysis of the serological monitoring performed from 2007 through 2013 showed sporadic circulation of notifiable low-pathogenicity avian influenza (LPAI) viruses in Belgian holdings with a fluctuating apparent flock seroprevalence according to years and species. Overall, the highest apparent flock seroprevalence was detected for the H5 subtype in domestic Anatidae, with 20%-50% for breeding geese and 4%-9% for fattening ducks. Positive serology against non-H5/H7 viruses was also observed in the same species with the use of the IDScreen influenza A antibody competition ELISA kit (ID-vet NP ELISA), and confirmed by isolation of H2, H3, H6, and H9 LPAI viruses. Among Galliformes, the apparent flock seroprevalence was lower, ranging between 0.3% and 1.3%. Circulation of notifiable LPAI viruses was only observed in laying hens with a similar seroprevalence for H5 and H7. Based on ID-vet NP ELISA results, no circulation of LPAI viruses, regardless the subtype, was observed in breeding chickens and fattening turkeys. Retrospectively, the use of an ELISA as first-line test not only reduced the number of hemagglutination inhibition tests to be performed, but also gave a broader evaluation of the prevalence of LPAI viruses in general, and might help to identify the most at-risk farms. PMID:27309088

  9. Differences in bleeding behavior after endoscopic band ligation: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Schiefke Ingolf

    2010-01-01

    Full Text Available Abstract Background Endoscopic band ligation (EBL is generally accepted as the treatment of choice for bleeding from esophageal varices. It is also used for secondary prophylaxis of esophageal variceal hemorrhage. However, there is no data or guidelines concerning endoscopic control of ligation ulcers. We conducted a retrospective study of EBL procedures analyzing bleeding complications after EBL. Methods We retrospectively analyzed data from patients who underwent EBL. We analyzed several data points, including indication for the procedure, bleeding events and the time interval between EBL and bleeding. Results 255 patients and 387 ligation sessions were included in the analysis. We observed an overall bleeding rate after EBL of 7.8%. Bleeding events after elective treatment (3.9% were significantly lower than those after treatment for acute variceal hemorrhage (12.1%. The number of bleeding events from ligation ulcers and variceal rebleeding was 14 and 15, respectively. The bleeding rate from the ligation site in the group who underwent emergency ligation was 7.1% and 0.5% in the group who underwent elective ligation. Incidence of variceal rebleeding did not vary significantly. Seventy-five percent of all bleeding episodes after elective treatment occurred within four days after EBL. 20/22 of bleeding events after emergency ligation occured within 11 days after treatment. Elective EBL has a lower risk of bleeding from treatment-induced ulceration than emergency ligation. Conclusions Patients who underwent EBL for treatment of acute variceal bleeding should be kept under medical surveillance for 11 days. After elective EBL, it may be reasonable to restrict the period of surveillance to four days or even perform the procedure in an out-patient setting.

  10. 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...

  11. Values at Stake: A 30-Year Retrospective of Shareholder and Stakeholder Value Orientation in Annual Reports of Large Swedish Companies

    OpenAIRE

    Axelsson, Mathias; Nettersand, Maria

    2003-01-01

    Bakgrund: Det verkar som om inte en enda dag går förbi utan att det är något i media beträffande företag och deras olika aktiviteter som berör samhället som helhet eller enskilda individer. På senare år har både media och allmänheten kritiserat företag för att ha verksamhet som påverkar såväl individer som hela orter och kommuner negativt. Pudelns kärna i sammanhanget är den klassiska debatten kring företags etiska och sociala skyldigheter samt vems intressen företag egentligen existerar för ...

  12. 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.

  13. 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.

  14. 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.

  15. Video content analysis on body-worn cameras for retrospective investigation

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; ter Haar, Frank B.; Eendebak, Pieter T.; den Hollander, Richard J. M.; Burghouts, Gertjan J.; Wijn, Remco; van den Broek, Sebastiaan P.; van Rest, Jeroen H. C.

    2015-10-01

    In the security domain, cameras are important to assess critical situations. Apart from fixed surveillance cameras we observe an increasing number of sensors on mobile platforms, such as drones, vehicles and persons. Mobile cameras allow rapid and local deployment, enabling many novel applications and effects, such as the reduction of violence between police and citizens. However, the increased use of bodycams also creates potential challenges. For example: how can end-users extract information from the abundance of video, how can the information be presented, and how can an officer retrieve information efficiently? Nevertheless, such video gives the opportunity to stimulate the professionals' memory, and support complete and accurate reporting. In this paper, we show how video content analysis (VCA) can address these challenges and seize these opportunities. To this end, we focus on methods for creating a complete summary of the video, which allows quick retrieval of relevant fragments. The content analysis for summarization consists of several components, such as stabilization, scene selection, motion estimation, localization, pedestrian tracking and action recognition in the video from a bodycam. The different components and visual representations of summaries are presented for retrospective investigation.

  16. 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.

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

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    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

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

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    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.

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

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    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.

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

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    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.

  1. 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.

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

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    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.

  3. HER2 status in advanced gastric carcinoma: A retrospective multicentric analysis from Sicily

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    IENI, A.; BARRESI, V.; GIUFFRÈ, G.; CARUSO, R.A.; LANZAFAME, S.; VILLARI, L.; SALOMONE, E.; ROZ, E.; CABIBI, D.; FRANCO, V.; CERTO, G.; LABATE, A.; NAGAR, C.; MAGLIOLO, E.; BROGGI, B.; FAZZARI, C.; ITALIA, F.; TUCCARI, G.

    2013-01-01

    According to the ToGA trial, HER2 has been shown to be predictive for the success of treatment with trastuzumab in advanced gastric cancer (AGC). A number of studies have analyzed HER-2/neu overexpression in gastric carcinoma and identified the rate of HER2 positivity to be markedly varied. To date, the prevalence of HER2 overexpression in Sicilian people with AGC is unknown. Therefore, in the present study, a retrospective immunohistochemical analysis of HER2 was performed in a cohort of 304 AGC samples that were obtained from the archives of 10 Sicilian anatomopathological diagnostic units in order to verify the positive rate of HER2-positive cases. Furthermore, the characteristics of histotype, grade, stage and Ki-67 expression were also analyzed. HER2 overexpression was encountered in 17.43% of all the gastric adenocarcinomas, which was consistent with the results that have been reported elsewhere in the literature. A progressive increase in HER2 overexpression was observed, from the poorly cohesive histotype to the tubular adenocarcinomas and gastric hepatoid adenocarcinomas. HER2 overexpression was significantly associated with a high grade, advanced stage and high Ki-67 labeling index. Further investigations performed jointly by pathologists and oncologists within the geographical area of the present study should confirm that the association of trastuzumab with chemotherapy results in an improvement of survival in patients with AGC. PMID:24260051

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

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    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.

  5. Prognostic factors and outcomes of adult-onset hemophagocytic lymphohistiocytosis: a retrospective analysis of 34 cases

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    Masafumi Oto

    2015-06-01

    Full Text Available Adult-onset hemophagocytic lymphohistiocytosis (HLH has features that are distinct from that of HLH in pediatric patients. The clinical records at the Japanese Red Cross Kumamoto Hospital were reviewed. We retrospectively analyzed 34 patients who fulfilled the diagnostic criteria of HLH-2004. The median age of patients was 60.0 (range 15-86. Underlying diseases were diagnosed in 17 patients. They consisted of malignant lymphoma (n=3, other neoplastic disease (n=3, viral infection (n=4, collagen vascular disease (n=3, Kikuchi’s disease (n=3 and drug (n=1. Underlying diseases were not diagnosed in 17 patients despite examination. The treatments were steroids (n=18, dexamethasone + cyclosporine A (CSA + etoposide (n=4, multidrug chemotherapy (n=2, steroids and CSA (n=3. Eleven patients died during observation. In a multivariate analysis, the significant predictor for death was age at onset (hazard ratio, 1.22; 95%CI, 1.02-1.44; P=0.027. Autopsy was performed in 4 cases, but the underlying disease remained unknown in 3 of those cases. Adult-onset HLH has high diversity and various outcomes. The mechanism of adult-onset HLH is not fully understood and further research is required.

  6. 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.

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

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    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.

  8. Comparative Analysis of Carrier-Based Obturation and Lateral Compaction: A Retrospective Clinical Outcomes Study

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    Robert Hale

    2012-01-01

    Full Text Available The purpose of this retrospective study was to compare the outcome of primary endodontic treatment using a standardized cleaning and shaping technique and obturation with either lateral compaction or carrier-based obturation. Patients received primary endodontic treatment in the predoctoral dental clinic using a standardized cleaning and shaping protocol. All root canals were obturated using AH PlusTM sealer with lateral compaction of gutta-percha (LC or carrier-based obturation (CBO. A total of 205 cases met the inclusion criteria. 71 teeth in 60 patients were recalled after 2 years and evaluated both clinically and radiographically by two independent examiners. Success was defined as a lack of clinical symptoms and a normal periodontal ligament space or reduction in size of a previously existing periapical radiolucency. Chi-square and logistic regression were used for statistical analysis with a significance level of P<0.05. There was no difference in success rates between cases obturated with LC or CBO (P=0.802; overall success rate was 83%. Molars had a significantly lower success rate (53% than premolar and anterior teeth (89% (P=0.005, irrespective of the obturation technique used. When a standardized cleaning and shaping protocol was used by predoctoral dental students in a controlled university setting, there was no difference in success rates between cases obturated with LC or CBO.

  9. 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.

  10. Parents were accurate proxy reporters of urgent pediatric asthma health services—a retrospective agreement analysis

    Science.gov (United States)

    Ungar, Wendy J.; Davidson-Grimwood, Sara R.; Cousins, Martha

    2016-01-01

    Objective To assess agreement between parents’ proxy reports of children’s respiratory-related health service use and administrative data. Study Design and Setting A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Results Agreement between administrative data and respondent reports (n =545) was substantial for hospitalizations in the past year (κ =0.80 [0.74, 0.86]), moderate for ED visits in the past year (κ =0.60 [0.53, 0.67]), and slight for physician visits (κ =0.13 [0.00, 0.27]) in the past 6 months. Income, parent’s education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (P <0.05) for children who had an asthma attack in the past 6 months (κ =0.61 [0.54, 0.68]) compared to children who did not (κ =0.25 [0.00, 0.59]). Conclusion Parents of asthmatic children are reliable reporters of their child’s respiratory-related urgent health services utilization. PMID:17938060

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

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    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.

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

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    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.

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

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    Nadezhda S. Deleva

    2012-02-01

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

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

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    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.

  15. A retrospective analysis of a community-based health program in Papua New Guinea.

    Science.gov (United States)

    Ashwell, Helen Elizabeth Scott; Barclay, Lesley

    2009-06-01

    The Women and Children's Health Project was a large Australian funded aid Project that sought to improve the health of women and children in Papua New Guinea between 1998 and 2004. Community development and health promotion interventions aimed to increase community support for attended birth and children's health. Green and Kreuter's [Green, L. W. and Kreuter, M. W. (2005) Health Program Planning: An Educational and Ecological Approach, 4th edition. McGraw-Hill, New York] precede-proceed model of health program planning was applied retrospectively to critique the design, implementation and evaluation of the Project. An outcome evaluation (2006) provided data for this analysis and investigated long-term impact using a multi-methods approach. Application of the precede-proceed model was useful, but the model fails to sufficiently well identify 'inhibiting factors' as part of the educational and ecological assessment during the planning phase. Pre-defined objectives and contractually obligated outputs in a donor funded business model negatively influenced Project activity and outcomes. Despite this and the challenging context for implementation, Project interventions improved interaction between the community and health systems, and improved use of maternal child health services. PMID:19342392

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

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    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.

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

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    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

  18. 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

  19. 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

  20. Retrospective Analysis of Azithromycin Versus Fluoroquinolones for the Treatment Of Legionella Pneumonia

    OpenAIRE

    Nagel, Jerod L.; Rarus, Rachel E.; Crowley, Alex W.; Alaniz, Cesar

    2014-01-01

    A single-center retrospective study that compared clinical outcomes of patients with Legionella pneumonia treated with azithromycin versus fluoroquinolones for more than 12 years found that azithromycin appears to have clinical efficacy similar to fluoroquinolones.

  1. 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

  2. Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis

    OpenAIRE

    Tauqeer Hussain Mallhi; Amer Hayat Khan; Azreen Syazril Adnan; Azmi Sarriff; Yusra Habib Khan; Fauziah Jummaat

    2015-01-01

    Background Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients. Methodology A total 667 dengue patients (2008–2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods. Results Th...

  3. NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

    Science.gov (United States)

    Thomas, D.; Wear, M.; VanBaalen, M.; Lee, L.; Fitts, M.

    2011-01-01

    As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future

  4. A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

    Science.gov (United States)

    Yuan, Meiqin; Wang, Zeng; Hu, Guinv; Yang, Yunshan; Lv, Wangxia; Lu, Fangxiao; Zhong, Haijun

    2016-01-01

    Peritoneal metastasis (PM) is a poor prognostic factor in patients with gastric cancer. The aim of this study was to evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer with PM by retrospective analysis. A total of 54 gastric cancer patients with positive ascitic fluid cytology were included in this study: 23 patients were treated with systemic chemotherapy combined with HIPEC (HIPEC+ group) and 31 received systemic chemotherapy alone (HIPEC- group). The patients were divided into 4 categories according to the changes of ascites, namely disappear, decrease, stable and increase. The disappear + decrease rate in the HIPEC+ group was 82.60%, which was statistically significantly superior to that of the HIPEC- group (54.80%). The disappear + decrease + stable rate was 95.70% in the HIPEC+ group and 74.20% in the HIPEC- group, but the difference was not statistically significant. In 33 patients with complete survival data, including 12 from the HIPEC+ and 21 from the HIPEC- group, the median progression-free survival was 164 and 129 days, respectively, and the median overall survival (OS) was 494 and 223 days, respectively. In patients with ascites disappear/decrease/stable, the OS appeared to be better compared with that in patients with ascites increase, but the difference was not statistically significant. Further analysis revealed that patients with controlled disease (complete response + partial response + stable disease) may have a better OS compared with patients with progressive disease, with a statistically significant difference. The toxicities were well tolerated in both groups. Therefore, HIPEC was found to improve survival in advanced gastric cancer patients with PM, but the difference was not statistically significant, which may be attributed to the small number of cases. Further studies with larger samples are required to confirm our data.

  5. 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.

  6. A retrospective clinical and epidemiological analysis of cases of hepatitis E in St. Petersburg

    Directory of Open Access Journals (Sweden)

    H. D. Peradze

    2012-01-01

    Full Text Available Hepatitis E – zoonotic disease that has received a nosological independence twenty years ago, when Russian scientist, Professor M.S. Balayan, identified the pathogen (hepatitis E. It was believed that the disease can manifest itself only in the acute form, and occur only in regions with subtropical and tropical climate conditions. The development and introduction of practicing of modern scientific research methods for detecting antibodies to activator change, to view the global prevalence of infection and present doubts on inabilities of transformation into a chronic f a retrospective analysis of hospital cases of acute jaundice hepatitis E in Saint-Petersburg.Etiologic accessory to hepatitis E implemented by discovery in serum of patients a specific marker of infection hepatitis E – an anti-HEV.In the analysis of archive documentation for 2000–2011 from the patients which were hospitalized in the Clinical Infectious Diseases Hospital by S.P. Botkin only 11patients were diagnosed with «acute hepatitis E». Which indicates the presence of patients with acute hepatitis E infection among hospitalized in hospitals of the city of St. Petersburg are not endemic for this disease. The presence of cases of disease of the indigenous inhabitants of the city during the past years, which isn’t going beyond its limits, indicates the existence of «autochthonous» hepatitis E.

  7. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

    Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

  8. 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

  9. A retrospective analysis of survival and prognostic factors after stereotactic radiosurgery for aggressive meningiomas

    International Nuclear Information System (INIS)

    While most meningiomas are benign, aggressive meningiomas are associated with high levels of recurrence and mortality. A single institution’s Gamma Knife radiosurgical experience with atypical and malignant meningiomas is presented, stratified by the most recent WHO classification. Thirty-one patients with atypical and 4 patients with malignant meningiomas treated with Gamma Knife radiosurgery between July 2000 and July 2011 were retrospectively reviewed. All patients underwent prior surgical resection. Overall survival was the primary endpoint and rate of disease recurrence in the brain was a secondary endpoint. Patients who had previous radiotherapy or prior surgical resection were included. Kaplan-Meier and Cox proportional hazards models were used to estimate survival and identify factors predictive of recurrence and survival. Post-Gamma Knife recurrence was identified in 11 patients (31.4%) with a median overall survival of 36 months and progression-free survival of 25.8 months. Nine patients (25.7%) had died. Three-year overall survival (OS) and progression-free survival (PFS) rates were 78.0% and 65.0%, respectively. WHO grade II 3-year OS and PFS were 83.4% and 70.1%, while WHO grade III 3-year OS and PFS were 33.3% and 0%. Recurrence rate was significantly higher in patients with a prior history of benign meningioma, nuclear atypia, high mitotic rate, spontaneous necrosis, and WHO grade III diagnosis on univariate analysis; only WHO grade III diagnosis was significant on multivariate analysis. Overall survival was adversely affected in patients with WHO grade III diagnosis, prior history of benign meningioma, prior fractionated radiotherapy, larger tumor volume, and higher isocenter number on univariate analysis; WHO grade III diagnosis and larger treated tumor volume were significant on multivariate analysis. Atypical and anaplastic meningiomas remain difficult tumors to treat. WHO grade III diagnosis and treated tumor volume were significantly

  10. 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...

  11. 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.

  12. Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up

    OpenAIRE

    Castel, Nikki; Soon-Sutton, Taylor; Deptula, Peter; Flaherty, Anna; Parsa, Fereydoun Don

    2015-01-01

    Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six month...

  13. Re-irradiation in the treatment of patients with cerebral metastases of solid tumors: retrospective analysis

    International Nuclear Information System (INIS)

    Goal of this retrospective analysis was to evaluate the role of repeat whole brain radiotherapy in the palliative care of patients with brain metastases due to solid tumors. Data regarding demographic data, primary tumor, metastasis, radiotherapy and symptoms were compiled on 134 patients with cerebral metastases that received repeat whole brain radiotherapy (WBRT) in our clinic between 2002 and 2011. The analyzed group consisted of 63 (47%) women and 71 (53%) men with a median age of 57 at the start of re-irradiation. Most frequent primary site was the lung (87%). Sixty patients with lung cancer received the first WBRT prophylactically. At the time of re-WBRT 81% of all patients suffered from additional extracerebral metastases. Time between first and second WBRT was a median of 13.4 months. Full dose for the first WBRT was 30 Gy in 2.0 Gy single dose, for the second 20 Gy in 2.0 Gy single dose. At the start of the Re-WBRT 81 patients (60.4%) had mild, 32 (23.9%) severe neurological symptoms, 21 patients (15.7%) were asymptomatic. The median Karnofsky performance status was 70%. Overall, re-WBRT was tolerated satisfactorily. Main side effects were fatigue, erythema and focal alopecia, 10% of patients discontinued treatment before reaching the planned dose. Median survival was 2.8 months since the end of the re-WBRT with good performance status at the start of the re-irradiation being a key indicator for longer survival. Fifty-two patients (39%) showed a clinical improvement of neurological symptoms after the therapy, 59 patients (44%) remained stable, 23 patients (17%) showed worse symptoms. From this large patient collective we were able to show that re-WBRT can be an important therapeutic option with low rate of acute side effects for patients in adequate general condition

  14. Retrospective analysis of patients self-referred to comprehensive ophthalmology seeking second opinions

    Directory of Open Access Journals (Sweden)

    Gologorsky D

    2013-06-01

    Full Text Available Daniel Gologorsky1, Scott H Greenstein2 1Dartmouth Medical School, Hanover, NH, USA; 2Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA Abstract: Patients choose to seek a second opinion in matters related to their health for a variety of reasons, and the total cost associated with these second opinion visits is estimated to be billions of dollars annually. Understanding the reasons behind second opinion self-referrals is key to improving patient satisfaction and reducing redundancy in delivered health care. This study represents a retrospective analysis of the records from a single provider at the Massachusetts Eye and Ear Infirmary (MEEI Comprehensive Ophthalmology Service in order to determine the various reasons that patients self-refer to an ophthalmology clinic seeking second opinions. A total of 174 patients presenting for a second opinion were identified over a one-year period. Patients presented for second opinions for two primary reasons: 60% presented in order to seek a confirmation of a diagnosis from an outside ophthalmologist (54% or optometrist (6%, and 40% presented due to a previous adverse experience with an outside provider, such as perceived treatment failure (26%, poor bedside manner (3%, distrust of the provider (5%, and poor provider communication skills (7%. This study strives to reiterate that the reduction of adverse patient experiences through effective communication of expected treatment options and outcomes, with a realistic time course of therapy, could significantly improve patient satisfaction and reduce costly second opinion visits. Keywords: referral, self-referral, second opinion, comprehensive ophthalmology

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Retrospective Analysis of Metabolic Syndrome: Prevalence and Distribution in Executive Population in Urban Pakistan

    Directory of Open Access Journals (Sweden)

    Niloufer Sultan Ali

    2012-01-01

    Full Text Available Background. Metabolic Syndrome (MetS is a major public health concern. Objective. The aim of this study was to estimate the frequency of MetS, its components, and factors associated with MetS amongst apparently healthy individuals in Pakistan. Methods. A retrospective cross-sectional study was conducted at the executive Clinics of Aga Khan Hospital, Pakistan. Medical records of patients aged ≥18 years visiting the clinics from July 2011 to December 2011 were consecutively reviewed. Records in which either MetS components data or 10% of overall data was missing were excluded. A total of 1329 participants’ records was included in final analysis. Data was analyzed using SPSS version 19 and multivariable logistic regression was used to identify the factors associated with MetS. Results. A total of 847 (63.7% participants had MetS; mean age of the participants were 47.6 ± 11.6 years. About 70.4% were males and 29.6% were females. Approximately 70% of participants had BMI ≥25 kg/m2. MetS was associated with male gender (AOR = 2.1; 95% C.I: 1.6–3.2 and history of diabetes among parents (AOR = 3.0; 95% C.I: 1.6–6.0. Conclusion. This study shows that a large proportion of population has MetS and is overweight or obese. This requires urgent interventions on part of health care providers’ especially family physicians. Educating masses about life style factors can make a difference. Further researches on this issue are warranted.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. Retrospective Analysis of Lung Transplant Recipients Found to Have Unexpected Lung Cancer in Explanted Lungs.

    Science.gov (United States)

    Nakajima, Takahiro; Cypel, Marcelo; de Perrot, Marc; Pierre, Andrew; Waddell, Tom; Singer, Lianne; Roberts, Heidi; Keshavjee, Shaf; Yasufuku, Kazuhiro

    2015-01-01

    Unexpected lung cancer is sometimes found in explanted lungs. The objective of this study was to review these patients and their outcomes to better understand and optimize management protocols for lung transplant candidates with pulmonary nodules. Retrospective analysis of pretransplant imaging and clinicopathologic characteristics of patients who were found to have lung cancer in their explanted lungs was performed. From January 2003 to December 2012, 13 of 853 lung transplant recipients were found to have unexpected lung cancer in their explanted lung (1.52%). Of them, 9 cases were for interstitial lung disease (2.8%; 9/321 recipients) and 4 cases were for chronic obstructive pulmonary disease (1.57%; 4/255 recipients). The median period between computed tomographic scan and lung transplantation was 2.40 months (range: 0.5-19.2). On computed tomographic scan, only 3 cases were shown to possibly have a neoplasm by the radiologist. The staging of these lung cancers was as follows: 3 cases of IA, 1 case of IB, 5 cases of IIA, 1 case of IIIA, and 3 cases of IV. Of 13 cases, 9 died owing to cancer progression. On the contrary, only 1 stage I case with small cell lung cancer showed cancer recurrence. The median survival time was 339 days, and the 3-year survival rate was 11.0%. In conclusion, most of the patients with unexpected lung cancer showed poor prognosis except for the early-stage disease. The establishment of proper protocol for management of such nodules is important to improve the management of candidates who are found to have pulmonary nodules on imaging. PMID:26074103

  2. Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center

    Directory of Open Access Journals (Sweden)

    S S Muttagi

    2011-01-01

    Full Text Available Aim: Being a tertiary referral center, we encounter the highest number of oral cancer patients in India, and there is direct involvement of the jaw bone in approximately 40% of these cases. There are no large case series from the Indian subcontinent on metastatic tumors to the jaw bones. With this retrospective analysis, we intend to estimate the incidence of this rare manifestation in the jaw bones in our patients and compare it with the available literature. Materials and Methods: All patients with biopsy proven metastatic disease involving jaw bones having complete clinical data were included. Results: Nineteen out of 10,411 oral cancer patients who reported between the years 2000 and 2005 were included. Breast and thyroid malignancies (5/19 each were commonest in the females to metastasize to the mandible, whereas in the males, there was no predominant site that resulted in jaw bone metastasis, although mandible was commonly affected. Neuroblastoma of adrenal gland metastasized to maxilla in the age group ranging from 4 months to 16 years. Maxilla was the commonest jaw bone affected in this age group. In five cases, jaw bone was found to be the first site of metastasis. Conclusions: There is variation in the primary site that causes metastasis to the jaw bones depending on age, sex and geographic distribution. Jaw bone metastases are rare and can be the first site of metastasis. We get approximately four cases in a year with metastatic disease manifesting in the jaw bones. Metastasis to jaw bone is associated with poor prognosis.

  3. Retrospective analysis of 104 histologically proven adult brainstem gliomas: clinical symptoms, therapeutic approaches and prognostic factors

    International Nuclear Information System (INIS)

    Adult brainstem gliomas are rare primary brain tumors (<2% of gliomas). The goal of this study was to analyze clinical, prognostic and therapeutic factors in a large series of histologically proven brainstem gliomas. Between 1997 and 2007, 104 patients with a histologically proven brainstem glioma were retrospectively analyzed. Data about clinical course of disease, neuropathological findings and therapeutic approaches were analyzed. The median age at diagnosis was 41 years (range 18-89 years), median KPS before any operative procedure was 80 (range 20-100) and median survival for the whole cohort was 18.8 months. Histopathological examinations revealed 16 grade I, 31 grade II, 42 grade III and 14 grade IV gliomas. Grading was not possible in 1 patient. Therapeutic concepts differed according to the histopathology of the disease. Median overall survival for grade II tumors was 26.4 months, for grade III tumors 12.9 months and for grade IV tumors 9.8 months. On multivariate analysis the relative risk to die increased with a KPS ≤ 70 by factor 6.7, with grade III/IV gliomas by the factor 1.8 and for age ≥ 40 by the factor 1.7. External beam radiation reduced the risk to die by factor 0.4. Adult brainstem gliomas present with a wide variety of neurological symptoms and postoperative radiation remains the cornerstone of therapy with no proven benefit of adding chemotherapy. Low KPS, age ≥ 40 and higher tumor grade have a negative impact on overall survival

  4. Retrospective Analysis of Bevacizumab in Combination with Fotemustine in Chinese Patients with Recurrent Glioblastoma Multiforme

    Directory of Open Access Journals (Sweden)

    Zhiguang Liu

    2015-01-01

    Full Text Available The aim of this study was to assess the activity and safety of bevacizumab (BEV and fotemustine (FTM for the treatment of recurrent glioblastoma multiforme (GBM patients and explore the potential prognostic parameters on survival. This study retrospectively analyzed all patients with GBM who were treated with at least one cycle of BEV and FTM from July 2010 to October 2012. A total of 176 patients with recurrent GBM were enrolled. The response rate and disease control rate were 46.6% and 90.9%, respectively. A 6-month PFS rate of 33.3% (95% CI: 26.5%–40.3% and a median PFS of 5.0 (95% CI: 2.4–7.5 months were observed. The median OS was 8.0 (95% CI: 6.7–9.2 months. Multivariate analysis showed that risk factors with a significant influence on the PFS of all patients were Karnofsky Performance Status (KPS (≥70 versus <70, HR=0.53, 95% CI: 0.39–0.73, and P=0.01 and MGMT status (methylated versus unmethylated, HR=0.69, 95% CI: 0.52–0.97, and P=0.04. The most common treatment-related adverse events were fatigue, proteinuria, hypophonia, hypertension, thrombocytopenia, anemia, and neutropenia. In conclusion, combination of BEV with FTM is well tolerated and may derive some clinical benefits in recurrent GBM patients. Higher KPS and MGMT promoter hypermethylation were suggested to be associated with prolonged survival.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    Science.gov (United States)

    Kerr-Layton, J A; Stamm, C A; Peterson, L S; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgical indication, and history of gonadotropin-releasing hormone (GnRH) use. Cases were evaluated for the presence of plasma cells and assigned a grade between 0 and 3. RESULTS: Indications included cervical dysplasia (4), carcinoma in situ (2), abnormal uterine bleeding (3), and adnexal mass (3). Some degree of abnormal uterine bleeding occurred in all cases. Plasma cell endometritis was twice as common in HIV-infected women compared to HIV-negative specimens (11/11 versus 11/22) (P < 0.05). Plasma cell endometritis was also of a higher grade in specimens from HIV-infected women than in controls (P = 0.001). CONCLUSION: Chronic endometritis was common and of a higher grade among HIV-infected women requiring hysterectomy in our series. Diagnosis and treatment of endometritis should be considered in HIV-infected women with uterine bleeding and/or tenderness. We speculate that antiretroviral and/or antimicrobial treatment for endometritis may effectively treat endometritis and eliminate the need for surgery in some HIV-infected women. We suggest that consideration and treatment of endometritis in HIV-1 infected women being evaluated for possible hysterectomy has the potential to reduce costs and morbidity for patients and providers who may be exposed during surgical procedures. PMID:9812252

  9. Single Center Retrospective Analysis of Conventional and Radial TIG Catheters for Transradial Diagnostic Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Marc Vorpahl

    2015-01-01

    Full Text Available Current guidelines favor the radial approach for coronary angiography. Therefore, specialty radial diagnostic catheters were designed to engage both coronary arteries with a single device. However, it is unclear if single catheters are superior to conventional catheters. A retrospective analysis was performed of consecutive right radial coronary angiographies to determine catheter use, fluoroscopy time, radiation dosage, and consumption of contrast. Procedures were performed with a single TIG catheter or conventional catheters (CONV. Procedures with coronary artery bypass grafts or ventricular angiographies were excluded. 273 transradial procedures were performed successfully. 95 procedures were performed with CONV and 178 procedures with a TIG. Crossover to additional catheters was higher in TIG (15.2% compared to CONV (5.3%, p=0.02. Fluoroscopy time was comparable between CONV and TIG, without crossover (2.2±1.2 min versus 2.3±1.2 min; n.s., however, greater in the case of crossover for CONV (5.8±0.7 and TIG (7.6±3.0; p=0.0001. Radiation dosage was similar in CONV and the TIG, without crossover (1419±1075, cGy∗cm2 versus 1690±1138; n.s., however, greater for CONV (2374±620 and TIG (3733±2281, p=0.05 with crossover. Overall, the amount of contrast was greater in TIG (56±13 mL versus CONV (48±3 mL; p=0.0003. CONV femoral catheters may be the primary choice for radial approach.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Appropriateness of antibiotic treatment in intravenous drug users, a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Fluckiger Ursula

    2008-04-01

    Full Text Available Abstract Background Infectious disease is often the reason for intravenous drug users being seen in a clinical setting. The objective of this study was to evaluate the appropriateness of treatment and outcomes for this patient population in a hospital setting. Methods Retrospective study of all intravenous drug users hospitalized for treatment of infectious diseases and seen by infectious diseases specialists 1/2001–12/2006 at a university hospital. Treatment was administered according to guidelines when possible or to alternative treatment program in case of patients for whom adherence to standard protocols was not possible. Outcomes were defined with respect to appropriateness of treatment, hospital readmission, relapse and mortality rates. For statistical analysis adjustment for multiple hospitalizations of individual patients was made by using a generalized estimating equation. Results The total number of hospitalizations for infectious diseases was 344 among 216 intravenous drug users. Skin and soft tissue infections (n = 129, 37.5% of hospitalizations, pneumonia (n = 75, 21.8% and endocarditis (n = 54, 15.7% were most prevalent. Multiple infections were present in 25%. Treatment was according to standard guidelines for 78.5%, according to an alternative recommended program for 11.3%, and not according to guidelines or by the infectious diseases specialist advice for 10.2% of hospitalizations. Psychiatric disorders had a significant negative impact on compliance (compliance problems in 19.8% of hospitalizations in multiple logistic regression analysis (OR = 2.4, CI 1.1–5.1, p = 0.03. The overall readmission rate and relapse rate within 30 days was 13.7% and 3.8%, respectively. Both non-compliant patient behavior (OR = 3.7, CI 1.3–10.8, p = 0.02 and non-adherence to treatment guidelines (OR = 3.3, CI 1.1–9.7, p = 0.03 were associated with a significant increase in the relapse rate in univariate analysis. In 590 person-years of follow

  13. 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

  14. [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.

  15. An Assessment of Actual and Potential Building Climate Zone Change and Variability From the Last 30 Years Through 2100 Using NASA's MERRA and CMIP5 Simulations

    Science.gov (United States)

    Stackhouse, Paul W., Jr.; Chandler, William S.; Hoell, James M.; Westberg, David; Zhang, Taiping

    2015-01-01

    Background: In the US, residential and commercial building infrastructure combined consumes about 40% of total energy usage and emits about 39% of total CO2 emission (DOE/EIA "Annual Energy Outlook 2013"). Building codes, as used by local and state enforcement entities are typically tied to the dominant climate within an enforcement jurisdiction classified according to various climate zones. These climate zones are based upon a 30-year average of local surface observations and are developed by DOE and ASHRAE. Establishing the current variability and potential changes to future building climate zones is very important for increasing the energy efficiency of buildings and reducing energy costs and emissions in the future. Objectives: This paper demonstrates the usefulness of using NASA's Modern Era Retrospective-analysis for Research and Applications (MERRA) atmospheric data assimilation to derive the DOE/ASHRAE building climate zone maps and then using MERRA to define the last 30 years of variability in climate zones for the Continental US. An atmospheric assimilation is a global atmospheric model optimized to satellite, atmospheric and surface in situ measurements. Using MERRA as a baseline, we then evaluate the latest Climate Model Inter-comparison Project (CMIP) climate model Version 5 runs to assess potential variability in future climate zones under various assumptions. Methods: We derive DOE/ASHRAE building climate zones using surface and temperature data products from MERRA. We assess these zones using the uncertainties derived by comparison to surface measurements. Using statistical tests, we evaluate variability of the climate zones in time and assess areas in the continental US for statistically significant trends by region. CMIP 5 produced a data base of over two dozen detailed climate model runs under various greenhouse gas forcing assumptions. We evaluate the variation in building climate zones for 3 different decades using an ensemble and quartile

  16. 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

  17. Guidelines for retrospective safety analysis. Prepared for DRIVE II Project V2002 Horizontal Project for the Evaluation of Safety HOPES.

    OpenAIRE

    Oppe, S.

    1994-01-01

    This report contains the following contributions: Concepts and definitions (Oppe, S); Traffic in its social context (Chaloupka, C and Risser, R); The checklist as a retrospective safety tool (Chaloupka, C and Risser, R); Experimental design (Kulmala, R); Evaluation of the traffic process and its safety effects (Oppe, S); Methods for process evaluation (Steyvers, FJJM); Methods for product evaluation (Oppe, S); Accident analysis (Oppe, S); Time related models (Oppe, S); Behavioural models (Ste...

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

    with that of the case-only model. RESULTS: Results from our simulation study indicate that our retrospective model exhibits high power in capturing even relatively small effect with reasonable sample sizes. Application of our method to data from an association study on the catalase -262C/T promoter polymorphism...

  4. 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

  5. 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

  6. Acute Fatty Liver of Pregnancy: A Retrospective Analysis of 56 Cases

    Institute of Scientific and Technical Information of China (English)

    Yan-Ping Zhang; Wei-Qi Kong; Sheng-Ping Zhou; Yun-Hoi Gong; Rong Zhou

    2016-01-01

    Background:Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening complication occurring in the third trimester.It is often fatal to both mother and fetus.The complicated clinical manifestations as well as an insufficient understanding of the disease make the precise diagnosis and effective treatment of AFLP challenging.A full understanding of the risk factors,clinical features,and test findings of AFLP is critical for its timely diagnosis and treatment.Methods:We performed a retrospective study of 56 patients with AFLP between June 2008 and July 2013.We analyzed the clinical features,laboratory results,perioperative management,and patient outcomes.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,P =0.016) and international normalized ratio (INR;OR =40.034,95% CI=2.517-636.693,P =0.009) as risk factors.The perinatal infant death rate was related to gestational age at delivery (OR =1.298,95% CI=1.040-1.618,P =0.021),direct bilirubin (OR =1.05,95% CI=1.008-1.094,P =0.020),and fibrin degradation products (OR =0.973,95% CI =0.950-0.996,P =0.021).Conclusions: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

  7. Intussusception in southern India: comparison of retrospective analysis and active surveillance.

    Science.gov (United States)

    Jehangir, Susan; John, Jacob; Rajkumar, Sangeeth; Mani, Betty; Srinivasan, Rajan; Kang, Gagandeep

    2014-08-11

    Surveillance for intussusception is a post marketing requirement for rotavirus vaccines following observation of a small increased risk of intussusception after rotavirus vaccination in some global settings. This study presents the clinical presentation and outcomes of children who presented with intussusception at a large tertiary care facility directly (non-surveillance) as retrospective analysis of a period where rotavirus vaccine was not in routine use, or as part of active surveillance in a phase III oral rotavirus vaccine trial. Hospital records of children under 2 years of age treated for intussusception between 1 January 2010 and 31 August 2013 at the Christian Medical College Hospital, Vellore, India, were reviewed. Sixty-one cases of intussusception in children under two years of age presented at the hospital. An additional 16 cases of ultrasound diagnosed intussusception were identified through the active surveillance of a cohort of 1500 children participating in a rotavirus phase III trial in the same period. In the nonsurveillance group, median age at presentation was 214 days (IQR 153-321) with 52 events (85.3%) occurring in the first year of life. Cases were seen year-round with no definitive evidence of seasonality. Thirty-one (50.8%) intussusceptions required surgical reduction, 26 (42.6%) had pneumatic reduction and 2 (3.3%) barium enema reduction. Two intussusceptions (3.3%) resolved spontaneously. There were no deaths, all children were discharged after recovery. Active surveillance identified 16 children with a median age at event of 375 days (IQR 248-574). Nine (56%) children had small bowel or transient intussusception that resolved spontaneously. Seven intussusceptions were reduced radiologically; none required surgery. In summary, there were significant differences between presentation and outcomes in cases of intussusception identified by passive and active surveillance, likely related to enhanced and early detection of intussusception

  8. Maternal deaths in Sagamu in the new millennium: a facility-based retrospective analysis

    Directory of Open Access Journals (Sweden)

    Fakoya Tuminu A

    2006-03-01

    Full Text Available Abstract Background Health institutions need to contribute their quota towards the achievement of the Millennium Development Goal (MDG with respect to maternal health. In order to do so, current data on maternal mortality is essential for careproviders and policy makers to appreciate the burden of the problem and understand how best to distribute resources. This study presents the magnitude and distribution of causes of maternal deaths at the beginning of the 21st century in a Nigerian referral hospital and derives recommendations to reduce its frequency. Methods A retrospective descriptive analysis of all cases of maternal deaths at Olabisi Onabanjo University Teaching Hospital, Sagamu, Southwest Nigeria between 1 January 2000 to 30 June 2005. Results There were 75 maternal deaths, 2509 live births and 2728 deliveries during the study period. Sixty-three (84.0% of the deaths were direct maternal deaths while 12 (16.0% were indirect maternal deaths. Major causes of deaths were hypertensive disorders in pregnancy (28.0%, haemorrhage (21.3% and sepsis (20.0%. Overall, eclampsia was the leading cause of deaths singly accounting for 24.0% of all maternal deaths. Abortion and HIV-related mortality accounted for 1.3% and 4.0% of maternal deaths, respectively. The maternal mortality ratio of 2989.2 per 100,000 live births was significantly higher than that reported for 1988–1997 in the same institution. Up to 67/794 (8.4% patients referred from other facilities died compared to 8/1934 (0.4% booked patients (OR: 22.1; 95% CI: 10.2–50.1. Maternal death was more likely to follow operative deliveries than non-operative deliveries (27/545 vs 22/2161; OR: 5.07; 95% CI: 2.77–9.31. Conclusion At the middle of the first decade of the new millennium, a large number of pregnant women receiving care in this centre continue to die from preventable causes of maternal death. Adoption of evidence-based protocol for the management of eclampsia and improvement in

  9. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases.

    Science.gov (United States)

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

    We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. 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. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest (n=3, 0.4%). In 634 of cases, the place of hanging was the subject's own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in

  10. 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.

  11. 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

  12. 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

  13. 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

    Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11 years after operation, a reduction in the hallux valgus angles, the intermetatarsal angles and the width of the forefeet was found....... 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...... the age. In 37 of 46 feet the overall result was found satisfactory by the patients. The authors find that McBride's operation can be used for hallux valgus, also in patients above 30 years, in spite of the generally accepted restriction to younger individuals....

  14. 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

  15. Mortality and morbidity in children caused by falling televisions: a retrospective analysis of 71 cases

    OpenAIRE

    Gokhan, Servan; Kose, Ozkan; Ozhasenekler, Ayhan; Orak, Murat; USTUNDAG, Mehmet; Guloglu, Cahfer

    2011-01-01

    Objectives To quantify injuries in children that result from toppled televisions. Methods Children presenting directly to emergency department due to injuries caused by falling televisions were identified from our digital patient database, and a retrospective chart review of 71 children was performed. Descriptive statistics were applied. Results 71(1.8%) out of 3856 admissions due to injuries sustained at home were TV-related injuries. There were 50 (70.4%) boys and 21(29.6%) girls. Mean age ...

  16. Effects of Radiotherapy in the treatment of multiple myeloma: a retrospective analysis of a Single Institution

    OpenAIRE

    Matuschek, Christiane; Ochtrop, Thomas A; Bölke, Edwin; Ganswindt, Ute; Fenk, Roland; Gripp, Stephan; Kröpil, Patric; Gerber, Peter Arne; Kammers, Kai; Hamilton, Jackson; Orth, Klaus; Budach, Wilfried

    2015-01-01

    Background Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. Patients and methods We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie & Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of...

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

    OpenAIRE

    Kyung-Jin Yun; Ju Ah Lee; Jiae Choi; Mi Mi Ko; Cham-kyul Lee; Myeong Soo Lee; Eun-Yong Lee

    2015-01-01

    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 w...

  18. Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma

    OpenAIRE

    Tamura, Yosuke; Fujiwara, Yutaka; Yamamoto, Noboru; Nokihara, Hiroshi; Horinouchi, Hidehito; Kanda, Shintaro; Goto, Yasushi; Kubo, Emi; Kitahara, Shinsuke; Tsuruoka, Kenjiro; Tsuta, Koji; Ohe, Yuichiro

    2015-01-01

    Background Pulmonary pleomorphic carcinoma (PPC) follows an aggressive clinical course and outcomes are disappointing. Due to its rarity, however, the clinicopathological and molecular characteristics of this disease remain unclear. Methods We retrospectively evaluated the efficacy of chemotherapy and molecular targeted therapy in 16 patients with PPC who received chemotherapy or EGFR-TKI. We also investigated the status of EGFR mutation, KRAS mutation and ALK expression. Results On histologi...

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

    OpenAIRE

    Lal Sukhbir; Saini Vikas; Choudhary Balram; Saini Reetu

    2012-01-01

    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 ...

  20. Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

    OpenAIRE

    Yates Robert; Tulloh Robert; Tillett Angela; Lee LLeona CL; Kelsall Wilf

    2006-01-01

    Abstract Background The patent ductus arteriosus (PDA) is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor (PSI) use prior to ligation affects outcome. Methods A retrospective case note review study to det...

  1. Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis

    OpenAIRE

    Punzo Giorgio; Farella Antonio; Solla Raffaele; Liuzzi Raffaele; Cella Laura; De Cicco Luigi; Tranfa Fausto; Strianese Diego; Conson Manuel; Bonavolontà Giulio; Salvatore Marco; Pacelli Roberto

    2009-01-01

    Abstract Background Primary orbital lymphoma is a rare disease that accounts for 10% of all orbital tumors. Radiotherapy on the orbital cavity is the treatment of choice for this unusual presentation of localized non-Hodgkin's lymphoma (NHL). The aim of this study is to retrospectively evaluate the effectiveness and the toxicity of radiation treatment in patients with primary orbital lymphoma. Methods Forty-seven consecutive patients having primary orbital lymphoma treated in our department b...

  2. Retrospective analysis of perianal Paget s disease with underlying anorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To analyze clinical and pathological characteristics of an aggressive subtype of perianal Paget's disease(PPD) and explore its rational treatment modalities.METHODS:PPD patients were retrospectively collected in the institutional colorectal database of the Fudan University Shanghai Cancer Center.Detailed patient histories of past medical condition,diagnosis,treatment,and pathological findings were reviewed.Surgical specimen from diagnosis and surgery were reviewed by two independent pathologists for con...

  3. Retrospective analysis of third-line chemotherapy in advanced non-small cell lung cancer

    OpenAIRE

    Ali Murat Tatli; Deniz Arslan; Mukremin Uysal; Sema Sezgin Goksu; Seyda Gulenay Gunduz; Hasan Senol Coskun; Mustafa Ozdogan; Burhan Savas; Hakan Sat Bozcuk

    2015-01-01

    Background: First- and second-line chemotherapies have been demonstrated to be effective in treatment of patients with inoperable, advanced non-small cell lung cancer (NSCLC), although the role of third-line chemotherapy remains unclear. The present investigation assessed treatment outcomes in patients with advanced NSCLC who received third-line and higher chemotherapy. Patients and Methods: This retrospective study included consecutive patients with advanced NSCLC who received at least t...

  4. The impact of thyroid function on intrauterine insemination outcome - a retrospective analysis

    OpenAIRE

    Jatzko, Birgit; Vytiska-Bistorfer, Elisabeth; Pawlik, Alexandra; Promberger, Regina; Mayerhofer, Klaus; Ott, Johannes

    2014-01-01

    Background Hashimoto’s thyroiditis is the most common endocrinopathy in premenopausal women, and is associated with various gynecological problems, including recurrent miscarriage and unexplained infertility. A possible influence of Hashimoto’s thyroiditis on the success of intrauterine insemination seems likely, but has not been evaluated as yet. Therefore, the aim of our study was to retrospectively analyze the impact on intrauterine insemination outcome of thyroid function and markers sugg...

  5. 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

  6. Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases

    OpenAIRE

    Baek, Seung-Woo; Lee, Myung-Won; Ryu, Hae-Won; Lee, Kyu-Seop; SONG, IK-CHAN; Lee, Hyo-Jin; Yun, Hwan-Jung; Kim, Samyong; Jo, Deog-Yeon

    2011-01-01

    Background There has been no report on the clinical features or natural history of autoimmune hemolytic anemia (AIHA) in the Korean adult population. This study retrospectively analyzed the clinical characteristics and long-term outcomes of AIHA in the Korean adults. Methods Patients newly diagnosed with AIHA between January 1994 and December 2010 at Chungnam National University Hospital were enrolled. Patient characteristics at diagnosis, response to treatment, and the natural course of the ...

  7. Retrospective analysis of keratoconus at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

    OpenAIRE

    Alabdelmoneam M

    2012-01-01

    Mussaed AlabdelmoneamFaculty of Applied Medical Sciences, Shaqra University, Shaqra University, Saudi ArabiaBackground: This work was a retrospective study undertaken in a tertiary eye care hospital to evaluate the putative prevalence and referral patterns for keratoconus by gender, age, and region of Saudi Arabia.Methods: Files from 1638 keratoconus patients from different regions of Saudi Arabia referred to King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, between January 1999 and ...

  8. 安徽省18~30岁青年咬合关系临床调查分析%A clinical survey and analysis on the bite relationship of occlusion in youth and 18 ~ 30 years old in Anhui

    Institute of Scientific and Technical Information of China (English)

    曾红梅; 周学军; 韩冬

    2011-01-01

    Objective To investigate and analyse the prevalent even symptoms of malocclusion、sanine relationship and molar relationship in youth of 18 to 30 years old in Anhui. Methods This survey was based on WHO oral surveys basic methods,and adopted the classification standard of individual normal occlusion canine relationship and molar relationship. The random sampling method was used and a random sample of 1206( men 710,women 496)youth,aged between 18 and 30 without history of orthodontic,were chosen from Anhui province.The study was carried out by orthodontic specialist from Hefei lth People's Hospital Department of Stomatology. Results The prevalence of malocclusion among youth at 18 ~30 years old from Anhui was 87.81% ( men 86.48% ,women 89.72% ). Women's right and left canine relationship Class I ,Class Ⅱ ,Class Ⅲ were 20.23% and 55.73% and 24.04% and 22.25% ,55.73% and 22.02% respectively. Men's right and left canine relationship Class Ⅰ ,Class Ⅱ ,ClassⅢ were 13.36% 、56.51% ,30. 13% and 20.52% ,44.79% and 34.69% respectively.Women's right and left molar relationship of Angle Class I was 42.02% and 41.12% ,Angle Class Ⅱ was 31.24% and 28.09% ,Angle Class Ⅲ was 26.74% and 30.79%. Men's right and left molar relationship of Angle Class I was 28. 0l % and 27.04%, Angle Class Ⅱ was 37.46% and 33.22% ,Angle ClassⅢ was 34.53% and 39.74%. Conclusion The morbility rate of malocclusion is high. Class I of canine and molar relationship is low. Malocclusion and abnormal bite relationship should be taught and treated as early as possible. and the situation is critical.%目的 调查分析安徽省18~30岁青年错(牙合)畸形患病率及尖牙、磨牙关系情况.方法 根据WHO出版的口腔健康调查基本方法,以个别正常(牙合)和尖牙、磨牙关系分类法为标准,由口腔正畸科专业医师从合肥市第一人民医院口腔科就诊人员中随

  9. 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

  10. 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

  11. 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…

  12. How will Climate Change Affect Agriculture over the Next 10-30 Years

    Science.gov (United States)

    Agriculture is dependent upon the climate resources of temperature, sunlight, precipitation, and carbon dioxide. Efficient production depends upon optimum conditions of temperature and water supply and changes in these climatic variables will affect plant and animal systems over the next 10- 30 year...

  13. Left ventricular pseudoaneurysm found after mitral valve replacement performed 30 years earlier.

    Science.gov (United States)

    Castilla, Elena; Gato, Manuel; Ruiz, José Ramón

    2010-03-01

    Pseudoaneurysm of the left ventricle (LV) is a rare cardiac disease that occurs after myocardial infarction or cardiac surgery. Because patients frequently present with nonspecific symptoms, a high index of suspicion is needed to make the diagnosis. This report describes an unusual case demonstrating a large LV pseudoaneurysm after mitral valve replacement performed 30 years earlier. PMID:20197588

  14. 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…

  15. 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…

  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. Planting Misinformation in the Human Mind: A 30-Year Investigation of the Malleability of Memory

    Science.gov (United States)

    Loftus, Elizabeth F.

    2005-01-01

    The misinformation effect refers to the impairment in memory for the past that arises after exposure to misleading information. The phenomenon has been investigated for at least 30 years, as investigators have addressed a number of issues. These include the conditions under which people are especially susceptible to the negative impact of…

  18. Preliminary results of a 30-year daily rainfall data base in southern Italy

    DEFF Research Database (Denmark)

    Federico, Stefano; Avolio, Elenio; Pasqualoni, Loredana;

    2009-01-01

    This paper presents first exploratory results and analyses performed on a 30-year (1978–2007) homogeneous precipitation database that has been created for the Calabria peninsula, southern Italy. The database consists of complete time series of daily values of precipitation from 88 stations distri...

  19. Association between use of warfarin with common sulfonylureas and serious hypoglycemic events: retrospective cohort analysis

    Science.gov (United States)

    Romley, John A; Gong, Cynthia; Jena, Anupam B; Goldman, Dana P; Williams, Bradley

    2015-01-01

    Study question Is warfarin use associated with an increased risk of serious hypoglycemic events among older people treated with the sulfonylureas glipizide and glimepiride? Methods This was a retrospective cohort analysis of pharmacy and medical claims from a 20% random sample of Medicare fee for service beneficiaries aged 65 years or older. It included 465 918 beneficiaries with diabetes who filled a prescription for glipizide or glimepiride between 2006 and 2011 (4 355 418 person quarters); 71 895 (15.4%) patients also filled a prescription for warfarin (416 479 person quarters with warfarin use). The main outcome measure was emergency department visit or hospital admission with a primary diagnosis of hypoglycemia in person quarters with concurrent fills of warfarin and glipizide/glimepiride compared with the rates in quarters with glipizide/glimepiride fills only, Multivariable logistic regression was used to adjust for individual characteristics. Secondary outcomes included fall related fracture and altered consciousness/mental status. Summary answer and limitations In quarters with glipizide/glimepiride use, hospital admissions or emergency department visits for hypoglycemia were more common in person quarters with concurrent warfarin use compared with quarters without warfarin use (294/416 479 v 1903/3 938 939; adjusted odds ratio 1.22, 95% confidence interval 1.05 to 1.42). The risk of hypoglycemia associated with concurrent use was higher among people using warfarin for the first time, as well as in those aged 65-74 years. Concurrent use of warfarin and glipizide/glimepiride was also associated with hospital admission or emergency department visit for fall related fractures (3919/416 479 v 20 759/3 938 939; adjusted odds ratio 1.47, 1.41 to 1.54) and altered consciousness/mental status (2490/416 479 v 14 414/3 938 939; adjusted odds ratio 1.22, 1.16 to 1.29). Unmeasured factors could be correlated with both warfarin use and

  20. 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

  1. 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

  2. Retrospective Analysis of Bevacizumab in Combination with Fotemustine in Chinese Patients with Recurrent Glioblastoma Multiforme

    OpenAIRE

    Zhiguang Liu; Guanqun Zhang; Liang Zhu; Jiangbo Wang; Dongbo Liu; Lifei Lian; Jianlin Liu; Tianbao Lai; Xiaorong Zhuang

    2015-01-01

    The aim of this study was to assess the activity and safety of bevacizumab (BEV) and fotemustine (FTM) for the treatment of recurrent glioblastoma multiforme (GBM) patients and explore the potential prognostic parameters on survival. This study retrospectively analyzed all patients with GBM who were treated with at least one cycle of BEV and FTM from July 2010 to October 2012. A total of 176 patients with recurrent GBM were enrolled. The response rate and disease control rate were 46.6% and 9...

  3. 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.

  4. 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.

  5. 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.

  6. 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.

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

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    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.

  9. Is Statin Use Associated With Tendon Rupture? A Population-Based Retrospective Cohort Analysis.

    Science.gov (United States)

    Contractor, Tahmeed; Beri, Abhimanyu; Gardiner, Joseph C; Tang, Xiaoqin; Dwamena, Francesca C

    2015-01-01

    Previous case reports and small studies have suggested that 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (HMG-CoA-Is) may increase the risk of tendon rupture. We conducted a population-based retrospective cohort evaluation to better assess this relationship. From approximately 800,000 enrollees of a private insurance database, those who were aged ≤64 years with at least 1 year of continuous enrollment were selected. Exposure was defined as initiation of HMG-CoA-I after the beginning of the study period. Each exposed person was matched with 2 controls of similar age and gender. Baseline characteristics, including known risk factors for tendon rupture, were compared between exposed and control cohorts with fidelity to the study's matched design. After adjusting for differences in follow-up and baseline characteristics, incidence rate ratios for tendon rupture was assessed in HMG-CoA-I users and nonusers. A total of 34,749 exposed patients were matched with 69,498 controls. There was no difference in the occurrence of tendon ruptures in HMG-CoA-I users versus nonusers. The results remained unchanged after adjustment for age and gender. In conclusion, this population-based retrospective cohort evaluation suggests that use of HMG-CoA-Is as a group are not associated with tendon rupture. PMID:24451300

  10. A retrospective analysis of cross-reacting cetuximab IgE antibody and its association with severe infusion reactions

    International Nuclear Information System (INIS)

    Severe infusion reactions (SIRs) at rates of 5% or less are known side effects of biological agents, including mAbs such as cetuximab. There are currently no prospectively validated risk factors to aid physicians in identifying patients who may be at risk of experiencing an SIR following administration of any of these drugs. A retrospective analysis of 545 banked serum or plasma samples from cancer patients participating in clinical trials of cetuximab was designed to evaluate whether the presence of pretreatment IgE antibodies against cetuximab, as determined by a commercially available assay system, is associated with SIRs during the initial cetuximab infusion. Patients with a positive test indicating the presence of pretreatment antibodies had a higher risk of experiencing an SIR; however, at the prespecified cutoff utilized in this analysis, the test has a relatively low-positive predictive value (0.577 [0.369–0.766]) and a negative predictive value of 0.961 (0.912–0.987) in an unselected patient population. Data collected in this large retrospective validation study support prior observations of an association between the presence of pretreatment IgE antibodies cross-reactive with cetuximab and SIRs. Further analysis of the test's ability to predict patients at risk of an SIR would be required before this assay could be used reliably in this patient population

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

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    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

  12. Evaluation of the Modern Era Retrospective-Analysis for Research and Applications (MERRA) Global Water and Energy Budgets

    Science.gov (United States)

    Bosilovich, Michael G.; Robertson, F. R.; Chen, J.

    2010-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has completed 27 years of data) soon to be caught up to present. Here) we present an evaluation of those years currently available) including comparisons with the existing long reanalyses (ERA40) JRA25 and NCEP I and II) as well as with global data sets for the water and energy cycle. Time series shows that the MERRA budgets can change with some of the variations in observing systems, but that the magnitude of energy imbalance in the system is improved with more observations. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations).

  13. 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.

  14. 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.

  15. 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 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...... 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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.

  18. 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...

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

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    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

  20. Prevalence of Zygomatic Air Cell Defect in adults—A retrospective panoramic radiographic analysis

    International Nuclear Information System (INIS)

    Objectives: This research involved retrospectively evaluating panoramic radiographs of patients from India with the intention of assessing the prevalence of Zygomatic Air Cell Defect (ZACD) and establishing its dominant location and type. Methods: Seven thousand seven hundred and fifty-five panoramic radiographs of routine outpatients aged between 19 and 91 years were concomitantly evaluated by four investigators for estimating the prevalence and characteristics of the Zygomatic Air Cell Defect. Results: The prevalence of ZACD was noted to be 1.82%, with male preponderance. Unilateralality and multilocular appearance of ZACD were the dominant patterns observed. Conclusion: The frequency of ZACD amongst Indian population is in harmony with most of the similar studies conducted on various geographic populations.

  1. 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.

  2. 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.

  3. Revisiting 30 years of biofunctionalization and surface chemistry of inorganic nanoparticles for nanomedicine

    Science.gov (United States)

    Conde, João; Dias, Jorge T.; Grazú, Valeria; Moros, Maria; Baptista, Pedro V.; de la Fuente, Jesus M.

    2014-01-01

    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. PMID:25077142

  4. 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.

  5. Retrospective Analysis of 5100 Mammography Imaging in a Tertiary University Hospital

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    Bircan Alan

    2016-06-01

    Full Text Available Objective: In this study, our aim is to retrospectively evaluate, in the light of literature, mammographic find­ings of 5100 patients whose mammography imaging was performed from 2010 to 2015 in the Medical Faculty, Dicle University, and Children’s and Obstetrics Hospital, Diyarbakır. Methods: We retrospectively examined 5400 mam­mograms. Since the report and age data regarding 300 cases were missing, they were excluded from the study, and hence 5100 cases were included into the study. Each patient’s age, mammography findings were evaluated. Breast imaging results were categorized according to BI­RADS (Breast imaging reporting and data system clas­sification. Results: The mean age of 5100 patients included into the study was 51.0 years. The localization of the lesion was detected most in the upper outer quadrant in both right and left breasts (62.9% in the right breast, 58.3% in the left breast. When BIRADS 4 and 5 lesions were assessed, they all were observed to be at equal rate in both breasts, and the lesions were mainly located in the upper outer quadrant. When BIRADS scores were com­pared according to age groups, the incidence of BIRADS 4 and BIRADS 5 lesions was determined to be higher in >35 years of age than under 35 years of age, which was statistically significant (p 35 years of age, and that they were most frequently located in the up­per outer quadrant.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis

    Directory of Open Access Journals (Sweden)

    Punzo Giorgio

    2009-12-01

    Full Text Available Abstract Background Primary orbital lymphoma is a rare disease that accounts for 10% of all orbital tumors. Radiotherapy on the orbital cavity is the treatment of choice for this unusual presentation of localized non-Hodgkin's lymphoma (NHL. The aim of this study is to retrospectively evaluate the effectiveness and the toxicity of radiation treatment in patients with primary orbital lymphoma. Methods Forty-seven consecutive patients having primary orbital lymphoma treated in our department between May 1983 and September 2006 were investigated in a retrospective study. Either 60Co γ rays or 6 MV X rays were used to deliver daily fractions of 1.8 or 2.0 Gy, 5 times/week, with total doses ranging from 34.2 to 50 Gy. Forty-three patients had stage IE, three had stage II and one stage IV disease. Thirty-eight patients had marginal zone B-cell lymphoma, 5 diffuse large B cell lymphoma, 3 mantle cell lymphoma and 1 Burkitt lymphoma. Local control (LC, disease free survival (DFS, overall survival (OS and late side effects were evaluated in all patients. Results With a median follow up of 45 months, LC was obtained in 100% of patients. The estimated 5- and 7-year DFS rates were 75.8% and 55.3%, and the 5- and 7-year OS rates were 88.7% and 79.9% respectively. Acute toxicity was minimal. Late toxicity such as cataract, keratitis, retinopathy and xerophthalmia occurred respectively in 12 (25.5%, 5 (10.6%, 1 (2.1%, and 9 (19.1% patients. Conclusion Radiotherapy is an effective and at the same time well tolerated treatment for primary orbital lymphoma.

  8. 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

  9. Surgical Management of Solitary Nerve Sheath Tumors of the Cervical Spine: A Retrospective Case Analysis Based on Tumor Location and Extension

    OpenAIRE

    Abe, Junya; Takami, Toshihiro; NAITO, Kentaro; Yamagata, Toru; Arima, Hironori; Ohata, Kenji

    2014-01-01

    Complete resection of spinal nerve sheath tumors (NSTs) does not always result in significant neurological deficit. The purpose of this retrospective case analysis was to discuss the optimal surgical strategy for spinal NST of the cervical spine. Twenty-four patients who underwent surgery for solitary cervical NST over the past decade were included in this retrospective study. Patients with neurofibromatosis or schwannomatosis were excluded. Seventeen of the 24 cases (70.8%) showed extradural...

  10. 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.

  11. The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience

    Science.gov (United States)

    Suma, Hisayoshi

    2016-01-01

    Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures. PMID:27525230

  12. Revisiting 30 years of biofunctionalization and surface chemistry of inorganic nanoparticles for nanomedicine

    OpenAIRE

    João eConde; Dias, Jorge T.; Valeria eGrazú; Maria eMoros; Baptista, Pedro V; de la Fuente, Jesús M

    2014-01-01

    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 ...

  13. 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.

  14. The history of Cochlear™Nucleus® sound processor upgrades:30 years and counting

    Institute of Scientific and Technical Information of China (English)

    Anne L. Beiter; Esti Nel

    2015-01-01

    Objective:To review developments in sound processors over the past 30 years that have resulted in significant improvements in outcomes for Nucleus® recipients. Copyright © 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  15. Studies using single-subject designs in sport psychology: 30 years of research

    OpenAIRE

    Martin, Garry L.; Thompson, Kendra; Regehr, Kaleigh

    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 summarize that body of research, discuss its strengths and limitations, and identify areas for future research.

  16. Validation of a high-resolution precipitation database (CHIRPS) over Cyprus for a 30-year period

    Science.gov (United States)

    Katsanos, Dimitrios; Retalis, Adrianos; Michaelides, Silas

    2016-03-01

    A study for a 30-year period (1981-2010) for a new precipitation database is performed over the island of Cyprus. Climate Hazards Group Infrared Precipitation with Station data (CHIRPS) is a more than 30-year quasi-global rainfall dataset, spanning 50°S-50°N (and all longitudes). Starting in 1981 to near-present, CHIRPS incorporates 0.05° resolution satellite imagery with in situ station data to create gridded rainfall time series. In this study, CHIRPS database is firstly compared to other precipitation databases over the Mediterranean basin. In the following, this study focuses over Cyprus, where a dense and reliable network of rain gauges is available. CHIRPS data are compared for the first time with in situ measurements in this area, for the aforementioned 30-year period. Monthly and annual comparisons are presented for each of the 0.05 × 0.05 degree cells overlaying the island of Cyprus. Results showed good correlation between CHIRPS values and recorded precipitation, although an overestimation of the in situ rainfall data has been noted during the last decade.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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...

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

    Institute of Scientific and Technical Information of China (English)

    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 clinicopathological features of solid pseudopapillary neoplasm of the pancreas.

    Science.gov (United States)

    Ugras, Nesrin; Yerci, Ömer; Coşkun, Sinem Kantarcıoğlu; Ocakoğlu, Gökhan; Sarkut, Pınar; Dündar, Halit Ziya

    2016-07-01

    Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm that accounts for 2-3% of all primary pancreatic neoplasms. This study aimed to characterize clinicopathological features associated with SPNs and to retrospectively evaluate the relationship of these features with predictive parameters associated with aggressive behavior. We reviewed 16 cases of SPN of the pancreas that had been diagnosed between 2005 and 2014 at our pathology department. A total of 16 cases, 15 female and one male, were evaluated in this study. The patient age ranged from 13 years to 63 years with a median of 35.70 years. The mean tumor diameter ranged from 2 cm to 18 cm with a mean diameter of 5.90 cm. We identified a significant association between the presence of clear cells and perineural invasion (p=0.019), which was considered to be a predictive factor for aggressive behavior. Other features (i.e., localization, nuclear grooves, central hyalinization, myxoid stroma, eosinophilic bodies, foamy histiocyte aggregates, multinucleated cells, and calcification) were not significantly associated with predictive factors for aggressive behavior. One patient died as a result of a pancreatic fistula that developed as a postoperative complication. The remaining 15 patients are alive and have not demonstrated any signs of recurrence or metastasis. The current study suggested that the presence of clear cells might serve as a possible prognostic indicator of perineural invasion, which is a predictive parameter associated with aggressive behavior in SPN. PMID:27450024

  1. [Retrospective analysis of consecutively treated distal radius fractures with the external fixator].

    Science.gov (United States)

    Melik, N; Togninalli, D; Biegger, P

    1994-12-01

    The purpose of this study was to determine retrospectively some subjective and objective parameters following the operative treatment of 32 patients with "complex" (intraarticular and/or comminuted) fractures of the distal radius using the small AO external fixation device. The mean follow-up period was 20 months (minimum 4, maximum 48) and the mean age of the subjects was 62 years (minimum 27, maximum 91). Subjective results such as "general feeling", mobility, strength and pain, expressed with a scoring system (% of maximum obtainable points), showed an overall good result and ranged between 71% (pain), 81% (strength) and 91% (mobility and "general feeling"). Regarding the objective results, no major skin or soft tissue distress (Sudeck dystrophy) was noted. However, there was a general tendency towards a mobility deficit of the wrist operated on, which was statistically significant (P than 10 months), showed no relevant difference between the two groups (age of both similar), as expressed by age ( than 60 years); the data only showed differences in strength and pain (scores by 92% vs 82% for force and 92% vs 76% for pain) and in flexion and extension (-22.8% and -14%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7855610

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

    Science.gov (United States)

    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.

  3. Surgical Treatment of Aortic Aneurysm and Aortic Dissection:A Retrospective Analysis of 122 Cases

    Institute of Scientific and Technical Information of China (English)

    Tucheng SUN; Xionggang JIANG; Kailun ZHANG; Jie CAI; Shu CHEN; NYANGASSA B J; Zongquan SUN

    2009-01-01

    The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection.Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed.The elective operations were performed in 107 patients while emergency surgery was done in 15 cases.Different surgical strategies were employed on the basis of diseased region,including simple ascending aortic replacement (n=3),aortic root replacement (n=43),hemi-arch replacement/total arch replacement + elephant trunk technique (n=32),thoracic/thoracoabdominal aortic replacement (n=8) and endovascular repair (n=36).In this series,there is 4 cases of perioperative death due to massive cerebral hemorrhage (n=1),respiratory failure (n=1) and multiple organ dysfunction syndrome (MODS) (n=2).Three cases developed post-operative massive cerebral infarction and the relatives of the patients abandoned treatment.Instant success rate of endovascular repair was 100%.The intimal rupture was sealed.Blood flow was unobstructed in true lumen and no false lumen was visualized.It was concluded that aggressive surgery should be considered in the patients with thoracic aneurysm and aortic dissection.Surgical procedures should vary with the location and the nature of the lesions.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Retrospective Analysis of Locally Advanced Noninflammatory Breast Cancer From Chennai, South India, 1990-1999

    International Nuclear Information System (INIS)

    Purpose: This was a retrospective observational study to elicit the outcome of the therapeutic strategy of concurrent neoadjuvant chemoradiotherapy protocol for locally advanced breast cancer. Methods and Materials: A large series of 1,117 consecutive cases of locally advanced breast cancer treated at the Cancer Institute (WIA), in Chennai, South India, between 1990 and 1999 and followed through 2004 formed the basis for this study. Disease-free survival was the main outcome, and nodal and tumor downstaging were the intermediate outcome measures studied. Results: Primary tumor downstaging was observed in 45% and nodal downstaging in 57.5%. The disease-free survival rate of nodal downstaged patients at 5, 10, and 15 years was 75%, 65%, and 58%, respectively. The corresponding rates for pre- and postoperative node-negative patients were 70%, 60%, and 59%. The best survival was seen among those who were tumor and node negative postoperatively. Nodal downstaging halved the risk of disease recurrence and death compared with node positivity, irrespective of tumor sterility. Conclusions: A randomized trial using cyclophosphamide, methotrexate, and 5-fluorouracil vs. an anthracycline-based regimen in the setting of concurrent chemoradiotherapy appears indicated. Additional preoperative chemotherapy to maximize nodal and tumor downstaging should be investigated. A change in postoperative chemotherapy according to nodal status could also be explored

  6. Postoperative nausea and vomiting. A retrospective analysis in patients undergoing elective craniotomy.

    Science.gov (United States)

    Fabling, J M; Gan, T J; Guy, J; Borel, C O; el-Moalem, H E; Warner, D S

    1997-10-01

    Nausea and vomiting are important complications after craniotomy, for which there are little published epidemiologic data. We retrospectively examined the incidence of postcraniotomy nausea and vomiting to define risk factors. Medical records from 199 adults undergoing elective craniotomy were identified. Data extracted from surgery and the initial 48 hours postoperatively included gender, age, supratentorial versus infratentorial craniotomy, type of anesthesia (general versus monitored anesthesia care), intraoperative fentanyl dose, duration of anesthesia, antiemetic administration intraoperatively and postoperatively, and incidence of postoperative nausea, emesis, and opioid use. Postoperative nausea was recorded in 99 patients (50%) and emesis in 78 patients (39%). Postoperative opioids were administered to 170 patients (85%). Antiemetics were given intraoperatively to 13 patients (7%) and postoperatively to 121 patients (61%). More women (61%) than men (37%) had nausea (P = 0.001); emesis (women = 46%; men = 31%, P = 0.03); and postoperative antiemetic use (women = 69%; men = 51%, P = 0.013). The incidence of postoperative nausea (P = 0.04) and vomiting (P = 0.06) was greater in patients having infratentorial surgery. Emesis was more frequent in younger patients (P = 0.03). Postoperative nausea and vomiting were independent of anesthetic duration, fentanyl dose, or postoperative opioid use and occurred with similar frequency after general anesthesia or monitored anesthesia care. We conclude that postoperative nausea and vomiting occur frequently after craniotomy. Infratentorial surgery, female gender, and younger age are significant risk factors for this complication. PMID:9339401

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Serum hepatic enzyme manifestations in patients with severe acute respiratory syndrome:Retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Hui-Juan Cui; Bin Zhang; Chuan-Jin Hua; Yue-Wen Gong; Xiao-Lin Tong; Ping Li; Ying-Xu Hao; Xiao-Guang Chen; Ai-Guo Li; Zhi-Yuan Zhang; Jun Duan; Min Zhen

    2004-01-01

    AIM: To evaluate the hepatic function in patients with severe acute respiratory syndrome (SARS) and possible causes of hepatic disorder in these patients.METHODS: One hundred and eighty-two patients with SARS were employed in a retrospective study that investigated hepatic dysfunction. Liver alanine aminotransferase (ALT),aspartate aminotransferase (AST) and lactic dehydrogenase (LDH) were analyzed in these patients. Patients with different hospital treatments were further investigated.RESULTS: Of the 182 patients, 128(70.3%) had abnormal ALT activity, 57(31.3%) had abnormal AST activity and 87(47.8%) had abnormal LDH activity. The peak of elevated hepatic enzyme activities occurred between the sixth day and the tenth day after the first day of reported fever. Of the 182 patients, 160(87.9%) had been treated with antibiotics, 137(75.2%) with Ribavirin, and 115(63.2%) with methylpredisolone. There was no statistically significant correlation between the duration of Ribavirin treatement and hepatic dysfunction.CONCLUSION: Abnormal liver functions were common in patients with SARS and could be associated with virus replication in the liver.

  10. 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.

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  13. Bowenoid transformation in seborrheic keratosis: A retrospective analysis of 429 patients

    Directory of Open Access Journals (Sweden)

    Parvin Rajabi

    2012-01-01

    Full Text Available Background: Seborrheic keratosis is a common, benign skin tumor. Numerous reports have shown its possibility of malignant transformation. This study was designed to demonstrate the occurrence of concomitant seborrheic keratosis and skin cancers. Materials and Methods : Data was retrospectively reviewed from all patients with a diagnosis of seborrheic keratosis in pathology department of Alzahra Hospital and a private pathology laboratory in Isfahan, Iran over a 4-year period. We classified all demographic data and associated dysplasia or Bowen′s disease and analyzed them by student-t or chi-square tests. Results : From all 429 specimens, 5 (1.2% were found to be associated with Bowen′s disease and one (0.2% with mild dysplasia in squamous epithelium. All cases arose within the clinically, atypical seborrheic keratosis. More men were affected with lesions alone and with malignancy (230/423 (54.4% and 5/6 (83.3%, respectively compared to women. The average age of patients suffering from lesions with and without associated malignancy was 57 and 54 years, respectively. The common site of lesion alone was head and neck but lesions with malignancy involved lower extremities. The two lesions were significantly different in site of occurrence (p < 0.001. Conclusion : Generally, although the association between seborrheic keratosis and skin malignancy appears to be accidental, it must always be in mind. Therefore, histopathologic examination of all seborrheic keratosis should be considered, especially when seborrheic keratosis has atypical clinical manifestations.

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

    Directory of Open Access Journals (Sweden)

    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:

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

    Institute of Scientific and Technical Information of China (English)

    ZHENG Jian-ming; SONG Wen-li; TU Jin-peng; FENG Gang; MO Chun-bai; SHEN Zhong-yang

    2011-01-01

    Background Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.Methods We retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.Results Of all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively.After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations)with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.Conclusion Although SPKT provides a successful and effective treatment for diabetics with end-stage renal disease,how to reduce the complications of this treatment still need further effort.

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

    International Nuclear Information System (INIS)

    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

  17. 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.

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

    Science.gov (United States)

    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. PMID:25521216

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

    Science.gov (United States)

    Yang, Yanhui; Xue, Feng; Shi, Hao; Wang, Hongmei; Zhang, Lei; Ji, Linxiang; Yang, Renchi

    2015-01-01

    Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the autoantibody directed against factor VIII in patients without previous history of a bleeding disorder. We retrospectively analyzed the characteristics and outcomes of 49 patients with AHA diagnosed in our center from February 1994 to October 2012. Twenty-four patients with acute bleeding episodes were treated with prothrombin complex concentrate (PCC) at a relative low dose of 30 to -50 U/kg/d and achieved good outcomes without any adverse reaction. Corticosteroids alone or in combination with cyclophosphamide were used as the first-line therapy to eradicate the inhibitors. In 39 evaluable patients, 35 (89.7%) achieved complete remission (CR). This study demonstrates that when bypassing agents such as recombinant activated factor VII and activated PCCs are not affordable or available, low dose PCC is effective and safe to control acute bleeding in patients with AHA. First-line therapy achieved good outcomes with a CR rate of 89.7%.

  20. Spinal bone metastases in gynecologic malignancies: a retrospective analysis of stability, prognostic factors and survival

    International Nuclear Information System (INIS)

    The aim of this retrospective study was to evaluate the stability of spinal metastases in gynecologic cancer patients (pts) on the basis of a validated scoring system after radiotherapy (RT), to define prognostic factors for stability and to calculate survival. Fourty-four women with gynecologic malignancies and spinal bone metastases were treated at our department between January 2000 and January 2012. Out of those 34 were assessed regarding stability using the Taneichi score before, 3 and 6 months after RT. Additionally prognostic factors for stability, overall survival, and bone survival (time between first day of RT of bone metastases and death from any cause) were calculated. Before RT 47% of pts were unstable and 6 months after RT 85% of pts were stable. Karnofsky performance status (KPS) >70% (p = 0.037) and no chemotherapy (ChT) (p = 0.046) prior to RT were significantly predictive for response. 5-year overall survival was 69% and 1-year bone survival was 73%. RT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors. KPS may be a predictor for response. Pts who received ChT prior to RT may require additional bone supportive treatment to overcome bone remodeling imbalance. Survival in women with bone metastases from gynecologic cancer remains poor

  1. Retrospective analysis of never events in panniculectomy and abdominoplasty patients and their financial implications.

    Science.gov (United States)

    Champaneria, Manish C; Workman, Adrienne D; Pham, Anh Tuan; Adetayo, Oluwaseun A; Gupta, Subhas C

    2014-10-01

    In 2008, the Centers for Medicare and Medicaid Service adapted a list from the National Quality Forum consisting of 10 hospital-acquired conditions, also known as never events. Deeming such events as preventable in a safe-hospital setting, reimbursement is no longer provided for treatments arising secondary to these events. A retrospective chart review identified 90 panniculectomy and abdominoplasty patients. The hospital-acquired conditions examined include surgical-site infections (SSI), vascular-catheter associated infections, deep venous thrombosis/pulmonary embolism, retained foreign body, catheter-related urinary tract infection, manifestations of poor glycemic control, falls and trauma, air embolism, pressure ulcers (stages III and IV), and blood incompatibility. Information regarding age, American Society of Anesthesiologists (ASA) classification, body mass index, smoking, and chemotherapy were collected. Patients were divided into 2 groups, namely, those who developed never events and those with no events. Of the 90 patients, 14 (15.5%) developed never events because of SSI. No events occurred in the remaining 9 categories. Statistically significant risk factors included American Society of Anesthesiologists classification, age, and diabetes mellitus. The most common never event was SSI. In light of the obvious prevalence of the risk factors in patients who develop these events, the question of whether never events are truly unavoidable arises. Despite this, awareness of the impact on patient care, health care and hospital reimbursement is vital to understanding the new paradigm of the "one size fits all." PMID:23722579

  2. Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients.

    Science.gov (United States)

    Chiang, Katherine S; Mesinkovska, Natasha A; Piliang, Melissa P; Bergfeld, Wilma F

    2015-11-01

    Diphenylcyclopropenone (DPCP) is widely considered the most effective topical immunotherapy for refractory or extensive alopecia areata (AA), but questions regarding how long to try DPCP therapy before terminating and what factors are prognostic of therapeutic success still remain unanswered. In this retrospective study of 50 AA patients, we evaluated DPCP efficacy and identified patient factors predictive of therapeutic success/failure. The median duration of DPCP treatment was 3 years, with 47% patients experiencing their first regrowth in the first 6 months of DPCP therapy, 20% between 6 months-1 year, and 8% between 1-2 years. In our study, treatment success, defined as ⩾50% terminal hair regrowth, was reached in 71% of alopecia totalis patients and in 56% of alopecia universalis patients. Three factors were statistically significant predictors of poor treatment outcome-extent of hair loss before DPCP treatment, history of thyroid disease, and extent of body hair involvement. Relapse was observed in 44% of patients and significantly associated with history of thyroid disease. Common side effects were itching, rash, and local lymphadenopathy. The results of this study support our belief that DPCP therapy is a viable treatment option, can be successfully accomplished at home, and should not be terminated before 2 years. PMID:26551948

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  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. Rehospitalization following percutaneous coronary intervention for commercially insured patients with acute coronary syndrome: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Meadows Eric S

    2012-07-01

    Full Text Available Abstract Background While prior research has provided important information about readmission rates following percutaneous coronary intervention, reports regarding charges and length of stay for readmission beyond 30 days post-discharge for patients in a large cohort are limited. The objective of this study was to characterize the rehospitalization of patients with acute coronary syndrome receiving percutaneous coronary intervention in a U.S. health benefit plan. Methods This study retrospectively analyzed administrative claims data from a large US managed care plan at index hospitalization, 30-days, and 31-days to 15-months rehospitalization. A valid Diagnosis Related Group code (version 24 associated with a PCI claim (codes 00.66, 36.0X, 929.73, 929.75, 929.78–929.82, 929.84, 929.95/6, and G0290/1 was required to be included in the study. Patients were also required to have an ACS diagnosis on the day of admission or within 30 days prior to the index PCI. ACS diagnoses were classified by the International Statistical Classification of Disease 9 (ICD-9-CM codes 410.xx or 411.11. Patients with a history of transient ischemic attack or stroke were excluded from the study because of the focus only on ACS-PCI patients. A clopidogrel prescription claim was required within 60 days after hospitalization. Results Of the 6,687 ACS-PCI patients included in the study, 5,174 (77.4% were male, 5,587 (83.6% were Conclusions For ACS patients who underwent PCI, revascularization procedures represented a large portion of rehospitalizations. Revascularization procedures appear to be the most frequent, most costly, and earliest cause for rehospitalization after ACS-PCI.

  6. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Retrospective analysis of rituximab therapy and splenectomy in childhood chronic and refractory immune thrombocytopenic purpura.

    Science.gov (United States)

    Ay, Yilmaz; Karapinar, Tuba H; Oymak, Yesim; Toret, Ersin; Demirag, Bengu; Ince, Dilek; Ozcan, Esin; Moueminoglou, Nergial; Koker, Sultan A; Vergin, Canan

    2016-06-01

    Immune thrombocytopenic purpura (ITP) results from accelerated platelet destruction mediated by autoantibodies to platelet glycoproteins. Some patients with chronic ITP are refractory to all therapies [steroids, intravenous immunoglobulin (IVIG), anti-D and immunosuppresive drugs] and have chronic low platelet counts and episodic bleeding. We retrospectively evaluated the efficacy and safety of rituximab treatment and splenectomy in paediatric patients diagnosed with chronic and refractory ITP who were unresponsive to steroids, IVIG, cyclosporine and mycophenolate mofetil. Records of patients with chronic and refractory ITP in 459 patients with primary ITP who were followed up in our hospital from January 2005 to December 2014 were reviewed. Fifteen of patients received rituximab and/or applied splenectomy. Fifteen chronic ITP patients (10 boys, five girls) with a mean age of 10 years were enrolled in the study. Two of these patients were suffering from Evans syndrome. The median time since diagnosis of ITP was 10 years. The median follow-up duration after starting Rituximab and splenectomy were 13 and 9.5 months, respectively.None of the seven patients who were treated with rituximab achieved a response. A splenectomy was performed in six of the seven patients who had been treated with rituximab. Complete and partial responses were achieved in 67 and 33% of the patients, respectively. We evaluated the clinical characteristics and responses of chronic ITP patients who did not receive rituximab therapy and underwent a splenectomy. The success rate was 100% in the eight patients with chronic and refractory ITP. Rituximab therapy might not be beneficial for some children with severe chronic ITP who are refractory to standard agents. A splenectomy might be useful and preferable to rituximab. PMID:26656905

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

    Science.gov (United States)

    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.

  13. A retrospective analysis of survival and prognostic factors of male breast cancer from a single center

    International Nuclear Information System (INIS)

    Less than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients. We retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients’ OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis. In the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS. Lymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease

  14. Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

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    Yates Robert

    2006-05-01

    Full Text Available Abstract Background The patent ductus arteriosus (PDA is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor (PSI use prior to ligation affects outcome. Methods A retrospective case note review study to determine the outcome of premature infants undergoing patent ductus arteriosus ligation in one tertiary neonatal intensive care unit and two paediatric cardiothoracic centres. Results We had follow-up data on 87 infants. Cumulative mortality rates at 7 days, 30 days and at hospital discharge were 2%, 8% and 20% respectively. The incidence of chronic lung disease, intraventricular haemorrhage, necrotising enterocolitis and retinopathy of prematurity were 77%, 39%, 26% and 28% respectively. There was no difference in mortality, incidence of chronic lung disease or duration of oxygen dependence between those who had and those who had not received a PSI prior to surgical ligation. In those who had received 2 or more courses of PSI prior to surgical ligation, there was a trend to increase in the duration of oxygen therapy and chronic lung disease, but no difference in mortality. Conclusion This study shows that patent ductus arteriosus ligation is a relatively safe procedure (30 day survival 92% but there is substantial late mortality and a high incidence of morbidity in the survivors. 2 or more courses of PSI prior to surgical ligation trends to increased oxygen dependence and chronic lung disease. This high risk population requires careful follow-up. A definitive prospective cohort study is lacking.

  15. 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.

  16. 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.

  17. 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

  18. Retroperitoneal Fibrosis: A Retrospective Clinical Data Analysis of 30 Patients in a 10-year Period

    Institute of Scientific and Technical Information of China (English)

    Hai-Jiang Zhou; Yong Yan; Biao Zhou; Tian-Fei Lan; Xue-Yan Wang; Chun-Sheng Li

    2015-01-01

    Background:Retroperitoneal fibrosis (RPF) is an uncommon disease that is characterized by development of fibrosclerotic tissues involving retroperitoneal structures.This study aimed to investigate the clinical features of 30 patients with RPF in a single center in Beijing in a 10-year period.Methods:We retrospectively analyzed clinical data on demographic characteristics,clinical manifestations,laboratory findings,radiological findings,modalities of treatments,outcomes and prognosis of 30 patients with RPF.Patients were treated in Beijing Chao-Yang Hospital between January 2003 and December 2013.Results:The mean age of patients with RPF was 56.7 ± 14.4 years.Twenty-three patients were men and seven patients were women.Acute phase reactants were elevated in most patients.Rheumatic factor was positive in 4/25 (16.0%) patients,and antinuclear antibody was positive in 6/22 (27.3%) patients.Elevation of IgG4 was observed in 9/22 (40.9%) patients.The most common type was I + Ⅲ (n =13),followed by Ⅰ + Ⅱ +Ⅲ (n =12).Five patients undertook an 18F-fluoro-deoxy-D-glucose positron emission tomography examination and increased uptake was detected in four patients.Eight patients received combination therapy with glucocorticoids and tamoxifen.Surgical intervention treatments included intraureteral double-J stent implantation (n =26),percutaneous nephrostomy (n =2),open ureterolysis and intraperitonealization of the ureters (n =5) and Iaparoscopic ureterolysis and intraperitonealization of the ureters (n =5).Three patients underwent hemodialysis because of renal failure.Conclusions:Clinical characteristics of RPF patients in our study are similar to those previously reported.Steroids and immunosuppressive therapy combined with ureterolysis could be a viable choice of treatment for RPF.More prospective,multi-center studies with a longer follow-up are warranted.

  19. 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.

  20. Locking plate versus retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis A retrospective analysis

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    Chi Zhang

    2015-01-01

    Full Text Available Background: Tibiotalocalcaneal arthrodesis (TTCA surgery is indicated for the end-stage disease of the tibiotalar and subtalar joints.Although different fixation technique of TTCA has been proposed to achieve high fusion rate and low complication rate, there is still no consensus upon this point. The purpose of this study is to compare the clinical efficacy of retrograde intramedullary nail fixation (RINF and locking plate fixation (LPF for TTCA. Materials and Methods: Fifty four patients who underwent TTCA through the lateral approach with lateral fibular osteotomy using RINF (32 patients, 18 male/14 female, mean age: 48 or LPF (22 patients, 12 male/10 female, mean age: 51 between January 2007 and January 2010 were retrospectively analyzed. Demographic and clinical characteristics, surgery (operation time, blood loss outcomes (postoperative fusion rates, visual analog scale and foot and ankle surgery score and complications were compared. Results: The LPF group had a shorter operation time (72.3 ± 9.2 vs. 102.8 ± 11.1 min, P < 0.001, less blood loss (75.9 ± 20.2 vs. 140.0 ± 23.8 ml, P < 0.001 and less intraoperative fluoroscopy sessions (3.6 ± 0.9 vs. 8.4 ± 1.3, P < 0.001 than the RINF group. Patients were followed up for 12-24 months (mean of 16.2 months. Both groups had similar postoperative fusion rates (90.6% and 95.4% and the LPF group showed a nonsignificant lower complication rate (18.2% vs. 28.1% respectively. Patients at higher risk on nonunion due to rheumatoid diseases may have a lower nonunion rate with LPF than RINF (one out of eight vs. three out of nine, P < 0.001. Conclusions: The LPF for TTCA was simpler to perform compared with RINF, but with similar postoperative outcomes and complication rates.

  1. 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.

  2. Impaired glucose metabolism in HIV-infected pregnant women: a retrospective analysis.

    Science.gov (United States)

    Moore, Rebecca; Adler, Hugh; Jackson, Valerie; Lawless, Mairead; Byrne, Maria; Eogan, Maeve; Lambert, John S

    2016-06-01

    Metabolic complications, including diabetes mellitus, have been increasingly recognised in HIV-infected individuals since the introduction of antiretroviral therapy, particularly protease inhibitors (PIs). Pregnancy is also a risk factor for impaired glucose metabolism, and previous studies have given conflicting results regarding the contribution of PIs to impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) in pregnant HIV-infected women. We conducted a retrospective review of all HIV-infected women attending a combined infectious disease and antenatal clinic between 2007 and 2013 who underwent a 100 g oral glucose tolerance test (OGTT) at 24-28 weeks. We grouped the patients based on whether their OGTT result was normal or abnormal, and compared the groups using standard parametric tests (t-test and Fisher's exact test). Of 263 women with HIV who attended the clinic, 142 (53.9%) attended for OGTT and were eligible for inclusion. The mean age was 31 years (SD 5.37), all women were of European or African origin and 33.7% had a body mass index ≥30 kg/m(2) About 93.7% were on PI-based regimens. At delivery, the mean CD4 count was 526 cells/µL, and 13% of patients had a detectable viraemia. The prevalence of IGT was 2.8%, while the prevalence of GDM was 2.1%. Also, 71.4% (n = 5) of women with abnormal glucose metabolism were taking PIs versus 94.8% (n = 128) of normoglycaemic women (p = 0.06). We did not confirm an increased rate of GDM in HIV-infected women in our patient population and found no association between PI use and GDM. PMID:25999164

  3. 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.

  4. Trends of Blood and Plasma Donations in Kazakhstan: 12-Years Retrospective Analysis.

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    Nurbek Igissinov

    2014-05-01

    Full Text Available Each country faces a continuing challenge to collect enough blood to meet the national needs. According to WHO, there should be at least 20 blood donations per 1,000 population for developing countries, in Kazakhstan this indicator was only 16.8 in 2011. Thus, we conducted an epidemiological assessment and drew a map of the regional distribution of blood and plasma donations in Kazakhstan during the years 2000-2011.The retrospective study was conducted from 2000 to 2011. Data on blood and its components donations were acquired from the Ministry of Health (annual statistical reporting form N° 39.During 2000-2011, number of blood donors decreased to 17.4% and blood donations to 6.3%. The proportion of non-remunerated blood donations and donors decreased from 97.6% to 77.9% and 97.9% to 87.7%, respectively. The paid donations had the opposite trend. Number of plasma donors increased in 2.1 times, plasma donations in 2.4 times, nevertheless the proportion of non-remunerated plasma donations decreased from 60.1% to 29.8%. The average number of blood donations per 1,000 population decreased from 19.8 (2000 to 16.8 (2011, plasma donations increased from 1.4 to 3.1. Regionally, annual average rates of blood and plasma donations per 1,000 population over 12 years varied greatly.This is the first study conducted in Kazakhstan to provide detailed information, including the regional characteristics of blood and plasma donations over an extended period of time, which can be used in blood transfusion services work.

  5. Immune checkpoint blockade with concurrent electrochemotherapy in advanced melanoma: a retrospective multicenter analysis.

    Science.gov (United States)

    Heppt, Markus V; Eigentler, Thomas K; Kähler, Katharina C; Herbst, Rudolf A; Göppner, Daniela; Gambichler, Thilo; Ulrich, Jens; Dippel, Edgar; Loquai, Carmen; Schell, Beatrice; Schilling, Bastian; Schäd, Susanne G; Schultz, Erwin S; Matheis, Fanny; Tietze, Julia K; Berking, Carola

    2016-08-01

    Growing evidence suggests that concurrent loco-regional and systemic treatment modalities may lead to synergistic anti-tumor effects in advanced melanoma. In this retrospective multicenter study, we evaluate the use of electrochemotherapy (ECT) combined with ipilimumab or PD-1 inhibition. We investigated patients with unresectable or metastatic melanoma who received the combination of ECT and immune checkpoint blockade for distant or cutaneous metastases within 4 weeks. Clinical and laboratory data were collected and analyzed with respect to safety and efficacy. A total of 33 patients from 13 centers were identified with a median follow-up time of 9 months. Twenty-eight patients received ipilimumab, while five patients were treated with a PD-1 inhibitor (pembrolizumab n = 3, nivolumab n = 2). The local overall response rate (ORR) was 66.7 %. The systemic ORR was 19.2 and 40.0 % in the ipilimumab and PD-1 cohort, respectively. The median duration of response was not reached in either group. The median time to disease progression was 2.5 months for the entire population with 2 months for ipilimumab and 5 months for PD-1 blockade. The median overall survival was not reached in patients with ipilimumab and 15 months in the PD-1 group. Severe systemic adverse events were detected in 25.0 % in the ipilimumab group. No treatment-related deaths were observed. This is the first reported evaluation of ECT and simultaneous PD-1 inhibition and the largest published dataset on ECT with concurrent ipilimumab. The local response was lower than reported for ECT only. Ipilimumab combined with ECT was feasible, tolerable and showed a high systemic response rate. PMID:27294607

  6. 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.

  7. 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.

  8. The biochemistry and nutrition group: 30 years of research in a developing country.

    Science.gov (United States)

    Levy Benshimol, A

    1996-12-01

    The most relevant results of 30 years of research from the Group of Biochemistry and Nutrition are presented. Research was focused mainly around the identification and detection of the heatlabile toxic factors present in legume seeds of human consumption, namely protease inhibitors and lectins with special emphasis on their isolation, molecular characterization, mechanistic and nutritional relevance of both protein groups. The antinutritional effect of the polyphenols, thermolabile compounds present in colored seeds, has also been studied as well as the impact of seed complex carbohydrates on the digestive process. PMID:9137631

  9. 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

  10. Natural Products as Sources of New Drugs over the 30 Years from 1981 to 2010†

    OpenAIRE

    Newman, David J.; Cragg, Gordon M.

    2012-01-01

    This review is an updated and expanded version of the three prior reviews that were published in this journal in 1997, 2003 and 2007. In the case of all approved therapeutic agents, the time frame has been extended to cover the 30 years from January 1st 1981 to December 31st 2010 for all diseases world-wide, and from 1950 (earliest so far identified) to December 2010 for all approved antitumor drugs world-wide. We have continued to utilize our secondary subdivision of a “natural product mimic...

  11. 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.

  12. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    International Nuclear Information System (INIS)

    The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. 64% (215 patients) were classified stable prior to radiotherapy. Of the stable osseous metastases, none were rated unstable in the further course (p < 0.001, McNemar test). Of the 123 patients in whom the metastases were classified unstable prior to radiotherapy, 21 patients (17%) were classified stable after three months, and 30 patients (24%) stable after six months. A pathological fracture was diagnosed in 62 patients (18%) prior to radiotherapy. Regarding cases of osteolytic metastases of the vertebral bodies in which no fractures could be detected prior to the start of therapy, fractures occurred in 2% of all patients (n = 7) within six months following radiotherapy. Our analysis demonstrated that pathological fractures following radiotherapy occur in the very minority of vertebral lesions for patients with a favorable outcome. The use of a systematic radiological scoring system to classify osteolytic metastases of the vertebral column has shown to be feasible in daily routine. Prospective clinical trials are warranted in order to analyse, to what extent patients with osseous metastases can be mobilized by physiotherapy for strengthening the paravertebral muscles before radiotherapy effects can be measured by means of radiological recalcification

  13. 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

  14. 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

  15. Retrospective analysis of the clinical course of patients treated for polymyalgia

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    Do-Nguyen D

    2013-04-01

    Full Text Available Dung Do-Nguyen,1 Charles A Inderjeeth,1–3 Jack Edelman,2 Patrick Cheah2 1Rehabilitation and Aged Care, North Metropolitan Health Service, 2Department of Rheumatology, Sir Charles Gairdner Hospital, 3Faculty of Medicine and Pharmacology, The University of Western Australia, Perth, WA, Australia Background: Polymyalgia rheumatica is a chronic inflammatory rheumatic condition, for which the mainstay of treatment is corticosteroids. Here, we review the clinical course of treated patients initially presenting with polymyalgic symptoms. Methods: A retrospective audit was performed of patients who presented with a possible diagnosis of polymyalgia rheumatica. Biochemical markers and prednisone doses were assessed at the initial review, at one month, and 3, 6, and 12 months later. Results: A cohort of 135 patients was identified, comprising 91 females and 44 males of mean age 70.7 years. All patients were treated with oral prednisone at an initial mean dose of 21.3 mg. Mean baseline C-reactive protein level and erythrocyte sedimentation rate were 41.6 mg/L and 48.6 mm/hour, respectively. Following initiation of therapy, there was a dramatic and sustained decrease in both inflammatory markers. A clinical response was observed in 96.2% of patients, but remission was achieved in only 18.2%. Of those initially diagnosed with polymyalgia rheumatica, 24.8% were subsequently diagnosed with a different rheumatic condition. Conclusion: The excellent response rate to corticosteroid therapy is well established in the literature, but in this research, remission rates were comparatively low during the 12-month study period. The current value of disease-modifying antirheumatic drugs and biologic therapy appears uncertain, and further trials to establish their precise role would be beneficial. A large portion of patients presenting with polymyalgia were eventually diagnosed to have another rheumatic disease, thus reflecting the broad differential diagnosis of

  16. 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

  17. 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

  18. 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.

  19. Urinary Strong Ion Difference as a Marker of Renal Dysfunction. A Retrospective Analysis

    Science.gov (United States)

    2016-01-01

    Introduction The kidneys play a crucial role in the regulation of electrolytes and acid-base homeostasis. Urinary Strong Ion Difference (SIDu = NaU + KU—ClU) represents an important aspect of renal acid-base regulation. We evaluated the role of SIDu as a marker of renal dysfunction in critically ill patients. Materials and Methods Patients admitted to the Medical Intensive Care Unit with a diagnosis of AKI for whom concomitant urinary samples available for SIDu calculation were retrospectively reviewed and staged according to KDIGO criteria for 3 days from inclusion. Patients were classified as Recovered (R-AKI) or Persistent-AKI (P-AKI) whether they exited KDIGO criteria within the 3-day observation period or not. A control group with normal renal function and normal serum acid-base and electrolytes was prospectively recruited in order to identify reference SIDu values. Results One-hundred-and-forty-three patients with a diagnosis of AKI were included: 77 with R-AKI, and 66 with P-AKI. Thirty-six controls were recruited. Patients with P-AKI had more severe renal dysfunction and higher mortality than patients with R-AKI (SCr 2.23(IQR:1.68–3.45) and 1.81(IQR1.5–2.5) mg/dl respectively, p<0.001; 24-h UO 1297(950) and 2100(1094) ml respectively, p = 0.003); 30-d mortality, 39% and 13% respectively; p<0.001). SIDu significantly differed between groups, with rising values from controls to P-AKI groups (16.4(12), 30(24) and 47.3(21.5) mEq/l respectively, p<0.001). Discussion SIDu may be a simple and inexpensive tool in AKI patients’ evaluation. Further research is needed to evaluate the ability of SIDu to identify patients with renal dysfunction before derangements in serum creatinine or urine output are observed. PMID:27258049

  20. 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. PMID:27591649

  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. What Can We Learn About Glaciers and Ice Sheets From 30 Years of Landsat Imagery?

    Science.gov (United States)

    Gardner, A. S.; Scambos, T.; Fahnestock, M. A.; Moholdt, G.; Nilsson, J.

    2015-12-01

    Glacier and ice sheets are known to be rapidly changing and currently account for two thirds of observed sea level rise. Attributing the causes of the rapid decline in land ice requires separation of mass change processes, i.e. accumulation of precipitation, meltwater runoff, and solid ice discharge. Here we examine a 30 year record of Landsat imagery to determine trends in glacier velocity at a global scale in an attempt to identify anomalies in glacier flow that are contributing to changes in land ice mass. The Landsat archive represents a treasure trove of information with hundreds of thousands of images acquired over glaciers and ice sheets during the past 30 years. Gleaning useful and consistent surface displacement information from a multiple sensor archive that is heavily contaminated by cloud, saturated images, poorly resolved sensor geometry, and data gaps has proved challenging. Temporal stacking of displacement fields (Dehecq et al., 2015) and correcting for unresolved topography (Roseanau et al., 2012) have been shown to greatly improve derived velocities. Here we present results from a global processing of the complete Landsat archive for information on glacier surface displacements. We highlight patterns of coherent regional change as well as well as rapid basin-scale changes in glacier flow.

  3. Chernobyl: 30 years after - Proceedings of the technical meeting of the French Society of Radiation Protection

    International Nuclear Information System (INIS)

    The French Society of Radiation Protection (SFRP) organized a technical meeting on the present day situation of the Chernobyl site, 30 years after the accident of the nuclear power plant. The review deals with the situation of the facility and of its safety works, the environment, the management of wastes, the workers and populations exposure, and the health monitoring of the exposed populations. This document brings together the abstracts and the presentations (slides) of the different talks given at the meeting: 1 - The main highlights 30 years after the Chernobyl accident (Didier CHAMPION, SFRP); 2 - Circumstances, progress and consequences of the Chernobyl accident - Lessons and experience feedback for the other RBMK reactors (Michel CHOUHA, IRSN); 3 - Chernobyl, a confinement arch for 100 years (Patrick CHABRIER, Thomas CHAUVEAU - BOUYGUES); 4 - The reactor wastes management and the dismantling operations (Guy DAMETTE - IRSN); 5 - Environment contamination in the vicinity of the site (Yves THIRY - ANDRA); 6 - Impact of the accident on agriculture (Vanessa DURAND - IRSN); 7 - The fate of remediation wastes (Francois BESNUS - IRSN); 8 - Chernobyl fallouts in France (Philippe RENAUD - IRSN); 9 - The ecological consequences of the Chernobyl accident (Christelle ADAM-GUILLERMIN - IRSN); 10 - Results of liquidators and populations exposure (Florence MENETRIER - CEA); 11 - Thyroid cancers monitoring in the Chernobyl area and the role of modifying genetic factors (Fabienne LESUEUR - Institut Curie); 12 - Results of the Chernobyl accident health impact studies (Dominique LAURIER - IRSN); 13 - Impact on populations living condition (Thierry SCHNEIDER - CEPN); 14 - Molecular signature of radiation induced thyroid tumors (Sylvie CHEVILLARD - CEA)

  4. Gender Trends in Radiation Oncology in the United States: A 30-Year Analysis

    International Nuclear Information System (INIS)

    Purpose: Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women's participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention. Methods and Materials: We examined the gender of first and senior US physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010, and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared with female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the past 3 decades, using Association of American Medical Colleges data. Results: The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010. Conclusions: Female first and senior authorship in the Red Journal has increased significantly, as has women's participation among full-time faculty, but women remain underrepresented among radiation oncology residents compared with their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology

  5. The multifaceted world of sustainability. An analysis of about 30 years of studies

    OpenAIRE

    Dettori, Angela

    2015-01-01

    The concept of sustainability has emerged as a response to the most stringent problems of humanity. Initially defined in the Brundtland report published by the World Commission on Environment and Development in 1987 as the “development that meets the needs of the present without compromising the ability of future generations to meet their own needs” (United Nations, 1987:43), sustainable development constituted the main topic of the Conference on Environment and Development ...

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Gender Trends in Radiation Oncology in the United States: A 30-Year Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Awad A. [Temple University School of Medicine, Philadelphia, Pennsylvania (United States); Egleston, Brian [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Holliday, Emma [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eastwick, Gary [Temple University School of Medicine, Philadelphia, Pennsylvania (United States); Takita, Cristiane [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-01-01

    Purpose: Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women's participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention. Methods and Materials: We examined the gender of first and senior US physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010, and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared with female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the past 3 decades, using Association of American Medical Colleges data. Results: The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010. Conclusions: Female first and senior authorship in the Red Journal has increased significantly, as has women's participation among full-time faculty, but women remain underrepresented among radiation oncology residents compared with their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology.

  8. 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

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

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    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

  10. Toxicity of upfront 131I-metaiodobenzylguanidine (131I-MIBG) therapy in newly diagnosed neuroblastoma patients: a retrospective analysis

    International Nuclear Information System (INIS)

    In the treatment of patients with high-risk neuroblastoma, different doses of 131I-metaiodobenzylguanidine (131I-MIBG) are administered at different time points during treatment. Toxicity, mainly haematological (thrombocytopenia), from 131I-MIBG therapy is known to occur in extensively chemotherapy pretreated neuroblastoma patients. Up to now, acute toxicity from 131I-MIBG as initial treatment has never been studied in a large cohort. The aim of this retrospective study was to document acute toxicity related to upfront 131I-MIBG. All neuroblastoma patients (stages 1-4 and 4S) treated upfront with 131I-MIBG at the Emma Children's Hospital, Academic Medical Centre (1992 - 2008) were included in this retrospective analysis. The acute toxicity (during therapy) and short-term toxicity (1st month following therapy) of the first two 131I-MIBG therapies were studied. Of 66 patients (34 boys, 32 girls; median age 2.2 years, range 0.1 - 9.4 years), 49 had stage 4 disease, 5 stage 4S, 6 stage 3, 1 stage 2 and 5 stage 1. The median first dose was 441 MBq/kg (range 157 - 804 MBq/kg). The median second dose was 328 MBq/kg (range 113 - 727 MBq/kg). The most frequently observed symptoms were nausea and vomiting (21 %, maximum grade II). The main toxicity was grade IV haematological, occurring only in stage 4 patients, after the first and second 131I-MIBG therapies: anaemia (5 % and 4 %, respectively), leucocytopenia (3 % and 4 %) and thrombocytopenia (2 % and 4 %). No stem cell rescue was needed. The main acute toxicity observed was haematological followed by nausea and vomiting. One patient developed posterior reversible encephalopathy syndrome during 131I-MIBG therapy, possibly related to 131I-MIBG. We consider 131I-MIBG therapy to be a safe treatment modality. (orig.)

  11. 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.

  12. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

    International Nuclear Information System (INIS)

    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)

  13. 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)

  14. 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.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  17. 30-year changes in the nitrogen inputs to the Yangtze River Basin

    International Nuclear Information System (INIS)

    To understand both spatial and temporal changes in nitrogen inputs to the Yangtze River Basin (YRB), we collected decadal statistical data for 1980, 1990, 2000 and 2010 at the county level and the annual statistical data for the period 1980–2010 at the provincial level of China. Based on these datasets, we estimated the nitrogen inputs, including the atmospheric deposition, synthetic N fertilizer, biological N fixation and recycling reactive N inputs, such as N from human waste and animal excrement, crop residue recycled as manure, and N emission from burning crop residue. The results showed that, geographically, the variation of the total amount of N input during the last 30 years (δN = N2010 – N1980) has increased about 0–50 kg ha−1 over most of the area of the YRB. Moreover, it has increased dramatically by about 50–300 kg ha−1 in the Sichuan Basin, the Han River Basin, the Poyang and Dongting lake basins, and the Yangtze Delta as well. Temporally, the total amount of N inputs to the whole YRB was approximately 16.4 Tg N in 2010, which was a 2.0-fold increase over 1980. It increased dramatically in the 1990s and then stabilized at a high level in the 2000s. The major N inputs were human and animal wastes as well as synthetic fertilizers, but they varied regionally. Animal waste was the major input to the water source regions, and its contribution percentage gradually decreased from upper to lower reaches. In contrast, the contribution of N fertilizer increased from upper to lower reaches, and became the major input to the middle and lower reaches. The total N inputs changed slightly in the upper reaches, but increased largely in the middle reaches in the last 30 years. However, in the lower reaches, it had increased remarkably before 2000, and then tended to decrease in the last decade. Finally, the atmospheric N deposition over the basin increased continuously in the last 30 years. (paper)

  18. A method for a retrospective analysis of course objectives: have pursued objectives in fact been attained?

    NARCIS (Netherlands)

    Plomp, Tjeerd; Meer, van der Adri

    1979-01-01

    A method pertaining to the identification and analysis of course objectives is discussed. A framework is developed by which post facto objectives can be determined and students' attainment of the objectives can be assessed. The method can also be used for examining the quality of instruction. Using

  19. 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.

  20. Human Papillomavirus Assays and Cytology in Primary Cervical Screening of Women Aged 30 Years and Above

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Preisler, Sarah;

    2016-01-01

    In women aged ≥30 years, Human Papillomavirus testing will replace cytology for primary cervical screening. We compared Hybrid Capture 2 (HC2), cobas, CLART, and APTIMA HPV assays with cytology on 2869 SurePath samples from women undergoing routine screening at 30-65 years in Copenhagen, Denmark...... (positive test results without ≥CIN3) varied between 3.3% with cytology and 14.9% with cobas. All HPV assays led to significantly more false-positive tests, whereas compared to HC2 cobas and CLART were associated with a significantly higher and APTIMA with a significantly lower proportion. Detection of CIN1...... was particularly increased for the three DNA assays. With APTIMA combined with cytological triage, about 20% more women were referred for colposcopy than with cytology screening. With the three DNA assays, the increase was ≥50%. The number of women with repeated testing was twice as high with APTIMA and almost...

  1. 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...

  2. 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.

  3. 30 years of "International Journal of Behavioral Development": Thematic orientation, internationality and impact of publications since its inception - A bibliometric study

    OpenAIRE

    Schui, Gabriel; Krampen, Günter

    2008-01-01

    Inspired by the 1990 analysis by Schoepflin and Müller-Brettel, the scientific Output of the International Journal of Behavioral Development is bibliometrically traced for the past 30 years. Bibliometric data was collected using the PsyclNFO and Social Science Citation Index (SSCI) databases. The fields APA-thesarus descriptors, classification code, age group (all PsyclNFO), country, and number of citations (all SSCI) were used. Information on author affiliations was obtained online from the ...

  4. Cardiac amyloidosis in a heart transplant patient - A case report and retrospective analysis of amyloidosis evolution

    OpenAIRE

    Kintsler, Svetlana; Jäkel, Jörg; Brandenburg, Vincent; Kersten, Katrin; Knuechel, Ruth; Röcken, Christoph

    2015-01-01

    Cardiac amyloidosis is a very rare cause of heart failure in heart transplant recipients but an important differential diagnosis in cases of progressive cardiac failure. We report a 72-year-old male patient with the diagnosis of senile systemic amyloidosis (SSA) in a transplanted heart 15 years after transplantation by the initial diagnosis of the dilated cardiomyopathy. Additionally performed immunohistochemical analysis with anti-transthyretin antibody of the cardiac biopsies of the last 15...

  5. Non-accidental injury: a retrospective analysis of a large cohort

    Energy Technology Data Exchange (ETDEWEB)

    Carty, Helen; Pierce, Agnes [RLC NHS Trust-Alder Hey, Liverpool L12 2 AP (United Kingdom)

    2002-12-01

    The radiology literature describing the injuries of child abuse is very extensive. Articles on the distribution of injuries and the way in which a diagnosis was reached are less frequent. This article represents the detailed analysis of a cohort of patients, suspected of being victims of abuse, referred to the authors. It necessarily reflects personal experience and is not a population study. The distribution of the injuries in a cohort of 467 patients is reviewed. (orig.)

  6. They played the merger game: A retrospective analysis in the UK videogames market

    OpenAIRE

    Aguzzoni, Luca; Argentesi, Elena; Buccirossi, Paolo; Ciari, Lorenzo; Duso, Tomaso; Tognoni, Massimo; Vitale, Cristiana

    2013-01-01

    We study the effect of a merger in a dynamic high-technology industry - the videogame market - which is characterized by frequent introduction of new products. To assess the impact of the merger between two large specialist retailers in the UK, we perform a difference-in-differences analysis comparing the price evolution of the merging parties to that of their 7 major competitors on an original sample of 196 videogames belonging to six different consoles. The results of our econometric analys...

  7. Identifying Gender-Preferred Communication Styles within Online Cancer Communities: A Retrospective, Longitudinal Analysis

    OpenAIRE

    Durant, Kathleen T.; McCray, Alexa T.; Charles Safran

    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 ...

  8. Retrospective genomic analysis of sorghum adaptation to temperate-zone grain production

    OpenAIRE

    Thurber, Carrie S.; Ma, Justin M; Higgins, Race H; Brown, Patrick J.

    2013-01-01

    Background Sorghum is a tropical C4 cereal that recently adapted to temperate latitudes and mechanized grain harvest through selection for dwarfism and photoperiod-insensitivity. Quantitative trait loci for these traits have been introgressed from a dwarf temperate donor into hundreds of diverse sorghum landraces to yield the Sorghum Conversion lines. Here, we report the first comprehensive genomic analysis of the molecular changes underlying this adaptation. Results We apply genotyping-by-se...

  9. 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.

  10. Immunity of patients surviving 20 to 30 years after allogeneic or syngeneic bone marrow transplantation.

    Science.gov (United States)

    Storek, J; Joseph, A; Espino, G; Dawson, M A; Douek, D C; Sullivan, K M; Flowers, M E; Martin, P; Mathioudakis, G; Nash, R A; Storb, R; Appelbaum, F R; Maloney, D G

    2001-12-15

    The duration of immunodeficiency following marrow transplantation is not known. Questionnaires were used to study the infection rates in 72 patients surviving 20 to 30 years after marrow grafting. Furthermore, in 33 of the 72 patients and in 16 donors (siblings who originally donated the marrow) leukocyte subsets were assessed by flow cytometry. T-cell receptor excision circles (TRECs), markers of T cells generated de novo, were quantitated by real-time polymerase chain reaction. Immunoglobulin G(2) (IgG(2)) and antigen-specific IgG levels were determined by enzyme-linked immunosorbent assay. Infections diagnosed more than [corrected] 15 years after transplantation occurred rarely. The average rate was 0.07 infections per patient-year (one infection every 14 years), excluding respiratory tract infections, gastroenteritis, lip sores, and hepatitis C. The counts of circulating monocytes, natural killer cells, B cells, CD4 T cells, and CD8 T cells in the patients were not lower than in the donors. The counts of TREC(+) CD4 T cells in transplant recipients younger than age 18 years (at the time of transplantation) were not different from the counts in their donors. In contrast, the counts of TREC(+) CD4 T cells were lower in transplant recipients age 18 years or older, even in those with no history of clinical extensive chronic graft-versus-host disease, compared with their donors. The levels of total IgG(2) and specific IgG against Haemophilus influenzae and Streptococcus pneumoniae were similar in patients and donors. Overall, the immunity of patients surviving 20 to 30 years after transplantation is normal or near normal. Patients who received transplants in adulthood have a clinically insignificant deficiency of de novo-generated CD4 T cells, suggesting that in these patients the posttransplantation thymic insufficiency may not be fully reversible. PMID:11739150

  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. PMID:23013115

  12. Variability of the Surface Meteorological Fields over Eurasia for the Recent 30 Years

    International Nuclear Information System (INIS)

    On the basis of the Japanese reanalysis (JRA25) dataset (1979-2008), linear trends, interannual to decadal variability of the sea level pressure (SLP), surface air temperature (SAT) and precipitation fields over the Eurasian region have been studied. For the recent 30 years there are only significant positive linear trends of SAT in the northwestern part of the Eurasia/eastern Asia in winter and central Europe in summer. Areas with significant negative trends of SAT are absent. For precipitation field there are no significant tendencies except for the significantly positive area over England both in winter and in summer time. In winter, there are two areas with the opposite SLP tendencies: insignificant negative (to the north of 45-50N) and significant positive (to the south of 45-50N) one. These trends could be accompanied by the corresponding tendencies bee-hive reproduction and honey production in different regions of Ukraine. Space-time patterns of the first, second and third EOF of the fields under study are mainly determined by the NAO and in the less extent by the SO (only in spring-summer). It was found that the leading modes become more contributive over the Eurasia for the last 30 years comparing with NCEP data for the previous period (1950-2001). It could imply that an internal signal of the ocean-atmosphere system, which determines space-time patterns over Eurasia, has arisen. Intercomparison of the space-time EOF patterns between JRA25 and NCEP (1950-2001) re-analyses show that in autumn, winter and spring the first 3-4 corresponding time coefficients stay at the same order (coefficient correlations between them are significant), while in summer such correspondence in order of modes is changed. (author)

  13. VIP Data Explorer: A Tool for Exploring 30 years of Vegetation Index and Phenology Observations

    Science.gov (United States)

    Barreto-munoz, A.; Didan, K.; Rivera-Camacho, J.; Yitayew, M.; Miura, T.; Tsend-Ayush, J.

    2011-12-01

    Continuous acquisition of global satellite imagery over the years has contributed to the creation of long term data records from AVHRR, MODIS, TM, SPOT-VGT and other sensors. These records account for 30+ years, as these archives grow, they become invaluable tools for environmental, resources management, and climate studies dealing with trends and changes from local, regional to global scale. In this project, the Vegetation Index and Phenology Lab (VIPLab) is processing 30 years of daily global surface reflectance data into an Earth Science Data Record of Vegetation Index and Phenology metrics. Data from AVHRR (N07,N09,N11 and N14) and MODIS (AQUA and TERRA collection 5) for the periods 1981-1999 and 2000-2010, at CMG resolution were processed into one seamless and sensor independent data record using various filtering, continuity and gap filling techniques (Tsend-Ayush et al., AGU 2011, Rivera-Camacho et al, AGU 2011). An interactive online tool (VIP Data Explorer) was developed to support the visualization, qualitative and quantitative exploration, distribution, and documentation of these records using a simple web 2.0 interface. The VIP Data explorer (http://vip.arizona.edu/viplab_data_explorer) can display any combination of multi temporal and multi source data, enable the quickly exploration and cross comparison of the various levels of processing of this data. It uses the Google Earth (GE) model and was developed using the GE API for images rendering, manipulation and geolocation. These ESDRs records can be quickly animated in this environment and explored for visual trends and anomalies detection. Additionally the tool enables extracting and visualizing any land pixel time series while showing the different levels of processing it went through. User can explore this ESDR database within this data explorer GUI environment, and any desired data can be placed into a dynamic "cart" to be ordered and downloaded later. More functionalities are planned and will be

  14. An inter-laboratory retrospective analysis of immunotoxicological endpoints in non-human primates: flow cytometry immunophenotyping.

    Science.gov (United States)

    Krejsa, Cecile M; Neradilek, Moni Blazej; Polissar, Nayak L; Cox, Nick; Clark, Darcey; Cowan, Laine; Bussiere, Jeanine; Lebrec, Herve

    2013-01-01

    Non-human primates may be the only relevant species for pharmacology or toxicology studies of certain biologics, due to lack of activity in other species. Flow cytometry immunophenotyping is often included as a minimally invasive adjunct to standard toxicity testing. A retrospective inter-laboratory analysis was conducted to assess counts and variability of the main cell types monitored in toxicity studies, and to provide guidance for conduct and interpretation of immunophenotyping assessments in cynomolgus monkeys. Univariate and multivariate models were developed. Study design factors influencing cell counts and variability were identified and a power analysis was performed. Pre-study and on-study counts were generally similar; longitudinal analysis showed little drift in mean counts or within-animal variability over time. Within-animal variability was lower than inter-animal variability. Gender was associated with small but significant differences in mean counts and variability. Age was associated with significant differences in variability. Immunophenotype definitions were associated with significant differences in mean counts and within-animal variability for most cell types. Power analysis for groups of 6-8 animals showed that differences of ≈50% in counts of T-cells, T-cell subsets, and B-cells compared to pre-treatment values may be detected; for NK cells and monocytes, differences of ≈60-90% may be detected. This review yields some general points to consider for immunophenotyping studies, i.e. (a) analysis of log-transformed cell count data and comparisons using each animal as its own reference will improve ability to detect changes, (b) the magnitude of change detectable given study group size should be considered, (c) multiplication of sampling timepoints during a study seems unnecessary, (d) consideration should be given to using only one gender, when applicable, to increase power while minimizing animal usage, and (e) the choice of immunophenotype

  15. Parenting Environment and Scholastic Achievement during Adolescence: A Retrospective Study.

    Science.gov (United States)

    Taris, Toon W.; Bok, Inge A.

    1996-01-01

    This study examined the effects of perceived parenting style (overly protective versus a warm and loving environment) on the scholastic achievement of 986 Dutch adults age 18-30 years. Retrospective and longitudinal data suggested that respondents with overprotective parents drop out more frequently and have a lower level of educational attainment…

  16. Research of Neutron Characteristics of ChNPP RBMK-1000 in the Institute for Nuclear research in pre-and post-emergency period: retrospective analysis

    International Nuclear Information System (INIS)

    The paper considers scientific and technical cooperation of the Institute for Nuclear Research of the Academy of Sciences of the Ukrainian SSR and Chornobyl NPP in the pre- and post-emergency period. The research presents the retrospective analysis of the software for RBMK-1000 safety analysis. Attention is paid to the need for safety analysis improvement by implementation of the latest software, and for creation of the scientific and research institute in Ukraine to address the whole spectrum of nuclear challenges

  17. 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.

  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. Alveolar process fractures in the permanent dentition. Part 1. Etiology and clinical characteristics. A retrospective analysis of 299 cases involving 815 teeth

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva

    2015-01-01

    AIM: To describe the etiology and clinical characteristics of alveolar process fractures treated in a regional trauma clinic. MATERIAL AND METHOD: The study is a retrospective descriptive analysis of 299 patients (180 males, 119 females; 815 permanent teeth) diagnosed with fractures of the alveolar...

  20. 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

  1. Retrospective Analysis of the Oral Immunisation of Wild Boar Populations against Classical Swine Fever Virus (CSFV) in region Eifel of Rhineland-Palatinate

    OpenAIRE

    Von Rüden, Stefan; Staubach, Christoph; Kaden, Volker; Hess, R.G.; Blicke, Julia; Kühne, Sabine; Sonnenburg, Jana; Fröhlich, Andreas; Teuffert, Jürgen; Moennig, Volker

    2008-01-01

    Retrospective Analysis of the Oral Immunisation of Wild Boar Populations against Classical Swine Fever Virus (CSFV) in region Eifel of Rhineland-Palatinate GERMANY (von Ruden, Stefan) GERMANY Received: 2007-12-25 Revised: 2008-04-07 Accepted: 2008-04-18

  2. 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.

  3. 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

  4. Retrospect & Prospect

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Analysis of Econnomic Performance and Trends for Textile Industry 2005\\2006 Analysis and assessment of industrial performance 2005 In 2005, the industry had satisfactory economic operations on the whole, better than the expected, in spite of wavy

  5. The expression of cytoglobin as a prognostic factor in gliomas: a retrospective analysis of 88 patients

    International Nuclear Information System (INIS)

    Evidence suggests that cytoglobin (Cygb) may function as a tumor suppressor gene. We immunohistochemically evaluated the expression of Cygb, phosphatidylinositol-3 kinase (PI-3K), phosphorylated (p)-Akt, Interleukin-6 (IL-6), tumor necrosis factor-α (TNFα) and vascular endothelial growth factor (VEGF) in 88 patients with 41 high-grade gliomas and 47 low-grade gliomas. Intratumoral microvessel density (IMD) was also determined and associated with clinicopathological factors. Low expression of Cygb was significantly associated with the higher histological grading and tumor recurrence. A significant negative correlation emerged between Cygb expression and PI3K, p-Akt, IL-6, TNFα or VEGF expression. Cygb expression was negatively correlated with IMD. There was a positive correlation between PI3K, p-Akt, IL-6, TNFα and VEGF expression with IMD.High histologic grade, tumor recurrence, decreased Cygb expression, increased PI3K expression, increased p-Akt expression and increased VEGF expression correlated with patients’ overall survival in univariate analysis. However, only histological grading and Cygb expression exhibited a relationship with survival of patients as independent prognostic factors of glioma by multivariate analysis. Cygb loss may contribute to tumor recurrence and a worse prognosis in gliomas. Cygb may serve as an independent predictive factor for prognosis of glioma patients

  6. Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates—a 30 year prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Laura Hokkanen

    2014-03-01

    Full Text Available Background. Neonatal hyperbilirubinemia (HB may cause severe neurological damage, but serious consequences are effectively controlled by phototherapy and blood exchange transfusion. HB is still a serious health problem in economically compromised parts of the world. The long term outcome has been regarded favorable based on epidemiological data, but has not been confirmed in prospective follow-up studies extending to adulthood. Methods. We studied the long term consequences of HB in a prospective birth cohort of 128 HB cases and 82 controls. The cases are part of a neonatal at-risk cohort (n = 1196 that has been followed up to 30 years of age. HB cases were newborns ≥ 2500 g birth weight and ≥ 37 weeks of gestation who had bilirubin concentrations > 340 µmol/l or required blood exchange transfusion. Subjects with HB were divided into subgroups based on the presence (affected HB or absence (unaffected HB of diagnosed neurobehavioral disorders in childhood, and compared with healthy controls. Subjects were seen at discharge, 5, 9 and 16 years of life and parent’s and teacher’s assessments were recorded. At 30 years they filled a questionnaire about academic and occupational achievement, life satisfaction, somatic and psychiatric symptoms including a ADHD self-rating score. Cognitive functioning was tested using ITPA, WISC, and reading and writing tests at 9 years of life. Results. Compared to controls, the odds for a child with HB having neurobehavioral symptoms at 9 years was elevated (OR = 4.68. Forty-five per cent of the HB group were affected by cognitive abnormalities in childhood and continued to experience problems in adulthood. This was apparent in academic achievement (p < 0.0001 and the ability to complete secondary (p < 0.0001 and tertiary (p < 0.004 education. Also, the subgroup of affected HB reported persisting cognitive complaints e.g., problems with reading, writing and mathematics. Childhood symptoms of hyperactivity

  7. Hypofractionated radiation therapy for invasive thyroid carcinoma in dogs: a retrospective analysis of survival

    International Nuclear Information System (INIS)

    Thirteen dogs with invasive thyroid carcinoma (WHO classification T2b or T3b) seen between January 1991 and October 1997 were treated by external beam Irradiation. Four once-weekly fractions of 9 gray of 4 MeV X-rays were administered. Four of the dogs died of progression of the primary disease and four from metastatic spread. Of the remaining dogs, three died of unrelated problems, although two were still alive at the time of the censor. Kaplan-Meier analysis of the survival time from first dose to death from either primary or metastatic disease gave a median survival time of 96 weeks (mean 85 weeks, range six to 247 weeks). Radiographic evidence of pulmonary metastatic disease at presentation had no prognostic value whereas crude growth rate was a highly significant factor. The present series Indicates that radiation therapy should be considered an important modality for the control of invasive thyroid carcinoma in the dog

  8. Blast From the Past: A Retrospective Analysis of Blast-induced Head Injury.

    Science.gov (United States)

    Yu, Kristin E; Murphy, Justin M; Tsao, Jack W

    2016-03-01

    Because of the sharp increase in the number of military personnel exposed to explosive blasts in combat, research has been dedicated toward understanding the impact of explosions on the brain. It is important to consider that potential injuries that military personnel sustain may be both in the form of physical injury as well as "invisible" neuronal and psychological damage. Since the inception of the study of blast science in the Medieval and Renaissance eras, significant improvements have been made in the historical record keeping and biomedical analysis of blast injuries. This editorial comments on the evolution of blast science and the recognition of neurological sequelae from both the historical and scientific perspectives. PMID:26926849

  9. 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.

  10. 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.

  11. 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

  12. Survival nomogram for curatively resected Korean gastric cancer patients: multicenter retrospective analysis with external validation.

    Directory of Open Access Journals (Sweden)

    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.

  13. Evaluating Frequency, Diagnostic Quality, and Cost of Lyme Borreliosis Testing in Germany: A Retrospective Model Analysis

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    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.

  14. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

    Science.gov (United States)

    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.

  15. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    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.

  16. CAN FUTURE STUDIES TRULY PREDICT THE FUTURE? A RETROSPECTIVE ANALYSIS OF TWO APPROACHES

    Directory of Open Access Journals (Sweden)

    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.

  17. Acute Fatty Liver of Pregnancy: A Retrospective Analysis of 56 Cases

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. The role of climatic variables in winter cereal yields: a retrospective analysis.

    Science.gov (United States)

    Luo, Qunying; Wen, Li

    2015-02-01

    This study examined the effects of observed climate including [CO2] on winter cereal [winter wheat (Triticum aestivum), barley (Hordeum vulgare) and oat (Avena sativa)] yields by adopting robust statistical analysis/modelling approaches (i.e. autoregressive fractionally integrated moving average, generalised addition model) based on long time series of historical climate data and cereal yield data at three locations (Moree, Dubbo and Wagga Wagga) in New South Wales, Australia. Research results show that (1) growing season rainfall was significantly, positively and non-linearly correlated with crop yield at all locations considered; (2) [CO2] was significantly, positively and non-linearly correlated with crop yields in all cases except wheat and barley yields at Wagga Wagga; (3) growing season maximum temperature was significantly, negatively and non-linearly correlated with crop yields at Dubbo and Moree (except for barley); and (4) radiation was only significantly correlated with oat yield at Wagga Wagga. This information will help to identify appropriate management adaptation options in dealing with the risk and in taking the opportunities of climate change.

  20. False-negative results of breast core needle biopsies – retrospective analysis of 988 biopsies

    International Nuclear Information System (INIS)

    Breast cancer is the most common malignant neoplasm and the most common cause of death among women. The core needle biopsy is becoming a universal practice in diagnosing breast lesions suspected of malignancy. Unfortunately, breast core needle biopsies also bear the risk of having false-negative results. 988 core needle breast biopsies were performed at the Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, between 01 March 2006 and 29 February 2008. Malignant lesions were diagnosed in 426/988 (43.12%) cases, atypical hyperplasia in 69/988 (6.98%), and benign lesions in 493/988 (49.90%) cases. Twenty-two out of 988 biopsies (2.23%) were found to be false negative. Histopathological assessment of tissue specimens was repeated in these cases. In 14/22 (64%) cases, the previous diagnosis of a benign lesion was changed. In 8/22 (36%) cases, the diagnosis of a benign lesion was confirmed. False-negative rate was calculated at 2.2%. The rate of false-negative diagnoses resulting from a radiological mistake was estimated at 36%. The rate of false-negative diagnoses, resulting from histopathological assessment, was 64%. False-negative results caused by a radiological error comprised 1.5% of all histopathologically diagnosed cancers and atypias (sensitivity of 98.5%). There were no false-positive results in our material - the specificity of the method was 100%. Histopathological interpretation is a substantial cause of false-negative results of breast core needle biopsy. Thus, in case of a radiological-histopathological divergence, histopathological analysis of biopsy specimens should be repeated. The main radiological causes of false-negative results of breast core needle biopsy are as follows: sampling from an inappropriate site and histopathological non-homogeneity of cancer infiltration

  1. Re-irradiation for painful heel spur syndrome. Retrospective analysis of 101 heels

    International Nuclear Information System (INIS)

    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.)

  2. A retrospective analysis of veterinary medical curriculum development in The Netherlands.

    Science.gov (United States)

    Jaarsma, Debbie A D C; Scherpbier, Albert J J A; van Beukelen, Peter

    2009-01-01

    Over the past two decades, the Faculty of Veterinary Medicine of Utrecht University (FVMU) has introduced major curriculum changes to keep pace with modern veterinary educational developments worldwide. Changes to program outcomes have been proposed according to professional and societal demands, with more attention paid to generic competencies and electives and species/sector differentiation. Furthermore, changes in educational approaches and the educational organization have been proposed, aiming at a transition from teacher-centered education toward more student-centered education. Curriculum development is a complex and difficult process, with many elements interacting. For a new curriculum to become valid, curriculum elements and their interrelation-such as statements of intent (also called outcomes, goals, or objectives), content, teaching and learning strategies, assessment strategies, and context-need to be addressed in the educational philosophy (i.e., the intended curriculum). This paper describes a document analysis of the major curriculum reforms of the FVMU. Curriculum committee reports were critically analyzed to gain insight into the intentions of the curriculum designers and the match between the curriculum elements, as described by Prideaux. The results show that the reports paid considerable attention to generic competency training, especially to academic training, and to the introduction of more student-centered teaching and learning strategies. However, little attention was paid to assessment strategies and the statements of intent were defined rather broadly. Curriculum evaluation (i.e., what is delivered to the students and how is the curriculum experienced) is needed at all curriculum levels. Possible mismatches between levels need to be identified.

  3. 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  

  4. 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.

  5. Chemoradiotherapy-Associated Myelosuppression: A Retrospective Analysis of Risk Factors for Patients with Non-Small Cell Lung Cancer

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    Ufuk Mehmet Yılmaz

    2015-04-01

    Full Text Available Objective: Concomitant chemoradiotherapy (CRT is the standard treatment for patients with stage III non-small cell lung cancer (NSCLC. Myelosuppression can be a significant problem in concomitant CRT. The aim of this study was to assess the parameters obtained before concomitant CRT to define the risk factors for myelosuppression in patients with locally advanced NSCLC. Methods: We retrospectively analyzed 81 patients with NSCLC who received concomitant platinum-based chemoradiotherapy between January 2008 and December 2012. Seventy-eight patients (96.2% received etoposide (50 mg/m2, intravenously on days 1–5, 29–33 plus cisplatin (50 mg/m2, on days 1, 8, 29, and 36, and 3 patients (3.8% received docetaxel (20 mg/m2/w, on weeks 1–8 plus cisplatin (20 mg/m2/w, on weeks 1–8 concurrently with thoracic radiotherapy to a total dose of 40–66.6 Gy. The risk factors were examined for their association with myelosupression (grade 3 or 4 leukopenia, neutropenia, thrombocytopenia, or anemia by logistic regression analysis. Results: Grade 3 or higher neutropenia, leukopenia, thrombocytopenia, or anemia occurred in 51.8%, 53%, 8.6%, and 7.4% of the patients, respectively. Multivariate analysis revealed that the risk factors for neutropenia were performance status (p=0.032, white blood cell count (p=0.023, and pretreatment creatinine level (p=0.018. On multivariate analysis, white blood cell count (OR, 3.311; p=0.027; 95% CI, 1.148–9.545 was found as significant risk factor for CRT-induced leukopenia Conclusion: Patients with a poor pretreatment performance status, low white blood cell count, and high creatinine level are at a risk of myelosupression. These characteristics of the patients should be considered while making treatment decisions.

  6. Treatment delay of bone tumours, compilation of a sociodemographic risk profile: A retrospective study

    International Nuclear Information System (INIS)

    Bone tumours are comparatively rare tumours and delays in diagnosis and treatment are common. The purpose of this study was to analyse sociodemographic risk factors for bone tumour patients in order to identify those at risk of prolonged patients delay (time span from first symptoms to consultation), professional delay (from consultation to treatment) or symptom interval (from first symptoms to treatment). Understanding these relationships might enable us to shorten time to diagnosis and therapy. We carried out a retrospective analysis of 265 patients with bone tumours documenting sociodemographic factors, patient delay, professional delay and symptom interval. A multivariate explorative Cox model was performed for each delay. Female gender was associated with a prolonged patient delay. Age under 30 years and rural living predisposes to a prolonged professional delay and symptom interval. Early diagnosis and prompt treatment are required for successful management of most bone tumour patients. We succeeded in identifying the histology independent risk factors of age under 30 years and rural habitation for treatment delay in bone tumour patients. Knowing about the existence of these risk groups age under 30 years and female gender could help the physician to diagnose bone tumours earlier. The causes for the treatment delays of patients living in a rural area have to be investigated further. If the delay initiates in the lower education of rural general physicians, further training about bone tumours might advance early detection. Hence the outcome of patients with bone tumours could be improved

  7. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC IN THE DIAGNOSIS OF SKIN AND SUBCUTANEOUS LESIONS: A RETROSPECTIVE ANALYSIS

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    Gautam

    2016-01-01

    Full Text Available BACKGROUND Cytopathology of skin has been established to be useful in the diagnosis of several skin lesions. This study aims to evaluate cytopathology as a quick non-invasive method for early diagnosis of different skin conditions including neoplastic and non-neoplastic. Fine Needle Aspiration Cytology (FNAC is a simple and rapid diagnostic technique. The present study is a retrospective analysis of 356 patients who were cytologically evaluated for various skin and superficial soft tissue lesions over a period of four years (W. E. F. January 2012 to December 2015 in the Department of Dermatology and Pathology of Tripura Medical College and Dr. BRAM Teaching Hospital. Amongst the 356 cases reported, 170 cases were non-neoplastic and 186 were reported as neoplastic skin lesions. Out of 186 neoplastic lesions, 134 (72.04% were benign in nature and rest of the cases were malignant, i.e. only 52 cases (27.95%. Commonest non-neoplastic lesion epidermal inclusion cyst followed by acute suppurative lesions. Other lesions which were commonly reported in our study were Granulomatous lesions. It has been observed that FNAC performed carefully, skilfully with proper selection of cases leads to an early diagnosis in majority of the skin lesions.

  8. The threshold of hypothyroidism after radiation therapy for head and neck cancer. A retrospective analysis of 116 cases

    International Nuclear Information System (INIS)

    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 <30 Gy had a significantly lower incidence of 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. (author)

  9. 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.

  10. The polyomaviruses WUPyV and KIPyV: a retrospective quantitative analysis in patients undergoing hematopoietic stem cell transplantation

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    Motamedi Nasim

    2012-09-01

    Full Text Available Abstract Background The polyomaviruses WUPyV and KIPyV have been detected in various sample types including feces indicating pathogenicity in the gastrointestinal (GI system. However, quantitative viral load data from other simultaneously collected sample types are missing. As a consequence, primary replication in the GI system cannot be differentiated from swallowed virus from the respiratory tract. Here we present a retrospective quantitative longitudinal analysis in simultaneously harvested specimens from different organ sites of patients undergoing hematopoietic stem cell transplantation (HSCT. This allows the definition of sample types where deoxyribonucleic acid (DNA detection can be expected and, as a consequence, the identification of their primary replication site. Findings Viral DNA loads from 37 patients undergoing HSCT were quantified in respiratory tract secretions (RTS, stool and urine samples as well as in leukocytes (n = 449. Leukocyte-associated virus could not be found. WUPyV was found in feces, RTS and urine samples of an infant, while KIPyV was repeatedly detected in RTS and stool samples of 4 adult patients. RTS and stool samples were matched to determine the viral load difference showing a mean difference of 2.3 log copies/ml (p  Conclusions The data collected in this study suggest that virus detection in the GI tract results from swallowed virus from the respiratory tract (RT. We conclude that shedding from the RT should be ruled out before viral DNA detection in the feces can be correlated to GI symptoms.

  11. Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas

    International Nuclear Information System (INIS)

    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

  12. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis.

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    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.

  13. 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.

  14. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases.

    Science.gov (United States)

    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.

  15. 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 ...

  16. 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

  17. Identifying gender-preferred communication styles within online cancer communities: a retrospective, longitudinal analysis.

    Directory of Open Access Journals (Sweden)

    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

  18. 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

  19. The Ofidia Project: a Retrospective Fire Danger Forecast Analysis in Mediterranean Environment

    Science.gov (United States)

    Sirca, C.; Bacciu, V. M.; Salis, M.; Mirto, L.; Fiore, S.; Aloisio, G.; Spano, D.

    2015-12-01

    OFIDIA (Operational FIre Danger preventIon plAtform) is a two-year project started in May 2013 funded by the European Territorial Cooperation Programme Greece Italy (2007 - 2013). The project aims to improve the operational capability of forecasting, preventing, and fighting forest wildfires, and enhance the cross-border cooperation for fire danger assessment. More specifically, OFIDIA aims at developing an operational fire danger prevention platform, with the ability for near real-time fire danger forecast and fire behaviour analysis in Apulia (Italy) and Epirus (Greece) regions to help forest fires services in the effective prevention and response to forecasted danger.One of the preliminary activities of the project was the evaluation of fire danger performances by analysing the relationship between the predicted daily fire danger and observed fire activity (number of fires and area burned). To achieve this task, fire activity and danger patterns were characterised and their relationships were investigated for the period 2000-2012. The Italian Forest Service (CFS, Corpo Forestale dello Stato) provided fire statistics at NUT03 level. The data were homogenized and uncertainties corrected, and then burned area and number of fires were analysed according to the main fire regime characteristics (seasonality, fire return interval, fire incidence, fire size distribution, etc). Then, three fire danger models (FFWI, FWI, and IFI) were selected and computed starting from the fifth-generation Pennsylvania State University-National Center for Atmospheric Research Mesoscale Model (MM5) forecast.Results showed a high inter- and intra-annual variability in fire activiy, also considering the different type of affected vegetation. As for other Mediterranean areas, a smaller number of large fires caused a high proportion of burned area. Furthermore, fire activity showed significant correlations with the outputs obtained by the applied models. High relationships were found between

  20. A 35-40% Likelihood of a Highly Damaging Tokyo Earthquake in Next 30 Years

    Science.gov (United States)

    Stein, R. S.; Toda, S.; Parsons, T.; Bozkurt, S. B.

    2005-12-01

    Tokyo and its outlying cities are home to one-quarter of Japan's 127 million people. Highly destructive earthquakes struck the capital in 1703, 1855 and 1923, the last of which took 105,000 lives. Reoccurrence of any of these shocks today would cost about one trillion dollars, of which perhaps 10% is insured. Fueled by Tokyo's rich data trove but hindered by its complexity, we carried out a new hazard assessment. We used the prehistoric record of great earthquakes preserved in uplifted marine terraces and tsunami deposits (17 M~8 shocks in the past 7,000 years), historical shaking (10,000 intensity observations in the past 400 years), the dense modern seismic network (300,000 earthquakes in the past 30 years), and the world's best geodetic array (150 GPS vectors spanning the past 10 years). We propose that a dislodged block of the Pacific plate is jammed between the Pacific, Philippine Sea and Eurasian plates beneath Tokyo, and controls much of Tokyo's seismic behavior for M≤7.5 shocks, including the damaging 1855 M~7.3 Ansei-Edo shock. On the basis of frequency-magnitude curves, earthquakes similar to the Ansei-Edo event should be quite frequent (25-35% likelihood in an average 30-yr period), and so such events dominate the combined probabilities. In contrast, our renewal model for the great 1703 and 1923 type plate boundary shocks yields a ~1% probability for the next 30 yr, with a time-averaged 30-yr probability of ~8%. The resulting net likelihood for severe shaking in Tokyo, Kawasaki, and Yokohama for the next 30 years is 25%-40%, but how can it be validated? The long historical record in Kanto affords a rare opportunity to calculate the probability of shaking in an alternative manner, based almost exclusively on intensity observations. This approach permits robust estimates for the spatial distribution of shaking, even for sites with few observations. The resulting probability of severe shaking over an average 30-yr period is ~35% in the Tokyo, Kawasaki

  1. 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

  2. Re-irradiation for painful heel spur syndrome. Retrospective analysis of 101 heels

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. 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.

  4. Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study

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    Ivor M D′Souza

    2015-01-01

    Full Text Available Introduction: Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation between transverse expansion and changes in the arch perimeter, arch width and arch length. Methods: For this purpose, 10 subjects (five males, five females were selected who had been treated by rapid maxillary expansion (RME using hyrax rapid palatal expander followed by fixed mechanotherapy (PEA. Pretreatment (T1, postexpansion (T2, and posttreatment (T3 dental models were compared for dental changes brought about by RME treatment and its stability at the end of fixed mechanotherapy. After model measurements were made, the changes between T1-T2, T2-T3 and T1-T3 were determined for each patient. The mean difference between T1-T2, T2-T3 and T1-T3 were compared to assess the effects of RME on dental arch measurements. Results are expressed as mean ± standard deviation and are compared by repeated measures analysis of variance followed by a post-hoc test. Arch perimeter changes are correlated with changes in arch widths at the canine, premolar and molar

  5. 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.

  6. 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.

  7. Food irradiation - after 30 years, where do we stand: A government perspective

    International Nuclear Information System (INIS)

    The use of irradiation to improve the safety, protect the nutritional benefits, and preserve the quality of fresh and processed foods is a well established and proven technology. Over the past 30 years, the United States Government has invested in the science of confirm safety and in the technology to show application. The United States Department of Agriculture and the Food and Drug Administration have approved sources of ionizing radiation for the treatment of foods, and their application to most meats, fruits, vegetables, and spices. Despite the value of this technology to the food industry and to the health and welfare of the public, only minimal application of this technology occurs. This underscorces the importantce of increasing the public's understanding of radiation risks relative to other hazards. Accordingly, the Committee on Interagency Radiation Research and Policy Coordination of the Executive Office of the President has made recommendations for the creation of a centralized National Radiation Information Center that would work closely with Federal departments and agencies in responding to public queries about radiation issues and Federal programs. (orig.)

  8. Treatment of rectal prolapse in children with cow milk injection sclerotherapy:30-year experience

    Institute of Scientific and Technical Information of China (English)

    Mirko (Z)ganjer; Ante Cizmic; Irenej Cigit; Bo(z)idar (Z)upancic; Igor Bumci; Ljiljana Popovic; Antun Kljenak

    2008-01-01

    AIM:To evaluate the role and our experience of injecti-on sclerotherapy with cow milk in the treatment of rectal prolapse in children.METHODS:In the last 30 years (1976-2006) we made 100 injections of sclerotherapy with cow milk in 86 chil-dren.In this study we included children who failed to respond to conservative treatment and we perform ope-rative treatment.RESULTS:In our study we included 86 children and in all of the patients we perform cow milk injection sclerot-herapy.In 95.3% (82 children) of patients sclerotherapy was successful.In 4 (4.7%) patients we had recurrent rectal prolapse where we performed operative treatment.Below 4 years we had 62 children (72%) and 24 older children (28%).In children who needed operative trea-tment we performed Thiersch operation and without any complications.CONCLUSION:Injection sclerotherapy with cow milk for treatment rectal prolapse in children is a simple and effective treatment for rectal prolapse with minimal com-plications.

  9. 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. PMID:27284054

  10. 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.)

  11. Surveillance of Infectious Diseases by the Sentinel Laboratory Network in Belgium: 30 Years of Continuous Improvement.

    Science.gov (United States)

    Muyldermans, Gaëtan; Ducoffre, Geneviève; Leroy, Mathias; Dupont, Yves; Quolin, Sophie

    2016-01-01

    In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983-2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources. PMID:27571203

  12. 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.

  13. 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.

  14. Interannual variability of the Indonesian Throughflow transport: A revisit based on 30 year expendable bathythermograph data

    Science.gov (United States)

    Liu, Qin-Yan; Feng, Ming; Wang, Dongxiao; Wijffels, Susan

    2015-12-01

    Based on 30 year repeated expendable bathythermograph (XBT) deployments between Fremantle, Western Australia, and the Sunda Strait, Indonesia, from 1984 to 2013, interannual variability of geostrophic transport of the Indonesian Throughflow (ITF) and its relationships with El Niño Southern Oscillation (ENSO) and the Indian Ocean Dipole (IOD) are investigated. The IOD induced coastal Kelvin waves propagate along the Sumatra-Java coast of Indonesia, and ENSO induced coastal Kelvin waves propagate along the northwest coast of Australia, both influencing interannual variations of the ITF transport. The ITF geostrophic transport is stronger during La Niña phase and weaker during El Niño phase, with the Niño3.4 index leading the ITF variability by 7 months. The Indian Ocean wind variability associated with the IOD to a certain extent offset the Pacific ENSO influences on the ITF geostrophic transport during the developing and mature phases of El Niño and La Niña, due to the covarying IOD variability with ENSO. The ITF geostrophic transport experiences a strengthening trend of about 1 Sv every 10 years over the study period, which is mostly due to a response to the strengthening of the trade winds in the Pacific during the climate change hiatus period. Decadal variations of the temperature-salinity relationships need to be considered when estimating the geostrophic transport of the ITF using XBT data.

  15. Technical Note: 30 years of HIRS data of upper tropospheric humidity

    Directory of Open Access Journals (Sweden)

    K. Gierens

    2014-07-01

    Radiation Sounder data to produce a 30-year data set of upper tropospheric humidity with respect to ice (UTHi. Since the required brightness temperatures (channels 12 and 6, T12 and T6 are intercalibrated to different versions of the HIRS sensors (HIRS/2 and HIRS/4 it is necessary to convert the channel 6 brightness temperatures which are intercalibrated to HIRS/4 into equivalent brightness temperatures intercalibrated to HIRS/2, which is achieved using a linear regression. Using the new regression coefficients we produce daily files of UTHi, T12 and T6, for each NOAA satellite and METOP-A (Meteorological Operational Satellite Programme, which carry the HIRS instrument. From this we calculate daily and monthly means in 2.5° × 2.5° resolution for the northern midlatitude zone 30–60° N. As a first application we calculate decadal means of UTHi and the brightness temperatures for the two decades 1980–1989 and 2000–2009. We find that the humidity mainly increased from the 1980s to the 2000s and that this increase is highly statistically significant in large regions of the considered midlatitude belt. The main reason for this result and its statistical significance is the corresponding increase of the T12 variance. Changes of the mean brightness temperatures are less significant.

  16. Characteristics of atmospheric aerosol optical depth variation over China in recent 30 years

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    This note retrieves the annual and monthly mean 0.75 μm aerosol optical depth (AOD) by using the daily direct solar radiation and sunshine duration data of 47 solar stations from 1961 to 1990. The characteristic of AOD variation over China in recent 30 years was analyzed. The results indicate that AOD increased obviously over China from 1961 to 1990. AOD increased most rapidly over the east part of Southwest China, the middle-and-lower reaches of the Yangtze River and the Tibetan Plateau. The increasing trend of AOD is also relatively distinct in North China, the Shandong Peninsula, east part of Qinghai Province, and coastal areas of Guangdong Province. However, in most parts of Northwest China and Northeast China, the increase of AOD is less significant, while in the west part of the Xinjiang Uygur Autonomous Region and some parts of Yunnan Province, AOD shows decreasing tendency. Generally, AOD reaches its maximum in spring and the minimum appears in summer. As to the linear trend, the maximum occurs in spring but the minimum in winter. Among the 47 stations selected in this note, the largest three stations of AOD are Chengdu, Chongqing and Nanchong, respectively, which all lie in the Sichuan Basin, and the smallest value of AOD occurs in Jinghong located in Yunnan Province.

  17. 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.

  18. 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.

  19. The changing patterns of drug use among American Indian students over the past 30 years.

    Science.gov (United States)

    Beauvais, Fred; Jumper-Thurman, Pamela; Burnside, Martha

    2008-01-01

    Drug use among American Indian (AI) youth continues at higher levels than those found among other youth. While the rates are higher, the patterns of increases and decreases over the past 30-year period have been similar, indicating that AI youth are part of the larger adolescent culture. There is a set of secular influences that affect the rates of drug use in both groups in the same manner. The major implication of these findings is that effective interventions in non-AI groups may also be effective among AI adolescents. Intervention activities, however, must be adapted to be culturally congruent. Despite rising concern over methamphetamine use on reservations, the data presented here indicate that, with the exception of two points in time, the rates have not increased substantially for AI youth who remain in school. School dropouts and young adults/adults may be more vulnerable to the abuse of methamphetamines and the rates of use may be higher in these groups. PMID:19085827

  20. Effect Of Yoga On Cardiovascular And Mental Status In Normal Subjects Above 30 years Of Age

    Directory of Open Access Journals (Sweden)

    Anita Herur

    2010-10-01

    Full Text Available The cardiovascular diseases are much on a rise ever since the past few decades in developing countries. This study was done to analyze the effect of yoga on cardiovascular and mental status in normal subjects above the age of 30 years. The cardiovascular status was assessed by recording the blood pressure and heart rate; and mental status in terms of a questionnaire, before and after 6 months of regular yogic practice. The mean resting heart rate(beats/min before yoga was 77.8 ± 4.8, which reduced significantly to 71.3 ± 5.2 after 6months of yogic practice (p<0.001. The mean resting systolic blood pressure (mm Hg before yogic practice was 131.4 ± 10.2 and after 6months, it was lowered to a highly significant (p<0.001 level of 123.5 ± 9.9. The mean resting diastolic blood pressure (mm Hg before yoga was 85.6 ± 6.8 and reduced significantly (p<0.001 to 79.6 ± 7.3. The mean General Health Questionnare-28(GHQ-28 score before yogic practice was 8.4 ± 5.7 which reduced to 5.0 ± 4.1 after 6 months (p<0.001, showing a positive attitude of the subjects. Hence, yogic practice can be used as an intervention in ageing persons to reduce the morbidity and mortality from cardiovascular diseases.

  1. Sex differences in sub-clinical psychosis--results from a community study over 30 years.

    Science.gov (United States)

    Rössler, Wulf; Hengartner, Michael P; Ajdacic-Gross, Vladeta; Haker, Helene; Angst, Jules

    2012-08-01

    Sex differences in schizophrenia have long been reported. They are found within almost all aspects of the disease, from incidence and prevalence, age of onset, symptomatology, and course to its psycho-social outcome. Many sex-related hypotheses have been developed about the biology, psychology, or sociology of that disease. A further approach to study sex differences would be to examine such differences in sub-clinical psychotic states as well. If factors related to full-blown psychosis were equally meaningful over the entire psychosis continuum, we should expect that "true" sex differences could also be identified in sub-clinical psychosis. Here, we studied sex differences in sub-clinical psychosis within a community cohort in Zurich, Switzerland. This population was followed for over 30 years and included males and females between the ages of 20/21 and 49/50. We applied two different measures of sub-clinical psychosis representing schizotypal signs and schizophrenia nuclear symptoms. Using cross-sectional and longitudinal analyses, we found no significant sex differences in sub-clinical psychosis over time with respect to age of onset, symptomatology, course, or psycho-social outcome. Thus it appears that sex differences in psychosis manifest themselves at the high end of the continuum (full-blown schizophrenia) rather than within the sub-threshold range. Possibly males and females have separate thresholds for certain symptoms because they are differently vulnerable or exposed to various risk factors. PMID:22632902

  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. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years.

    Science.gov (United States)

    Boffano, Paolo; Kommers, Sofie C; Karagozoglu, K Hakki; Forouzanfar, Tymour

    2014-12-01

    The epidemiology of facial trauma may vary widely across countries (and even within the same country), and is dependent on several cultural and socioeconomic factors. We know of few reviews of published reports that have considered the sex distribution and aetiology of maxillofacial trauma throughout the world. The aim of this review was to discuss these aspects as they have been presented in papers published during the last 30 years. We made a systematic review of papers about the epidemiology of maxillofacial trauma that were published between January 1980 and December 2013 and identified 69 studies from Africa (n=9), North America and Brazil (n=6), Asia (n=36), Europe (n=16), and Oceania (n=2). In all the studies men outnumbered women, the ratio usually being more than 2:1. In American, African, and Asian studies road traffic crashes were the predominant cause. In European studies the aetiology varied, with assaults and road traffic crashes being the most important factors. In Oceania assaults were the most important. A comparison of the incidence of maxillofacial trauma of different countries together with a knowledge of different laws (seat belts for drivers, helmets for motocyclists, speed limits, and protection worn during sports and at work) is crucial to allow for improvement in several countries. To our knowledge this paper is the first attempt to study and compare the aetiologies of maxillofacial trauma. PMID:25218316

  4. 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. PMID:19962635

  5. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  7. CAN A SPECIFIC NECK STRENGTHENING PROGRAM DECREASE CERVICAL SPINE INJURIES IN A MEN'S PROFESSIONAL RUGBY UNION TEAM? A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    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

  8. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie's disease: a retrospective analysis of 309 cases.

    Science.gov (United States)

    Paulis, Gianni; Romano, Gennaro; Paulis, Andrea

    2016-01-01

    Peyronie's disease (PD) is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED) is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score), evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED), 116 cases, and group B (PD without ED), 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B). Sexual bother was greater in group A compared with group B (9.7 versus 7.6). Intensities of depressive symptoms and sexual bother were significantly higher compared with cases with no curvature when the bend angle was ≥30°. Our study confirms that an integrated psychological support with medical treatment is needed in patients with PD. PMID:27486570

  9. Evolution of the Urban Heat Island of the city of Bologna (Italy) in the last 30 years

    Science.gov (United States)

    Ventura, Francesca; Gaspari, Nicola; Piana, Stefano; Rossi Pisa, Paola

    2010-05-01

    The Urban Heat Island (UHI) phenomenon is the air temperature difference between the urban area and the surrounding agricultural area of a city, due to the anthropic activities and different surfaces typical of the town. This phenomenon has been documented for many cities with different population, topography and climate (Chandler, 1962 and Oke, 1982 among the first), and has been quantified in many areas (see as an example for Italy Agnese et al, 2008). Many causes contribute to the UHI, such as different heat capacities of vegetated surfaces as compared to buildings and paving materials; different absorption due to canopy geometry; anthropogenic heat sources and so on. (for example see Camilloni and Barros, 1997) What is not so easy to find in literature is the study of the evolution of this phenomenon with time. UHI could be improved by changes in the town behaviour (increase in car traffic or winter-heating/summer-cooling), reduced by the enlargement of the suburb area, arriving to include the rural meteorological stations, or mitigated by the general growth of air temperature due to global warming. In this work, results from the analysis of two 30 years time series air temperature data are presented. The first data set comes from an agrometeorological station sited in the Botanical garden of the University of Bologna, in the centre of the town (44° 30' 05"N, 11° 21' 18" E). The second agrometeorological station is sited in the experimental farm of the University of Bologna in Cadriano (44° 33' 03" N, 11° 24' 36" E), 9 km from the first and outside of the town boundaries. Both data series range from 1978 to 2007 and are measured by mechanical thermoigrometers. Detailed information about instruments and data treatment are available in Matzneller et al. (2009). Results show an increasing trend in both stations for air maximum (Tmax) and minimum (Tmin) temperatures, more evident in the rural data. The mean UHI is of about 1.3 ± 0.7 °C as an average on the 30

  10. 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

  11. a retrospective analysis

    OpenAIRE

    Chizari, Sepideh

    2012-01-01

    Introduction: Primary cutaneous CD30 positive lymphoproliferative disorders are the second most common group of CTCLs, accounting for approximately 30% of CTCLs. This group includes primary cutaneous anaplastic large cell lymphoma (c-ALCL), lymphomatoid papulosis (LyP), and borderline cases. It is now generally accepted that c-ALCL and LyP form a spectrum of disease, and that histologic criteria alone are often insufficient to differentiate between these 2 ends of this spectrum. The clinical ...

  12. Apollo: A Retrospective Analysis

    Science.gov (United States)

    Launius, Roger D.

    2004-01-01

    The program to land an American on the Moon and return safely to Earth in the 1960s has been called by some observers a defining event of the twentieth century. Pulitzer Prize-winning historian Arthur M. Schlesinger, Jr., even suggested that when Americans two centuries hence study the twentieth century, they will view the Apollo lunar landing as the critical event of the century. While that conclusion might be premature, there can be little doubt but that the flight of Apollo 11 in particular and the overall Apollo program in general was a high point in humanity s quest to explore the universe beyond Earth. Since the completion of Project Apollo more than twenty years ago there have been a plethora of books, studies, reports, and articles about its origin, execution, and meaning. At the time of the twenty-fifth anniversary of the first landing, it is appropriate to reflect on the effort and its place in U.S. and NASA history. This monograph has been written as a means to this end. It presents a short narrative account of Apollo from its origin through its assessment. That is followed by a mission by mission summary of the Apollo flights and concluded by a series of key documents relative to the program reproduced in facsimile. The intent of this monograph is to provide a basic history along with primary documents that may be useful to NASA personnel and others desiring information about Apollo.

  13. MEAD retrospective analysis report

    DEFF Research Database (Denmark)

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

    2003-01-01

    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...

  14. Standardization for Ki-67 assessment in moderately differentiated breast cancer. A retrospective analysis of the SAKK 28/12 study.

    Directory of Open Access Journals (Sweden)

    Zsuzsanna Varga

    Full Text Available Proliferative activity (Ki-67 Labelling Index in breast cancer increasingly serves as an additional tool in the decision for or against adjuvant chemotherapy in midrange hormone receptor positive breast cancer. Ki-67 Index has been previously shown to suffer from high inter-observer variability especially in midrange (G2 breast carcinomas. In this study we conducted a systematic approach using different Ki-67 assessments on large tissue sections in order to identify the method with the highest reliability and the lowest variability.Five breast pathologists retrospectively analyzed proliferative activity of 50 G2 invasive breast carcinomas using large tissue sections by assessing Ki-67 immunohistochemistry. Ki-67-assessments were done on light microscopy and on digital images following these methods: 1 assessing five regions, 2 assessing only darkly stained nuclei and 3 considering only condensed proliferative areas ('hotspots'. An individual review (the first described assessment from 2008 was also performed. The assessments on light microscopy were done by estimating. All measurements were performed three times. Inter-observer and intra-observer reliabilities were calculated using the approach proposed by Eliasziw et al. Clinical cutoffs (14% and 20% were tested using Fleiss' Kappa.There was a good intra-observer reliability in 5 of 7 methods (ICC: 0.76-0.89. The two highest inter-observer reliability was fair to moderate (ICC: 0.71 and 0.74 in 2 methods (region-analysis and individual-review on light microscopy. Fleiss'-kappa-values (14% cut-off were the highest (moderate using the original recommendation on light-microscope (Kappa 0.58. Fleiss' kappa values (20% cut-off were the highest (Kappa 0.48 each in analyzing hotspots on light-microscopy and digital-analysis. No methodologies using digital-analysis were superior to the methods on light microscope.Our results show that all methods on light-microscopy for Ki-67 assessment in large tissue

  15. Importance of re-calibration time on pulse contour analysis agreement with thermodilution measurements of cardiac output: a retrospective analysis of intensive care unit patients.

    Science.gov (United States)

    Scully, Christopher G; Gomatam, Shanti; Forrest, Shawn; Strauss, David G

    2016-10-01

    We assessed the effect of re-calibration time on cardiac output estimation and trending performance in a retrospective analysis of an intensive care unit patient population using error grid analyses. Paired thermodilution and arterial blood pressure waveform measurements (N = 2141) from 222 patient records were extracted from the Multiparameter Intelligent Monitoring in Intensive Care II database. Pulse contour analysis was performed by implementing a previously reported algorithm at calibration times of 1, 2, 8 and 24 h. Cardiac output estimation agreement was assessed using Bland-Altman and error grid analyses. Trending was assessed by concordance and a 4-Quadrant error grid analysis. Error between pulse contour and thermodilution increased with longer calibration times. Limits of agreement were -1.85 to 1.66 L/min for 1 h maximum calibration time compared to -2.70 to 2.41 L/min for 24 h. Error grid analysis resulted in 74.2 % of points bounded by 20 % error limits of thermodilution measurements for 1 h calibration time compared to 65 % for 24 h. 4-Quadrant error grid analysis showed analysis method and thermodilution showed poor agreement to monitor changes in cardiac output.

  16. Prevalence of dry eye amongst black and Indian university students aged 18–30 years

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    Bryce Castelyn

    2015-03-01

    Full Text Available Background: The overall prevalence of dry eye in South Africa seems to be increasing. University students work under conditions predisposing them to dry eye, which may affect some tasks. The predominant race groups at the University of KwaZulu-Natal (UKZN are black and Indian, which suggested a study in this student population to assist the diagnosis and management of such subjects.Aim and setting: To compare the prevalence of dry eye amongst black and Indian students at the UKZN’s Westville campus.Methods: One hundred participants, equally divided by gender and race, between 18 and 30 years old were enrolled. Dry eye symptoms were investigated by the ocular surface disease index (OSDI, tear thinning time (TTT, tear breakup time (TBUT and Schirmer’s 2 in that sequence on both eyes of each participant.Results: The OSDI revealed that 41% of participants had some dry eye symptoms whilst 59% had no symptoms. Clinical testing showed that 81% of participants had dry eye. Half of the black participants had dry eye symptoms and 82% had clinical signs of dry eye. Of the 50 Indian participants, 32% had dry eye symptoms and 80% had clinical signs. Of the 50 male participants, 34% were symptomatic and 86% had clinical signs. Of the 50 female participants, 48% had dry eye symptoms and 76% had clinical signs. Participants were asymptomatic even in the presence of clinical dry eye signs.Conclusion: For both races and genders, clinical signs of dry eye were more common than symptoms. Black participants were more likely to report symptoms than Indians, and more women than men reported having symptoms. Male participants were more likely than female to have clinical signs of dry eye.

  17. A 30-year history of earthquake crisis communication in California and lessons for the future

    Science.gov (United States)

    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

  18. 30 years of upper air soundings on board of R/V POLARSTERN

    Science.gov (United States)

    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, http://dx.doi.org/10.1594/PANGAEA.810000" target="_blank">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.

  19. Spontaneus bilateral pedicle fracture 30 years after Harrington Instrumentation for idiopathic scoliosis: a case report

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. 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

  2. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics

    Science.gov (United States)

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Ferrando, Arny A.; Elijah, Itoro E.; Mlcak, Ronald P.; Finnerty, Celeste C.; Wolfe, Robert R.; Herndon, David N.

    2011-01-01

    Purpose This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Methods: Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-2H5]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Results Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p < 0.05). Muscle protein fractional synthesis rate (FSR) was higher in children (adult vs. children, 0.11 ± 0.05 vs. 0.16 ± 0.10 %/h, p < 0.05). Leg muscle protein breakdown was not different between the groups (adult vs. children, 179 ± 115 vs. 184 ± 124 nmol Phe/ min/100 ml leg volume, p < 0.05; synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. Conclusion In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children. PMID:21647721

  3. Retrospective characterization of ontogenetic shifts in killer whale diets via δ13C and δ15N analysis of teeth

    Science.gov (United States)

    Newsome, Seth D.; Etnier, Michael A.; Monson, Daniel H.; Fogel, Marilyn L.

    2009-01-01

    Metabolically inert, accretionary structures such as the dentin growth layers in teeth provide a life history record of individual diet with near-annual resolution. We constructed ontogenetic ??13C and ??15N profiles by analyzing tooth dentin growth layers from 13 individual killer whales Orcinus orca collected in the eastern northeast Pacific Ocean between 1961 and 2003. The individuals sampled were 6 to 52 yr old, representing 2 ecotypes-resident and transient - collected across ???25?? of latitude. The average isotopic values of transient individuals (n = 10) are consistent with a reliance on mammalian prey, while the average isotopic values of residents (n = 3) are consistent with piscivory. Regardless of ecotype, most individuals show a decrease in ??15N values of ???2.5% through the first 3 yr of life, roughly equivalent to a decrease of one trophic level. We interpret this as evidence of gradual weaning, after which, ontogenetic shifts in isotopic values are highly variable. A few individuals (n = 2) maintained relatively stable ??15N and ??13C values throughout the remainder of their lives, whereas ??15N values of most (n = 11) increased by ???1.5%, suggestive of an ontogenetic increase in trophic level. Significant differences in mean ??13C and ??15N values among transients collected off California suggest that individuality in prey preferences may be prevalent within this ecotype. Our approach provides retrospective individual life history and dietary information that cannot be obtained through traditional field observations of free-ranging and elusive species such as killer whales, including unique historic ecological information that pre-dates modern studies. By providing insights into individual diet composition, stable isotope analysis of teeth and/or bones may be the only means of evaluating a number of hypothesized historical dietary shifts in killer whales of the northeast Pacific Ocean. ?? Inter-Research 2009.

  4. Dementia-specific risks of scabies: Retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989–90

    Directory of Open Access Journals (Sweden)

    Nishiura Hiroshi

    2005-10-01

    Full Text Available Abstract Background Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989–90, for which permission to publish was only recently obtained. Methods A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. Results Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067. Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8 and moving beyond the room (but within the ward (OR = 4.1; 95% CI: 1.4, 12.5 were significantly associated with infection, while types of room (Western or Japanese and sleeping arrangement (on beds or futons laid directly on the floor appeared not to be risk factors. Conclusion Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help

  5. Retrospective characterization of ontogenetic shifts in killer whale diets via δ13C and δ15N analysis of teeth

    Science.gov (United States)

    Newsome, Seth D.; Etnier, Michael A.; Monson, Daniel H.; Fogel, Marilyn L.

    2009-01-01

    Metabolically inert, accretionary structures such as the dentin growth layers in teeth provide a life history record of individual diet with near-annual resolution. We constructed ontogenetic δ13C and δ15N profiles by analyzing tooth dentin growth layers from 13 individual killer whales Orcinus orca collected in the eastern northeast Pacific Ocean between 1961 and 2003. The individuals sampled were 6 to 52 yr old, representing 2 ecotypes—resident and transient—collected across ~25° of latitude. The average isotopic values of transient individuals (n = 10) are consistent with a reliance on mammalian prey, while the average isotopic values of residents (n = 3) are consistent with piscivory. Regardless of ecotype, most individuals show a decrease in δ15N values of ~2.5‰ through the first 3 yr of life, roughly equivalent to a decrease of one trophic level. We interpret this as evidence of gradual weaning, after which, ontogenetic shifts in isotopic values are highly variable. A few individuals (n = 2) maintained relatively stable δ15N and δ13C values throughout the remainder of their lives, whereas δ15N values of most (n = 11) increased by ~1.5‰, suggestive of an ontogenetic increase in trophic level. Significant differences in mean δ13C and δ15N values among transients collected off California suggest that individuality in prey preferences may be prevalent within this ecotype. Our approach provides retrospective individual life history and dietary information that cannot be obtained through traditional field observations of free-ranging and elusive species such as killer whales, including unique historic ecological information that pre-dates modern studies. By providing insights into individual diet composition, stable isotope analysis of teeth and/or bones may be the only means of evaluating a number of hypothesized historical dietary shifts in killer whales of the northeast Pacific Ocean

  6. Clinical Outcome of Patients with Breast Phyllodes Tumors: A Retrospective Analysis of 129 Cases in Shiraz, Southern Iran

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    Majid Akrami

    2015-10-01

    Full Text Available Background: Phyllodes tumors are uncommon neoplasms of the breast. Data about their outcome is limited. This study aims to evaluate patients diagnosed with phyllodes tumors in terms of local recurrence, distant metastasis and overall survival. Methods: We retrospectively reviewed the medical records of 129 women with phyllodes tumors who referred to our center from 1999 to 2013. Clinical and pathological features, local and regional recurrence, distant metastasis and overall survival were determined. SPSS 15.0 statistical software was used for analysis. Results:Mean patient age was 39 years (17-67 years. Mean size of the tumor was 5.38 cm. There were 105 (81.4% benign, 8 (6.2% borderline and 16 (12.4% malignant tumors. The mean follow-up period of patients was 28 months (6 to 128 months. The rate of local recurrence among benign tumors was 3.8% (4 cases; in borderline cases the rate was 12.5% (1 case and for malignant cases, it was 18.7% (3 cases. Three patients each recurred twice and one patient had local recurrence for a third time. Two patients died of malignant tumor-related disease - one due to advanced regional recurrence and lung metasta