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Sample records for carcinomatosis multi-center retrospective

  1. Gastric leptomeningeal carcinomatosis: Multi-center retrospective analysis of 54 cases

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    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

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

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    Narayanan Rajmohan L

    2011-05-01

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

  3. Intravenous ketamine for the treatment of refractory status epilepticus: a retrospective multi-center study

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    Gaspard, Nicolas; Foreman, Brandon; Judd, Lilith M.; Brenton, James N.; Nathan, Barnett R.; McCoy, Blathnaid M.; Al-Otaibi, Ali; Kilbride, Ronan; Fernández, Ivan Sánchez; Mendoza, Lucy; Samuel, Sophie; Zakaria, Asma; Kalamangalam, Giridhar P.; Legros, Benjamin; Szaflarski, Jerzy P.; Loddenkemper, Tobias; Hahn, Cecil D.; Goodkin, Howard P.; Claassen, Jan; Hirsch, Lawrence J.; LaRoche, Suzette M.

    2013-01-01

    Summary Purpose To examine patterns of use, efficacy and safety of intravenous ketamine for the treatment of refractory status epilepticus (RSE). Methods Multicenter retrospective review of medical records and EEG reports in ten academic medical centers in North America and Europe, including 58 subjects, representing 60 episodes of RSE were identified between 1999 and 2012. Seven episodes occurred after anoxic brain injury. Key findings Permanent control of RSE was achieved in 57% (34/60) of episodes. Ketamine was felt to have contributed to permanent control (“possible” or “likely” responses) in 32% (19/60) including seven (12%) in which ketamine was the last drug added (likely responses). Four of the seven likely responses, but none of the 12 possible ones, occurred in patients with post-anoxic brain injury. No likely responses were observed when infusion rates were lower than 0.9mg/kg/h; when ketamine was introduced at least eight days after SE onset; or after failure of seven or more drugs. Ketamine was discontinued due to possible adverse events in five patients. Complications were mostly attributed to concurrent drugs, especially other anesthetics. Mortality rate was 43% (26/60), but was lower when SE was controlled within 24h of ketamine initiation (16% vs. 56%, p=0.0047). Significance Ketamine appears to be a relatively effective and safe drug for the treatment of RSE. This retrospective series provides preliminary data on effective dose and appropriate time of intervention to aid in the design of a prospective trial to further define the role of ketamine in the treatment of RSE. PMID:23758557

  4. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix:A retrospective study with review of literature

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    Mamta Singla

    2016-01-01

    Full Text Available Background: Pulmonary lymphangitic carcinomatosis (LC secondary to cervical squamous cell carcinoma (SCC is an uncommon cause of diffuse infiltrative lung disease. Its reported incidence is quiet low. Materials and Methods: Fifty cases of cervical carcinoma were studied from 2005 to 2014. There was only one case of squamous cell carcinoma cervix that developed pulmonary lymphangitic carcinomatosis subsequently. Clinical manifestations of LC such as dyspnea and non-productive cough can mimic with clinical picture of pneumonia, pneumonitis, pulmonary embolism, congestive heart failure, asthma, and sarcoidosis and thus can be a diagnostic dilemma for treating physician. A review of world literature was also done to examine all the reported cases of cervical carcinoma which presented as pulmonary lymphangitic carcinomatosis. A few cases have been reported so far. Concussion: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic Squamous Cell Carcinoma (SCC of the cervix and is associated with a poor prognosis. Increased clinical alertness of such patterns of metastases in cervical cancer along with accurate pathological diagnosis is compulsory to guide proper therapy in these patients.

  5. Clinicopathologic characteristics and prognostic factors of ovarian fibrosarcoma: the results of a multi-center retrospective study

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    Liao Ling-Min

    2010-10-01

    Full Text Available Abstract Background Ovarian fibrosarcomas are very rare tumors, and therefore, few case studies have evaluated the prognostic factors of this disease. To our knowledge, this study represents the largest study to evaluate the clinical and pathologic factors associated with ovarian fibrosarcoma patients. Methods Thirty-one cases of ovarian fibrosarcoma were retrospectively reviewed, which included medical records for eight patients, and 23 published case reports from 1995 through 2009. Patient treatment regimens included total hysterectomy with bilateral adnexectomy and an omentectomy (BAO (n = 9, oophorectomy (OR (n = 8, chemotherapy (CT (n = 1, BAO followed by chemotherapy (BAO+CT (n = 11, BAO followed by radiotherapy (BAO+RT (n = 1, and oophorectomy followed by radiotherapy (OR + RT (n = 1. Results The patients of this cohort were staged according to the guidelines of the Federation of Gynecology and Obstetrics (FIGO, with 15, 6, 9, and 1 stage I-IV cases identified, respectively. Mitotic count values were also evaluated from 10 high-power fields (HPFs, and 3 cases had an average mitotic count P = 0.007 and treatment (P = 0.008 were predictive of poor prognosis. Furthermore, patients with stage I tumors that received BAO+CT were associated with a better prognosis. Conclusions Mitotic activity, and cells positive for Ki-67 were identified as important factors in the diagnosis of ovarian fibrosarcoma. Furthermore, FIGO stage and treatment modalities have the potential to be prognostic factors of survival, with BAO followed by adjuvant chemotherapy associated with an improved treatment outcome.

  6. Concomitant pulmonary tuberculosis in hospitalized healthcare-associated pneumonia in a tuberculosis endemic area: a multi-center retrospective study.

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    Jia-Yih Feng

    Full Text Available BACKGROUND: In tuberculosis (TB endemic areas, Mycobacterium tuberculosis is an important but easily misdiagnosed pathogen in community-acquired pneumonia (CAP. However, the occurrence of concomitant pulmonary tuberculosis (PTB in hospitalized healthcare-associated pneumonia (HCAP has never been investigated. METHODS AND FINDINGS: Seven hundred and one hospitalized HCAP and 934 hospitalized CAP patients from six medical centers in Taiwan were included in this nationwide retrospective study. Concomitant PTB was defined as active PTB diagnosed within 60 days of admission due to HCAP or CAP. The predictors for concomitant PTB and the impact of PTB on the outcomes of pneumonia were investigated. Among the enrolled subjects, 21/701 (3% of the HCAP patients and 25/934 (2.7% of the CAP patients were documented to have concomitant PTB. In multivariate analysis, a history of previous anti-TB treatment (OR = 5.84, 95% CI: 2.29-20.37 in HCAP; OR = 3.33, 95% CI: 1.09-10.22 in CAP and escalated pneumonia severity index (PSI scores (OR = 1.014, 95% CI: 1.002-1.026, in HCAP; OR = 1.013, 95% CI: 1.001-1.026, in CAP were independent predictors for concomitant PTB in both CAP and HCAP patients. Regarding treatment outcomes, HCAP patients with concomitant PTB were associated with more acute respiratory failure within 48 hours of admission (47.6% vs. 22.6%, p = 0.008, higher intensive care unit admission rate (61.9% vs. 35.7%, p = 0.014, longer hospitalization (39.6±34.1 vs. 23.7±27 days, p = 0.009, and higher in-hospital mortality (47.6% vs. 26.3%, p = 0.03 than those without concomitant PTB. Exposure to certain groups of antibiotics for the treatment of pneumonia was not associated with the occurrence of concomitant PTB. CONCLUSIONS: In HCAP patients, the occurrence of concomitant PTB is comparable with that in CAP patients and associated with higher PSI scores, more acute respiratory failure, and higher in-hospital mortality.

  7. Assessment effect of central venous pressure in fluid resuscitation in the patients with shock: a multi-center retrospective research

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    HU Bo; XIANG Hu; LIANG Hui; YU Li; XU Tao; YANG Jun-hui; DU Zhao-hui

    2013-01-01

    Background Central venous pressure (CVP) and intrathoracic blood volume index (ITBVI) were used to assess the fluid status.It has previously been shown that CVP is not as accurate as ITBVI for all the shock patients.We therefore hypothesized that the change of CVP has the ability to predict fluid responsiveness in some clinical cases of shock.Methods From September 1st 2009 to September 1st 2011,sixty-three patients with shock from different Intensive Care Unit (ICU) were collected into this retrospective study.All the patients received fluid challenge strategy (infusing 300 ml hydroxyethyl starch in 20 minutes),were monitored with CVP and pulse-indicated continuous cardiac output (PICCO).The correlation between changes in cardiac index (△CI),CVP (△CVP) and ITBVI (△ITBVI) were analyzed.Fluid responsiveness was defined as an increase in CI≥10%.Receiver operating characteristic (ROC) curves were generated for △CVP and △ITBVI.Results For all the patients,there was no correlation between △CI and △CVP (P=0.073),but in the subgroup analysis,the correlation between △CI and △CVP was significant in those younger than 60 years old (P=-0.018) and those with hypovolemic shock (P=0.001).The difference of areas under the ROC curves of △CVP and △ITBVI were not statistically significant in the group younger than 60 years old or hypovolemic shock group (P >0.05,respectively).However,no similar results can be found in the group older than 60 years old and the other two shock type groups from ROC curves of △CVP and △ITBVI.Conclusions △CVP is not suitable for evaluating the volume status of the shock patients with fluid resuscitation regardless of their condition.However,in some ways,△CVP have the ability to predict fluid responsiveness in the younger shock patients or in the hypovolemic shock patients.

  8. A retrospective, multi-center cohort study evaluating the severity- related effects of cerebrolysin treatment on clinical outcomes in traumatic brain injury.

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    Muresanu, Dafin F; Ciurea, Alexandru V; Gorgan, Radu M; Gheorghita, Eva; Florian, Stefan I; Stan, Horatiu; Blaga, Alin; Ianovici, Nicolai; Iencean, Stefan M; Turliuc, Dana; Davidescu, Horia B; Mihalache, Cornel; Brehar, Felix M; Mihaescu, Anca S; Mardare, Dinu C; Anghelescu, Aurelian; Chiparus, Carmen; Lapadat, Magdalena; Pruna, Viorel; Mohan, Dumitru; Costea, Constantin; Costea, Daniel; Palade, Claudiu; Bucur, Narcisa; Figueroa, Jesus; Alvarez, Anton

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome.

  9. Risk of bladder cancer among patients with diabetes treated with a 15 mg pioglitazone dose in Korea: a multi-center retrospective cohort study.

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    Jin, Sang-Man; Song, Sun Ok; Jung, Chang Hee; Chang, Jin-Sun; Suh, Sunghwan; Kang, Seung Min; Jung, Inkyung; Park, Cheol-Young; Kim, Jae Hyeon; Cho, Jae Hyoung; Lee, Byung-Wan

    2014-02-01

    It has not yet been determined whether chronic exposure to relatively low doses of pioglitazone increases risk of bladder cancer. We aimed to assess the risk of bladder cancer associated with pioglitazone in Korean patients. This was a retrospective cohort study of diabetic patients who had ≥ 2 clinic visits between November 2005 and June 2011 at one of four tertiary referral hospitals in Korea. A prevalent case-control analysis nested within the cohort was conducted to further adjust confounders. A total of 101,953 control patients and 11,240 pioglitazone-treated patients were included, in which there were 237 and 30 cases of incidental bladder cancer (64.9 and 54.9 per 100,000 person-years; age, sex-adjusted HR 1.135, 95% confidence interval [CI] 0.769-1.677), respectively. In the prevalent case-control analysis nested within the cohort, use of pioglitazone for a duration of > 6 months, but not ever use of pioglitazone, was associated with an increased rate of bladder cancer as compared to never use of pioglitazone. In conclusion, we failed to exclude the possible association between use of pioglitazone for a duration of > 6 months and bladder cancer.

  10. Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

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    Men, Min; Fan, Weijun; Zhang, Kaixian; Bi, Jingwang; Yang, Xia; Zheng, Aimin; Huang, Guanghui; Wei, Zhigang

    2016-01-01

    Objective To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. Materials and Methods From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. Results Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). Conclusion CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer. PMID:27833402

  11. Prognostic and Predictive Factors in Patients with Advanced Penile Cancer Receiving Salvage (2nd or Later Line) Systemic Treatment: A Retrospective, Multi-Center Study

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    Buonerba, Carlo; Di Lorenzo, Giuseppe; Pond, Gregory; Cartenì, Giacomo; Scagliarini, Sarah; Rozzi, Antonio; Quevedo, Fernando J.; Dorff, Tanya; Nappi, Lucia; Lanzetta, Gaetano; Pagliaro, Lance; Eigl, Bernhard J.; Naik, Gurudatta; Ferro, Matteo; Galdiero, Mariano; De Placido, Sabino; Sonpavde, Guru

    2016-01-01

    Introduction and objectives: Metastatic penile squamous cell carcinoma (PSCC) is associated with dismal outcomes with median overall survival (OS) of 6–12 months in the first-line and <6 months in the salvage setting. Given the rarity of this disease, randomized trials are difficult. Prognostic risk models may assist in rational drug development by comparing observed outcomes in nonrandomized phase II studies and retrospective data vs. predicted outcomes based on baseline prognostic factors in the context of historically used agents. In this retrospective study, we constructed a prognostic model in the salvage setting of PSCC patients receiving second or later line systemic treatment, and also explored differences in outcomes based on type of treatment. Materials and methods: We performed a chart review to identify patients with locally advanced unresectable or metastatic PSCC who received second or later line systemic treatment in centers from North America and Europe. The primary outcome was OS from initiation of treatment, with secondary outcomes being progression-free survival (PFS) and response rate (RR). OS was estimated using the Kaplan-Meier method. Cox proportional hazards regression was used to identify prognostic factors for outcomes using univariable and multivariable models. Results: Sixty-five patients were eligible. Seventeen of 63 evaluable patients had a response (27.0%, 95% confidence interval [CI] = 16.6–39.7%) and median OS and PFS were 20 (95% CI = 20–21) and 12 (95% CI = 12, 16) weeks, respectively. Visceral metastasis (VM) and hemoglobin (Hb) ≤ 10 gm/dl were consistently significant poor prognostic factors for both OS and PFS, and Hb was also prognostic for response. The 28 patients with neither risk factor had a median OS (95% CI) of 24 (20–40) weeks and 1-year (95% CI) OS of 13.7% (4.4–42.7%), while the 37 patients with 1 or 2 risk factors had median OS (95% CI) of 20 (16–20) weeks and 1-year (95% CI) OS of 6.7% (1.8–24

  12. Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.

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    Togo, Yoshikazu; Kubo, Tatsuhiko; Taoka, Rikiya; Hiyama, Yoshiki; Uehara, Teruhisa; Hashimoto, Jiroh; Kurimura, Yuichiro; Takahashi, Satoshi; Tsukamoto, Taiji; Miyazaki, Jun; Nishiyama, Hiroyuki; Kira, Shinichiro; Kiyota, Hiroshi; Yazawa, Satoshi; Niwa, Naoya; Hongo, Hiroshi; Oya, Mototsugu; Kato, Taku; Yasuda, Mitsuru; Deguchi, Takashi; Ishikawa, Kiyohito; Hoshinaga, Kiyotaka; Matsumoto, Minori; Shigemura, Katsumi; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato; Wada, Koichiro; Uehara, Shinya; Watanabe, Toyohiko; Kumon, Hiromi; Kobayashi, Kanao; Matsubara, Akio; Matsumoto, Masahiro; Sho, Takehiko; Hamasuna, Ryoichi; Matsumoto, Tetsuro; Hayami, Hiroshi; Nakagawa, Masayuki; Yamamoto, Shingo

    2014-04-01

    We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance.

  13. A Retrospective, Multi-Center, Post-Marketing Observational Study to Evaluate the Effectiveness of Ademetionine 1,4-Butanedisulfonate Injection (Transmetil®) Treatment in Chinese Patients with Intrahepatic Cholestasis Caused by Viral Hepatitis

    Institute of Scientific and Technical Information of China (English)

    Wen Xie; Ming-sheng Chen; Cun-jin Mei; Xiao-lin Guo; Xiao-hu Zhao; Jiang-bin Wang; Zheng-qin Fan; Jian-he Gan; Qing Xie; Jun Cheng; Hong Zhao; Yu Chen; Qin Zhang; Wei Lu; Wei Liu; Ai-rong Hu; Han-wei Li; Ping Feng

    2013-01-01

    Obejective Ademetionine 1,4-butanedisulfonate [S-adenosyl-L-methionine (SAMe)/Transmetil®, Abbott] has been available in China for more than 15 years, and it has been shown to reduce serum bilirubin and transaminase levels in patients with viral hepatitis (VH). However, no large-scale studies have focused on the impact of SAMe treatment regimen on reducing the serum total bilirubin (TBil) in VH patients with intrahepatic cholestasis (IHC). The main objective of this study was to evaluate the effectiveness of intravenous SAMe (Transmetil®) treatment in reducing the serum TBil by 50%. Methods This retrospective, multi-center, cross-sectional medical record review involved patients aged≥18 years. Records of 1 280 hospitalized VH patients at 16 sites diagnosed with IHC who had received intravenous SAMe 1 000 mg or 2 000 mg q.d. for at least 7 days from January 1, 2006 to June 30, 2009, were screened and 905 records were randomly selected. Results The safety set (SS) included 834 patients and the full analysis set included 826 patients. TBil levels after 14 days injection treatment were available for 763 patients. TBil decreased≥ 50%versus baseline after 14 days treatment in 288 (37.7%) patients (95%CI 34.3%, 41.2%). Twenty-nine non-serious adverse events (non-SAEs) were reported in 19 (2.3%) patients, and 29 SAEs were reported in 10 patients (1.2%). All adverse events (AEs) were considered unrelated to the drug. Conclusions This retrospective study shows that intravenous SAMe administration in VH patients with IHC is associated with signiifcant reduction of TBil levels in more than 30%of patients 14 days after treatment initiation.

  14. A Retrospective, Multi-Center, Post-Marketing Observational Study to Evaluate the Effectiveness of Ademetionine 1,4-Butanedisulfonate Injection (Transmetil?) Treatment in Chinese Patients with Intrahepatic Cholestasis Caused by Viral Hepatitis

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Obejective Ademetionine 1,4-butanedisulfonate [S-adenosyl-L-methionine (SAMe)/Transmetil?, Abbott] has been available in China for more than 15 years, and it has been shown to reduce serum bilirubin and transaminase levels in patients with viral hepatitis (VH). However, no large-scale studies have focused on the impact of SAMe treatment regimen on reducing the serum total bilirubin (TBil) in VH patients with intrahepatic cholestasis (IHC). The main objective of this study was to evaluate the effectiveness of intravenous SAMe (Transmetil?) treatment in reducing the serum TBil by 50%. Methods This retrospective, multi-center, cross-sectional medical record review involved patients aged≥18 years. Records of 1 280 hospitalized VH patients at 16 sites diagnosed with IHC who had received intravenous SAMe 1 000 mg or 2 000 mg q.d. for at least 7 days from January 1, 2006 to June 30, 2009, were screened and 905 records were randomly selected. Results The safety set (SS) included 834 patients and the full analysis set included 826 patients. TBil levels after 14 days injection treatment were available for 763 patients. TBil decreased≥ 50%versus baseline after 14 days treatment in 288 (37.7%) patients (95%CI 34.3%, 41.2%). Twenty-nine non-serious adverse events (non-SAEs) were reported in 19 (2.3%) patients, and 29 SAEs were reported in 10 patients (1.2%). All adverse events (AEs) were considered unrelated to the drug. Conclusions This retrospective study shows that intravenous SAMe administration in VH patients with IHC is associated with signiifcant reduction of TBil levels in more than 30%of patients 14 days after treatment initiation.

  15. Impact of Pressurized Intraperitoneal Aerosol Chemotherapy on Quality of Life and Symptoms in Patients with Peritoneal Carcinomatosis: A Retrospective Cohort Study

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    Grass, Fabian; Kefleyesus, Amaniel; Achtari, Chahin; Romain, Benoit; Montemurro, Michael

    2017-01-01

    Background. Peritoneal cancer treatment aims to prolong survival, but preserving Quality of Life (QoL) under treatment is also a priority. Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a novel minimally invasive repeatable treatment modality. The aim of the present study was to assess QoL in our cohort of PIPAC patients. Methods. Analysis of all consecutive patients included from the start of PIPAC program (January 2015). QoL (0–100: optimal) and symptoms (no symptom: 0–100) were measured prospectively before and after every PIPAC procedure using EORTC QLQ-C30. Results. Forty-two patients (M : F = 8 : 34, median age 66 (59–73) years) had 91 PIPAC procedures in total (1 : 4x, 17 : 3x, 12 : 2x, and 12 : 1x). Before first PIPAC, baseline QoL was measured as median of 66 ± 2.64. Prominent complaints were fatigue (32 ± 4.3) and digestive symptoms as diarrhea (17 ± 3.75), constipation (17 ± 4.13), and nausea (7 ± 2.54). Overall Quality of Life was 64 ± 3.75 after PIPAC#1 (p = 0.57), 61 ± 4.76 after PIPAC#2 (p = 0.89), and 70 ± 6.67 after PIPAC#3 (p = 0.58). Fatigue symptom score was 44 ± 4.86 after PIPAC#1 and 47 ± 6.69 and 34 ± 7.85 after second and third applications, respectively (p = 0.40). Diarrhea (p = 0.31), constipation (p = 0.76), and nausea (p = 0.66) did not change significantly under PIPAC treatment. Conclusion. PIPAC treatment of peritoneal carcinomatosis had no negative impact on patients' overall QoL and its components or on main symptoms. This study was registered online on Research Registry (UIN: 1608).

  16. MR IMAGING OF MENINGEAL CARCINOMATOSIS BY SYSTEMIC MALIGNANCY

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    马林; 于生元; 蔡幼铨; 梁丽; 郭行高

    2003-01-01

    Objective.To investigate the magnetic resonance(MR)features of meningeal carcinomatosis,and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings. Methods. Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd-DTPA enhanced MR imaging. The enhancement patterns and features,as well as the types of meningeal involvement,were retrospectively analyzed. Results. Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd-DTPA,abnormal pia mater enhancement was detected in 9 cases,demonstrating as the continuous,thin,and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum,brainstem,and cerebrum. No abnormal enhancement in the subarach-noid space was found. Abnormal dura-arachnoid enhancement was seen in 3 cases,showing as the continuous,thick,and curvilineal high signal intensity over the convexities or in the tentorium without extension into the cortical sulci. Cerebral dura-arachnoid involvement was found in all 3 cases and one of them also showed abnormal enhancement in cerebellar dura-arachnoid and tentorium. Of the 11 cases,9 with pial involvement had abnormal cerebrospinal fluid(CSF)results,2 involving only the dura-arachnoid had normal CSF results. Conclusion. Meningeal carcinomatosis could be well demonstrated by Gd-DTPA enhanced MR imaging,and its type could be differentiated by the enhancement features. Combined with the clinical information,Gd-enhanced MR imaging may lead to the diagnosis and guide the therapy of meningeal carcinomatosis.

  17. Computed tomography in meningeal carcinomatosis

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    Koizumi, H.; Ono, N.; Horikoshi, S.; Uki, J.; Takeda, F. (Saitama Cancer Center (Japan))

    1982-04-01

    CT findings of meningeal carcinomatosis were studied in 17 patients (seven with lung cancer, two with breast cancer, one with gastric cancer, one with malignant melanoma, five with leukemia, and one with malignant lymphoma). The diagnosis was confirmed by a cytological survey of the cerebrospinal fluid and/or autopsy. Signs and symptoms caused by meningeal carcinomatosis at the CT examination varied from individual to individual. Those most frequently observed were signs of increased intracranial pressure, often accompanied by cranial nerve palsies, paresthesia, motor weakness, cerebellar signs, and nuchal stiffness, CT scan revealed evidence of meningeal carcinomatosis in ten cases out of the seventeen. CT evidences were obtained in 16.7% of the cases with hematologic malignancy and in 81.8% of those with non-hematologic malignancies. The CT findings of meningeal carcinomatosis may be summarized as follows: I. 1) Obliteration and narrowing of the cisterns and sulci, with contrast enhancement along them. 2) Enhanced spots/areas beneath the brain surface, with contrast enhancement. 3) Diffuse, slightly high density of the brain surface, with contrast enhancement. 4) Enhancement of the ventricular wall. 5) Hydrocephalus. II. 1) No CT abnormalities.

  18. Euclidean supergravity and multi-centered solutions

    Science.gov (United States)

    Sabra, W. A.

    2017-04-01

    In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein-Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D = 5, N = 2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein-Maxwell multi-centered solutions are also presented.

  19. Euclidean supergravity and multi-centered solutions

    Directory of Open Access Journals (Sweden)

    W.A. Sabra

    2017-04-01

    Full Text Available In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein–Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D=5, N=2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein–Maxwell multi-centered solutions are also presented.

  20. A Snapshot on the On-Label and Off-Label Use of the Interleukin-1 Inhibitors in Italy among Rheumatologists and Pediatric Rheumatologists: A Nationwide Multi-Center Retrospective Observational Study

    Science.gov (United States)

    Vitale, Antonio; Insalaco, Antonella; Sfriso, Paolo; Lopalco, Giuseppe; Emmi, Giacomo; Cattalini, Marco; Manna, Raffaele; Cimaz, Rolando; Priori, Roberta; Talarico, Rosaria; Gentileschi, Stefano; de Marchi, Ginevra; Frassi, Micol; Gallizzi, Romina; Soriano, Alessandra; Alessio, Maria; Cammelli, Daniele; Maggio, Maria C.; Marcolongo, Renzo; La Torre, Francesco; Fabiani, Claudia; Colafrancesco, Serena; Ricci, Francesca; Galozzi, Paola; Viapiana, Ombretta; Verrecchia, Elena; Pardeo, Manuela; Cerrito, Lucia; Cavallaro, Elena; Olivieri, Alma N.; Paolazzi, Giuseppe; Vitiello, Gianfranco; Maier, Armin; Silvestri, Elena; Stagnaro, Chiara; Valesini, Guido; Mosca, Marta; de Vita, Salvatore; Tincani, Angela; Lapadula, Giovanni; Frediani, Bruno; De Benedetti, Fabrizio; Iannone, Florenzo; Punzi, Leonardo; Salvarani, Carlo; Galeazzi, Mauro; Rigante, Donato; Cantarini, Luca

    2016-01-01

    Background: Interleukin (IL)-1 inhibitors have been suggested as possible therapeutic options in a large number of old and new clinical entities characterized by an IL-1 driven pathogenesis. Objectives: To perform a nationwide snapshot of the on-label and off-label use of anakinra (ANA) and canakinumab (CAN) for different conditions both in children and adults. Methods: We retrospectively collected demographic, clinical, and therapeutic data from both adult and pediatric patients treated with IL-1 inhibitors from January 2008 to July 2016. Results: Five hundred and twenty-six treatment courses given to 475 patients (195 males, 280 females; 111 children and 364 adults) were evaluated. ANA was administered in 421 (80.04%) courses, CAN in 105 (19.96%). Sixty-two (32.1%) patients had been treated with both agents. IL-1 inhibitors were employed in 38 different indications (37 with ANA, 16 with CAN). Off-label use was more frequent for ANA than CAN (p < 0.0001). ANA was employed as first-line biologic approach in 323 (76.7%) cases, while CAN in 37 cases (35.2%). IL-1 inhibitors were associated with corticosteroids in 285 (54.18%) courses and disease modifying anti-rheumatic drugs (DMARDs) in 156 (29.65%). ANA dosage ranged from 30 to 200 mg/day (or 1.0–2.0 mg/kg/day) among adults and 2–4 mg/kg/day among children; regarding CAN, the most frequently used posologies were 150mg every 8 weeks, 150mg every 4 weeks and 150mg every 6 weeks. The frequency of failure was higher among patients treated with ANA at a dosage of 100 mg/day than those treated with 2 mg/kg/day (p = 0.03). Seventy-six patients (14.4%) reported an adverse event (AE) and 10 (1.9%) a severe AE. AEs occurred more frequently after the age of 65 compared to both children and patients aged between 16 and 65 (p = 0.003 and p = 0.03, respectively). Conclusions: IL-1 inhibitors are mostly used off-label, especially ANA, during adulthood. The high frequency of good clinical responses suggests that IL-1

  1. Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Mehmet Akce

    2014-01-01

    Full Text Available A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9 g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved.

  2. Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis Secondary to Mucinous Adenocarcinoma of the Appendix

    OpenAIRE

    Sparks, David S.; Morris, Bradley; Xu, Wen; Fulton, Jessica; Atkinson, Victoria; Meade, Brian; Lutton, Nicholas

    2015-01-01

    Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a radical but effective treatment option for select peritoneal malignancies. We sought to determine our early experience with this method for peritoneal carcinomatosis secondary to mucinous adenocarcinomas of appendiceal origin. As such, we performed a retrospective clinical study of 30 consecutive patients undergoing CRS with planned HIPEC at the Princess Alexandra Hospital, between June 2009 to Dece...

  3. Leptomeningeal carcinomatosis in esophageal cancer: a case series and systematic review of the literature.

    Science.gov (United States)

    Lukas, R V; Mata-Machado, N A; Nicholas, M K; Salgia, R; Antic, T; Villaflor, V M

    2015-01-01

    The aim of this study was to more clearly define the clinical course of leptomeningeal carcinomatosis due to esophageal cancer. A single institution retrospective case series was conducted. Additionally, a systematic review of the literature was performed. We present a large case series (n = 7) of leptomeningeal carcinomatosis due to esophageal cancer. Our case series and systematic review of the literature report similar findings. In our series, we report a predominance of male patients (86%) with adenocarcinoma histology (77%). Variable onset of leptomeningeal involvement of esophageal cancer in relation to the original diagnosis of the primary disease (5 months to 3 years and 11 weeks) was noted. Disease progresses quickly and overall survival is poor, measured in weeks (2.5-16 weeks) from the diagnosis of leptomeningeal involvement. Four of our patients initiated whole-brain radiation therapy with only two completing the course prior to clinical deterioration. Our patient with the longest survival (16 weeks) received intrathecal topotecan and oral temozolomide. Leptomeningeal carcinomatosis secondary to esophageal cancer has a poor prognosis. A clearly beneficial treatment modality is lacking.

  4. Multiple Dural Tuberculomas Presenting as Leptomeningeal Carcinomatosis

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    Hasan Kocaeli

    2011-01-01

    Full Text Available Objective and Importance. We present the rare occurrence of multiple dural-based tuberculomas mimicking leptomeningeal carcinomatosis in a young immunocompetent patient. Clinical Presentation. A 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI revealed multiple dural-based enhancing lesions with cerebral edema. Intervention. A right frontal craniotomy was performed for diagnosis. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells which was consistent with tuberculosis (TB, and the patient was placed on anti-TB therapy for 24 months. Conclusion. To the best of our knowledge isolated diffuse involvement of the dura mater by TB, mimicking leptomeningeal carcinomatosis, as the sole manifestation of disease has not been reported before. Since pachymeningeal TB is rarely suspected when atypical radiological appearance is combined with the absence of systemic disease, biopsy is inevitably required for diagnosis.

  5. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Science.gov (United States)

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  6. 脑膜癌病%Meningeal carcinomatosis

    Institute of Scientific and Technical Information of China (English)

    倪伟光

    2001-01-01

    目的探讨脑膜癌病的临床表现、 EEG、 CT、 MRI及脑脊液细胞学检查与诊断之间的关系。进一步提高对脑膜癌病的认识。方法对 4例脑膜癌病的临床资料及 EEG、 CT、 MRI、脑脊液检查进行综合分析。结果脑膜癌病主要病变累及软脑膜、颅神经及脊神经根。临床表现复杂,主要出现脑症状,颅神经症状和脊神经症状。脑脊液检查,多数患者蛋白与细胞数轻-中度增高,葡萄糖及氯化物减少。结论 EEG、 CT、 MRI检查对诊断脑膜癌病有重要参考价值。诊断时需注意与结核性脑膜炎,新型隐球菌性脑膜炎及脑囊虫病相鉴别。脑脊液发现癌细胞是诊断本病的可靠依据。%Objective To improve the knowledge about meningeal carcinomatosis by exploring the relationship between the clinical characteristics、 EEG、 CT、 MRI、 cerebrospinal fluid(CSF) and diagnosis. Methods The clinical materials of 4 patients with meningeal carcinomatosis and EEG、 CT、 MRI、 Cytomorphology in CFS were analysed. Results Meningeal carcinomatosis mainly involve some tissues such as cranial nerves、 pia mater、 spinal nervous roots and appear some symptoms associated with these diseased tissues. In CSF of most patients with this disease there is a slight- middle increase in protein and amount of cells, decrease in glucose and chloride. Conclusion EEG、 CT and MRI play an important role in the diagnosis of meningeal carcinomatosis. There is a necessity to differentiate it from cerebral tuberculosis, cytoccous meningitis and cerebral cysticercosis. It is reliable evidence to find cancer cell in CSF.

  7. Meningeal carcinomatosis in undifferentiated nasopharyngeal carcinoma: a case report.

    Science.gov (United States)

    Cushman, Daniel M; Giese, German; Rouhani, Panta

    2014-07-01

    Meningeal carcinomatosis is the tumoral invasion of the leptomeninges. It is caused by the spread of malignant cells throughout the subarachnoid space, which produces signs and symptoms due to multifocal involvement. Cranial nerve symptoms are the most common focal findings. The diagnosis is usually made by imaging and/or cytology. Head and neck cancers are the cause of approximately 2% of all cases of meningeal carcinomatosis; in very rare cases, they are caused by a nasopharyngeal carcinoma. We report a case of meningeal carcinomatosis that was caused by a recurrence of undifferentiated nasopharyngeal carcinoma. The patient, a 60-year-old woman, experienced no focal neurologic symptoms and exhibited no radiologic evidence of meningeal involvement. We also review the literature on meningeal carcinomatosis secondary to nasopharyngeal carcinoma.

  8. Pulmonary Lymphangitic Carcinomatosis due to Renal Cell Carcinoma.

    Science.gov (United States)

    Guddati, Achuta K; Marak, Creticus P

    2012-05-01

    Renal cell carcinoma is an aggressive disease with a high rate of mortality. It is known to metastasize to the lung, liver, bone and brain. However, manifestation through lymphatic spread to the lungs is rare. Lymphangitic carcinomatosis is commonly observed in malignancies of the breast, lung, pancreas, colon and cervix. It is unusual to observe lymphangitic carcinomatosis of the lungs due to renal cell carcinoma. Lymphangitic carcinomatosis of the lungs may result in severe respiratory distress and may be the direct cause of death. Currently, there are no known modalities of preventing or slowing lymphangitic carcinomatosis besides treating the primary tumor. However, early detection may change the course of the disease and may prolong survival. This is compounded by the difficulty involved in diagnosing lymphangitic carcinomatosis of the lung which frequently involves lung biopsy. Immunohistochemical studies are often used in conjunction with regular histochemistry in ascertaining the primary tumor and in differentiating it from pulmonary metastasis. In this case report, we describe the presentation and clinical course of renal cell carcinoma in a patient which manifested as lymphangitis carcinomatosa of the lungs. The patient underwent surgical resection of the primary tumor with lymph node resection but presented with a fulminant lymphangitic carcinomatosis of the lungs within two weeks. Immunohistochemistry of the tissue obtained by the biopsy confirmed the diagnosis which was subsequently corroborated during his autopsy. This case illustrates the necessity of an urgent follow-up of chemotherapy and immunotherapy in such patients.

  9. Pulmonary Lymphangitic Carcinomatosis due to Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Achuta K. Guddati

    2012-05-01

    Full Text Available Renal cell carcinoma is an aggressive disease with a high rate of mortality. It is known to metastasize to the lung, liver, bone and brain. However, manifestation through lymphatic spread to the lungs is rare. Lymphangitic carcinomatosis is commonly observed in malignancies of the breast, lung, pancreas, colon and cervix. It is unusual to observe lymphangitic carcinomatosis of the lungs due to renal cell carcinoma. Lymphangitic carcinomatosis of the lungs may result in severe respiratory distress and may be the direct cause of death. Currently, there are no known modalities of preventing or slowing lymphangitic carcinomatosis besides treating the primary tumor. However, early detection may change the course of the disease and may prolong survival. This is compounded by the difficulty involved in diagnosing lymphangitic carcinomatosis of the lung which frequently involves lung biopsy. Immunohistochemical studies are often used in conjunction with regular histochemistry in ascertaining the primary tumor and in differentiating it from pulmonary metastasis. In this case report, we describe the presentation and clinical course of renal cell carcinoma in a patient which manifested as lymphangitis carcinomatosa of the lungs. The patient underwent surgical resection of the primary tumor with lymph node resection but presented with a fulminant lymphangitic carcinomatosis of the lungs within two weeks. Immunohistochemistry of the tissue obtained by the biopsy confirmed the diagnosis which was subsequently corroborated during his autopsy. This case illustrates the necessity of an urgent follow-up of chemotherapy and immunotherapy in such patients.

  10. Extensive cortical involvement in leptomeningeal carcinomatosis.

    Science.gov (United States)

    Ayzenberg, I; Börnke, C; Tönnes, C; Ziebarth, W; Lavrov, A; Lukas, C

    2012-12-01

    We present a 77-year-old previously well patient with facial asymmetry and progressive weakness of the lower extremities. An initial MRI revealed slight contrast enhancement of the meninges. Three consecutive cerebrospinal fluid examinations demonstrated low glucose concentration, marked elevation of total protein and moderate pleocytosis. No tumor cells, fungi, acid-fast bacilli or mycobacterial DNA were found. The patient's level of consciousness deteriorated dramatically, and follow-up MRI showed widespread extensive cortical hyperintensities. The lesions showed restricted diffusion on diffusion-weighted images as well as low values on the corresponding apparent diffusion coefficient maps, the changes consistent with diffuse cytotoxic edema. Neuropathological examination findings were of leptomeningeal carcinomatosis (LMC) with diffuse continuous infiltration of the cerebral cortex, cerebellum and spinal cord. The autopsy revealed a subcentimetre adenocarcinoma of the lung. To our knowledge, this is the first report demonstrating extensive cortical involvement in adenocarcinomatous LMC.

  11. Calcification of peritoneum and peritoneal fluid perfusion malfunction in carcinomatosis of serous membranes of peritoneal cavity

    Directory of Open Access Journals (Sweden)

    Gantsev SK

    2016-09-01

    Full Text Available The article describes the peritoneal calcification in peritoneal carcinomatosis, as well as its possible role in the development of carcinomatosis within the frames of the authors’ alternative theory. The analysis of the "serous-lymph hatches" condition of the intact peritoneum and peritoneum in carcinomatosis was carried out. Also the elemental quantitative calcium determination in the intact peritoneum and the peritoneum in peritoneal carcinomatosis was carried out using the atomic emission spectrometry.

  12. 脑膜癌病12例临床特点分析%Clinical analysis of meningeal carcinomatosis in 12 patients

    Institute of Scientific and Technical Information of China (English)

    万继峰; 陆尤; 徐云燕; 刘长春; 常素杰; 周卫东

    2012-01-01

    Objective To explore clinical features, cerebrospinal fluid cytology and imaging findings in meningeal carcinomatosis. Methods The data of clinic, cerebrospinal fluid cytology and imaging findings of 12 patients with meningeal carcinomatosis were analyzed retrospectively, and relevant literatures were also reviewed. Results Headache, vomiting were the most of the capital symptoms of these meningeal carcinomatosis, cranial and spinal nerve damage and signs of meningeal irritation might be associated. There were abnormal levels of intracranial pressure in different extent, and tumor cells were found in the cytological examination of cerebrospinal fluid, while in the MRI enhanced scanning, abnormal linear and strip enhancement of meninges were noted. Conclusion Meningeal carcinomatosis are of some clinical manifestations, and both cerebrospinal fluid cytology results noting tumor cells and MRI enhanced scanning examination are important evidences in diagnosing meningeal carcinomatosis.%目的 探讨脑膜癌病的临床、脑脊液细胞学和影像学特点.方法 对12例诊断为脑膜癌病患者的临床资料进行回顾性总结,并结合文献进行分析.结果 临床首发症状以头痛、呕吐为主,可伴脑神经和脊神经损害及脑膜刺激征;脑脊液压力均不同程度增高,脑脊液中均找到癌细胞;头颅MRI增强扫描可见脑膜强化.结论 脑膜癌病临床表现有一定特征,脑脊液细胞学检查发现癌细胞,头颅MRI增强扫描发现脑膜强化对脑膜癌病的确诊有重要意义.

  13. Neuroborreliosis Mimicking Leptomeningeal Carcinomatosis in a Patient With Breast Cancer

    Directory of Open Access Journals (Sweden)

    Stefanie Fischer MD

    2014-03-01

    Full Text Available Leptomeningeal carcinomatosis is a serious complication of advanced cancer. Various clinical manifestations may present, such as headache, nausea, seizures, cranial neuropathies. In this article, we report the case of a 65-year-old woman with metastatic breast cancer who was admitted to hospital suffering from facial palsy, which was suspected to be caused by leptomeningeal tumor infiltration. Magnetic resonance imaging (MRI scans of the head and spine showed meningeal enhancement of the facial nerve, conus medullaris, and fibers of the cauda equina, which were radiologically interpreted as leptomeningeal carcinomatosis. Assessment of cerebrospinal fluid found no malignant cells but investigation for infectious diseases established the diagnosis of neuroborreliosis. Antibiotic treatment with doxycycline was performed. After completion of treatment, follow-up MRI scans found complete regression of meningeal enhancement. Several months later, the patient is still in good condition and without neurological symptoms. Hence, initial diagnosis of leptomeningeal carcinomatosis was rejected. This case report should alert oncologists to carefully rule out infectious diseases before leptomeningeal carcinomatosis is diagnosed. Cerebrospinal fluid analysis is strongly recommended due to low specificity of MRI images in this regard.

  14. The European contribution to "Sugarbaker's protocol" for the treatment of colorectal peritoneal carcinomatosis Aportación europea al "protocolo de Sugarbaker" en el tratamiento de la carcinomatosis peritoneal colorrectal

    Directory of Open Access Journals (Sweden)

    A. Gómez Portilla

    2009-02-01

    Full Text Available Introduction: in 1981, Dr. PH Sugarbaker, challenging oncological orthodoxy, considered carcinomatosis to be a locoregional stage of the disease that was still susceptible to treatment with curative intent. To this end he developed a new therapeutic alternative based on the combined treatment. The macroscopic disease treated by maximum radical oncological cytoreductive surgery (through the peritonectomies described by him, followed by treatment of the residual microscopic disease with the direct intra-abdominal application of intraoperative chemotherapy with locoregional intensification, modulated by hyperthermia and early normothermic postoperative intra-abdominal chemotherapy. Using this new therapeutic regimen, known as "Sugarbaker's Protocol", his group has reported 45% survival rates in carcinomatosis of colorectal origin at 5 years, and, in selected groups of patients, 50% survival rates at 5 years. The scientific community, however, has criticized these results considering that: it is a personal experience, with a not homogenous treatment protocol with developmental modifications over time, that it is a retrospective non-randomized study, and finally that the cytostatics used in his protocol are obsolete. Various European groups have replied to these main criticisms confirming the good results that this new therapeutic alternative offers for patients with carcinomatosis of colorectal origin. The purpose of this article is to present these contributions. Material and methods: all the articles published in the English language by European groups in the world's medical literature have been reviewed using the Pubmed-MEDLINE database to identify the relevant articles related to the treatment of carcinomatosis of colorectal origin using cytoreduction and intraperitoneal chemotherapy from January 1980 to January 2008. Results: the European contribution during these 25 years in favour of the "Sugarbaker's Protocol" has consisted fundamentally in

  15. A multi-center retrospective study of organ involvement in adult patients with polymyositis or dermatomyositis%成人多发性肌炎和(或)皮肌炎多器官损害多中心回顾性研究

    Institute of Scientific and Technical Information of China (English)

    赵千子; 王国春; 刘湘源; 张江林; 穆荣; 左晓霞; 李小峰; 武丽君; 巩路

    2014-01-01

    Objective To explore the prevalence and characteristics of main organ involvement in adult patients with polymyositis (PM) or dermatomyositis (DM) and determine their specific relative factors.Methods Using unified questionnaire,we retrospectively collected the medical records of 1 387 confirmed adult PM/DM patients from 2007 to 2012 at 22 rheumatology centers in China.Statistical analyses were performed with chi-square or Fisher exact test and multivariate analyses with logistic regression.Results A total of 1 387 patients were collected with 460 (33.2%) PM and 927 (66.8%) DM.The female:male ratio was 2.4∶ 1.Their onset age was(47 ± 14) years.A total of 1 031 (74.3%) patients had organ involvement.The prevalence of pulmonary involvement,arthritis,gastrointestinal and cardiac involvement were 44.6%,32.3%,21.9% and 20.3% respectively.The multivariate analysis indicated that older onset age (P < 0.01) was positively associated with pulmonary involvement while myalgia (P <0.05) was negatively associated.Fever (P < 0.05),weight loss (P < 0.05) and Raynaud's phenomenon (P < 0.01) were positively associated with arthritis while muscle weakness (P < 0.05) negatively associated.Weight loss (P <0.05),Raynaud's phenomenon (P <0.01) and muscle weakness (P <0.05)were positively associated with gastrointestinal involvement.Weight loss (P < 0.05) and swollen limbs (P <0.05) were positively associated with cardiac involvement.Conclusion The prevalence of organ involvement is high in adult PM/DM patients.Our study may aid the diagnosis of organ damage in PM/DM patients.%目的 分析成人多发性肌炎(PM)和(或)皮肌炎(DM)主要器官损害的发生率和特点,并确定与其相关的特异性因素.方法 使用统一的调查表,回顾性收集2007至2012年在全国22个三级甲等医院风湿免疫科住院的符合纳入排除标准的1 387例成人PM和(或)DM患者的病例资料,并进行统计分析.结果 共收集1 387

  16. 非离断Roux-e n-Y吻合在全腹腔镜下远端胃癌根治术消化道重建中应用的多中心数据回顾分析%Retrospective analysis of multi-center data on the application of uncut Roux-en-Y gastrojejunostomy in totally laparoscopic distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    朱甲明; 臧卫东; 臧潞; 李勇

    2016-01-01

    Objective To investigate the feasibility and safety of uncut Roux-en-Y gastroduodenostomy in totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. Methods Clinical data of 30 gastric cancer patients from 4 hospitals undergoing TLDG plus uncut Roux-en-Y gastroduodenostomy from February 2014 to January 2015 were analyzed retrospectively. Results Among 30 gastric cancer patients, 8 were in Guangdong General Hospital, 9 in The Second Hospital of Jilin University, 4 in Ruijin Hospital and 9 in Fujian Provincial Cancer Hospital, who were diagnosed as distal gastric cancer by pathology without distant metastasis. The clinical staging of these patients was stageⅠA in 7 cases, stageⅠB in 4, stageⅡA in 6, stageⅡB in 5, stage Ⅲ A in 5, stage Ⅲ B in 1, stage Ⅲ C in 2. All the main surgeons were experienced with more than 50 operations of totally laparoscopic distal gastrectomy for gastric cancer. All the 30 patients completed operations successfully. The incision length was (4.8 ± 1.2) cm, total operation time and anastomosis time was (223.5 ± 47.2) and (52.8 ± 10.9) minutes, intra-operative blood loss was (53.0 ± 30.7) ml and number of harvested lymph nodes was 36.9 ± 0.9. No case was transferred to open operation. The detain time of gastric tube was (2.5 ± 1.2) days, the first time to flatus was (2.9 ± 0.9) days and the first time to liquid diet intake was (2.9 ± 1.2) days. No perioperative death was found. Postoperative lymphatic leakage occurred in 1 case and peritoneal bleeding occurred in 1 case , which was cured by conservative treatment. No one developed anastomosis-related complication. Conclusion Uncut Roux-en-Y gastroduodenostomy reconstruction is safe and feasible in totally laparoscopic distal gastrectomy for gastric cancer.%目的:探讨非离断(Uncut)Roux-en-Y吻合术应用于全腹腔镜远端胃癌根治术消化道重建中的安全性和可行性。方法回顾性分析2014年2月至2015年1月间在广东省人

  17. Multi-center retrospective study of single-port and multi-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy%单孔和多孔胸腔镜肺叶、肺段切除术多中心回顾性分析

    Institute of Scientific and Technical Information of China (English)

    吉春宇; 项杨威; 章雪飞; 王喆歆; 冯键; 方文涛

    2016-01-01

    Objective To assess the feasibility and perioperative outcomes of single-port and multi-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy.Methods The clinical data of 458 patients undergoing video-assisted thoracoscopic anatomic lobectomy or segmentectomy in Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Affiliated Hospital of National Taiwan University, University of HongKong Queen Mary Hospital,Shenzhen Hospital and Korea University Guro Hospital between 2013 and 2014 were retrospectively analyzed.Patients were divided into single-port thoracoscopic group and multi-port(including 2-port, 3-port and 4-port) thoracoscopic group according to surgical approaches.The parameters of duration of operation,volume of blood loss during operation,conversion of surgical approach,number and stations of lymph nodes harvested,postoperative chest tube drainage time, volume of chest tube drainage, postoperative hospitalization time, incidence of hospital readmission, perioperative morbidity and mortality,and pain score within 3 days after operation were compared between two groups.Results There was no significant difference in the number and stations of lymph nodes harvested, incidence of hospital readmission,postoperative morbidity and mortality,and pain score on the third day after operation between two group(P>0.05).The duration of operation and volume of blood loss during operation in single-port group were significantly longer or larger than those in multi-port group(t=2.039,P =0.042;χ2 =23.534,P <0.001) The pain scores on the first day and second day after operation in single-port group were significantly lower than those in multi-port group(χ2 =9.959,P =0.002;χ2 =11.971,P <0.0001)5). Conclusions Single-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy is a safe and feasible approach,which has less surgical trauma and postoperative pain than the traditional multiple-port approach.%目的:分析和比较单

  18. Multi-Center Vector Field Methods for Wave Equations

    Science.gov (United States)

    Soffer, Avy; Xiao, Jianguo

    2016-12-01

    We develop the method of vector-fields to further study Dispersive Wave Equations. Radial vector fields are used to get a-priori estimates such as the Morawetz estimate on solutions of Dispersive Wave Equations. A key to such estimates is the repulsiveness or nontrapping conditions on the flow corresponding to the wave equation. Thus this method is limited to potential perturbations which are repulsive, that is the radial derivative pointing away from the origin. In this work, we generalize this method to include potentials which are repulsive relative to a line in space (in three or higher dimensions), among other cases. This method is based on constructing multi-centered vector fields as multipliers, cancellation lemmas and energy localization.

  19. A multiple correlation factors analysis of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture.A multi-center retrospective study%股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死多中心多因素相关分析

    Institute of Scientific and Technical Information of China (English)

    周锦春; 郭敦明; 王青; 陈哲峰; 崔维顶; 范卫民; 刘锋

    2013-01-01

    Objective To determine the incidence of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture and to investigate the multiple factors correlated to avascular femoral head necrosis.Methods All the patients of intra-capsular femoral neck fracture who accepted closed reduction and cannulated compression screws fixation between 2001 and 2010 in Jiangsu Province were reviewed in multi-centers retrospectively.The multiple factors were analyzed including age,gender,affected side,mechanism of injury,fracture classification,procedure delay,quality of reduction,time of full-weight-bearing,configuration of the screws and removal of the screws.Multiple correlation factors were analyzed with SPSS 13.0 statistic system.Results Complete case records were documented in 1849 cases who were followed up for an average 6.5±2.7 years (range,2-10 years).Avascular necrosis occurred in 246 cases (13.3%).The average time of diagnosis of avascular necrosis was 17±4.6months (range,8-72 months) after injury.The average Harris score of the hips which didn't develop to avascular necrosis was 93.8±8.9 (range,78~100) at the last follow up.Multiple correlation factors analysis indicated that displacement degrees of fracture and the quality of reduction were significantly correlated to the incidence of avascular necrosis (OR=2.078,3.423).Conclusion Closed reduction and cannulated compression screws fixation after the intra-capsular femoral neck fracture can get satisfactory results.Displacement degrees of fracture and the quality of reduction are significantly correlated to the incidence of avascular femoral head necrosis.%目的 调查股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死的发生率,探讨各影响因素与股骨头坏死的相关性.方法 对江苏地区2001至2010年期间接受闭合复位加压螺纹钉内固定治疗的股骨颈骨折患者进行回顾性调查.以股骨头坏

  20. [Intrathecal methotrexate in breast cancer meningeal carcinomatosis - Experience with a new administration schedule].

    Science.gov (United States)

    Cochereau, Delphine; Da Costa, Sabrina; Le Maignan, Christine; Gauthier, Hélène; Cochereau, Jérôme; Espié, Marc; Giacchetti, Sylvie; Teixeira, Luis

    2016-05-01

    Methotrexate represents the standard intrathecal treatment of breast cancer meningeal carcinomatosis. However, its optimal schedule remains undefined. The aim of the present study was to evaluate results obtained with the methotrexate schedule used in Saint-Louis hospital (Paris). Patients followed in Saint-Louis hospital for breast cancer and who received intrathecal methotrexate were included in this retrospective monocentric study. Intrathecal treatment received contained methotrexate 12 mg/day (days: 1-5) and then 15 mg/week until progression or toxicity. Between 2003 and 2015, 41 patients were included. Primitive tumours were RH+/HER2-, HER2+ and triple-negative in respectively 66%, 14%, 5% and 15% of patients, 22% of them had meningeal carcinomatosis as metastatic disease initial manifestation. Objective response rate was 54%, median overall survival was 4.0 mois [CI 95%: 3-7.3] and 1-year survival rate was 15.2% (11.4%, 50% et 0% in RH+/HER2-, HER2+ and triple-negative subgroups; HR=0.45 [0.21-0.97] between HER2+ and RH+/HER2-). In univariate analysis, prognostic factors were brain involvement (p=0.049), initial cerebrospinal fluid protein level (p=0.0002) and concomitant systemic treatment received (p=0.049). This intrathecal methotrexate schedule demonstrates a similar median overall survival as the one obtained with a dose-dense schedule and an improved quality of life. Nevertheless, as the objective response and 1-year survival rates are slightly inferior, a dose-dense schedule remains still preferred in HER2+ patients or in those harboring a mainly meningeal progression.

  1. Hidrocefalia y Carcinomatosis Leptomeningea secundaria a Adenocarcinoma pulmonar

    Directory of Open Access Journals (Sweden)

    Jose Alexis Quesada

    2015-03-01

    Full Text Available La carcinomatosis leptomeningea se diagnostica en aproximadamente un 5% al 7% de los tumores malignos, dentro de los cuales, el mas frecuente es el Carcinoma pulmonar en todos sus subtipos histológicos. Presentamos un caso clínico en el cual el paciente se presenta con un cuadro cefelea, visión borrosa e hidrocefalia de origen idiopático como síntoma inicial. Meses después de la colocación de una derivación Ventriculo-peritoneal, reingresa con un síndrome de desgaste, pérdida de peso, hiporexia, astenia y adinamia, en donde el estudio de necropsia revelo un adenocarcinoma pulmonar poco diferenciado con micrometastasis cerebrales y carcinomatosis leptomeningea.

  2. Current treatment options for colon cancer peritoneal carcinomatosis

    OpenAIRE

    Aoyagi, Tomoyoshi; Terracina, Krista P; Raza, Ali; Takabe, Kazuaki

    2014-01-01

    Peritoneal carcinomatosis (PC), the dissemination of cancer cells throughout the lining of the abdominal cavity, is the second most common presentation of colon cancer distant metastasis. Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years, it has been repeatedly shown that these therapies remain ineffective for colon cancer PC. Recently, there has been a rapid accumulation of reports that cytoreductive surgery combined with hyper...

  3. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix

    Directory of Open Access Journals (Sweden)

    Senger Jenna-Lynn B

    2010-12-01

    Full Text Available Abstract Introduction Pulmonary metastasis presenting as lymphangitic carcinomatosis arising from squamous cell carcinoma (SCC of the cervix is a rare event. Poorly represented in the literature, this event is associated with a difficulty in accurate diagnosis, b grave prognosis, and the c lack of recognized predisposing risk factors. Case Report A 50 year-old female presented at our practice with a three-month history of a productive cough associated with dyspnoea and shortness of breath. A chest x-ray and computed tomography (CT scan revealed multiple bilateral patchy areas with subsegmental atelectasis in both lungs which was investigated with a bronchoscopy, left thoracoscopy, and a left lung biopsy. Pathological examination of the wedge biopsy of the left upper lobe revealed neoplastic sheets of cell disturbed along the septal vessels, perivascular/peribronchial lymphatics, and the subpleural lymphatics. This lymphangitic carcinomatosis was confirmed to be metastatic from SCC of the cervix that had been diagnosed and treated two years ago. She was treated with systemic Carbo/Taxol chemotherapy and corticosteroids as a palliative measure. Despite temporary improvement, she died 13 months later. Conclusion Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic SCC of the cervix. As clinical presentations including radiographic imaging mimics other pulmonary entities, accurate diagnosis remains a challenge. Increased clinical awareness of such patterns of metastases in cervical cancer supported by accurate pathological diagnosis is imperative to guide appropriate therapy in these patients.

  4. Ethics review of pediatric multi-center drug trials.

    Science.gov (United States)

    Needham, Allison C; Kapadia, Mufiza Z; Offringa, Martin

    2015-02-01

    The assessment of safety and efficacy of therapeutics for children and adolescents requires the use of multi-centered designs. However, the need to obtain ethical approval from multiple independent research ethics boards (REBs) presents as a challenge to investigators and sponsors who must consider local requirements while ensuring that the protection of human subjects is consistent across sites. In pediatrics, this requirement is complicated by pediatric-specific ethical concerns such as the acquisition of assent and consent and the need for pediatric expertise to assess the scholarly merit of the proposed research. Efforts to tackle these challenges have focused on the process of ethics review, which will improve efficiency. In addition to improving process, we suggest further research to fill gaps in the evidence base for recommendations and decisions made by REBs, specifically their effectiveness to protect human subjects. Evidence gathered will contribute to the successful development, adoption and implementation of harmonized guidance to apply ethics principles in order to protect children through research rather than from research.

  5. Intracranial Leptomeningeal Carcinomatosis from Breast Cancer Detected on 18F-FDG PET.

    Science.gov (United States)

    Carra, Bradley J; Clemenshaw, Michael N

    2015-09-01

    Leptomeningeal carcinomatosis is an uncommon manifestation of non-central nervous system (CNS) metastatic disease. Diagnosis, however, has important prognostic and treatment implications. We present a case in which intracranial leptomeningeal carcinomatosis from a primary breast cancer was detected with (18)F-FDG PET/CT, despite its low sensitivity for detection of CNS metastases from non-CNS primary tumors.

  6. Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: a population-based study.

    NARCIS (Netherlands)

    Lemmens, V.E.; Klaver, Y.L.B.; Verwaal, V.J.; Rutten, H.J.; Coebergh, J.W.W.; Hingh, I.H.J.T. de

    2011-01-01

    The aim of our study was to provide population-based data on incidence and prognosis of synchronous peritoneal carcinomatosis and to evaluate predictors for its development. Diagnosed in 1995-2008, 18,738 cases of primary colorectal cancer were included. Predictors of peritoneal carcinomatosis were

  7. Treatment of Leptomeningeal Carcinomatosis in a Patient With Metastatic Cholangiocarcinoma

    Science.gov (United States)

    McNeill, Katharine; Volpicelli, Frank M.; Warltier, Karin; Iturrate, Eduardo; Okamura, Charles; Adler, Nicole; Smith, Joshua; Sigmund, Alana; Mednick, Aron; Wertheimer, Benjamin; Hochman, Katherine

    2014-01-01

    A 49-year-old woman with cholangiocarcinoma metastatic to the lungs presented with new-onset unrelenting headaches. A lumbar puncture revealed malignant cells consistent with leptomeningeal metastasis from her cholangiocarcinoma. Magnetic resonance imaging (MRI) of the brain revealed leptomeningeal enhancement. An intrathecal (IT) catheter was placed and IT chemotherapy was initiated with methotrexate. Her case is notable for the rarity of cholangiocarcinoma spread to the leptomeninges, the use of IT chemotherapy with cytologic and potentially symptomatic response, and a possible survival benefit in comparison to previously reported cases of leptomeningeal carcinomatosis secondary to cholangiocarcinoma. PMID:26157901

  8. Lymphangitic Carcinomatosis as a Cause of Malignant Transient Pleural Transudate

    Directory of Open Access Journals (Sweden)

    Raquel Garcia Sevila

    2009-01-01

    Full Text Available Although it is generally accepted that a malignant transient pleural transudate may appear during the early stages of lymphatic obstruction, cases demonstrating such probability are rare in literature. A 67-year-old woman was admitted to hospital because a lymphangitic carcinomatosis and a transudative infrapulmonary pleural effusion with a cytology positive for adenocarcinoma. One month later the effusion keeps being positive for adenocarcinoma but exudative in character. Lymphatic obstruction appears as the cause of the initial transudative characteristics of the pleural effusion.

  9. Uterine adenocarcinoma with abdominal carcinomatosis in a beluga whale.

    Science.gov (United States)

    Lair, S; De Guise, S; Martineau, D

    1998-04-01

    A case of uterine adenocarcinoma is reported in a 26-yr-old, free-ranging beluga whale (Delphinapterus leucas) from the St. Lawrence estuary (Quebec, Canada). This neoplasm appeared as a segmental stenotic thickening of the left uterine horn composed of well differentiated, but disorganized and infiltrative, glandular structures surrounded by an extensive scirrhous stroma. Abdominal carcinomatosis was observed on the mesosalpinx and on the serosal aspect of the gastric compartments. This is the first report of a malignancy originating in the uterus of a cetacean.

  10. Carcinomatosis peritoneal secundaria a carcinoma Lobulillar de mama

    OpenAIRE

    PRIEGO J,PABLO; RODRÍGUEZ V,GLORIA; REGUERO C,Mª EUGENIA; CABANAS M,JACOBO; LISA C,EDUARDO; PEROMINGO F,ROBERTO; FRESNEDA M,VIRGILIO

    2007-01-01

    Introducción: Aunque el cáncer de mama metastatiza con mayor frecuencia en ganglios linfáticos, hueso, pulmón e hígado, también se puede extender hacia el tracto gastrointestinal, peritoneo y órganos ginecológicos. Material y Método: Describimos tres casos de carcinomatosis peritoneal secundaria a la diseminación metastásica de un carcinoma lobulillar infiltrante de mama. En los tres casos el diagnóstico se hizo varios años después del descubrimiento del tumor primario y en dos de ellos se ob...

  11. Bilateral sudden sensorineural hearing loss caused by leptomeningeal carcinomatosis: case report and review.

    Science.gov (United States)

    Öztürk, Murat; Ila, Kadri; Düzgöl, Cihan; Akansel, Gür; Almaç, Ahmet

    2014-01-01

    Leptomeningeal carcinomatosis is a rare condition characterized by diffuse infiltration of the meninges after the metastasis of the solid tumors. Bilateral sudden hearing loss is a rare initial symptom. In this article, we report a 44-year-old male patient with bilateral sudden hearing loss and dizziness. Magnetic resonance imaging showed involvement of the bilateral vestibulocochlear nerves. Malignant cells were detected in cerebrospinal fluid cytology. To the best of our knowledge, leptomeningeal carcinomatosis due to duodenum adenocarcinoma has not been reported before in the English literature. Leptomeningeal carcinomatosis should be kept in mind in patients who have bilateral sudden sensorineural hearing loss.

  12. Multi-Center Electronic Structure Calculations for Plasma Equation of State

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, B G; Johnson, D D; Alam, A

    2010-12-14

    We report on an approach for computing electronic structure utilizing solid-state multi-center scattering techniques, but generalized to finite temperatures to model plasmas. This approach has the advantage of handling mixtures at a fundamental level without the imposition of ad hoc continuum lowering models, and incorporates bonding and charge exchange, as well as multi-center effects in the calculation of the continuum density of states.

  13. Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Gani, C.; Mueller, A.C.; Eckert, F.; Schroeder, C.; Bamberg, M.; Berger, B. [Univ. of Tuebingen (Germany). Dept. of Radiation Oncology; Bender, B. [Univ. of Tuebingen (Germany). Dept. of Diagnostics and Interventional Neuroradiology; Pantazis, G. [Univ. of Tuebingen (Germany). Dept. of Neuropathology

    2012-02-15

    The purpose of the present study was to investigate outcome after whole brain radiotherapy (WBRT) alone as a palliative treatment without concomitant chemotherapy for intracranial leptomeningeal carcinomatosis (LMC). Overall survival and treatment response were retrospectively analyzed in 27 consecutive patients with LMC from breast and lung cancer. All patients had evidence of intracranial manifestations of LMC. Seven potential prognostic factors were evaluated. Median overall survival (OS) for the entire group was 8.1 weeks. OS rates after 6 and 12 months were 26% and 15%, respectively. Improvement of neurological deficits was observed in 3 patients. In 3 of 4 patients with follow-up MRI studies, a decreased size of contrast-enhanced lesions was observed. Prognostic factors for improved OS on univariate analysis were absence of cranial nerve dysfunction, Karnofsky Performance Score (KPS) > 60%, and time interval > 35 months between the initial diagnosis of malignant disease and development of LMC. On multivariate analysis, absence of cranial nerve dysfunction remained the only significant prognosticator for OS (median 3.7 vs. 19.4 weeks, p < 0.001). WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT. (orig.)

  14. Intraperitoneal photodynamic therapy for peritoneal carcinomatosis and sarcomatosis

    Science.gov (United States)

    Hahn, Stephen M.; Fraker, Douglas L.; Zhu, Timothy C.; Yodh, Arjun G.; Rodriguez, Carmen E.; Smith, Debbie; Currens, Ann; Glatstein, Eli

    2000-03-01

    The preliminary results of an ongoing Phase II trial of Photofrin-mediated intraperitoneal PDT (IP PDT) are presented. The clinical endpoints of this trial are to determine the response rates of patients with carcinomatosis and sarcomatosis to IP PDT and to document the toxicities of IP PDT in a defined patient population. Photofrin, 2.5 mg/kg, was administered intravenously 48 hours prior to debulking surgery and light delivery, 57 patients with ovarian cancer, gastrointestinal cancers, and sarcomas were enrolled. 44 patients received Photofrin and received light treatment. 39 patients are valuable for response. 8 of 39 patients had a complete radiographic response to IP PDT 3 months after treatment. 3 patients are alive without evidence of disease 6, 6 and 9 months after treatment. 1 patient is alive and has no evidence of intra-abdominal disease but has developed lung metastases. Toxicities include post-operative fluid shifts, hypotension, hydronephrosis, pleural effusions, enteric fistula, transient liver function test elevation, thrombocytopenia, and wound dehiscence. Toxicity is related to pre-operative tumor bulk and to the extensiveness of surgery required. IP PDT is feasible and leads to an initial clinical response rate of 25 percent in patients with incurable peritoneal carcinomatosis and sarcomatosis.

  15. Intrathecal Trastuzumab Treatment in Patients with Breast Cancer and Leptomeningeal Carcinomatosis.

    Science.gov (United States)

    Park, Won-Young; Kim, Han-Jo; Kim, Kyoungha; Bae, Sang-Byung; Lee, Namsu; Lee, Kyu-Taek; Won, Jong-Ho; Park, Hee-Sook; Lee, Sang-Cheol

    2016-04-01

    Leptomeningeal carcinomatosis is a fatal manifestation of metastatic breast cancer. Investigation of intrathecal (IT) trastuzumab for leptomeningeal carcinomatosis is currently underway; however, there has been no consensus. We report on two cases of human epidermal growth factor receptor 2 positive (HER2+) breast cancer following IT trastuzumab for leptomeningeal carcinomatosis. The first patient was treated with weekly IT 15 mg methotrexate plus IT 50 mg trastuzumab for 7 months, followed by IT trastuzumab (50 mg > 25 mg) for 18 months. The other patient received IT trastuzumab with systemic chemotherapy (trastuzumab and/or paclitaxel) for 13 months. Good control of leptomeningeal disease was achieved with IT trastuzumab in both patients, with survival durations of 20 and 29 months, respectively. We suggest that IT trastuzumab is a promising treatment for patients with HER2+ breast cancer and leptomeningeal carcinomatosis.

  16. TENIPOSIDE FOR MENINGEAL CARCINOMATOSIS OF SMALL-CELL LUNG-CANCER

    NARCIS (Netherlands)

    VANDERGRAAF, WTA; HAAXMAREICHE, H; BURGHOUTS, JTM; POSTMUS, PE

    1993-01-01

    A female patient with small cell lung cancer and extensive bone marrow metastases achieved a complete response after combination chemotherapy including etoposide. During maintenance therapy meningeal carcinomatosis was diagnosed. After intravenous administration of teniposide she improved dramatical

  17. Leptomeningeal Carcinomatosis Secondary to Gastroesophageal Adenocarcinoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ayman A Abdo

    2002-01-01

    Full Text Available BACKGROUND: Leptomeningeal carcinomatosis (LC is a rare metastatic complication of solid tumours. It has been mainly described in association with breast cancer, lung cancer and melanoma.

  18. Value of {sup 18}F-FDG PET in the detection of peritoneal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Akiko; Kawano, Tsuyoshi; Takahashi, Nobukazu; Lee, Jin; Nakagami, Yoshihiro; Inoue, Tomio [Yokohama City University, Department of Radiology, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan); Miyagi, Etsuko; Hirahara, Fumiki [Yokohama City University, Department of Obstetrics and Gynecology, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan); Togo, Shinji; Shimada, Hiroshi [Yokohama City University, Department of Gastroenterological Surgery, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan)

    2004-10-01

    Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis. We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUV{sub max}) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured. The sensitivity and positive predictive value (PPV) of combined FDG PET and CT were superior to those of CT alone for the detection of peritoneal lesions (sensitivity: 66.7% vs 22.2%, p<0.025; PPV: 92.3% vs 50.0%, p<0.05). The most frequent pattern of FDG uptake in patients with peritoneal carcinomatosis was abnormally intense focal uptake near the abdominal wall. An SUV{sub max} threshold of 5.1 produced a diagnostic accuracy of combined FDG PET and CT of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 14 patients (40.0%), and led to alteration of the therapeutic strategy in five (14.3%) of the enrolled cancer patients. We found that use of an intra-abdominal FDG uptake cut-off value for SUV{sub max} of >5.1 assists in the diagnosis of peritoneal carcinomatosis. FDG PET may play an important role in the clinical management of patients with suspected peritoneal carcinomatosis. (orig.)

  19. Dysphagia and anorexia as presentations of leptomeningeal carcinomatosis.

    Science.gov (United States)

    Aiyer, Rohit; Engelman, Ester; Xue, Wei; Yu, Edward

    2016-04-12

    A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.

  20. Current treatment options for colon cancer peritoneal carcinomatosis.

    Science.gov (United States)

    Aoyagi, Tomoyoshi; Terracina, Krista P; Raza, Ali; Takabe, Kazuaki

    2014-09-21

    Peritoneal carcinomatosis (PC), the dissemination of cancer cells throughout the lining of the abdominal cavity, is the second most common presentation of colon cancer distant metastasis. Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years, it has been repeatedly shown that these therapies remain ineffective for colon cancer PC. Recently, there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) prolongs the life of colon cancer PC patients. Here, we will review the clinical presentation, the mechanisms of disease progression, and current treatment options for colon cancer PC, with a focus on the benefits and limitations of CRS-HIPEC.

  1. Meningeal carcinomatosis: an extremely rare involvement of urinary bladder carcinoma.

    Science.gov (United States)

    Uncu, Dogan; Arpaci, Fikret; Beyzadeoglu, Murat; Gunal, Armagan; Surenkok, Serdar; Ozturk, Mustafa; Ozet, Ahmet

    2010-01-01

    Meningeal carcinomatosis (MC) is a rare presentation of solid tumors, particularly breast cancer, lung cancer, and malignant melanoma. Recently, the incidence of MC has been reported to be increasing. It has a bad prognosis despite aggressive therapy. The usual clinical presentation is multifocal involvement of the neuraxis, with headache and radicular pain being the most common initial symptoms. The most frequent signs are motor deficits, altered mental status, and cranial nerve involvement. The treatment of MC remains controversial and no straightforward guidelines exist in the literature. MC from urinary bladder tumors is rare. In this case report, we present a 52-year-old male patient with meningeal metastasis from a primary urinary bladder carcinoma along with a review of the related literature. Free full text available at www.tumorionline.it

  2. Clinical Analysis of 8 Patients with Meningeal Carcinomatosis%脑膜癌病8例临床分析

    Institute of Scientific and Technical Information of China (English)

    丛树艳; 翟志永; 毕国荣; 黄达; 宋利春

    2012-01-01

    [Objective] To explore the characteristics of clinical manifestation, magnetic resonance imaging (MRI) findings and cerebrospinal fluid(CSF) findings of meningeal carcinomatosis in order to improve the diagnosis of the disease. [Methods] Clinical data of 8 patients diagnosed as meningeal carcinomatosis were analyzed retrospectively. [Results]The main clinical manifestations of 8 patients were headache, vomiting, dizziness, vision loss, mental symptoms, seizures, paralysis of limbs and so on. Among them, there were 5 cases of primary lung cancer, 2 cases of breast cancer and a case of unknown primary lesion. In all 8 patients, the pressure and protein content in CSF increased and white blood cell counts were normal or slightly elevated. Sugar and chloride content decreased in some cases. Tumor cells were found in CSF of two cases. Knhanced cranial MRI scan showed meningeal enhancement, leptomeningeal diffuse line-like enhancement in 3 cases, lep-tomeningeal diffuse line-like with nodular-like enhancement in 3 cases and dura line-like enhancement with nod-ular-like enhancement in 2 cases. [Conclusion] The clinical manifestation of meningeal carcinomatosis has no specificity. CSF cytological examination is an important method for the diagnosis of meningeal carcinomatosis, but the positive rate is low. Actively looking for the primary tumor and enhanced head MRI scan have important roles in the diagnosis of the disease.%[目的]探讨脑膜癌病的临床、MRI和脑脊液特点,以提高对本病的诊断水平.[方法]对8例确诊为脑膜癌病患者的临床资料进行回顾性分析.[结果]本组8例,临床主要表现为头痛、呕吐,眩晕、视力下降、精神症状,癫痫发作,肢体瘫痪等.其中原发病灶肺癌5例,乳腺癌2例及原发病灶不明1例.8例患者脑脊液压力及蛋白含量均增高,白细胞数正常或轻度增高,部分病例糖及氯化物降低,4例脑脊液查到瘤细胞.头颅MRI增强扫描均表现为脑膜强

  3. Clinical feature and image analysis of 29 cases of meningeal carcinomatosis

    Directory of Open Access Journals (Sweden)

    Jia-cai LIN

    2016-04-01

    Full Text Available Objective  To study the clinical features, laboratory results and image characteristics of meningeal carcinomatosis (MC. Methods  The clinical data, laboratory and image results, and cerebrospinal fluid (CSF findings of 29 cases diagnosed as MC were retrospectively reviewed and analyzed. Results  Lung cancer is more common as the primary malignancy in MC patients [16(55.2%]. The earliest neurological symptoms varied in MC patients, and headache was the most common symptom (58.6%, followed by epilepsy (13.8%, vision loss (10.3%, neuralgia (6.8%, hearing loss (6.8% and hoarseness (3.4%, and a part of MC patients presented some serious complications. Examination of CSF of MC patients revealed an increase in intracranial pressure, and the presence of white blood cells, red blood cells and increased protein content, while the contents of glucose and chlorides decreased. The content of carcinoembryonic antigen (CEA increased obviously, and CSF cytological exam was found to be positive in 26% patients. Head CT may not helpful for the diagnosis of the MC. The enhanced brain MRI scanning may reveal abnormal enhancement of piamater in 94.7% of MC patients, with diffuse enhancement in 94.4% of cases occurring mostly in piamater and subarachnoid space. Conclusions  MC is an unique form of brain metastases of malignant tumor. The clinical feature are varied and lack of specificity. Enhanced brain MRI scanning and CSF examination may provide some value for diagnosis. Meningeal metastasis is one of the most critical complications resulting in high mortality. Early diagnosis of MC followed by enhanced treatment can prolong survival time and improve patients' prognosis. DOI: 10.11855/j.issn.0577-7402.2016.03.09

  4. Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis Secondary to Mucinous Adenocarcinoma of the Appendix

    Science.gov (United States)

    Sparks, David S.; Morris, Bradley; Xu, Wen; Fulton, Jessica; Atkinson, Victoria; Meade, Brian; Lutton, Nicholas

    2015-01-01

    Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a radical but effective treatment option for select peritoneal malignancies. We sought to determine our early experience with this method for peritoneal carcinomatosis secondary to mucinous adenocarcinomas of appendiceal origin. As such, we performed a retrospective clinical study of 30 consecutive patients undergoing CRS with planned HIPEC at the Princess Alexandra Hospital, between June 2009 to December 2012, with mucinous adenocarcinomas of the appendix. CRS was performed in 30 patients, 13 received HIPEC intraoperatively and 17 received early postoperative intra-peritoneal chemotherapy (EPIC) in addition. Mean age was 52.3 years and median hospital stay was 26 days (range 12–190 days). Peritoneal cancer index scores were 0–10 in 6.7% of patients, 11–20 in 20% of patients and >20 in 73.3% of patients. Complete cytoreduction was achieved overall in 21 patients. In total, 106 complications were observed in 28 patients. Ten were grade 3-A, five were grade 3-B and one grade-5 secondary to a fatal PE on day 97. In patients who received HIPEC, there was no difference in disease-free survival (P = 0.098) or overall survival (P = 0.645) between those who received EPIC versus those who did not. This study demonstrates that satisfactory outcomes with regards to morbidity and survival can be achieved with CRS and HIPEC, at a single-centre institution with growing expertise in the technique. Our results are comparable with outcomes previously described in the international literature. PMID:25594636

  5. Radiotherapy of the neuroaxis for palliative treatment of leptomeningeal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, B.; Hueltenschmidt, B.; Sautter-Bihl, M.L. [Staedtisches Klinikum Karlsruhe (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    2001-04-01

    Background: Leptomeningeal carcinomatosis occurs in about 5% of solid tumors and may seriously compromise quality of life. Aim of the present study was to evaluate the feasibility of craniospinal irradiation with and without intrathecal chemotherapy and its efficacy with regard to symptom palliation and survival. Patients and Methods: 16 patients (mean age 46 years; nine breast cancers, five lung cancers, one renal cell cancer, one tumor of unknown primary site) with leptomeningeal carcinomatosis occurring after a median interval from primary tumor diagnosis of 5 months (0-300 months) received craniospinal irradiation between October 1995 and May 2000. The median total dose was 36 Gy (a 1.6-2.0 Gy). Ten patients were additionally treated with intrathecal methotrexate (15 mg per cycle, 2-8 cycles). Results: Median survival was 12 weeks, 8 weeks after radiotherapy alone, 16 weeks after combined modality treatment. 14 patients died from disease. Eleven patients (68%) experienced regression of their neurological symptoms during or soon after completion of radiotherapy. Seven patients regained their ability to walk, six had pain reduction, three regression of bladder and bowel incontinence. In three patients symptom progression and in two patients no change occurred. Side effects were: Myelosuppression (CTC) Grade I: n=2, Grade II: n=4, Grade III: n=4 patients and Grade IV: n=1. Nine patients had dysphagia, seven mucositis, three suffered from nausea. No late toxicity was observed. Conclusion: Craniospinal radiotherapy is feasible and effective for palliative treatment of leptomeningeal carcinomatosis. As far as the small patient number permits any definite conclusions, combined modality treatment seems superior to irradiation alone. (orig.) [German] Hintergrund: Eine Leptomeningeosis carcinomatosa, die bei ca. 5% aller soliden Tumoren auftritt, kann die Lebensqualitaet erheblich beeintraechtigen. Ziel der Studie war es, Machbarkeit und Effektivitaet einer

  6. 77 FR 9665 - Submission for OMB Emergency Review; Comment Request: A Multi-Center International Hospital-Based...

    Science.gov (United States)

    2012-02-17

    ... Multi- Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI... Institute (NCI), the National Institutes of Health (NIH), has submitted to the Office of Management and... currently valid OMB control number. Proposed Collection: Title: A Multi-Center International Hospital-...

  7. Leptomeningeal carcinomatosis can be presenting manifestation of breast carcinoma

    Directory of Open Access Journals (Sweden)

    Mandić-Stojmenović Gorana

    2016-01-01

    Full Text Available Introduction. Leptomeningeal carcinomatosis (LC is a serious complication occuring in solid cancer patients with rather poor prognosis. Case report. We presented a 47-yearold woman with the 6-month history of diffuse headache, nausea and visual obscuration. Initially, clinical status and brain magnetic resonance imaging (MRI indicated syndrome of idiopathic intracranial hypertension. Due to clinical progression and high papillary stasis, cerebrospinal fluid (CSF examination was performed only after ventriculoperitoneal shunt was implanted. This led to a significant although transient clinical improvement. Futher investigations led to the diagnosis of invasive lobular breast carcinoma and repeated CSF analysis revealed malignant breast carcinoma cells. In this case LC was an initial presentation of a malignant disease. Conclusion. In the presence of a high clinical suspicion of LC, in spite of initially negative findings, a clinician should persist in repeating relevant tests, such are MRI with larger amounts of gadolinium and high-volume cytological CSF analyses in order to make the diagnosis. [Projekat Ministarstva nauke Republike Srbije, br. 175022

  8. Leptomeningeal carcinomatosis as primary manifestation of pancreatic cancer.

    Science.gov (United States)

    Trinh, Victoria T; Medina-Flores, Rafael; Chohan, Muhammad O

    2016-08-01

    Leptomeningeal carcinomatosis (LMC) is a rare complication of cancer that often presents at an advanced stage after obvious metastasis of a primary cancer or locally advanced disease. We present an uncommon case of LMC secondary to pancreatic carcinoma presenting with headache, unilateral VII nerve palsy, and lower extremity weakness. Initial cerebrospinal fluid (CSF) studies were concerning for chronic aseptic meningitis but negative for malignant cells; the diagnosis of tuberculous meningitis was erroneously evoked. Three lumbar punctures were required to capture malignant cells. The diagnosis of LMC was based on CSF examination with cytology/immunohistochemistry and leptomeningeal enhancement on MRI. Post mortem autopsy revealed advanced and diffusely metastatic pancreatic adenocarcinoma. This patient demonstrates that solid tumors can present with leptomeningeal spread that often confuses the treating physician. Fungal or tuberculous meningitis can mimic LMC in the absence of neoplastic signs and negative CSF cytology. This event is exceedingly rare in pancreatic cancer. If the index of suspicion is high, repeat CSF sampling can increase the sensitivity of detection of malignant cells and thus result in the correct diagnosis.

  9. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma.

    Science.gov (United States)

    Iacoponi, S; Calleja, J; Hernandez, G; de la Cuesta, R Sainz

    2015-01-01

    Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as 'a bunch of grapes' occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a 'bunch of grapes' containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre.

  10. Novel diffusion-weighted magnetic resonance imaging findings in leptomeningeal carcinomatosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Y.F.; Chang, F.C.; Hu, H.H.; Hsu, L.C. [Taipei Veterans General Hospital, Taiwan (China). Depts. of Internal Medicine and Radiology, and Neurological Inst.

    2006-12-15

    This report presents a rare case of leptomeningeal carcinomatosis initially presenting with mental impairment and rapidly progressing to coma without any history of malignancy. In addition to highlighting the diagnostic difficulties, the linear high signal intensity along the cortex on the diffusion-weighted imaging (DWI) sequence of magnetic resonance (MR) imaging was identified accidentally. High signal change in the corresponding areas was also noted on unenhanced fluid-attenuated inversion recovery (FLAIR) MR imaging, which may be a novel method of diagnosing leptomeningeal carcinomatosis, which should be studied further.

  11. Solution of multi-center molecular integrals of Slater-type orbitals

    Science.gov (United States)

    Tai, H.

    1989-01-01

    The troublesome multi-center molecular integrals of Slater-type orbitals (STO) in molecular physics calculations can be evaluated by using the Fourier transform and proper coupling of the two center exchange integrals. A numerical integration procedure is then readily rendered to the final expression in which the integrand consists of well known special functions of arguments containing the geometrical arrangement of the nuclear centers and the exponents of the atomic orbitals. A practical procedure was devised for the calculation of a general multi-center molecular integrals coupling arbitrary Slater-type orbitals. Symmetry relations and asymptotic conditions are discussed. Explicit expressions of three-center one-electron nuclear-attraction integrals and four-center two-electron repulsion integrals for STO of principal quantum number n=2 are listed. A few numerical results are given for the purpose of comparison.

  12. LORIS: A web-based data management system for multi-center studies.

    Directory of Open Access Journals (Sweden)

    Samir eDas

    2012-01-01

    Full Text Available LORIS (Longitudinal Online Research and Imaging System is a modular and extensible web-based data management system that integrates all aspects of a multi-center study: from heterogeneous data acquisition (imaging, clinical, behavior, genetics to storage, processing and ultimately dissemination. It provides a secure, user-friendly, and streamlined platform to automate the flow of clinical trials and complex multi-center studies. A subject-centric internal organization allows researchers to capture and subsequently extract all information, longitudinal or cross-sectional, from any subset of the study cohort. Extensive error-checking and quality control procedures, security, data management, data querying and administrative functions provide LORIS with a triple capability (i continuous project coordination and monitoring of data acquisition (ii data storage/cleaning/querying, (iii interface with arbitrary external data processing pipelines. LORIS is a complete solution that has been thoroughly tested through the full life cycle of a multi-center longitudinal project# and is now supporting numerous neurodevelopment and neurodegeneration research projects internationally.

  13. Expanding the Use of Time-Based Metering: Multi-Center Traffic Management Advisor

    Science.gov (United States)

    Landry, Steven J.; Farley, Todd; Hoang, Ty

    2005-01-01

    Time-based metering is an efficient air traffic management alternative to the more common practice of distance-based metering (or "miles-in-trail spacing"). Despite having demonstrated significant operational benefit to airspace users and service providers, time-based metering is used in the United States for arrivals to just nine airports and is not used at all for non-arrival traffic flows. The Multi-Center Traffic Management Advisor promises to bring time-based metering into the mainstream of air traffic management techniques. Not constrained to operate solely on arrival traffic, Multi-Center Traffic Management Advisor is flexible enough to work in highly congested or heavily partitioned airspace for any and all traffic flows in a region. This broader and more general application of time-based metering is expected to bring the operational benefits of time-based metering to a much wider pool of beneficiaries than is possible with existing technology. It also promises to facilitate more collaborative traffic management on a regional basis. This paper focuses on the operational concept of the Multi-Center Traffic Management Advisor, touching also on its system architecture, field test results, and prospects for near-term deployment to the United States National Airspace System.

  14. Intestinal obstruction due to malign breast neoplasm and peritoneal carcinomatosis: a case report

    Directory of Open Access Journals (Sweden)

    Flávia Balsamo

    2012-06-01

    Full Text Available Peritoneal carcinomatosis due to breast cancer is rare and gastrointestinal tract involvement is also unusual. Symptoms are unspecific and can begin many years after the primary tumor. Investigation of carcinomatosis origin is mandatory as breast cancer carcinomatosis can relieve partially or totally with chemo and hormonal therapy. A case of colonic obstruction due to carcinomatosis secondary to breast cancer is reported, emphasizing its diagnostic aspects and treatment.A carcinomatose peritoneal secundária ao câncer de mama é entidade rara e o comprometimento do trato gastrointestinal é pouco frequente. A sintomatologia bastante inespecífica dificulta o diagnóstico e os sintomas podem surgir vários anos após o aparecimento do tumor primário. O diagnóstico da origem da carcinomatose é fundamental, pois quando a doença é secundária à neoplasia de mama, pode ocorrer remissão parcial e até total da doença com quimio e hormonioterapia. Relata-se caso de obstrução colônica devido a carcinomatose peritoneal secundária a neoplasia maligna de mama, com ênfase em seu diagnóstico e tratamento.

  15. Peritoneal mucinous carcinomatosis in a patient with a history of Hirschsprung's disease: The role of home parenteral nutrition Carcinomatosis mucinosa peritoneal en un paciente con antecedente de enfermedad de Hirschsprung: El papel de la nutrición parenteral

    OpenAIRE

    J. M. Moreno-Villares; A. Mañas-Rueda; M. León-Sanz

    2007-01-01

    A case of peritoneal mucinous carcinomatosis in a patient who suffered a Hirschsprung disease 30 year before is presented. TH present condition caused an irreversible intestinal obstruction and the patients received home parenteral nutrition without unremarkable complications longer than two years.Presentamos el caso de un paciente en quien se diagnosticó una carcinomatosis mucinosa peritoneal treinta años después de haber padecido una enfermedad de Hirschsprung. El cuadro clínico actual curs...

  16. A multi-center survey of childhood asthma in Turke--I: the cost and its determinants.

    Science.gov (United States)

    Beyhun, Nazim E; Soyer, Ozge U; Kuyucu, Semanur; Sapan, Nihat; Altintaş, Derya U; Yüksel, Hasan; Anlar, Fehmi Y; Orhan, Fazil; Cevit, Omer; Cokuğras, Haluk; Boz, Ayşen B; Yazicioğlu, Mehtap; Tanaç, Remziye; Sekerel, Bülent E

    2009-02-01

    Successful management of childhood asthma requires a thorough idea of the economic impact of asthma and its determinants, as policy makers and physicians inevitably influence the outcome. The aim of this study was to define the cost of childhood asthma in Turkey and its determinants. In April 2006, a multi-center, national study was performed where data regarding cost and control levels were collected. Asthmatic children (6-18 yr) with at least a 1-yr follow-up seen during a 1-month period with scheduled or unscheduled visits were included. The survey included a questionnaire-guided interview and retrospective evaluation of files. Cost and its determinants during the last year were analyzed. A total of 618 children from 12 asthma centers were surveyed. The total annual cost of childhood asthma was US$1597.4 +/- 236.2 and there was a significant variation in costs between study centers (p < 0.05). Frequent physician visits [odds ratio (95% confidence intervals)] [2.3 (1.6-3.4)], hospitalization [1.9 (1.1-3.3)], asthma severity [1.6 (1.1-2.8)], and school absenteeism due to asthma [1.5 (1.1-2.1)] were major predictors of total annual costs (p < 0.05 for each). The comparable cost of asthma among Turkish children with that reported in developed countries suggests that interventions to decrease the economic burden of pediatric asthma should focus on the cost-effectiveness of anti-allergic household measures and on improving the control levels of asthma.

  17. Remission of rheumatoid arthritis and potential determinants: a national multi-center cross-sectional survey.

    Science.gov (United States)

    Wang, Guan-Ying; Zhang, Sa-Li; Wang, Xiu-Ru; Feng, Min; Li, Chun; An, Yuan; Li, Xiao-Feng; Wang, Li-Zhi; Wang, Cai-Hong; Wang, Yong-Fu; Yang, Rong; Yan, Hui-Ming; Wang, Guo-Chun; Lu, Xin; Liu, Xia; Zhu, Ping; Chen, Li-Na; Jin, Hong-Tao; Liu, Jin-Ting; Guo, Hui-Fang; Chen, Hai-Ying; Xie, Jian-Li; Wei, Ping; Wang, Jun-Xiang; Liu, Xiang-Yuan; Sun, Lin; Cui, Liu-Fu; Shu, Rong; Liu, Bai-Lu; Yu, Ping; Zhang, Zhuo-Li; Li, Guang-Tao; Li, Zhen-Bin; Yang, Jing; Li, Jun-Fang; Jia, Bin; Zhang, Feng-Xiao; Tao, Jie-Mei; Lin, Jin-Ying; Wei, Mei-Qiu; Liu, Xiao-Min; Ke, Dan; Hu, Shao-Xian; Ye, Cong; Han, Shu-Ling; Yang, Xiu-Yan; Li, Hao; Huang, Ci-Bo; Gao, Ming; Lai, Bei; Cheng, Yong-Jing; Li, Xing-Fu; Song, Li-Jun; Yu, Xiao-Xia; Wang, Ai-Xue; Wu, Li-Jun; Wang, Yan-Hua; He, Lan; Sun, Wen-Wen; Gong, Lu; Wang, Xiao-Yuan; Wang, Yi; Zhao, Yi; Li, Xiao-Xia; Wang, Yan; Zhang, Yan; Su, Yin; Zhang, Chun-Fang; Mu, Rong; Li, Zhan-Guo

    2015-02-01

    The aim of this study is to investigate the remission rate of rheumatoid arthritis (RA) in China and identify its potential determinants. A multi-center cross-sectional study was conducted from July 2009 to January 2012. Data were collected by face-to-face interviews of the rheumatology outpatients in 28 tertiary hospitals in China. The remission rates were calculated in 486 RA patients according to different definitions of remission: the Disease Activity Score in 28 joints (DAS28), the Simplified Disease Activity Index (SDAI), the Clinical Disease Activity Index (CDAI), and the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definition. Potential determinants of RA remission were assessed by univariate and multivariate analyses. The remission rates of RA from this multi-center cohort were 8.6% (DAS28), 8.4% (SDAI), 8.2% (CDAI), and 6.8% (Boolean), respectively. Favorable factors associated with remission were: low Health Assessment Questionnaire (HAQ) score, absence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), and treatment of methotrexate (MTX) and hydroxychloroquine (HCQ). Younger age was also predictive for the DAS28 and the Boolean remission. Multivariate analyses revealed a low HAQ score, the absence of anti-CCP, and the treatment with HCQ as independent determinants of remission. The clinical remission rate of RA patients was low in China. A low HAQ score, the absence of anti-CCP, and HCQ were significant independent determinants for RA remission.

  18. [A case of meningeal carcinomatosis due to gastric cancer treated with intrathecal chemotherapy].

    Science.gov (United States)

    Kobayashi, Yuka; Sugitani, Soichi; Oseki, Koshi; Iiri, Takao

    2011-10-01

    A 71-year-old man was admitted to our hospital in September 2009 because of severe headache due to meningeal carcinomatosis. In July 2007, subtotal gastrectomy was carried out for gastric cancer. Because intraabdominal cytodiagnosis was positive, he received systemic chemotherapy for 2 years. Recurrent signs were not found on chest or abdominal CT just before hospitalization. He was given NSAIDs and corticosteroid, but his symptom did not improve. Subsequent intrathecal chemotherapy with MTX and Ara-C improved clinical symptoms dramatically. He received care at home for 3 months before he passed away due to pleural and peritoneal recurrence. Recently, since the frequency of meningeal carcinomatosis is increasing, combination treatment of intrathecal chemotherapy and systemic chemotherapy should be considered not only for improvement of clinical manifestations, but also for prognostic improvement.

  19. Current role of hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis from colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Bernardino; Rampone; Beniamino; Schiavone; Antonio; Martino; Giuseppe; Confuorto

    2010-01-01

    Peritoneal carcinomatosis is one of the most common routes of dissemination of colorectal cancer (CRC). It is encountered in 7% of patients at primary surgery, while it develops in about 4% to 19% of patients after curative surgery and in up to 44% of patients with recurrent CRC. Peritoneal involvement from colorectal malignancies has been considered traditionally as a manifestation of terminal disease, due to limited response to conventional surgical and chemotherapeutic treatments. In the past few years t...

  20. 5-FU-hydrogel inhibits colorectal peritoneal carcinomatosis and tumor growth in mice

    Directory of Open Access Journals (Sweden)

    Shi Huashan

    2010-08-01

    Full Text Available Abstract Background Colorectal peritoneal carcinomatosis (CRPC is a common form of systemic metastasis of intra-abdominal cancers. Intraperitoneal chemotherapy is a preferable option for colorectal cancer. Here we reported that a new system, 5-FU-loaded hydrogel system, can improve the therapeutic effects of intraperitoneal chemotherapy. Methods A biodegradable PEG-PCL-PEG (PECE triblock copolymer was successfully synthesized. The biodegradable and temperature sensitive hydrogel was developed to load 5-FU. Methylene blue-loaded hydrogel were also developed for visible observation of the drug release. The effects and toxicity of the 5-FU-hydrogel system were evaluated in a murine CRPC model. Results The hydrogel system is an injectable flowing solution at ambient temperature and forms a non-flowing gel depot at physiological temperature. 5-FU-hydrogel was subsequently injected into abdominal cavity in mice with CT26 cancer cells peritoneal dissemination. The results showed that the hydrogel delivery system prolonged the release of methylene blue; the 5-FU-hydrogel significantly inhibited the peritoneal dissemination and growth of CT26 cells. Furthermore, intraperitoneal administration of the 5-FU-hydrogel was well tolerated and showed less hematologic toxicity. Conclusions Our data indicate that the 5-FU-hydrogel system can be considered as a new strategy for peritoneal carcinomatosis, and the hydrogel may provide a potential delivery system to load different chemotherapeutic drugs for peritoneal carcinomatosis of cancers.

  1. Successful EGFR-TKI rechallenge of leptomeningeal carcinomatosis after gefitinib-induced interstitial lung disease.

    Science.gov (United States)

    Nakamichi, Shinji; Kubota, Kaoru; Horinouchi, Hidehito; Kanda, Shintaro; Fujiwara, Yutaka; Nokihara, Hiroshi; Yamamoto, Noboru; Tamura, Tomohide

    2013-04-01

    We report the case of a 49-year-old non-smoking Japanese woman with backache and difficulty in walking. She was diagnosed as having advanced lung adenocarcinoma, and an epithelial growth factor receptor mutation (in-frame deletions in exon 19) was found. After radiation therapy of bone metastases with spinal cord compression and brain metastases, gefitinib was administered. On day 2, she developed acute interstitial lung disease. Gefitinib therapy was discontinued and treatment with high-dose steroid therapy improved the interstitial lung disease. Cisplatin plus pemetrexed was initiated as second-line chemotherapy, but she was hospitalized again for leptomeningeal carcinomatosis. Considering the poor prognosis of leptomeningeal carcinomatosis, we decided that erlotinib was our only choice of treatment. As a third-line treatment, erlotinib was administered after informing the patient about the high risk of interstitial lung disease. Neurological symptoms were improved within a week and interstitial lung disease did not recur. The patient has received erlotinib successfully for 18 months without the recurrence of leptomeningeal carcinomatosis. Erlotinib rechallenge after gefitinib-induced interstitial lung disease must be carefully chosen based on the balance of a patient's risk and benefit.

  2. Asynchronous leptomeningeal carcinomatosis from pancreatic cancer: a case report and review of the literature.

    Science.gov (United States)

    Hong, Christopher S; Kurt, Habibe; Elder, J Bradley

    2014-10-01

    Central nervous system (CNS) metastases from pancreatic cancer are an exceedingly rare occurrence and have been predominantly described as focal lesions within the brain parenchyma. Even fewer reports exist of tumor spread to the leptomeninges, and most cases are discovered at autopsy. No report of leptomeningeal carcinomatosis without brain parenchymal involvement has been described to date. We describe a 72-year-old female diagnosed with inoperable, stage IV pancreatic cancer. She was treated with combination chemotherapy comprising Reolysin (reovirus serotype-3 Dearing strain), carboplatin, and paclitaxel. After 4 months of treatment, her tumor had decreased in size by 55 %, and CA19-9 levels had dropped 25-fold. However, 7 months after her initial cancer diagnosis, she presented with clinical symptoms and radiographic findings consistent with leptomeningeal carcinomatosis. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF), and biopsy was requested for tissue diagnosis. This confirmed pancreatic leptomeningeal carcinomatosis. Our case report demonstrates that leptomeningeal spread from pancreatic tumors may develop independent of focal brain parenchymal involvement and in the setting of controlled systemic disease. Furthermore, the present study describes the first case of CNS progression in the setting of systemic response to Reolysin therapy, suggesting this newly developing treatment may not prevent neurological spread of disease. If repeat cytology of CSF fails to detect malignant cells, biopsy should be pursued for definitive diagnosis. Surgery may also concurrently provide an opportunity to place an intraventricular catheter for delivery of intrathecal chemotherapies.

  3. Segmentation of age-related white matter changes in a clinical multi-center study

    DEFF Research Database (Denmark)

    Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.;

    2008-01-01

    Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...... Leukoaraiosis And Disability (LADIS). Semi-manually delineated WMC were used for validating the segmentation produced by the neural networks. The neural network segmentation demonstrated high consistency between subjects and centers, making it a promising technique for large studies. For WMC volumes less than...

  4. Performance of Ultrasound in the Diagnosis of Gout in a Multi-Center Study

    DEFF Research Database (Denmark)

    Ogdie, Alexis; Taylor, William J; Neogi, Tuhina

    2017-01-01

    OBJECTIVES: To examine the performance of ultrasound for the diagnosis of gout using presence of monosodium urate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multi-center observational cross-sectional study...... of consecutive subjects with at least one swollen joint who conceivably may have gout. All subjects underwent arthrocentesis; cases were subjects with MSU crystal confirmation. Rheumatologists or radiologists, blinded to the results of the MSU crystal analysis, performed ultrasound on one or more clinically...... with positive ultrasound results among subjects with gout. RESULTS: Ultrasound was performed in 824 subjects (416 cases and 408 controls). The sensitivity, specificity, PPV and NPV for the presence of any one of the features were 76.9%, 84.3%, 83.3% and 78.1% respectively. Sensitivity was higher among subjects...

  5. [Significance of Multi-center Obstetrics Perioperative Team Training Including Various Medical Staffs].

    Science.gov (United States)

    Komasawa, Nobuyasu; Fujita, Daisuke; Nakayama, Mai; Fujiwara, Shunsuke; Mihara, Ryosuke; Okada, Daisuke; Omoto, Haruka; Tanaka, Motoshige; Nishihara, Isao; Minami, Toshiaki

    2016-02-01

    We report the development of a multi-center/multispecialist obstetrics perioperative team training program. Participants were members of the team, including anesthesiologists, obstetricians, and operation nurses. A questionnaire survey was conducted prior to course participation to clarify any questions team members had. The courses included a lecture and simulation training with scenario-based discussions or the use of a simulator. Scenarios included massive bleeding during cesarean section, massive bleeding after vaginal delivery, and emergency cesarean section for premature placental abruption. After each course, participants discussed problems associated with obstetrics medical safety in the context of each theme. Simulation-based perioperative team training with anesthesiologists, obstetricians, and operation nurses may serve as a vehicle to promote perioperative obstetrics patient safety.

  6. Peritoneal carcinomatosis of colorectal origin. Current treatment: Review and update Carcinomatosis peritoneal de origen colorrectal. Estado actual del tratamiento: Revisión y puesta al día

    Directory of Open Access Journals (Sweden)

    A. Gómez Portilla

    2005-10-01

    Full Text Available Colorectal cancer is the most frequent tumor of the digestive tract. The high incidence of abdominal dissemination; the poor prognosis of these patients, with median survival consistently ranging from 5 to 9 months in all studies of peritoneal carcinomatosis from colorectal cancer; the failure of adjuvant systemic chemotherapy treatment with a maximal survival of 18 months despite the development of new cytostatic drugs, and new combinations of use, make it crucial to search for and develop new treatment strategies. We review the principles of Sugarbaker´s treatment protocol, which involves the combination of maximum cytoreductive radical oncological surgery for the treatment of all macroscopically disseminated disease with maximum perioperative intraperitoneal intensification chemotherapy to treat residual microscopic disease. We present the results of several scientific papers, all of them phase II studies with more than 10 patients treated, published in the medical literature by the main groups working in this line of treatment, together with the only phase III study reported and published so far, and finally the results of a recently reported retrospective international multicenter study. With this new alternative therapeutic approach, overall mean survival is 40% at 36 months, and 20% at 5 years. Based on these results, this new therapeutic approach is proposed as the treatment of choice for these unfortunate patients.El cáncer colorrectal es el tumor más frecuente del tracto digestivo. La alta incidencia de diseminación abdominal, el pobre pronóstico de estos pacientes con una mediana de supervivencia entre 5 y 9 meses demostrada repetidamente en todos los estudios de carcinomatosis peritoneal por cáncer colorrectal, el fracaso de los tratamientos sistémicos adyuvantes con quimioterapia con supervivencias máximas de 18 meses independientemente del desarrollo de nuevas drogas citostáticas y las nuevas combinaciones o formas de uso

  7. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI

    NARCIS (Netherlands)

    R.A. Feis (Rogier A.); S.M. Smith (Stephen); N. Filippini (Nicola); G. Douaud (Gwenaëlle); E.G.P. Dopper (Elise); V. Heise (Verena); A.J. Trachtenberg (Aaron J.); J.C. van Swieten (John); M.A. van Buchem (Mark); S.A.R.B. Rombouts (Serge); C.E. Mackay (Clare E.)

    2015-01-01

    textabstractResting-state fMRI (R-fMRI) has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acqui

  8. 77 FR 11136 - Proposed Collection; Comment Request; a Multi-Center International Hospital-Based Case-Control...

    Science.gov (United States)

    2012-02-24

    ... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: In compliance... the Office of Management and Budget (OMB) for review and approval. Proposed Collection: Title: A Multi-Center International Hospital- Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI). Type...

  9. 77 FR 56854 - Submission for OMB Review; Comment Request: A Multi-Center International Hospital-Based Case...

    Science.gov (United States)

    2012-09-14

    ... recent decades. Specifically, environmental exposures to industrial emissions, genetic susceptibility... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: Under the... currently valid OMB control number. Proposed Collection: Title: A Multi-Center International Hospital-...

  10. Distributed Scheduling Architecture for Multi-Center Time-Based Metering

    Science.gov (United States)

    Landry, Steven; Farley, Todd; Foster, John; Green, Steve; Hoang, Ty; Wong, Gregory L.

    2003-01-01

    The Traffic Management Advisor (TMA) is an air traffic control automation system currently in use in seven Air Route Traffic Control Centers (ARTCCs) to enable time based metering to busy airports within their airspace. However, this system is limited to operation within a single ARTCC, within about a 200 nautical mile radius of the airport, and on relatively simple streams of traffic. The need for coordinated metering within a greater (300+ nautical mile) radius of an airport, on streams of traffic with significant branching, and across ARTCC boundaries, has been identified. Early tests revealed that TMA could not simply be scaled up to handle such a problem. Instead, a loosely coupled hierarchy of schedules, in which constraints from downstream schedules are passed upstream, is required. Such an architecture reduces the reliance on distant projections of arrival times, making schedules robust to changes in sequence and to additions of aircraft (such as aircraft departing inside the system s scheduling horizon). This architecture is also scaleable, easily reconfigurable, and can be networked together. As such, it can be adapted for use in any size or configuration of airspace and with any number of airports delivering restrictions. An implementation of this distributed scheduling architecture is currently undergoing testing in the TMA-Multi Center system. This paper describes the architecture and its motivation.

  11. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P

    2010-07-01

    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  12. Dento-alveolar and maxillofacial injuries: a 5-year multi-center study. Part 1: general vs facial and dental trauma.

    Science.gov (United States)

    Lin, Shaul; Levin, Liran; Goldman, Sharon; Peleg, Kobi

    2008-02-01

    Maxillofacial injuries are a significant cause of morbidity and demand meticulously planned treatment. The aim of this present multi-center study was to evaluate the occurrence of dento-alveolar and maxillofacial injuries over a 5-year period. A retrospective cohort study of data from the Israel Trauma Registry was conducted for the years 2000-2004. The registry includes all trauma patients admitted and hospitalized due to an injury. Of the 111,010 hospitalized trauma patients, 5886 (5.3%) were diagnosed with maxillofacial or dental injuries. The main causes of injuries for hospitalized trauma patients were falls (48.1%) and motor vehicle accidents (25.2%), while the major causes of facial and dental injuries were vehicle accidents (39.6%, 56.8%, respectively) and falls (32.1%, 26.7%, respectively). High-risk age groups for dental and facial trauma were 10-18 years and 19-28 years, respectively, while for other trauma, ages for the greatest risk ranged from 0 to 9 years and over 59 years. Males were injured two to three times more frequently than females. A better understanding of the etiology of maxillofacial and dental injuries and identifying the high-risk groups should lead to appropriate prevention programs and treatment methods.

  13. Comparison of hyperthermia and adrenaline to enhance the intratumoral accumulation of cisplatin in a murin model of peritoneal carcinomatosis

    Directory of Open Access Journals (Sweden)

    Tixier Hervé

    2011-01-01

    Full Text Available Abstract Background The best method to deliver intraperitoneal chemotherapy (IPC for peritoneal carcinomatosis from ovarian cancer is not well defined. The aim of this study was to assess the ability of hyperthermia and adrenaline to enhance the intratumoral accumulation of cisplatin in a rat model of peritoneal carcinomatosis. Methods Four groups of 5 BDIX rats with ovarian peritoneal carcinomatosis underwent IPC with 30 mg/l of cisplatin according to the following conditions: normothermia at 37° for 1 or 2 hours, hyperthermia at 42°C for 1 hour or normothermia at 37°C for 2 hours with 2 mg/l adrenaline. Tissue platinum content was measured by atomic absorption spectroscopy. The effect of hyperthermia, adrenaline and the duration of exposure to the drug was measured in vivo (tissue concentration of platinum in tumor, abdominal and extra abdominal tissues and in vitro (cytotoxicity on human ovarian cancer cells. Results In vitro, hyperthermia and longer exposure enhanced the accumulation and the cytotoxic effect of cisplatin on cancer cells. In vivo, only the 2 hours treatment with adrenaline resulted in increased platinum concentrations. The rats treated with adrenaline showed significantly lower concentrations of cisplatin in extra peritoneal tissues than those treated with hyperthermia. Conclusion Adrenaline is more effective than hyperthermia in order to enhance the intratumoral concentration of cisplatin in rats with peritoneal carcinomatosis from ovarian origin. It may also decrease the systemic absorption of the drug.

  14. C-reactive protein concentration is associated with prognosis in patients suffering from peritoneal carcinomatosis of colorectal origin.

    NARCIS (Netherlands)

    Poll, M.C. van de; Klaver, Y.L.B.; Lemmens, V.E.; Leenders, B.J.; Nienhuijs, S.W.; Hingh, I.H.J.T. de

    2011-01-01

    PURPOSE: Only a limited number of patients with peritoneal carcinomatosis (PC) of colorectal origin benefit from palliative chemotherapy. Identification of prognostic factors may aid in patient selection. The plasma concentration of C-reactive protein (CRP) is increasingly recognized as prognostic f

  15. Toward quality assurance for metaphase FISH: A multi-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Dewald, G. [Mayo Clinic, Rochester, NY (United States); Higgins, R. [Abbott Northwestern Hospital, Minneapolis, MN (United States); Hirsch, B. [Univ. Minnesota Hospitals and Clinics, Minneapolis, MN (United States)] [and others

    1996-09-06

    Although fluorescent in situ hybridization (FISH) is rapidly becoming a part of clinical cytogenetics, no organization sponsors multi-center determinations of the efficacy of probes. We report on 23 laboratories that volunteered to provide slides and to use a probe for SNRPN and a control locus. Experiences with FISH for these laboratories during 1994 ranged from 0 to 645 utilizations (median = 84) involving blood, amniotic fluid and bone marrow. In an initial study of hybridization efficiency, the median percentage of metaphases from normal individuals showing two SNRPN and 2 control signals for slides prepared at each site was 97.0 (range = 74-100); for slides prepared by a central laboratory, it was 97.8 (range = 81.6-100). In a subsequent blind study, each laboratory attempted to score 5 metaphases from each of 23 specimens [8 with del(15)(q11.2{r_arrow}q12) and 15 with normal 15 chromosomes]. Of 529 challenges, the correct SNRPN pattern was found in 5 of 5 metaphases in 457 (86%) and in 4 of 5 in 33 (6%). Ambiguous, incomplete or no results were reported for 32 (6%) challenges. Seven (1%) diagnostic errors were made including 6 false positives and 1 false negative: 1 laboratory made 3 errors, 1 made 2, and 2 made 1 each. Most errors and inconsistencies seemed due to inexperience with FISH. The working time to process and analyze slides singly averaged 49.5 minutes; slides processed in batches of 4 and analyzed singly required 36.9 minutes. We conclude that proficiency testing for FISH using an extensive array of challenges is possible and that multiple centers can collaborate to test probes and to evaluate costs. 10 refs., 1 fig., 4 tabs.

  16. Regional Gray Matter Atrophy in Relapsing Remitting Multiple Sclerosis: Baseline Analysis of Multi-Center Data

    Science.gov (United States)

    Datta, Sushmita; Staewen, Terrell D.; Cofield, Stacy S.; Cutter, Gary R.; Lublin, Fred D.; Wolinsky, Jerry S.; Narayana, Ponnada A.

    2015-01-01

    Regional gray matter (GM) atrophy in multiple sclerosis (MS) at disease onset and its temporal variation can provide objective information regarding disease evolution. An automated pipeline for estimating atrophy of various GM structures was developed using tensor based morphometry (TBM) and implemented on a multi-center sub-cohort of 1008 relapsing remitting MS (RRMS) patients enrolled in a Phase 3 clinical trial. Four hundred age and gender matched healthy controls were used for comparison. Using the analysis of covariance, atrophy differences between MS patients and healthy controls were assessed on a voxel-by-voxel analysis. Regional GM atrophy was observed in a number of deep GM structures that included thalamus, caudate nucleus, putamen, and cortical GM regions. General linear regression analysis was performed to analyze the effects of age, gender, and scanner field strength, and imaging sequence on the regional atrophy. Correlations between regional GM volumes and expanded disability status scale (EDSS) scores, disease duration (DD), T2 lesion load (T2 LL), T1 lesion load (T1 LL), and normalized cerebrospinal fluid (nCSF) were analyzed using Pearson’s correlation coefficient. Thalamic atrophy observed in MS patients compared to healthy controls remained consistent within subgroups based on gender and scanner field strength. Weak correlations between thalamic volume and EDSS (r = −0.133; p < 0.001) and DD (r = −0.098; p = 0.003) were observed. Of all the structures, thalamic volume moderately correlated with T2 LL (r = −0.492; p-value < 0.001), T1 LL (r = −0.473; p-value < 0.001) and nCSF (r = −0.367; p-value < 0.001). PMID:25787188

  17. Regional gray matter atrophy in relapsing remitting multiple sclerosis: baseline analysis of multi-center data.

    Science.gov (United States)

    Datta, Sushmita; Staewen, Terrell D; Cofield, Stacy S; Cutter, Gary R; Lublin, Fred D; Wolinsky, Jerry S; Narayana, Ponnada A

    2015-03-01

    Regional gray matter (GM) atrophy in multiple sclerosis (MS) at disease onset and its temporal variation can provide objective information regarding disease evolution. An automated pipeline for estimating atrophy of various GM structures was developed using tensor based morphometry (TBM) and implemented on a multi-center sub-cohort of 1008 relapsing remitting MS (RRMS) patients enrolled in a Phase 3 clinical trial. Four hundred age and gender matched healthy controls were used for comparison. Using the analysis of covariance, atrophy differences between MS patients and healthy controls were assessed on a voxel-by-voxel analysis. Regional GM atrophy was observed in a number of deep GM structures that included thalamus, caudate nucleus, putamen, and cortical GM regions. General linear regression analysis was performed to analyze the effects of age, gender, and scanner field strength, and imaging sequence on the regional atrophy. Correlations between regional GM volumes and expanded disability status scale (EDSS) scores, disease duration (DD), T2 lesion load (T2 LL), T1 lesion load (T1 LL), and normalized cerebrospinal fluid (nCSF) were analyzed using Pearson׳s correlation coefficient. Thalamic atrophy observed in MS patients compared to healthy controls remained consistent within subgroups based on gender and scanner field strength. Weak correlations between thalamic volume and EDSS (r=-0.133; p<0.001) and DD (r=-0.098; p=0.003) were observed. Of all the structures, thalamic volume moderately correlated with T2 LL (r=-0.492; P-value<0.001), T1 LL (r=-0.473; P-value<0.001) and nCSF (r=-0.367; P-value<0.001).

  18. [Clinical practice guideline on peritoneal carcinomatosis treatment using surgical cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy].

    Science.gov (United States)

    Kavanagh, Mélanie; Ouellet, Jean-François

    2006-09-01

    In 2005, the Comité de l'évolution des pratiques en oncologie (CEPO) took it upon itself to develop a clinical practice guideline to determine the clinical value of surgical cytoreduction followed by hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) for treating peritoneal carcinomatosis stemming from colorectal cancer, cancers of the appendix and stomach, pseudomyxoma peritonei, and mesothelioma of the peritoneum. A review of the scientific literature was performed using the PubMed search engine. The period covered extended from January 1990 to January 2006, inclusively. The scientific literature search was limited to clinical trials (minimum phase II) and organizations elaborating clinical practice recommendations. Twenty-six studies were identified. Of these, only one was phase III. Although some of these studies have demonstrated a benefit from this treatment in terms of patient survival, HIPEC remains a complex procedure whose optimal use is uncertain. Given the morbidity and mortality associated with this treatment, this procedure requires a high level of expertise. Considering the evidence available, the CEPO recommends: 1) that complete cytoreduction followed by HIPEC be used in a clinical research context only, preferably in the presence of an isolated peritoneal carcinomatosis stemming from colorectal cancer, cancer of the appendix, peritoneal pseudomyxoma, or mesothelioma of the peritoneum; 2) that studies be conducted only in specialized centers with the necessary expertise and technical resources.

  19. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI

    OpenAIRE

    2015-01-01

    Resting-state fMRI (R-fMRI) has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acquisition and analysis, as fMRI data is particularly sensitive to structured noise resulting from hardware, software, and environmental differences. Here, we investigated whether a novel clean up tool for structu...

  20. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI.

    OpenAIRE

    2015-01-01

    Resting-state fMRI (R-fMRI) has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acquisition and analysis, as fMRI data is particularly sensitive to structured noise resulting from hardware, software and environmental differences. Here, we investigated whether a novel clean up tool for structur...

  1. Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of palliative chemotherapy.

    NARCIS (Netherlands)

    Klaver, Y.L.B.; Lemmens, V.E.; Creemers, G.J.; Rutten, H.J.; Nienhuijs, S.W.; Hingh, I.H.J.T. de

    2011-01-01

    BACKGROUND: Palliative chemotherapy improves survival in patients with metastasised colorectal cancer. However, there is a lack of data regarding the effectiveness of modern chemotherapy in patients with isolated peritoneal carcinomatosis (PC). PATIENTS AND METHODS: All patients with synchronous PC

  2. A multi-center study of hemodynamic characteristics exhibited by children with unexplained syncope

    Institute of Scientific and Technical Information of China (English)

    CHEN Li; TANG Chao-shu; DU Jun-bao; YANG Yuan-yuan; WANG Cheng; WANG Hong-wei; TIAN Hong; ZHANG Qing-you; CHEN Jian-jun; WANG Yu-li; KANG Yi-long

    2006-01-01

    Background Syncope is common in children and adolescents, with 15% estimated to have had at least one syncopal episode by age 18. In recent years, an increasing number of children, especially girls at their school age,have developed unexplained syncope. The mechanism of an unexplained syncope exhibited by children is incompletely studied; the association between different hemodynamic patterns and clinical features is also not clear. The aim of the study was to investigate the hemodynamic patterns of children with unexplained syncope and to examine the clinical relevance.Methods Two hundred and eight children [87 boys, 121 girls, aged 3-19 years, mean (11.66±2.72) years]were selectively recruited from May 2000 to April 2006 when they presented syncope as their main complaint at the Multi-center Network for Childhood Syncope in Beijing, Hunan Province, Hubei Province, and Shanghai of China. All of the patients underwent head-up tilt tests; data were analyzed using SPSS version 10.0 for Windows.Continuous variables were expressed as the mean±standard deviation. Dichotomous variables were compared through a χ2 test. A value of P<0.05 (two sided) was regarded as statistically significant.Results The age distribution of children with syncope was approximately normal. Head-up tilt tests was positive in 155 children, and the incidence of positive response of the baseline head-up tilt test for diagnosing unexplained syncope was 50.48%. The sensitivity value and diagnostic value of sublingual nitroglycerin head-up tilt test were both 74.52%. The hemodynamic pattern was normal in 53 children. The 155 children, who were positive in head-up tilt tests, showed signs of postural orthostatic tachycardia syndrome (60, 28.8%), the vasoinhibitory pattern (72, 34.6%), the cardioinhibitory pattern (5, 2.4%), and the mixed pattern (18, 8.7%). The gender distribution between the two age groups (age < 12 years vs age ≥ 12 years) was not different (P>0.05).The distribution of

  3. Current status and future strategies of cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    This article is to offer a concise review on the use of cytoreductive surgery (CRS) plus intraperitoneal hyperthermic chemotherapy (IPHC) for the treatment of peritoneal carcinomatosis (PC). Traditionally, PC was treated with systemic chemotherapy alone with very poor response and a median survival of less than 6 mo. With the establishment of several phase studies, a new trend has been developed toward the use of CRS plus IPHC as a standard method for treating selected patients with PC, in whom sufficient cytoreduction could be achieved. In spite of the need for more high quality phase studies, there is now a consensus among many surgical oncology experts throughout the world about the use of this new treatment strategy as standard care for colorectal cancer patients with PC. This review summarizes the current status and possible progress in future.

  4. Leptomeningeal carcinomatosis from renal cell cancer: treatment attempt with radiation and sunitinib (case report

    Directory of Open Access Journals (Sweden)

    Haukland Ellinor

    2010-05-01

    Full Text Available Abstract A case of leptomeningeal carcinomatosis in a patient with known brain and lung metastases from renal cell cancer without previous systemic therapy is presented. Neoplastic meningitis (NM developed 31 months after first diagnosis of simultaneous extra- and intracranial recurrence of kidney cancer and surgical resection of a cerebellar metastasis. In spite of local radiotherapy to the macroscopic NM lesions in the cervical and lumbar spine followed by initiation of sunitinib, the patient succumbed to his disease 4 months after the diagnosis of NM. The untreated lung metastases progressed very slowly during almost 3 years of observation. This case illustrates important issues around both biological behaviour and treatment approaches in metastatic renal cell cancer.

  5. A case of meningeal carcinomatosis presenting with the primary symptoms of facial palsy and sensorineural deafness.

    Science.gov (United States)

    Baba, Shunkichi; Matsuda, Han; Gotoh, Minoru; Shimada, Ken-Ichi; Yokoyama, Yukiko; Sakanushi, Atsuko

    2006-08-01

    We report the case of a 59-year-old man with meningeal carcinomatosis (MC) who presented with peripheral facial palsy and progressive sensorineural deafness. The patient had been operated on for gastric cancer 1 year previously, and no metastases had been detected in the retroperitoneum or thorax at follow-up examination 1 year later. However, he developed headache, deafness, and peripheral facial palsy and was referred to us for further evaluation, as magnetic resonance of the head had shown no abnormalities. Ramsay Hunt syndrome was suspected, but no increase in the cerebrospinal fluid cell count was detected. On the other hand, the balance test suggested a central disorder. In addition, the plasma level of carcinoembryonic antigen suddenly increased, suggesting MC. The cerebrospinal fluid was examined several times; in the end malignant cells and an increase in the cell count were detected, and the diagnosis of MC was established.

  6. Meningeal carcinomatosis from cervical cancer: a case report and review of the literature.

    Science.gov (United States)

    Devkota, Bishnu; Patel, Harnish

    2010-01-01

    Meningeal carcinomatosis (MC) from cervical cancer is rare. Diagnosis of this disease is often delayed due to variable presentation. We report an interesting case of MC from the uterine cervix and review general diagnostic and treatment considerations. The patient received chemotherapy and radiotherapy for stage IIB cervical cancer with resolution of symptoms for 3 years. Metastatic lesions were found in the right lung and paraaotic nodes on follow-up positron emission tomography scan, which completely resolved with subsequent chemotherapy. Unfortunately, the patient developed neurological symptoms consistent with MC, which was confirmed by cerebrospinal fluid cytology. Because of her poor cognition, available options were discussed with her family. She died peacefully in palliative care.

  7. Peritoneal mucinous carcinomatosis in a patient with a history of Hirschsprung's disease: The role of home parenteral nutrition Carcinomatosis mucinosa peritoneal en un paciente con antecedente de enfermedad de Hirschsprung: El papel de la nutrición parenteral

    Directory of Open Access Journals (Sweden)

    J. M. Moreno-Villares

    2007-08-01

    Full Text Available A case of peritoneal mucinous carcinomatosis in a patient who suffered a Hirschsprung disease 30 year before is presented. TH present condition caused an irreversible intestinal obstruction and the patients received home parenteral nutrition without unremarkable complications longer than two years.Presentamos el caso de un paciente en quien se diagnosticó una carcinomatosis mucinosa peritoneal treinta años después de haber padecido una enfermedad de Hirschsprung. El cuadro clínico actual cursó con una obstrucción intestinal no resoluble quirúrgicamente y fue tratado con nutrición parenteral domiciliaria durante más de dos años sin complicaciones.

  8. Clinical approved fluorescent dyes coupled to endomicroscopy for in vivo diagnostic of peritoneal carcinomatosis

    Science.gov (United States)

    Abbaci, Muriel; Dartigues, Peggy; Soufan, Ranya; De Leeuw, Frederic; Fabre, Monique; Laplace-Builhé, Corinne

    2015-03-01

    Peritoneal carcinomatosis is metastatic stage aggravating digestive, gynecological or bladder cancer dissemination and the preoperative evaluation of lesions remains difficult. There is therefore a need for minimal invasive innovative techniques to establish a precise preoperative assessment of cancer peritoneal cavity. Probe-based confocal laser endomicroscopy (pCLE) provides dynamic images of the microarchitecture of tissues during an endoscopy. The PERSEE project proposes new developments in robotics and pCLE for the exploration of the peritoneal cavity during laparoscopy. Two fluorescent dyes, Patent blue V and Indocyanine green have been evaluated on human ex vivo samples to improve the contrast of pCLE images. For a future implementation in clinical study, two topically staining protocols operable in vivo have been validated on 70 specimens from 25 patients with a peritoneal carcinomatosis. The specimens were then imaged by pCLE with an optical probe designed for the application. A histo-morphological correlative study was performed on 350 pCLE images and 70 standard histological preparations. All images were interpreted in a random way by two pathologists. Differential histological diagnostics such as normal peritoneum or pseudomyxoma could be recognized on fluorescence images. The statistical analysis of the correlative study is underway. These dyes already approved for human use are interesting for pCLE imaging because some micromorphological criteria look like to conventional histology and are readable by pathologist. Thus pCLE images using both dyes do not require a specific semiology unlike to what is described in the literature, for pCLE associated with fluorescein for the in vivo imaging of pancreatic cysts.

  9. Development of a Bayesian Belief Network Model for personalized prognostic risk assessment in colon carcinomatosis.

    Science.gov (United States)

    Stojadinovic, Alexander; Nissan, Aviram; Eberhardt, John; Chua, Terence C; Pelz, Joerg O W; Esquivel, Jesus

    2011-02-01

    Multimodality therapy in selected patients with peritoneal carcinomatosis is gaining acceptance. Treatment-directing decision support tools are needed to individualize care and select patients best suited for cytoreductive surgery +/- hyperthermic intraperitoneal chemotherapy (CRS +/- HIPEC). The purpose of this study is to develop a predictive model that could support surgical decisions in patients with colon carcinomatosis. Fifty-three patients were enrolled in a prospective study collecting 31 clinical-pathological, treatment-related, and outcome data. The population was characterized by disease presentation, performance status, extent of peritoneal cancer (Peritoneal Cancer Index, PCI), primary tumor histology, and nodal staging. These preoperative parameters were analyzed using step-wise machine-learned Bayesian Belief Networks (BBN) to develop a predictive model for overall survival (OS) in patients considered for CRS +/- HIPEC. Area-under-the-curve from receiver-operating-characteristics curves of OS predictions was calculated to determine the model's positive and negative predictive value. Model structure defined three predictors of OS: severity of symptoms (performance status), PCI, and ability to undergo CRS +/- HIPEC. Patients with PCI 20, who were not considered surgical candidates. Cross validation of the BBN model robustly classified OS (area-under-the-curve = 0.71). The model's positive predictive value and negative predictive value are 63.3 per cent and 68.3 per cent, respectively. This exploratory study supports the utility of Bayesian classification for developing decision support tools, which assess case-specific relative risk for a given patient for oncological outcomes based on clinically relevant classifiers of survival. Further prospective studies to validate the BBN model-derived prognostic assessment tool are warranted.

  10. Peritoneal carcinomatosis from ovarian cancer: chemosensitivity test and tissue markers as predictors of response to chemotherapy

    Directory of Open Access Journals (Sweden)

    Turci Livia

    2011-06-01

    Full Text Available Abstract Background Platinum-based regimens are the treatments of choice in ovarian cancer, which remains the leading cause of death from gynecological malignancies in the Western world. The aim of the present study was to compare the advantages and limits of a conventional chemosensitivity test with those of new biomolecular markers in predicting response to platinum regimens in a series of patients with peritoneal carcinomatosis from ovarian cancer. Methods Fresh surgical biopsy specimens were obtained from 30 patients with primary or recurrent peritoneal carcinomatosis from ovarian cancer. ERCC1, GSTP1, MGMT, XPD, and BRCA1 gene expression levels were determined by Real-Time RT-PCR. An in vitro chemosensitivity test was used to define a sensitivity or resistance profile to the drugs used to treat each patient. Results MGMT and XPD expression was directly and significantly related to resistance to platinum-containing treatment (p = 0.036 and p = 0.043, respectively. Significant predictivity in terms of sensitivity and resistance was observed for MGMT expression (75.0% and 72.5%, respectively; p = 0.03, while high predictivity of resistance (90.9% but very low predictivity of sensitivity (37.5% (p = 0.06 were observed for XPD. The best overall and significant predictivity was observed for chemosensitivity test results (85.7% sensitivity and 91.3% resistance; p = 0.0003. Conclusions The in vitro assay showed a consistency with results observed in vivo in 27 out of the 30 patients analyzed. Sensitivity and resistance profiles of different drugs used in vivo would therefore seem to be better defined by the in vitro chemosensitivity test than by expression levels of markers.

  11. F-18 FDG PET/CT in Bilateral Diffuse Pulmonary Lymphangitic Carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Senthil, Raja; Parghane, Rahul; Kashyap, Raghava; Bhattacharya, Anish; Mittal, Bhagwant Rai [Postgraduate Institute of Medical Education and Resaarch, Chandigarh (India)

    2012-06-15

    A 51-year-old female patient, who had undergone left-sided modified radical mastectomy for left breast carcinoma 4 years ago, presented with dyspnea of 4 months duration F-18 FDG PET/CT of this patient showed diffusely in-creased FDG uptake in the bilateral lung fields along the thickened bronchovascular bundles. SUVmax of lymphangitic lung was 5.2. The standardized uptake ratio (SUR) of mediastinal blood pool to lymphangitic lung was 0.44. High resolution computed tomography (HRCT) of the same patient showed thickening of interlobular septa and bronchovaseular bundles, with preservation of normal parenchymal architecture. Multiple intrapulmonary nodules and bilateral hilar lymphadenopathy with pulmonary lymphangitic carcinomatosis (PLC). The lungs are the second most common sites for metastases after lymph nodes. These metastases are usually nodular on radiologic images. PLC with interstitial involvement constitutes only 7% of pulmonary metastastases. The most common primary sites, in order of frequency, are adenocarcinoma of the lung, breast, stomach, colon, and prostrate. HRCT has been the modality of choice in the radiologic diagnosis of PLC. Only a few studies have de-scribed the F-18 FDG PET/CT findings in pulmonary lymphangitic carcinomatosis. These studies have shown diffusely increased FDG uptake corresponding to the typical changes in the CT as the most common finding. One study has reported that F-18 FDG PET/CT is 100% specific and 86% sensitive in diagnosing PLC by subjective analysis. The mean SUV in the region of pulmonary lymphangitic lung was 1.26{+-}0.45 and that of blood pool to normal lung was 3.78{+-}1.37.

  12. Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis

    Directory of Open Access Journals (Sweden)

    Silvia Lanfranconi

    2013-01-01

    Full Text Available Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83% out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%. Visual loss was the presenting clinical manifestation in 17 patients (50% and was the most common ocular symptom (70%. Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%. Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms.

  13. MR imaging of meningeal carcinomatosis by systemic malignancy%系统性恶性肿瘤所致脑膜癌病的磁共振成像表现

    Institute of Scientific and Technical Information of China (English)

    马林; 蔡幼铨; 梁丽; 郭行高; 于生元

    2001-01-01

    目的 探讨脑膜癌病的MRI表现特点,提高对脑膜癌病的影像学认识和诊断水平。方法 经确诊的脑膜癌病11例,MR常规扫描后均行钆喷替酸葡甲胺(Gd-DTPA)增强扫描,对其增强特点及病变类型进行了回顾性分析。结果 MR平扫均未见脑膜异常信号。增强扫描后9例显示软脑膜异常增强,表现为脑表面连续的、可延伸至脑沟内的细线状高信号,累及范围包括小脑、脑干及大脑表面,但未见明确的蛛网膜下腔异常增强。3例显示硬脑膜-蛛网膜异常增强,表现为大脑凸面或小脑幕等处连续的、较粗的弧线状高信号,该信号不延伸至脑沟内,3例均累及大脑凸面,其中1例同时累及小脑凸面和小脑幕。9例累及软脑膜者脑脊液均为异常,2例仅累及硬脑膜-蛛网膜者脑脊液均为正常。结论 MR增强扫描能很好地显示脑膜癌病,根据增强特点可以区分脑膜癌病的类型,结合临床对脑膜癌病能作出诊断并指导治疗。%Objective To investigate the MR features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings. Methods Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd-DTPA enhanced MR imaging. The enhancement patterns and features, as well as the types of meningeal involvement, were retrospectively analyzed. Results Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd-DTPA, abnormal pia mater enhancement was detected in 9 cases, demonstrating as the continuous, thin, and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum, brainstem, and cerebrum. No abnormal enhancement in the subarachnoid space was found. Abnormal dura-arachnoid enhancement was seen in 3 cases, showing

  14. A study of CT manifestations and origin of nodulous meningeal carcinomatosis%结节型脑膜转移瘤CT表现及组织来源的探讨

    Institute of Scientific and Technical Information of China (English)

    吴华超; 何旭升; 温志玲; 符有文; 王朝文

    2013-01-01

    目的:分析结节型脑膜转移瘤的CT影像表现及探讨结节型脑膜转移瘤的组织来源.方法:回顾性分析35例经手术病理、穿刺活检或CSF细胞学检查阳性证实为结节型脑膜转移瘤的病例,每例进行CT常规平扫和增强扫描.结果:35例结节型脑膜转移瘤的CT影像表现为位于颅骨内板下密度均匀的高密度影,边缘清楚.结节型脑膜转移瘤分结节状脑膜转移瘤和团块状脑膜转移瘤2型,结节状和团块状脑膜转移瘤伴颅骨破坏分别为6例(6/27,22.22%)和5例(5/8,62.50%),差异有统计学意义(P<0.05);结节状和团块状脑膜转移瘤为单发的脑膜转移瘤分别为5例(5/27,18.52%)和5例(5/8,62.50%),差异有统计学意义(P<0.05);并且结节状脑膜转移瘤和团块状脑膜转移瘤组织来源有明显不同.结论:结节型脑膜转移瘤CT影像表现具有特征性,CT是结节型脑膜转移瘤的重要检查方法.%Objective:To analyze the CT imaging manifestations and investigate the origination of nodular meningeal carcinomatosis (NMC).Methods:Thirty-five cases with NMC confirmed by operation and pathology or positive CSF examination were analyzed retrospectively.All cases were examined by plain and contrast CT.Results:CT imaging manifestations of NMC:the lesions were homogeneously high density shadows under the inner table of the skull,the edge of the lesion was well-defined,the lesions enhanced markerly on contrast CT scan.NMC divided into tubercular meningeal carcinomatosis (TMC) and mass-like meningeal carcinomatosis (MMC),there were 5 (5/8,62.50%) patients accompanied with destruction of the skull in MMC group,while only 6(6/27,22.22%) in TMC group(P<0.05),the solitary meningeal carcinomatosis of patients in 5 cases(5/27,18.52%) in TMC was lower than that of in 5(5/8,62.50%) in MMC group(P<0.05).There were obvious differences of the origination in TMC and MMC.Conclusion:CT imaging manifestations was characteristic of

  15. Clinical analysis of 25 cases of meningeal carcinomatosis%脑膜癌病25例临床分析

    Institute of Scientific and Technical Information of China (English)

    汤武装; 张丽; 张晓雷; 胡秀秀

    2013-01-01

    目的:探讨脑膜癌病的临床特点和诊断依据。方法对25例确诊为脑膜癌病患者的临床资料及脑脊液细胞学资料进行回顾性分析。结果25例脑膜癌病患者中,临床表现为头痛24例,恶心、呕吐21例,脑膜刺激征阳性20例,视乳头水肿12例,意识障碍6例,四肢无力6例,视力减退5例,癫痫发作5例,精神症状5例,听力障碍3例,头晕3例,发热2例,颈痛1例;20例患者头颅CT/MRI均未见脑膜异常,5例行头颅MRI增强扫描可见2例脑膜强化,1例脑皮质肿胀,1例脑积水,1例小脑蚓部左侧可疑结节;腰椎穿刺脑脊液压力升高12例,蛋白升高16例,糖、氯降低14例,23例患者行脑脊液细胞学检查均发现异型细胞,17例患者行脑脊液免疫组化染色均发现转移癌;17例患者经临床及病理学确定其原发肿瘤,来源于肺癌10例(其中1例肺癌合并前颊黏膜鳞癌)、胃癌3例、贲门癌2、乳腺癌1例、可疑卵巢癌1例,8例来源未明。结论脑膜癌病为恶性肿瘤颅内转移的特殊形式,临床表现复杂,缺乏特异性,早期以颅内压升高为主;头颅MRI增强扫描对脑膜癌病诊断有一定指导意义;脑脊液细胞学检查结合免疫组化染色是脑膜癌病确诊的主要依据。%Objective To investigate the clinical features and diagnostic evidence of meningeal carcinomatosis (MC). Methods The clinical data and cerebrospinal fluid(CSF) cytology data of 25 cases diagnosed as meningeal carcinomatosis were retrospectively reviewed. Results In 25 patients of MC, there were 11 men and 14 women and the mean age was (52±7.72) years old. 24 cases of patients with headache, 21 cases of patients with nausea and vomiting, meningeal irritation sign was positive in 20 cases, papilledema were found in 12 cases, disturbance of consciousness were found in 6 cases, four limbs weakness were found in 6 cases, vision loss were found in 5 cases, seizures were found in 5 cases, psychiatric symptoms

  16. ROLE OF PARENTERAL NUTRITION IN ONCOLOGIC PATIENTS WITH INTESTINAL OCCLUSION AND PERITONEAL CARCINOMATOSIS.

    Science.gov (United States)

    Aría Guerra, Eva; Cortés-Salgado, Alfonso; Mateo-Lobo, Raquel; Nattero, Lía; Riveiro, Javier; Vega-Piñero, Belén; Valbuena, Beatriz; Carabaña, Fátima; Carrero, Carmen; Grande, Enrique; Carrato, Alfredo; Botella-Carretero, José Ignacio

    2015-09-01

    Introducción y objetivos: el papel preciso de la nutrición parenteral en el manejo de los pacientes oncológicos con obstrucción intestinal no está bien definido todavía. El objetivo del presente trabajo es evaluar los efectos de la nutrición parenteral en este tipo de pacientes en cuanto al pronóstico. Material y métodos: fueron incluidos 55 pacientes con obstrucción intestinal y carcinomatosis peritoneal. La nutrición parenteral proporcionó 20-35 kcal/Kg/día y 1.0 g/kg/día de aminoácidos. El peso, el IMC, el tipo de tumor, el tipo de quimioterapia recibida y el ECOG, entre otras variables, fueron recogidas y analizadas. Resultados: un 69,1% de los pacientes presentaban tumors gastrointestinales, un 18,2% ginecológicos y otros tumores el 12,7% restante. La edad media fue de 60 ± 13 años, con un ECOG basal de 1,5 ± 0,5 y un IMC de 21,6 ± 4,3. La presencia de malnutrición fue de un 85%. La supervivencia desde el inicio de la nutrición parenteral no fue significativamente distinta entre los pacientes al considerar su ECOG basal (log rank = 0,593, p = 0,743), las líneas previas de quimioterapia recibida (log rank = 2,117, p = 0,548), el IMC basal (log rank = 2,686, p = 0,261), o el tipo de tumor (log rank = 2,066, p = 0,356). La supervivencia en los pacientes en que fue posible el alta hospitalaria con nutrición parenteral fue superior (log rank = 7,090, p = 0,008). La supervivencia en los pacientes en que se inició la quimioterapia durante o tras iniciar la nutrición parenteral fue también superior (log rank = 17,316, p < 0,001). Un total de 3,6% de los pacientes presentaron infección relacionada con el catéter sin afectar la supervivencia (log rank = 0,061, p = 0,804). Conclusión: la nutrición parenteral en los pacientes oncológicos con obstrucción intestinal y carcinomatosis peritoneal es segura y, en aquellos que responden a qui mioterapia, el uso de la nutrición parenteral domiciliaria, junto con en tratamiento antitumoral activo

  17. A multi-center study to define sarcopenia in patients with end-stage liver disease.

    Science.gov (United States)

    Carey, Elizabeth J; Lai, Jennifer C; Wang, Connie W; Dasarathy, Srinivasan; Lobach, Iryna; Montano-Loza, Aldo J; Dunn, Michael A

    2017-02-27

    Sarcopenia is associated with increased waitlist mortality, but a standard definition is lacking. In this retrospective study, we sought to determine the optimal definition of sarcopenia in end-stage liver disease (ESLD) patients awaiting LT. Included were 396 patients newly listed for LT in 2012 at five North American transplant centers. All CT scans were read by two individuals with inter-observer correlation of 98%. Using image analysis software, the total cross-sectional area (cm(2) ) of abdominal skeletal muscle at L3 was measured. The skeletal muscle index (SMI), which normalizes muscle area to patient height, was then calculated. The primary outcome was waitlist mortality, defined as death on the waitlist or removal from the waitlist for reasons of clinical deterioration. Sex-specific potential cut-off values to define sarcopenia were determined with a grid search guided by log-rank test statistics. Optimal search method identified potential cutoffs to detect survival differences between groups. The overall median SMI was 47.6 cm(2) /m(2) : 50.0 in men and 42.0 in women. At a median of 8.8 months follow-up, mortality was 25% in men and 36% in women. Patients who died had lower SMI than those who survived (45.6 vs 48.5 cm(2) /m(2) , p<0.001) and SMI was associated with waitlist mortality (HR 0.95, p<0.001). Optimal search method yielded SMI cut-offs of 50 cm(2) /m(2) for men and 39 cm(2) /m(2) for women; these cutoff values best combined statistical significance with a sufficient number of events to detect survival differences between groups. In conclusion, we recommend that an SMI < 50 cm(2) /m(2) for men and < 39 cm(2) /m(2) for women be used to define sarcopenia in patients with ESLD awaiting LT. This article is protected by copyright. All rights reserved.

  18. Management of venous thromboembolism in patients with acute leukemia at high bleeding risk: a multi-center study.

    Science.gov (United States)

    Napolitano, Mariasanta; Valore, Luca; Malato, Alessandra; Saccullo, Giorgia; Vetro, Calogero; Mitra, Maria Enza; Fabbiano, Francesco; Mannina, Donato; Casuccio, Alessandra; Lucchesi, Alessandro; Del Principe, Maria Ilaria; Candoni, Anna; Di Raimondo, Francesco; Siragusa, Sergio

    2016-01-01

    In the last decades, evaluation of clinically relevant thrombotic complications in patients with acute leukemia (AL) has been poorly investigated. The authors performed a multi-center study to evaluate the management of symptomatic venous thromboembolism (VTE) in adult patients with AL. The intention was to find as clinically relevant the following: symptomatic Venous Thrombosis (VT) occurred in typical (lower limbs) and atypical (cerebral, upper limbs, abdominal, etc) sites with or without pulmonary embolism (PE). Over a population of 1461 patients with AL, 22 cases of symptomatic VTE were recorded in hospitalized patients with a mean age of 54.6 years. The absolute incidence of VTE was 1.5%. VTE occurred during chemotherapy in 17/22 (77.2%) cases, mainly (14/17, 82.3%) during the induction phase. Treatment of acute VTE was based on Low Molecular Weight Heparin (LMWH) at full dosage for the first month from diagnosis and reduced dosage (75%) for the following months.

  19. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    Science.gov (United States)

    Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2013-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies. PMID:20703765

  20. Risk factors for acute kidney injury (AKI) in infants with melamine-associated urolithiasis and follow-up: a multi-center retrospective analysis.

    Science.gov (United States)

    He, Qiqi; Yue, Zhongjin; Tang, XiaoShuang; Chang, Hong; Wang, Wei; Shi, Wei; Wang, Zhiping; Shang, Panfeng

    2014-10-01

    Abstract An epidemic of urinary tract stones was noted among infants in China, 2008. This event was believed to be associated with consumption melamine-contaminated powdered formula. The patients with symptoms and clinical manifests had already been analyzed in our previous studies. In this study, our aim is to investigate the risk factors of melamine-associated acute kidney injury (AKI) and the potential relationship toward children growth in our five years follow-up. A total of 619 infants with melamine-associated urolithiasis were admitted into 20 different hospitals in the Gansu province, China. All clinical data were divided into AKI and control groups according to the occurrence of AKI. Univariate and multivariate analyses were performed with a logistic regression model to assess the independent risk factors of AKI. Logistic regression analysis revealed that the odds ratio (OR) of AKI was 19.62 in the group of infants who consumed Sanlu® milk powdered infant milk formula. A higher prevalence of AKI was observed in infants age of 6-11 months (OR: 9.59, p melamine infant formula (Sanlu® milk powdered infant formula), age (6-17 months) and symptoms of URTI, diarrhea, dehydration or fever were risk factors of AKI in infants with melamine-associated urolithiasis.

  1. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI.

    Directory of Open Access Journals (Sweden)

    Rogier Alexander Feis

    2015-10-01

    Full Text Available Resting-state fMRI (R-fMRI has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acquisition and analysis, as fMRI data is particularly sensitive to structured noise resulting from hardware, software and environmental differences. Here, we investigated whether a novel clean up tool for structured noise was capable of reducing center-related R-fMRI differences between healthy subjects.We analyzed 3 Tesla R-fMRI data from 72 subjects, half of whom were scanned with eyes closed in a Philips Achieva system in The Netherlands, and half of whom were scanned with eyes open in a Siemens Trio system in the UK. After pre-statistical processing and individual Independent Component Analysis (ICA, FMRIB’s ICA-based X-noiseifier (FIX was used to remove noise components from the data. GICA and dual regression were run and non-parametric statistics were used to compare spatial maps between groups before and after applying FIX.Large significant differences were found in all resting-state networks between study sites before using FIX, most of which were reduced to non-significant after applying FIX. The between-center difference in the medial/primary visual network, presumably reflecting a between-center difference in protocol, remained statistically different.FIX helps facilitate multi-center R-fMRI research by diminishing structured noise from R-fMRI data. In doing so, it improves combination of existing data from different centers in new settings and comparison of rare diseases and risk genes for which adequate sample size remains a challenge.

  2. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI

    Science.gov (United States)

    Feis, Rogier A.; Smith, Stephen M.; Filippini, Nicola; Douaud, Gwenaëlle; Dopper, Elise G. P.; Heise, Verena; Trachtenberg, Aaron J.; van Swieten, John C.; van Buchem, Mark A.; Rombouts, Serge A. R. B.; Mackay, Clare E.

    2015-01-01

    Resting-state fMRI (R-fMRI) has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acquisition and analysis, as fMRI data is particularly sensitive to structured noise resulting from hardware, software, and environmental differences. Here, we investigated whether a novel clean up tool for structured noise was capable of reducing center-related R-fMRI differences between healthy subjects. We analyzed three Tesla R-fMRI data from 72 subjects, half of whom were scanned with eyes closed in a Philips Achieva system in The Netherlands, and half of whom were scanned with eyes open in a Siemens Trio system in the UK. After pre-statistical processing and individual Independent Component Analysis (ICA), FMRIB's ICA-based X-noiseifier (FIX) was used to remove noise components from the data. GICA and dual regression were run and non-parametric statistics were used to compare spatial maps between groups before and after applying FIX. Large significant differences were found in all resting-state networks between study sites before using FIX, most of which were reduced to non-significant after applying FIX. The between-center difference in the medial/primary visual network, presumably reflecting a between-center difference in protocol, remained statistically significant. FIX helps facilitate multi-center R-fMRI research by diminishing structured noise from R-fMRI data. In doing so, it improves combination of existing data from different centers in new settings and comparison of rare diseases and risk genes for which adequate sample size remains a challenge. PMID:26578859

  3. Molecular Targeted Therapies for the Treatment of Leptomeningeal Carcinomatosis: Current Evidence and Future Directions.

    Science.gov (United States)

    Lee, Dae-Won; Lee, Kyung-Hun; Kim, Jin Wook; Keam, Bhumsuk

    2016-07-05

    Leptomeningeal carcinomatosis (LMC) is the multifocal seeding of cerebrospinal fluid and leptomeninges by malignant cells. The incidence of LMC is approximately 5% in patients with malignant tumors overall and the rate is increasing due to increasing survival time of cancer patients. Eradication of the disease is not yet possible, so the treatment goals of LMC are to improve neurologic symptoms and to prolong survival. A standard treatment for LMC has not been established due to low incidences of LMC, the rapidly progressing nature of the disease, heterogeneous populations with LMC, and a lack of randomized clinical trial results. Treatment options for LMC include intrathecal chemotherapy, systemic chemotherapy, and radiation therapy, but the prognoses remain poor with a median survival of <3 months. Recently, molecular targeted agents have been applied in the clinic and have shown groundbreaking results in specific patient groups epidermal growth factor receptor (EGFR)-targeted therapy or an anaplastic lymphoma kinase (ALK) inhibitor in lung cancer, human epidermal growth factor receptor 2 (HER2)-directed therapy in breast cancer, and CD20-targeted therapy in B cell lymphoma). Moreover, there are results indicating that the use of these agents under proper dose and administration routes can be effective for managing LMC. In this article, we review molecular targeted agents for managing LMC.

  4. Molecular Targeted Therapies for the Treatment of Leptomeningeal Carcinomatosis: Current Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Dae-Won Lee

    2016-07-01

    Full Text Available Leptomeningeal carcinomatosis (LMC is the multifocal seeding of cerebrospinal fluid and leptomeninges by malignant cells. The incidence of LMC is approximately 5% in patients with malignant tumors overall and the rate is increasing due to increasing survival time of cancer patients. Eradication of the disease is not yet possible, so the treatment goals of LMC are to improve neurologic symptoms and to prolong survival. A standard treatment for LMC has not been established due to low incidences of LMC, the rapidly progressing nature of the disease, heterogeneous populations with LMC, and a lack of randomized clinical trial results. Treatment options for LMC include intrathecal chemotherapy, systemic chemotherapy, and radiation therapy, but the prognoses remain poor with a median survival of <3 months. Recently, molecular targeted agents have been applied in the clinic and have shown groundbreaking results in specific patient groups epidermal growth factor receptor (EGFR-targeted therapy or an anaplastic lymphoma kinase (ALK inhibitor in lung cancer, human epidermal growth factor receptor 2 (HER2-directed therapy in breast cancer, and CD20-targeted therapy in B cell lymphoma. Moreover, there are results indicating that the use of these agents under proper dose and administration routes can be effective for managing LMC. In this article, we review molecular targeted agents for managing LMC.

  5. Delayed but Complete Response following Oral Temozolomide Treatment in Melanoma Leptomeningeal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Andreas F. Hottinger

    2011-04-01

    Full Text Available Isolated leptomeningeal recurrence of melanoma is rare, occurring in 2% of patients with central nervous system involvement secondary to melanoma. The optimal treatment of leptomeningeal carcinomatosis (LMC in melanoma has not yet been determined and remains a major challenge. We report a melanoma patient who presented with isolated LMC in the form of a new-onset weakness of the lower limbs, paresthesia of the left hand and foot, lumbago and headache. A lumbar puncture and spinal MRI confirmed LMC. The patient was treated with temozolomide 75 mg/m2/day on a 4 weeks on/2 weeks off schedule. After an initial transient clinical deterioration, the patient showed a complete radiological response as well as a dramatic improvement in quality of life. The encouraging clinical response reported here suggests that dose-intensified temozolomide might have significant activity in the treatment of leptomeningeal dissemination of melanoma and may be a valid treatment option for patients who have not been previously exposed to this agent. Moreover, this treatment regimen is extremely well tolerated and obviates the need for repeated intrathecal administrations of chemotherapeutic agents, which are often not well tolerated by patients who have significant co-morbidities due to their disease. As illustrated in this case, response to temozolomide may occur in a delayed manner, highlighting the importance of following temozolomide treatment long enough before determining that it is inefficient in a given patient.

  6. Cauda Equina Syndrome Secondary to Leptomeningeal Carcinomatosis of Gastroesophageal Junction Cancer

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    Amal Alkhotani

    2016-04-01

    Full Text Available Leptomeningeal carcinomatosis (LMC is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesophageal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness. Initial radiological examinations were unremarkable. Subsequently, he had worsening of his leg weakness, fecal incontinence, and urine retention. Two days later, he developed rapidly progressive cranial neuropathies including facial diplegia, sensorineural hearing loss, dysarthria, and dysphagia. MRI with and without contrast showed diffuse enhancement of leptomeninges surrounding the brain, spinal cord, and cauda equina extending to the nerve roots. Cerebrospinal fluid cytology was positive for malignant cells. The patient died within 10 days from the second presentation. In cancer patients with cauda equina syndrome and absence of structural lesion on imaging, LMC should be considered. To our knowledge, this is the first case of LMC secondary to gastroesophageal cancer presenting with cauda equina syndrome.

  7. Limited survival in patients with carcinomatosis from foregut malignancies after cytoreduction and continuous hyperthermic peritoneal perfusion.

    Science.gov (United States)

    Farma, Jeffrey M; Pingpank, James F; Libutti, Steven K; Bartlett, David L; Ohl, Susan; Beresneva, Tatiana; Alexander, H Richard

    2005-12-01

    Peritoneal carcinomatosis is a frequent mode of metastasis in patients with gastric, duodenal, or pancreatic cancer. Survival in this setting is short and therapeutic options are limited. This analysis examines the outcomes of 18 patients treated with operative cytoreduction and continuous hyperthermic peritoneal perfusion. Eighteen patients (6 males and 12 females) with gastric (n = 9), pancreatic (n = 7), or duodenal (n = 2) cancer were treated on protocol. Patients underwent optimal cytoreduction (complete gross resection, 11; minimal residual disease, 7) and a 90-minute perfusion with cisplatin. Clinical parameters and tumor and treatment characteristics were analyzed. Survival curves were estimated using the Kaplan-Meier method. Procedures included gastrectomy (n = 8), pancreaticoduodenectomy (n = 3), and hemicolectomy (n = 2). After cytoreduction, patients had no evidence of residual disease (n = 11), fewer than 100 implants less than 5 mm (n = 1), more than 100 implants between 5-10 mm (n = 3), or multiple implants with greater than 1 cm (n = 3). Five patients received a postoperative intraperitoneal dwell with 5-fluorouracil and paclitaxel. There was one perioperative mortality, and complications occurred in 10 patients. The median progression-free survival was 8 months (mean, 10 months; range, 1-47 months) with a median overall survival of 8 months (mean, 18 months; range, 1-74 months). In this cohort, peritoneal perfusion with cisplatin used to treat foregut malignancies has a high incidence of complications and does not significantly alter the natural history of the disease. Investigation of novel therapeutic approaches should be considered.

  8. Rapid Response to High-Dose, Pulsatile Erlotinib in Afatinib-Refractory Leptomeningeal Carcinomatosis from Adenocarcinoma of the Lung: A Case Report

    Directory of Open Access Journals (Sweden)

    Frank S. Fan

    2016-09-01

    Full Text Available Leptomeningeal carcinomatosis occurred in an old female patient who was on a standard dose of afatinib for the treatment of her non-small cell lung cancer harboring an epidermal growth factor receptor gene mutation sensitive to tyrosine kinase inhibitors when extracranial lesions were still under control. Shifting to high-dose, pulsatile erlotinib dramatically saved her from the devastating condition in a very short period of time. Inadequate afatinib concentration in cerebrospinal fluid is reasonably suspected, and there is a call for clinical trials testing high-dose afatinib in leptomeningeal carcinomatosis.

  9. Intrathecal trastuzumab (Herceptin) and methotrexate for meningeal carcinomatosis in HER2-overexpressing metastatic breast cancer: a case report.

    Science.gov (United States)

    Stemmler, Hans-Joachim; Mengele, Karin; Schmitt, Manfred; Harbeck, Nadia; Laessig, Dorit; Herrmann, Karin A; Schaffer, Pamela; Heinemann, Volker

    2008-09-01

    Leptomeningeal carcinomatosis represents a rare manifestation of metastatic breast cancer (MBC). We herewith report on a patient suffering from HER2 overexpressing MBC who received intrathecal methotrexate and trastuzumab for meningeal carcinomatosis. A 48-year-old woman was diagnosed with breast cancer in December 2002. Following surgery, six cycles of adjuvant FE100C plus irradiation and, subsequently for 1 year, trastuzumab were given. As a result of disseminated metastatic spread in October 2005, the patient received whole-brain radiotherapy for symptomatic central nervous system involvement, and was put on several trastuzumab-based combination regimens (capecitabine, vinorelbine, paclitaxel). In June 2006, the patient developed clinical signs of terminal cone involvement with overflow incontinence and paraparesis of the legs. Immediate radiation led to partial relief from clinical symptoms. Subsequently, the patient was put on the tyrosine kinase inhibitor lapatinib and capecitabine (August to October 2007), but on November 6th the patient suffered again from overflow incontinence and weakness of the legs. Failing to respond to lapatinib, the patient received gemcitabine/cisplatin and, additionally, was recommenced on intravenous trastuzumab. Owing to progressive leptomeningeal disease, the patient received repeated doses of intrathecal methotrexate and trastuzumab. Within 2 weeks and four intrathecal treatments, cerebrospinal fluid cytology showed the absence of tumor cells. Moreover, a striking clinical improvement with resolution of the paraparesis of the legs and overflow incontinence was observed. This case report gives details regarding the clinical course of a breast cancer patient who received intrathecal trastuzumab and methotrexate via lumbar puncture for meningeal carcinomatosis of HER2-overexpressing MBC.

  10. Patient-reported adverse effects of high-dose intravenous methylprednisolone treatment : a prospective web-based multi-center study in multiple sclerosis patients with a relapse

    NARCIS (Netherlands)

    Jongen, Peter Joseph; Stavrakaki, Ioanna; Voet, Bernard; Hoogervorst, Erwin; van Munster, Erik; Linssen, Wim H.; Sinnige, Ludovicus G.; Verhagen, Wim I.; Visser, Leo H.; van der Kruijk, Ruud; Verheul, Freek; Boringa, Jan; Heerings, Marco; Gladdines, Werner; Lonnqvist, Fredrik; Gaillard, Pieter

    2016-01-01

    In a prospective multi-center observational study, we evaluated the frequency, severity, and impact on activities of daily living (ADL) of adverse effects (AEs) of high-dose intravenous methylprednisolone (IVMP) in relapsing remitting multiple sclerosis (MS) patients with a relapse. Online self-repo

  11. Efficacy and safety of Changfu peritoneal dialysis solution:a multi-center prospective randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-hui; NI Zhao-hui; MEI Chang-lin; YU Xue-qing; LIU Fu-you; MIAO Li-ning; LIU Zhi-hong

    2013-01-01

    Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions.Some researchers believe that 6 L/d is enough for adequate dialysis,but there is no multi-center prospective study on Chinese population to confirm this.In this study,we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages,i.e.,6 L dose with Changfu dialysis solution,6 L dose with Baxter dialysis solution,8 L dose with Changfu dialysis solution,and 8 L dose with Baxter dialysis solution.After 48 weeks,the changes of primary and secondary efficacy indices were compared between different types and different dosages.We also analyzed the changes of safety indices.Results Changes of KW from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr).Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR).Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR.The decline of KW from baseline to 48 weeks in 6 L group was more than that in 8 L group.Change of Ccr was similar.During the 48-week period,the mean Kt/V was above 1.7/w,and mean Ccr was above 50 L·1.73 m-2·w-1.More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization,and the statistical differences disappeared after that.Conclusions The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution.During 48-week period,a dosage of 6 L/d was enough for

  12. Pharmacokinetic and pharmacodynamic analysis of hyperthermic intraperitoneal oxaliplatin-induced neutropenia in subjects with peritoneal carcinomatosis.

    Science.gov (United States)

    Valenzuela, Belén; Nalda-Molina, Ricardo; Bretcha-Boix, Pere; Escudero-Ortíz, Vanesa; Duart, Maria José; Carbonell, Vicente; Sureda, Manuel; Rebollo, José Pascual; Farré, Josep; Brugarolas, Antonio; Pérez-Ruixo, Juan José

    2011-03-01

    The objective of this study was to characterize the pharmacokinetics and the time course of the neutropenia-induced by hyperthermic intraperitoneal oxaliplatin (HIO) after cytoreductive surgery in cancer patients with peritoneal carcinomatosis. Data from 30 patients who received 360 mg/m(2) of HIO following cytoreductive surgery were used for pharmacokinetic-pharmacodynamic (PK/PD) analysis. The oxaliplatin plasma concentrations were characterized by an open two-compartment pharmacokinetic model after first-order absorption from peritoneum to plasma. An oxaliplatin-sensitive progenitor cell compartment was used to describe the absolute neutrophil counts in blood. The reduction of the proliferation rate of the progenitor cells was modeled by a linear function of the oxaliplatin plasma concentrations. The typical values of oxaliplatin absorption and terminal half-lives were estimated to be 2.2 and 40 h, with moderate interindividual variability. Oxaliplatin reduced the proliferation rate of the progenitor cells by 18.2% per mg/L. No patient's covariates were related to oxaliplatin PK/PD parameters. Bootstrap and visual predictive check evidenced the model was deemed appropriate to describe oxaliplatin pharmacokinetics and the incidence and severity of neutropenia. A peritoneum oxaliplatin exposure of 65 and 120 mg·L/h was associated with a 20% and 33% incidence of neutropenia grade 4. The time course of neutropenia following HIO administration was well described by the semiphysiological PK/PD model. The maximum tolerated peritoneum oxaliplatin exposure is 120 mg L/h and higher exposures should be avoided in future studies. We suggest the prophylactic use of granulocyte colony stimulating factor for patients treated with HIO exposure higher than 65 mg L/h.

  13. Peritoneal carcinomatosis of colorectal origin: Incidence,prognosis and treatment options

    Institute of Scientific and Technical Information of China (English)

    Yvonne LB Klaver; Valery EPP Lemmens; Simon W Nienhuijs; Misha DP Luyer; Ignace HJT de Hingh

    2012-01-01

    Peritoneal carcinomatosis (PC) is one manifestation of metastatic colorectal cancer (CRC).Tumor growth on intestinal surfaces and associated fluid accumulation eventually result in bowel obstruction and incapacitating levels of ascites,which profoundly affect the quality of life for affected patients.PC appears resistant to traditional 5-fluorouracil-based chemotherapy,and surgery was formerly reserved for palliative purposes only.In the absence of effective treatment,the historical prognosis for these patients was extremely poor,with an invariably fatal outcome.These poor outcomes likely explain why PC secondary to CRC has received little attention from oncologic researchers.Thus,data are lacking regarding incidence,clinical disease course,and accurate treatment evaluation for patients with PC.Recently,population-based studies have revealed that PC occurs relatively frequently among patients withCRC.Risk factors for developing PC have been identified:right-sided tumor,advanced T-stage,advanced N-stage,poor differentiation grade,and younger age at diagnosis.During the past decade,both chemotherapeutical and surgical treatments have achieved promising results in these patients.A chance for long-term survival or even cure may now be offered to selected patients by combining radical surgical resection with intraperitoneal instillation of heated chemotherapy.This combined procedure has become known as hyperthermic intraperitoneal chemotherapy.This editorial outlines recent advancements in the medical and surgical treatment of PC and reviews the most recent information on incidence and prognosis of this disease.Given recent progress,treatment should now be considered in every patient presenting with PC.

  14. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer:Intraperitoneal chemotherapy with taxanes

    Institute of Scientific and Technical Information of China (English)

    Hironori; Yamaguchi; Joji; Kitayama; Hironori; Ishigami; Shinsuke; Kazama; Hiroaki; Nozawa; Kazushige; Kawai; Keisuke; Hata; Tomomichi; Kiyomatsu; Toshiaki; Tanaka; Junichiro; Tanaka; Takeshi; Nishikawa; Kensuke; Otani; Koji; Yasuda; Soichiro; Ishihara; Eiji; Sunami; Toshiaki; Watanabe

    2015-01-01

    The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising results.Herein,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results.IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h.The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP chemotherapy.There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease progression.Usually,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient basis.According to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/m2.Phase Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011.The prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection bias.Although several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.

  15. Pharmacokinetics of mitomycin C after resection of peritoneal carcinomatosis and intraperitoneal chemohyperthermic perfusion.

    Science.gov (United States)

    Cerretani, D; Nencini, C; Urso, R; Giorgi, G; Marrelli, D; De Stefano, A; Pinto, E; Cioppa, T; Nastri, G; Roviello, F

    2005-12-01

    Over the last few years surgery on patients with abdominal malignancies has become more aggressive but the majority of patients present locoregional recurrence as peritoneal dissemination. Cytoreductive surgery followed by intraperitoneal chemohyperthermic perfusion (ICHP) has been described for treatment and prevention of locoregional cancer spread from various origins. This paper reports our study of the pharmacokinetics of mitomycin C (MMC) administered by intraperitoneal chemohyperthermic perfusion (ICHP) in patients with peritoneal carcinomatosis. 28 patients received MMC 20 mg/m2 intraperitoneally as a perfusion over 60 min. MMC was determined in perfusate, plasma and urine samples with a UV-HPLC method. A compartmental model was used to fit the drug concentrations in plasma and perfusate. Our results showed a mean maximum plasma concentration (Cmax) of 0.14 +/- 0.086 microg/ml with a peak time (Tmax) of 48..7 +/- 5.61 min. The mean area under the curve (AUC) and terminal half-life (t1/2) were 15.8 +/- 9.8 mg x min/L and 83.7 +/- 31.74 min respectively. Clearance (CL) was estimated by fitting the data by a compartmental model and the mean value was 72 +/- 66 L/h. The percent of the dose absorbed was very variable and ranged between 14 and 57% (mean 37 +/- 14%). The mean percentage of dose recovered unchanged in the urine during 24 hours was 7.21 +/- 3.73%. We conclude that ICHP in patients with peritoneal surface malignancies seems to have clinical value since it gives high peritoneal and tumor MMC concentrations with limited systemic exposure and toxicity.

  16. Induction of anti-tumor immunity by trifunctional antibodies in patients with peritoneal carcinomatosis

    Directory of Open Access Journals (Sweden)

    Lindhofer Horst

    2009-02-01

    Full Text Available Abstract Peritoneal carcinomatosis (PC from epithelial tumors is a fatal diagnosis without efficient treatment. Trifunctional antibodies (trAb are novel therapeutic approaches leading to a concerted anti-tumor activity resulting in tumor cell destruction. In addition, preclinical data in mouse tumor models demonstrated the induction of long lasting tumor immunity after treatment with trAb. We describe the induction of anti-tumor specific T-lymphocytes after intraperitoneal administration of trAb in patients with PC. 9 patients with progressive PC from gastric (n = 6 and ovarian cancer (n = 2, and cancer of unknown primary (n = 1 received 3 escalating doses of trAb after surgery and/or ineffective chemotherapy. The trAb EpCAM × CD3 (10, 20, 40 μg or HER2/neu × CD3 (10, 40, 80 μg were applicated by intraperitoneal infusion. Four weeks after the last trAb application, all patients were restimulated by subdermal injection of trAb + autologous PBMC + irradiated autologous tumor cells. Immunological reactivity was tested by analyzing PBMC for specific tumor reactive CD4+/CD8+ T lymphocytes using an IFN-γ secretion assay. In 5 of 9 patients, tumor reactive CD4+/CD8+ T-lymphocytes increased significantly, indicating specific anti-tumor immunity. A clinical response (stable disease, partial regression has been observed in 5 of 9 patients, with a mean time to progression of 3.6 months. Follow-up showed a mean survival of 11.8 months (median 8.0 months after trAb therapy. TrAb are able to induce anti-tumor immunity after intraperitoneal application and restimulation. The induction of long-lasting anti-tumor immunity may provide an additional benefit of the intraperitoneal therapy with trAb and should be further elevated in larger clinical trials.

  17. Randomized Multi-center Study of Baofuxin for Treatment of Bleeding Side-effect Induced by IUD

    Institute of Scientific and Technical Information of China (English)

    吴尚纯; 王翠萍; 程渭玉; 韩学军; 王素贞; 戚娟芳; 刘莹; 付伟

    2000-01-01

    Objective To observe the efficacy of Baofuxin for treatment of bleeding side effect induced by IUD.Method The study is a multi-center trial. The subjects were randomly allocated into two groups, Baofuxin group ( 90 cases) and Indomethacin group ( 90 cases). In the Baofuxin group, the subjects took the medicine on the first day of menses, once a bag,twice a day for 10 days. In the Indomethacin group, only one capsule was taken once a time, twice a day for 7 days. The treatment was given for three menstrual cycles.The subjects were asked to record their bleeding~spotting by using menstrual diary card not only during the treatment cycles but also during the three months previous and after the treatment cycles. The menstrual profile was analyzed by using MDSv2. 3 program that was provided by WHO.Results Within each 90-day reference period of treatment and post-treatment cycles,the number of bleeding/spotting days decreased obviously and bleeding/spotting free days were greatly increased. Both medicines have little effect on number of episode of bleeding/spotting. The subjects who thought the treatment were highly effective were 81. 1% in the Baofuxin group and 56. 2% in the Indomethacin group respectively (P< 0.01).Conclusion Both Baofuxin and indomethacin are highly effective on treatment of bleeding side effect induced by IUD, but Baofuxin had longer effects and was more acceptable.

  18. Stability of R2* and quantitative susceptibility mapping of the brain tissue in a large scale multi-center study

    Science.gov (United States)

    Wang, Rongpin; Xie, Guangyou; Zhai, Maoxiong; Zhang, Zhongping; Wu, Bing; Zheng, Dandan; Hong, Nan; Jiang, Tao; Wen, Baohong; Cheng, Jingliang

    2017-01-01

    Multi-center studies are advantageous for enrolling participants of varying pathological and demographical conditions, and especially in neurological studies. Hence stability of the obtained quantitative R2* and susceptibility in multicenter studies is a key issue for their widespread applications. In this work, the stabilities of simultaneously obtained R2* and susceptibility are investigated and compared across 10 sites that are equipped with the same scanner and receiver coil, the same post-processing process was used to achieve consistent experiment setup. Two healthy adult volunteers (one male and female) participated in this study. High intraclass correlation coefficient was obtained for both susceptibility (0.94) and R2* (0.96). The coefficients of variance for all measurements obtained were smaller than 0.1, the largest variations of measurements in all the chosen ROIs fall within ±20% from the median value. Higher level of stability was obtained in R2* as compared to susceptibility at 1 mm resolution (P < 0.05) and at 1.5 mm (P < 0.01). PMID:28349957

  19. Automated inter-rater reliability assessment and electronic data collection in a multi-center breast cancer study

    Directory of Open Access Journals (Sweden)

    Enger Shelley M

    2007-06-01

    Full Text Available Abstract Background The choice between paper data collection methods and electronic data collection (EDC methods has become a key question for clinical researchers. There remains a need to examine potential benefits, efficiencies, and innovations associated with an EDC system in a multi-center medical record review study. Methods A computer-based automated menu-driven system with 658 data fields was developed for a cohort study of women aged 65 years or older, diagnosed with invasive histologically confirmed primary breast cancer (N = 1859, at 6 Cancer Research Network sites. Medical record review with direct data entry into the EDC system was implemented. An inter-rater and intra-rater reliability (IRR system was developed using a modified version of the EDC. Results Automation of EDC accelerated the flow of study information and resulted in an efficient data collection process. Data collection time was reduced by approximately four months compared to the project schedule and funded time available for manuscript preparation increased by 12 months. In addition, an innovative modified version of the EDC permitted an automated evaluation of inter-rater and intra-rater reliability across six data collection sites. Conclusion Automated EDC is a powerful tool for research efficiency and innovation, especially when multiple data collection sites are involved.

  20. Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

    Science.gov (United States)

    Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.

    2014-02-01

    Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.

  1. Evaluation of a Teleform-based data collection system: A multi-center obesity research case study

    Science.gov (United States)

    Jenkins, Todd M.; Boyce, Tawny Wilson; Akers, Rachel; Andringa, Jennifer; Liu, Yanhong; Miller, Rosemary; Powers, Carolyn; Buncher, C. Ralph

    2016-01-01

    Utilizing electronic data capture (EDC) systems in data collection and management allows automated validation programs to preemptively identify and correct data errors. For our multi-center, prospective study we chose to use TeleForm, a paper-based data capture software that uses recognition technology to create case report forms (CRFs) with similar functionality to EDC, including custom scripts to identify entry errors. We quantified the accuracy of the optimized system through a data audit of CRFs and the study database, examining selected critical variables for all subjects in the study, as well as an audit of all variables for 25 randomly selected subjects. Overall we found 6.7 errors per 10,000 fields, with similar estimates for critical (6.9/10,000) and non-critical (6.5/10,000) variables – values that fall below the acceptable quality threshold of 50 errors per 10,000 established by the Society for Clinical Data Management. However, error rates were found to widely vary by type of data field, with the highest rate observed with open text fields. PMID:24709056

  2. A prospective, multi-center clinical and radiographic outcomes evaluation of ChronOS strip for lumbar spine fusion.

    Science.gov (United States)

    Kanter, Adam S; Gandhoke, Gurpreet S; Welch, William C; Arnold, Paul M; Cheng, Joseph S; Okonkwo, David O

    2016-03-01

    This prospective clinical study evaluated the use of a composite bone void filler (ChronOS Strip, DePuy Synthes, West Chester, PA, USA), combined with bone marrow aspirate plus local autologous bone, in a series of patients undergoing instrumented posterolateral spinal fusion with interbody support. Seventy-six patients were enrolled and treated per protocol at 13 clinical sites. At 24 months, 55/76 patients (72%) were evaluated, with 49/76 (65%) having sufficient data to determine the primary endpoint. The primary endpoint, posterolateral fusion success, was achieved in 48/54 (88.9%) patients at 12 months and in 45/49 (91.8%) patients at 24 months. At all follow-up time points, statistically significant improvements were observed when compared to baseline in back and leg pain and functional status as measured by visual analog scale, Oswestry Disability Index and 12-Item Short Form health surveys. This prospective multi-center series provides evidence that the composite bone void filler, when applied posterolaterally with instrumentation, bone marrow aspirate and/or local autologous bone and concomitant interbody support, can be used to achieve a successful posterolateral fusion, resulting in improvements in clinical outcomes in patients with degenerative disc disease.

  3. Efficacy and safety of ecabet sodium on functional dyspepsia :A prospective, double-blinded, randomized, multi-center controlled trial

    Institute of Scientific and Technical Information of China (English)

    Jun Haeng Lee; Soo Teik Lee; Eun Hyun Lee; Jong Chul Rhee; Jae J Kim; Ki-Baik Hahm; Dong Ho Lee; Nayoung Kim; Sung Kook Kim; Jong Jae Park; Seok Reyol Choi; Jong Hun Lee

    2006-01-01

    AIM: To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia.METHODS: We performed a multi-center, prospective,randomized, double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia. Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-Ⅱ criteria were enrolled from 7 centers. In the study group (115 patients), 1.5 g ecabet sodium was given twice a day. In the control group (121 patients),400 mg cimetidine was given twice a day. Symptoms and parameters of quality of life were analyzed at baseline, 3,14, and 28 d after initiating the treatment.RESULTS: Two-hundred and thirty-six patients completed the clinical trial. After 4 wk of treatment,the rates of improvement in patients with dyspeptic symptoms were not different between two groups (77.4% in the ecabet group and 79.3% in the cimetidine group, respectively, P > 0.05). Likewise, the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups.There was no clinically significant adverse event in both groups.CONCLUSION: In patients with functional dyspepsia,ecabet sodium has similar clinical efficacy with cimetidine.

  4. Adhesions due to peritoneal carcinomatosis caused by a renal carcinoma leading to mechanical gastric outlet obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Gruttadauria Salvatore

    2011-07-01

    Full Text Available Abstract Introduction Gastric outlet obstruction is a clinical syndrome caused by a variety of mechanical obstructions. Peptic ulcer disease used to be responsible for most gastric outlet obstruction, but in the last 40 years the prevalence of malignant tumors has risen significantly. Adhesive disease is an infrequent and insidious cause of mechanical gastric outlet obstruction. Case presentation We report the case of a 78-year-old Caucasian man who had a clinical history of a right nephrectomy for malignancy three years earlier and who was admitted for a severe gastric outlet obstruction (score of 1 confirmed both by an upper endoscopy and by a fluoroscopic view after contrast injection. A computed tomography scan and a laparotomy, with omental biopsies, showed a peritoneal carcinomatosis with the development of abdominal adhesions that prompted an abnormal gastric rotation around the perpendicular axis of his antrum with a dislocation in the empty space of his right kidney. Symptoms disappeared after surgical bypass through a gastrojejunostomy. Conclusions Our patient experienced a very rare complication characterized by the development of adhesions due to peritoneal carcinomatosis caused by a renal carcinoma treated with nephrectomy. These adhesions prompted an abnormal dislocation of his antrum, as an internal hernia, in the empty space of his right kidney.

  5. Multi-center Superstrata

    CERN Document Server

    Tian, Wukongjiaozi

    2016-01-01

    We construct a new class of superstrata, the regular supergravity solutions describing the microstates of D1-D5-P black holes. Our solutions are obtained by adding momentum charge to the D1-D5 geometries based on multiple concentric Kaluza-Klein monopoles.

  6. China collaborative study on dialysis: a multi-centers cohort study on cardiovascular diseases in patients on maintenance dialysis

    Directory of Open Access Journals (Sweden)

    Hou Fanfan

    2012-08-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the main cause of death in patients on chronic dialysis. The question whether dialysis modality impacts cardiovascular risk remains to be addressed. China Collaborative Study on Dialysis, a multi-centers cohort study, was performed to evaluate cardiovascular morbidity during maintenance hemodialysis (HD and peritoneal dialysis (PD. Method The cohort consisted of chronic dialysis patients from the database of 9 of the largest dialysis facilities around China. The inclusion period was between January 1, 2005, and December 1, 2010. Cardiovascular morbidity was defined as the presence of clinically diagnosed ischemic heart disease, heart failure, peripheral vascular disease, and/or stroke. The patients who had cardiovascular morbidity before initiation of dialysis were excluded. Data collection was based on review of medical record. Result A total of 2,388 adult patients (1,775 on HD and 613 on PD were enrolled. Cardiovascular morbidity affected 57% patients and was comparable between HD and PD patients. However, clinically diagnosed ischemic heart disease and stroke was more prevalent in PD than HD patients. When the patients were stratified by age or dialysis vintage, the cardiovascular morbidity was significantly higher in PD than HD among those aged 50 years or older, or those receiving dialysis over 36 months. Multivariate analysis revealed that the risk factors for cardiovascular morbidity had different pattern in PD and HD patients. Hyperglycemia was the strongest risk factor for cardiovascular morbidity in PD, but not in HD patients. Hypertriglyceridemia and hypoalbuminemia were independently associated with CVD only in PD patients. Conclusions Cardiovascular morbidity during chronic dialysis was more prevalent in PD than HD patients among those with old age and long-term dialysis. Metabolic disturbance-related risk factors were independently associated with CVD only in PD patients

  7. Effectiveness of fentanyl transdermal patch (fentanyl-TTS, durogegic) for radiotherapy induced pain and cancer pain: multi-center trial

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    Shin, Seong Soo; Choi, Eun Kyung [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-12-15

    To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. Our study was open labelled prospective phase IV multi-center study, the study population included patients with more 4 numeric rating scale (NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups: patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief: second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, {rho} = 0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There wa no major side effect.

  8. Statistical Machines for Trauma Hospital Outcomes Research: Application to the PRospective, Observational, Multi-Center Major Trauma Transfusion (PROMMTT Study.

    Directory of Open Access Journals (Sweden)

    Sara E Moore

    Full Text Available Improving the treatment of trauma, a leading cause of death worldwide, is of great clinical and public health interest. This analysis introduces flexible statistical methods for estimating center-level effects on individual outcomes in the context of highly variable patient populations, such as those of the PRospective, Observational, Multi-center Major Trauma Transfusion study. Ten US level I trauma centers enrolled a total of 1,245 trauma patients who survived at least 30 minutes after admission and received at least one unit of red blood cells. Outcomes included death, multiple organ failure, substantial bleeding, and transfusion of blood products. The centers involved were classified as either large or small-volume based on the number of massive transfusion patients enrolled during the study period. We focused on estimation of parameters inspired by causal inference, specifically estimated impacts on patient outcomes related to the volume of the trauma hospital that treated them. We defined this association as the change in mean outcomes of interest that would be observed if, contrary to fact, subjects from large-volume sites were treated at small-volume sites (the effect of treatment among the treated. We estimated this parameter using three different methods, some of which use data-adaptive machine learning tools to derive the outcome models, minimizing residual confounding by reducing model misspecification. Differences between unadjusted and adjusted estimators sometimes differed dramatically, demonstrating the need to account for differences in patient characteristics in clinic comparisons. In addition, the estimators based on robust adjustment methods showed potential impacts of hospital volume. For instance, we estimated a survival benefit for patients who were treated at large-volume sites, which was not apparent in simpler, unadjusted comparisons. By removing arbitrary modeling decisions from the estimation process and concentrating

  9. [Evaluation of the Effectiveness and Safety in a Multi-center Clinical Trial of VIBRANT SOUNDBRIDGE in Japan].

    Science.gov (United States)

    Doi, Katsumi; Kanzaki, Sho; Kumakawa, Kozo; Usami, Shin-ichi; Iwasaki, Satoshi; Yamanaka, Noboru; Naito, Yasushi; Gyo, Kiyofumi; Tono, Tetsuya; Takahashi, Haruo; Kanda, Yukihiko

    2015-12-01

    Middle ear implants (MEIs) such as the Vibrant Soundbridge (VSB) are attractive and alternative treatments for patients with conductive, sensorineural, and mixed hearing loss who do not benefit from, or who choose not to wear, conventional hearing aids (HAs). Recent studies suggest that MEIs can provide better improvements in functional gain, speech perception, and quality of life than HAs, although there are certain risks associated with the surgery which should be taken into consideration, including facial nerve or chorda tympanic nerve damage, dysfunctions of the middle and inner ears, and future device failure/explantation. In Japan, a multi-center clinical trial of VSB was conducted between 2011-2014. A round window vibroplasty via the transmastoid approach was adopted in the protocol. The bony lip overhanging the round window membrane (RWM) was extensively but very carefully drilled to introduce the Floating Mass Transducer (FMT). Perichondrium sheets were used to stabilize the FMT onto the RWM. According to the audiological criteria, the upper limit of bone conduction should be 45 dB, 50 dB, and 65 dB from 500 Hz to 4, 000 Hz. Twenty-five patients underwent the surgery so far at 13 different medical centers. The age at the surgery was between 26-79 years old, and there were 15 males and 10 females. The cause of conductive or mixed hearing loss was middle ear diseases in 23 cases and congenital aural atresia in two cases. The data concerning on the effectiveness and safety of VSB was collected before the surgery and 20 weeks after the surgery. Significant improvements of free-field Pure Tone Audiogram (PTA) from 250 Hz to 8, 000 Hz were confirmed (p VSB. However, the long-term efficacy and safety of these devices should be established.

  10. Interaction of iron deficiency anemia and hemoglobinopathies among college students and pregnant women: a multi center evaluation in India.

    Science.gov (United States)

    Mohanty, Dipika; Gorakshakar, Ajit C; Colah, Roshan B; Patel, Ramesh Z; Master, Dilip C; Mahanta, J; Sharma, Santanu K; Chaudhari, Utpal; Ghosh, Malay; Das, Sheila; Britt, Reitt P; Singh, Shawinder; Ross, Cecil; Jagannathan, Lata; Kaul, Rajni; Shukla, Deepak K; Muthuswamy, Vasantha

    2014-01-01

    Although iron deficiency anemia is very common in India, systematic large studies on the prevalence and hematological consequences of iron deficiency among carriers of β-thalassemia (β-thal) and other hemoglobinopathies are lacking. A multi center project was undertaken to screen college/university students and pregnant women for iron deficiency anemia and various hemoglobinopathies. Fifty-six thousand, seven hundred and seventy-two subjects from six states, Maharashtra, Gujarat, Karnataka, West Bengal, Assam and Punjab, were studied. Iron deficiency anemia was evaluated by measuring zinc protoporphyrin (ZPP) and hemoglobin (Hb) levels, while β-thal and other hemoglobinopathies were detected by measuring the red cell indices and by Hb analysis using high performance liquid chromatography (HPLC). College boys (2.2%), college girls (14.3%) and antenatal women (27.0%) without any hemoglobinopathies had iron deficiency anemia. Among the β-thal carriers, the prevalence of iron deficiency anemia was 17.3% in college boys, 38.1% in college girls and 55.9% in pregnant women, while in the Hb E [β26(B8)Glu→Lys; HBB: c.79G>A] carriers, it was 7.3% in college boys, 25.4% in college girls and 78.0% in antenatal women. In individuals with Hb E disease, the prevalence of iron deficiency anemia varied from 31.2-77.3% in the three groups. A significant reduction in Hb levels was seen when iron deficiency anemia was associated with hemoglobinopathies. However, the Hb A2 levels in β-thal carriers were not greatly reduced in the presence of iron deficiency anemia.

  11. Cross-sectional Multi-center Analysis of Portal Hypertension in 163 Children and Young Adults with Biliary Atresia

    Science.gov (United States)

    Shneider, Benjamin L.; Abel, Bob; Haber, Barbara; Karpen, Saul J.; Magee, John C.; Romero, Rene; Schwarz, Kathleen; Bass, Lee M.; Kerkar, Nanda; Miethke, Alexander G.; Rosenthal, Philip; Turmelle, Yumirle; Robuck, Patricia R.; Sokol, Ronald J.

    2012-01-01

    Objectives Biliary atresia (BA) frequently results in portal hypertension (PHT), complications of which lead to significant morbidity and mortality. The Childhood Liver Disease Research and Education Network (ChiLDREN) was utilized to perform a cross-sectional multi-centered analysis of PHT in children with BA. Methods BA subjects receiving medical management at a ChiLDREN site were enrolled. A priori, clinically evident PHT was defined as “definite” when there was either 1) history of a complication of PHT or 2) clinical findings consistent with PHT (both splenomegaly and thrombocytopenia). PHT was denoted as “possible” if one of the findings was present in the absence of a complication, while PHT was “absent” if none of the criteria were met. Results 163 subjects were enrolled between May 2006 and December 2009. At baseline, definite PHT was present in 49%, possible in 17% and absent in 34% of subjects. Demographics, growth and anthropometrics were similar amongst the 3 PHT categories. ALT, GGTP, and sodium levels were similar, while there were significant differences in AST, AST/ALT, albumin, total bilirubin, PT, WBC, platelet count and AST/platelet between definite and absent PHT. Thirty-four percent of those with definite PHT had either PT > 15s or albumin < 3 g/L. Conclusions Clinically definable PHT is present in two thirds of North American long-term BA survivors with their native livers. The presence of PHT is associated with measures of hepatic injury and dysfunction, although in this selected cohort the degree of hepatic dysfunction is relatively mild and growth is preserved. PMID:22903006

  12. Quantitative multi-parameter mapping of R1, PD*, MT and R2* at 3T: a multi-center validation

    Directory of Open Access Journals (Sweden)

    Nikolaus eWeiskopf

    2013-06-01

    Full Text Available Multi-center studies using magnetic resonance imaging facilitate studying small effect sizes, global population variance and rare diseases. The reliability and sensitivity of these multi-center studies crucially depend on the comparability of the data generated at different sites and time points. The level of inter-site comparability is still controversial for conventional anatomical T1-weighted MRI data. Quantitative multi-parameter mapping (MPM was designed to provide MR parameter measures that are comparable across sites and time points, i.e., 1mm high-resolution maps of the longitudinal relaxation rate (R1=1/T1, effective proton density (PD*, magnetization transfer saturation (MT and effective transverse relaxation rate (R2*=1/T2*. MPM was validated at 3T for use in multi-center studies by scanning five volunteers at three different sites. We determined the inter-site bias, inter-site and intra-site coefficient of variation (CoV for typical morphometric measures (i.e., gray matter probability maps used in voxel-based morphometry and the four quantitative parameters. The inter-site bias and CoV were smaller than 3.1% and 8%, respectively, except for the inter-site CoV of R2* (< 20%. The gray matter probability maps based on the MT parameter maps had a 14% higher inter-site reproducibility than maps based on conventional T1-weighted images. The low inter-site bias and variance in the parameters and derived gray matter probability maps confirm the high comparability of the quantitative maps across sites and time points. The reliability, short acquisition time, high resolution and the detailed insights into the brain microstructure provided by MPM makes it an efficient tool for multi-center imaging studies.

  13. Safety and efficacy of an olive oil-based triple-chamber bag for parenteral nutrition: a prospective, randomized, multi-center clinical trial in China

    OpenAIRE

    Jia, Zhen-Yi; Yang, Jun; XIA, Yang; Tong, Da-Nian; Gary P. Zaloga; Qin, Huan-Long; ,

    2015-01-01

    Background Small studies suggest differences in efficacy and safety exist between olive oil-based (OLIVE) and soybean oil-based (SOYBEAN) parenteral nutrition regimens in hospitalized adult patients. This large, prospective, randomized (1:1), open-label, multi-center, noninferiority study compared the delivery, efficacy, and safety of OLIVE (N = 226) with SOYBEAN (N = 232) in Chinese adults (≥18 years) admitted to a surgical service for whom parenteral nutrition was required. Methods Treatmen...

  14. Leptomeningeal carcinomatosis as only pathological finding at FDG-PET/CT in case of tumor marker elevation in breast cancer.

    Science.gov (United States)

    Grande, Maria Luz Dominguez; Rayo, Juan Ignacio; Serrano, Justo; Infante, Jose Rafael; Garcia, Lucia; Duran, Carmen; Gomez-Caminero, Felipe

    2014-01-01

    Leptomeningeal carcinomatosis is an infrequent disease and although its treatment is palliative, earlier diagnosis will lead to prolonged survival and improve functional outcome. Whole-body FDG-PET allows the entire spinal cord to be examined noninvasively, so close attention should be paid to the spinal canal, since these lesions can easily be mistaken for physiologic uptake, sometimes there is no clinical suspicion and may occur without concurrent active cancer. We present a female patient with a history of carcinoma of the breast, who presented an elevation of serum tumor marker CA 15-3. An FDG-PET/CT study only revealed multiple abnormal uptake at the vertebral foramen at thoracic and lumbosacral regions suggesting leptomeningeal metastases that were confirmed by MRI and cerebrospinal fluid cytology.

  15. A Multi-Center Controlled Study of the Acute and Chronic Effects of Cooling Therapy for MS

    Science.gov (United States)

    Luna, Bernadette; Schwid, Steven W.; Cutter, Gary; Murray, Ronald; Bowen, James; Pellegrino, Richard; Guisado, Raul; Webbon, Bruce W.; DeVincenzi, Donald (Technical Monitor)

    2000-01-01

    To determine the acute and chronic effects of cooling therapy on patients with MS using objective functional performance measures and self-assessed measures of fatigue. Cooling demyelinated nerves can reduce conduction block, potentially improving symptoms of MS. Significant acute and chronic effects of cooling have not been demonstrated in a multi-center, controlled, blinded study using objective measures of neurologic function. Patients (N=84) with definite MS, mild to moderate disability (EDSS less than 6.0), and self-reported heat sensitivity were enrolled at 5 study sites. Acute effects of cooling were assessed by randomly assigning subjects to high-dose or low-dose cooling for one hour using an active cooling vest and cap (Life Enhancement Technologies, Santa Clara, CA). Settings were individualized to maintain the cooling garments at 55 F for the high-dose treatment and 70 F for the low-dose treatment. Both patients and examining investigators were blinded to treatment assignments. The MSFC and visual acuity/contrast sensitivity were assessed before and 30 minutes after treatment. The following week, subjects had an identical visit with the alternate cooling treatment. Chronic effects of cooling were assessed by randomly assigning the same subjects to unblinded daily home cooling or observation for 4 weeks. All subjects completed the Rochester Fatigue Diary (RFD) twice weekly and subjective measures of strength, cognition, and energy level daily. At the end of the period, subjects completed the Modified Fatigue Impact Scale (MFIS) and underwent another high-dose cooling session with assessment of the MSFC and vision. After a one-week washout period, subjects crossed over to the alternate 4-week treatment. Oral temperatures were reduced with both acute treatments (0.8 +/- .06 F, high and 0.5 +/- .06 F, low). While mean MSFC did not change significantly during individual cooling sessions, post hoc analysis pooling the 3 high-dose cooling sessions revealed an

  16. Variation of Community Consultation and Public Disclosure for a Pediatric Multi-centered “Exception from Informed Consent” Trial

    Science.gov (United States)

    Holsti, Maija; Zemek, Roger; Baren, Jill; Stanley, Rachel M.; Prashant, Mahajan; Vance, Cheryl; Brown, Kathleen M.; Gonzalez, Victor; King, Denise; Jacobsen, Kammy; Shreve, Kate; van de Bruinhorst, Katrina; Jones, Anne Marie; Chamberlain, James M.

    2014-01-01

    Background The U.S. federal regulation “Exception from Informed Consent (EFIC) for Emergency Research,” 21 Code of Federal Regulations 50.24, permits emergency research without informed consent under limited conditions. Additional safeguards to protect human subjects include requirements for community consultation and public disclosure prior to starting the research. Because the regulations are vague about these requirements, Institutional Review Boards (IRBs) determine the adequacy of these activities at a local level. Thus there is potential for broad interpretation and practice variation. Aim To describe the variation of community consultation and public disclosure activities approved by IRBs, and the effectiveness of this process for a multi-center, EFIC, pediatric status epilepticus clinical research trial. Methods: Community consultation and public disclosure activities were analyzed for each of 15 participating sites. Surveys were conducted with participants enrolled in the status epilepticus trial to assess the effectiveness of public disclosure dissemination prior to study enrollment. Results Every IRB, among the 15 participating sites, had a varied interpretation of EFIC regulations for community consultation and public disclosure activities. IRBs required various combinations of focus groups, interviews, surveys, and meetings for community consultation; news releases, mailings, and public service announcements for public disclosure. At least 4,335 patients received information about the study from these efforts. 158 chose to be included in the “Opt Out” list. Of the 304 participants who were enrolled under EFIC, 12 (5%) had heard about the study through community consultation or public disclosure activities. The activities reaching the highest number of participants were surveys and focus groups associated with existing meetings. Public disclosure activities were more efficient and cost-effective if they were part of an in-hospital resource for

  17. Synchronous Low-grade Appendiceal Mucinous Neoplasm and Primary Peritoneal Low-grade Serous Carcinoma: A First Description of These 2 Neoplasms Presenting Together as Suspected Peritoneal Carcinomatosis.

    Science.gov (United States)

    Sekulic, Miroslav; Pichler Sekulic, Simona; Movahedi-Lankarani, Saeid

    2016-09-28

    Low-grade appendiceal mucinous neoplasm is a neoplasm typically of appendiceal origin, which is characterized by diffuse peritoneal involvement by pools of mucin with mucinous epithelium lacking high-grade cytologic atypia, and clinically presents as suspected peritoneal carcinomatosis. A similar clinical presentation can sometimes be seen with disseminated low-grade serous carcinomas of the peritoneum, fallopian tubes, or ovaries; however, this neoplasm is histologically characterized by tubal-type epithelium and invasive or confluent growth. In this case report, we describe a patient presenting with a clinical examination and radiologic features suggestive of peritoneal carcinomatosis and a prominent pelvic mass; however, after pathologic review, the patient was proven to have peritoneal involvement by both low-grade appendiceal mucinous neoplasm of appendiceal origin and a low-grade peritoneal primary serous carcinoma. In short, we present the first description of low-grade appendiceal mucinous neoplasm and serous carcinoma of the peritoneum presenting synchronously, providing morphologic characterization and immunohistochemical studies supporting the diagnosis, and illustrating a rare instance in which 2 neoplastic processes are underlying clinically suspected peritoneal carcinomatosis.

  18. Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified According to the Retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin

    Science.gov (United States)

    2010-12-22

    median survival after systemic 5-Fluorouracil/Leucovorin ( 5FU /L) based chemotherapy for PC of colorectal cancer can, under the best of circumstances...type of systemic chemotherapy regimen; no chemotherapy (best supportive care), 5-Fluorouracil/Leucovorin ( 5FU /L), or modern chemotherapy...Eighty-three patients (50%) had no chemotherapy treatment and received best supportive care only. Forty-two patients (25%) received 5FU /L chemotherapy

  19. Enhanced antitumor effects by docetaxel/LL37-loaded thermosensitive hydrogel nanoparticles in peritoneal carcinomatosis of colorectal cancer.

    Science.gov (United States)

    Fan, Rangrang; Tong, Aiping; Li, Xiaoling; Gao, Xiang; Mei, Lan; Zhou, Liangxue; Zhang, Xiaoning; You, Chao; Guo, Gang

    2015-01-01

    Intraperitoneal chemotherapy was explored in clinical trials as a promising strategy to improve the therapeutic effects of chemotherapy. In this work, we developed a biodegradable and injectable drug-delivery system by coencapsulation of docetaxel (Doc) and LL37 peptide polymeric nanoparticles (Doc+LL37 NPs) in a thermosensitive hydrogel system for colorectal peritoneal carcinoma therapy. Firstly, polylactic acid (PLA)-Pluronic L35-PLA (PLA-L35-PLA) was explored to prepare the biodegradable Doc+LL37 NPs using a water-in-oil-in-water double-emulsion solvent-evaporation method. Then, biodegradable and injectable thermosensitive PLA-L64-PLA hydrogel with lower sol-gel transition temperature at around body temperature was also prepared. Transmission electron microscopy revealed that the Doc+LL37 NPs formed with the PLA-L35-PLA copolymer were spherical. Fourier-transform infrared spectra certified that Doc and LL37 were encapsulated successfully. X-ray diffraction diagrams indicated that Doc was encapsulated amorphously. Intraperitoneal administration of Doc+LL37 NPs-hydrogel significantly suppressed the growth of HCT116 peritoneal carcinomatosis in vivo and prolonged the survival of tumor-bearing mice. Our results suggested that Doc+LL37 NPs-hydrogel may have potential clinical applications.

  20. Small bowel involvement is a prognostic factor in colorectal carcinomatosis treated with complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy

    Directory of Open Access Journals (Sweden)

    Benizri Emmanuel I

    2012-04-01

    Full Text Available Abstract Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC is a promising treatment for patients with peritoneal carcinomatosis (PC. Our objective was to identify new prognostic factors in patients with PC from colorectal cancer treated with this procedure. Methods All patients with PC from colorectal cancer treated by HIPEC from January 2000 to December 2007 were prospectively included. The tumor extension was assessed by the Peritoneal Cancer Index (PCI and the residual disease was recorded using the completeness cytoreductive score (CCs. All clinical and treatment data were computed in univariate and multivariable analyses using survival as primary end point. Results We carried out 51 complete procedures in 49 consecutive patients. The mean PCI was 10. The allocation of CCs was: CC-0 = 37, CC-1 = 14. The five-year overall and progression-free survival rate were 40% and 20%, respectively. Several prognostic factors for survival were identified by univariate analysis: PCI P P P = 0.06, area 5 (P = 0.031, area 7 (P = 0.014, area 8 (P = 0.022, area 10 (P P = 0.02. Only the involvement of the distal jejunum (area 10 was significant in the multivariable analysis (P = 0.027. Conclusions We demonstrated that the involvement of area 10 (distal jejunum of the PCI score was an independent factor associated with poor prognosis.

  1. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis: initial experience in Oaxaca, Mexico.

    Science.gov (United States)

    García-Matus, Rolando; Hernández-Hernández, Carlos Alberto; Leyva-García, Omar; Vásquez-Ciriaco, Sergio; Flores-Ayala, Guillermo; Navarro-Hernández, Quetzalli; Pérez-Bustamante, Gerardo; Valencia-Mijares, Norma Miriam; Esquivel, Jesus

    2012-09-01

    Peritoneal carcinomatosis (PC) has been traditionally considered a terminal disease with median survivals reported in the literature of 6 to 12 months. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) are playing an ever increasing role in the treatment of these patients. Excellent results have been achieved in well-selected patients but there is a very steep learning curve when starting a new program. A program for peritoneal surface malignancies in which patients with PC of gastrointestinal or gynecological origin were treated using multimodality therapy with combinations of systemic therapy, cytoreductive surgery (CRS), and HIPEC was initiated in December 2007 at "Hospital Regional de Alta Especialidad de Oaxaca," Mexico. We present the results of our initial experience. From December 2007 to February 2011, 26 patients were treated with CRS and HIPEC. There were 21 female patients. Most common indication (46%) was recurrent ovarian cancer. Mean duration of surgery was 260 minutes. Mean Peritoneal Cancer Index was 9. Twenty-three (88.5%) patients had a complete cytoreduction. Major morbidity and mortality rates were 19.5 and 3.8 per cent, respectively. Mean hospital stay was 8 days. At a mean follow-up of 20 months, median survival has not been reached. Rigorous preoperative workup, strict selection criteria, and mentoring from an experienced cytoreductive surgeon are mandatory and extremely important when starting a center for PC.

  2. Dento-alveolar and maxillofacial injuries: a 5-year multi-center study. Part 2: severity and location.

    Science.gov (United States)

    Lin, Shaul; Levin, Liran; Goldman, Sharon; Sela, Galit

    2008-02-01

    Maxillofacial and dental injuries are not uncommon. These injuries may cause morbidity and demand meticulously planned treatment. Part 1 of this study focused on the incidence of general trauma injuries, as well as facial or dental trauma. The aim of part 2 is to evaluate the severity and location of the dento-alveolar and maxillofacial injuries over 5 years. A retrospective cohort study was conducted based on data from the Israel National Trauma Registry. Patients admitted and hospitalized due to trauma injuries during the years 2000-2004, totaled 111,010 in which 5886 (5.3%) were maxillofacial or dental injuries. Most of these injuries were traffic-related (54.5%), followed by events at home (18.7%). Facial injuries combined with injuries to other organs involved occurred in 3721 (63.2%) of the patients. Most minor injuries were noted when no other organs were involved, while severe injuries were more common when multiple organs were involved. More than 25% of facial injuries required surgery. Meticulous epidemiologic studies are needed to support the leading role, extent, and severity of maxillofacial trauma.

  3. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Science.gov (United States)

    Lin, Hui-Jia; Du, Li-Zhong; Ma, Xiao-Lu; Shi, Li-Ping; Pan, Jia-Hua; Tong, Xiao-Mei; Li, Qiu-Ping; Zhou, Jian-Guo; Yi, Bing; Liu, Ling; Chen, Yun-Bing; Wei, Qiu-Fen; Wu, Hui-Qing; Li, Mei; Liu, Cui-Qing; Gao, Xi-Rong; Xia, Shi-Wen; Li, Wen-Bin; Yan, Chao-Ying; He, Ling; Liang, Kun; Zhou, Xiao-Yu; Han, Shu-Ping; Lyu, Qin; Qiu, Yin-Ping; Li, Wen; Chen, Dong-Mei; Lu, Hong-Ru; Liu, Xiao-Hong; Liu, Hong; Lin, Zhen-Lang; Liu, Li; Zhu, Jia-Jun; Xiong, Hong; Yue, Shao-Jie; Zhuang, Si-Qi

    2015-01-01

    Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed

  4. Outpatient management of intra-corporeal left ventricular assist device system in children: a multi-center experience.

    Science.gov (United States)

    Schweiger, M; Vanderpluym, C; Jeewa, A; Canter, C E; Jansz, P; Parrino, P E; Miera, O; Schmitto, J; Mehegan, M; Adachi, I; Hübler, M; Zimpfer, D

    2015-02-01

    Little is known about the outcomes of children supported on intracorporeal left ventricular assist device (HVAD), and the feasibility of outpatient management. All centers with pediatric patients discharged from the hospital on the device were identified using company database. A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 ± 2.3 years (range 8-15), mean weight 43 ± 19 kg (range 18-81), mean body surface area 1.3 ± 0.3 m(2) (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n = 5), noncompaction CMP (n = 4), toxic CMP (n = 2) and viral CMP (n = 1). Indications for support were permanent support (n = 1), bridge to recovery (n = 1) and bridge to transplantation (n = 10). Prior to HVAD implantation, all patients received intravenous inotropes and two patients were on temporary mechanical support. Overall mortality was 0%. Mean duration of inpatient and outpatient support were 56 (range: 19-95 days) and 290 days (range: 42-790), respectively. Mean readmission rate was 0.02 per patient month (2.1 per patient). No adverse events involving emergency department occurred. Eight children resumed local schooling. Home discharge of children supported on HVAD is feasible and safe. School integration can be achieved. There is wide center variability to discharge practice for children.

  5. Ruxolitinib in corticosteroid-refractory graft-versus-host disease after allogeneic stem cell transplantation: a multi-center survey

    Science.gov (United States)

    Zeiser, Robert; Burchert, Andreas; Lengerke, Claudia; Verbeek, Mareike; Maas-Bauer, Kristina; Metzelder, Stephan K.; Spoerl, Silvia; Ditschkowski, Markus; Ecsedi, Matyas; Sockel, Katja; Ayuk, Francis; Ajib, Salem; de Fontbrune, Flore Sicre; Na, Il-Kang; Penter, Livius; Holtick, Udo; Wolf, Dominik; Schuler, Esther; Meyer, Everett; Apostolova, Petya; Bertz, Hartmut; Marks, Reinhard; Lübbert, Michael; Wäsch, Ralph; Scheid, Christof; Stölzel, Friedrich; Ordemann, Rainer; Bug, Gesine; Kobbe, Guido; Negrin, Robert; Brune, Mats; Spyridonidis, Alexandros; Schmitt-Gräff, Annette; van der Velden, Walter; Huls, Gerwin; Mielke, Stephan; Grigoleit, Götz Ulrich; Kuball, Jürgen; Flynn, Ryan; Ihorst, Gabriele; Du, Jing; Blazar, Bruce R; Arnold, Renate; Kröger, Nicolaus; Passweg, Jakob; Halter, Jörg; Socié, Gerard; Beelen, Dietrich; Peschel, Christian; Neubauer, Andreas; Finke, Jürgen; Duyster, Justus; von Bubnoff, Nikolas

    2016-01-01

    Despite major improvements in allogeneic hematopoietic cell transplantation over the last decades, corticosteroid-refractory (SR) acute (a) and chronic (c) graft-versus-host disease (GVHD) cause high mortality. Pre-clinical evidence indicates the potent anti-inflammatory properties of the JAK1/2 inhibitor ruxolitinib. In this retrospective survey, 19 stem cell transplant centers in Europe and the United States reported outcome data from 95 patients who had received ruxolitinib as salvage-therapy for SR-GVHD. Patients were classified as having SR-aGVHD (n=54, all grade III or IV) or SR-cGVHD (n=41, all moderate or severe). The median number of previous GVHD-therapies was 3 for both SR-aGVHD (1–7) and SR-cGVHD (1–10). The ORR was 81.5% (44/54) in SR-aGVHD including 25 CRs (46.3%), while for SR-cGVHD the ORR was 85.4% (35/41). Of those patients responding to ruxolitinib, the rate of GVHD-relapse was 6.8% (3/44) and 5.7% (2/35) for SR-aGVHD and SR-cGVHD, respectively. The 6-month-survival was 79% (67.3%–90.7%,95% CI) and 97.4% (92.3%–100%,95% CI) for SR-aGVHD and SR-cGVHD, respectively. Cytopenia and CMV-reactivation were observed during ruxolitinib-treatment in both SR-aGVHD (30/54, 55.6% and 18/54, 33.3%) and SR-cGVHD (7/41, 17.1% and 6/41, 14.6%) patients. Ruxolitinib may constitute a promising new treatment option for SR-aGVHD and SR-cGVHD that should be validated in a prospective trial. PMID:26228813

  6. Gabapentin in traumatic nerve injury pain: A randomized, double-blind, placebo-controlled, cross-over, multi-center study

    DEFF Research Database (Denmark)

    Gordh, Torsten E; Stubhaug, Audun; Jensen, Troels S;

    2008-01-01

    A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400mg/day. The study comprised a run......), interference of sleep by pain, Clinician and Patient Global Impression of Change, and adverse effects. Nine centers randomized a total of 120 patients, 22 of whom withdrew. There was no statistically significant difference between the treatments for the primary outcome efficacy variable. However, gabapentin...... provided significantly better pain relief (p=0.015) compared with placebo. More patients had at least a 30% pain reduction with gabapentin compared with placebo (p=0.040) and pain interfered significantly less with sleep during gabapentin treatment compared with placebo (p=0.0016). Both the Patient (p=0...

  7. Anti-HMGCR antibodies as a biomarker for immune-mediated necrotizing myopathies: A history of statins and experience from a large international multi-center study.

    Science.gov (United States)

    Musset, Lucile; Allenbach, Yves; Benveniste, Olivier; Boyer, Olivier; Bossuyt, Xavier; Bentow, Chelsea; Phillips, Joe; Mammen, Andrew; Van Damme, Philip; Westhovens, René; Ghirardello, Anna; Doria, Andrea; Choi, May Y; Fritzler, Marvin J; Schmeling, Heinrike; Muro, Yoshinao; García-De La Torre, Ignacio; Ortiz-Villalvazo, Miguel A; Bizzaro, Nicola; Infantino, Maria; Imbastaro, Tiziana; Peng, Qinglin; Wang, Guochun; Vencovský, Jiří; Klein, Martin; Krystufkova, Olga; Franceschini, Franco; Fredi, Micaela; Hue, Sophie; Belmondo, Thibaut; Danko, Katalin; Mahler, Michael

    2016-10-01

    In an effort to find naturally occurring substances that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), statins were first discovered by Endo in 1972. With the widespread prescription and use of statins to decrease morbidity from myocardial infarction and stroke, it was noted that approximately 5% of all statin users experienced muscle pain and weakness during treatment. In a smaller proportion of patients, the myopathy progressed to severe morbidity marked by proximal weakness and severe muscle wasting. Remarkably, Mammen and colleagues were the first to discover that the molecular target of statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), is an autoantibody target in patients that develop an immune-mediated necrotizing myopathy (IMNM). These observations have been confirmed in a number of studies but, until today, a multi-center, international study of IMNM, related idiopathic inflammatory myopathies (IIM), other auto-inflammatory conditions and controls has not been published. Accordingly, an international, multi-center study investigated the utility of anti-HMGCR antibodies in the diagnosis of statin-associated IMNM in comparison to different forms of IIM and controls. This study included samples from patients with different forms of IIM (n=1250) and patients with other diseases (n=656) that were collected from twelve sites and tested for anti-HMGCR antibodies by ELISA. This study confirmed that anti-HMGCR autoantibodies, when found in conjunction with statin use, characterize a subset of IIM who are older and have necrosis on muscle biopsy. Taken together, the data to date indicates that testing for anti-HMGCR antibodies is important in the differential diagnosis of IIM and might be considered for future classification criteria.

  8. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Directory of Open Access Journals (Sweden)

    Hui-Jia Lin

    2015-01-01

    Full Text Available Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3% died and another 69 infants (26.7% died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019. BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other

  9. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Institute of Scientific and Technical Information of China (English)

    Hui-Jia Lin; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Jia-Hua Pan; Xiao-Mei Tong; Qiu-Ping Li

    2015-01-01

    Background:With the progress ofperinatal medicine and neonatal technology,more and more extremely low birth weight (ELBW) survived all over the world.This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.Methods:All infants admitted to 26 NICUs with a birth weight (BW) <1000 g were included between January 1,2011 and December 3 1,201 1.All the data were collected retrospectively from clinical records by a prospectively designed questionnaire.The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed.Categorical variables were performed with Pearson Chi-square test.Binary Logistic regression analysis was used to detect risk factors.Results:A total of 258 ELBW infants were admitted to 26 NICUs,of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks,and the mean BW was 868 ± 97 g.The overall survival rate at discharge was 50.0%.Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal.Furthermore,the survival rate was significantly higher in coastal areas than inland areas (53.6% vs.35.3%,P =0.019).BW <750 g and GA <28 weeks were the largest risk factors,and being small for gestational age was a protective factor related to mortality.Respiratory distress syndrome was the most common complication.The incidence of patent ductus arteriosus,intraventricular hemorrhage,periventricular leukomalacia,bronchopulmonary dysplasia,retinopathy of prematurity was 26.2%,33.7%,6.7%,48.1%,and 41.4%,respectively.Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.Conclusions:Our study was the first survey that revealed the present status of ELBW infants in the mainland of China.The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

  10. Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors.

    Science.gov (United States)

    Ozdemir, Yurday; Yildirim, Berna Akkus; Topkan, Erkan

    2016-09-01

    To assess the efficacy of whole-brain radiotherapy (WBRT) and prognostic factors in leptomeningeal carcinomatosis (LMC) of non-small-cell lung cancer (NSCLC) patients. WBRT records of 51 LMC patients confined to brain were reviewed. Eligible patients had squamous-cell carcinoma (SCC) or adenocarcinoma, and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-3. The WBRT was either 20 or 30 Gray. The primary and secondary objectives were to determine overall survival (OS) and prognostic factors for improved treatment response, respectively. Median age was 53 years (range 39-68), 58.8 % had SCC, 74.5 % had ECOG PS 1-2, and 70.6 % had LMC accompanied by parenchymal brain metastases (BM). The median follow-up was 4.1 months (range 0.7-14.4); all patients died due to disease progression. Median OS was 3.9 months (95 % CI 3.3-4.5) with 6 and 12 month estimates of 19.6 and 5.9 %, respectively. Evaluation of prognostic factors revealed that patients with ECOG 1, longer time to LMC (TT-LMC) from NSCLC diagnosis (>11.3 months), and absence of parenchymal BM had significantly superior OS than those patients with ECOG 2 (p = 0.01) or 3 (p  11.3 months, and no BM as independent prognosticators for better response to WBRT in NSCLC patients with LMC.

  11. Signet Cell in the Brain: A Case Report of Leptomeningeal Carcinomatosis as the Presenting Feature of Gastric Signet Cell Cancer

    Science.gov (United States)

    Khan, Muhammad Talha; Idrisov, Evgeny A; Maqsood, Aadil; Asad-Ur-Rahman, FNU; Abusaada, Khalid

    2017-01-01

    Malignant infiltration of pia and arachnoid mater, referred to as leptomeningeal carcinomatosis (LMC), is a rare complication of gastric carcinoma. The most common underlying malignancy in patients with LMC are leukemia, breast cancer, lymphoma, and lung cancer. We report a case of gastric adenocarcinoma that presented with LMC in the absence of overt gastrointestinal signs or symptoms. A 56-year-old Hispanic woman presented to the hospital with a three-week history of intermittent headaches and visual blurring. An initial brain imaging showed infarction in the distribution of right posterior inferior cerebellar artery (PICA) along with communicating hydrocephalus. She underwent ventriculoperitoneal (VP) shunt placement with improvement in her symptoms. Two months later she presented again with deterioration in her mental status. Imaging studies and cerebrospinal fluid (CSF) analysis confirmed the diagnosis of LMC. Further studies determined the primary tumor to be signet ring cell gastric adenocarcinoma. However, she did not have any preceding gastrointestinal symptoms. In light of the poor prognosis, the patient's family proceeded with comfort care measures. Our case portrays a rare presentation of gastric adenocarcinoma with LMC without other distant organ metastatic involvement. It also illustrates the occult nature of gastric carcinoma and signifies the importance of neurologic assessment of patients, with or at risk of gastric carcinoma. ​It also raises a theoretical concern for VP shunt as a potential conduit of malignant cells from the abdomen to the central nervous system, which may serve as an important susbtrate for future research.

  12. Enhanced antitumor effects by docetaxel/LL37-loaded thermosensitive hydrogel nanoparticles in peritoneal carcinomatosis of colorectal cancer

    Directory of Open Access Journals (Sweden)

    Fan R

    2015-12-01

    Full Text Available Rangrang Fan,1,* Aiping Tong,1,* Xiaoling Li,1 Xiang Gao,1 Lan Mei,1 Liangxue Zhou,1 Xiaoning Zhang,2 Chao You,1 Gang Guo1 1State Key Laboratory of Biotherapy and Cancer Center, Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, People’s Republic of China; 2Department of Pharmacology and Pharmaceutical Sciences, School of Medicine, Tsinghua University, and Collaborative Innovation Center for Biotherapy, Beijing, People’s Republic of China *These authors contributed equally to this work Abstract: Intraperitoneal chemotherapy was explored in clinical trials as a promising strategy to improve the therapeutic effects of chemotherapy. In this work, we developed a biodegradable and injectable drug-delivery system by coencapsulation of docetaxel (Doc and LL37 peptide polymeric nanoparticles (Doc+LL37 NPs in a thermosensitive hydrogel system for colorectal peritoneal carcinoma therapy. Firstly, polylactic acid (PLA-Pluronic L35-PLA (PLA-L35-PLA was explored to prepare the biodegradable Doc+LL37 NPs using a water-in-oil-in-water double-emulsion solvent-evaporation method. Then, biodegradable and injectable thermosensitive PLA-L64-PLA hydrogel with lower sol–gel transition temperature at around body temperature was also prepared. Transmission electron microscopy revealed that the Doc+LL37 NPs formed with the PLA-L35-PLA copolymer were spherical. Fourier-transform infrared spectra certified that Doc and LL37 were encapsulated successfully. X-ray diffraction diagrams indicated that Doc was encapsulated amorphously. Intraperitoneal administration of Doc+LL37 NPs–hydrogel significantly suppressed the growth of HCT116 peritoneal carcinomatosis in vivo and prolonged the survival of tumor-bearing mice. Our results suggested that Doc+LL37 NPs–hydrogel may have potential clinical applications. Keywords: intraperitoneal chemotherapy, injectable, nanoparticles, hydrogel

  13. Risk factors for leptomeningeal carcinomatosis in patients with brain metastases who have previously undergone stereotactic radiosurgery.

    Science.gov (United States)

    Huang, Andrew J; Huang, Karen E; Page, Brandi R; Ayala-Peacock, Diandra N; Lucas, John T; Lesser, Glenn J; Laxton, Adrian W; Tatter, Stephen B; Chan, Michael D

    2014-10-01

    Our objective was to explore the hypothesis that the risk of leptomeningeal dissemination (LMD) in patients who underwent stereotactic radiosurgery (SRS) for brain metastases is influenced by the site of the primary cancer, the addition of whole brain radiation therapy (WBRT), surgical resection, and control over their systemic disease. We conducted a retrospective cohort analysis of 805 patients who were treated with SRS for brain metastases between 1999 and 2012 at the Wake Forest Baptist Medical Center, and excluded all patients with evidence of LMD before SRS. The primary outcome was LMD. Forty-nine of 795 patients developed LMD with a cumulative incidence of 6.2% (95% Confidence Interval (CI), 4.7-8.0). Median time from SRS to LMD was 7.4 months (Interquartile Range (IQR), 3.3-15.4). A colorectal primary site (Hazard Ratio (HR), 4.5; 95% CI 2.5-8.0; p LMD. There was no evidence that surgical resection before SRS altered the risk of LMD (HR, 1.1; 95 % CI 0.6-2.0, p = 0.78). In patients who underwent SRS for brain metastases, a colorectal or breast primary site, distant brain failure, younger age, and an increased number of intracranial metastases were independently associated with LMD. Given its relative rarity as an outcome, multi-institutional prospective studies will likely be necessary to validate and quantify these relationships.

  14. Passenger Transportation in Multi-Center City Shenzhen%深圳市多中心空间结构下的客运交通组织

    Institute of Scientific and Technical Information of China (English)

    邓琪; 郭莉; 杨涛

    2015-01-01

    Urban area in Shenzhen has gradually transformed from a belt shape within the original Special Economic Zone into an outward radial-shaped city in the past three decades, which, to some extent, devi-ates the original urban development plan that calls for a multi-center development pattern. By summarizing the experience and lessons-learned from the interactive urban land use and transportation infrastructure de-velopment in Shenzhen, this paper proposes transportation system for a multi-center spatial development. Focusing on national, regional and urban passenger terminals, the paper emphasizes that context-sensitive concept should be introduced to the distribution of passenger terminals, which can match the intended ur-ban functional designs. Transportation arterial corridors should be developed to fit the urban structure of“three axis and two belt”, providing flexibility for future urban development. Based on the multi-center development plan and travel demand forecasting, the paper outlines the six transportation zones with differ-ent population and employment measures, public transit development goal, travel demand management strategy, and etc.%过去30年,深圳城市空间逐渐由原特区内的带状组团拓展至现阶段的全境轴带梯度推进,并出现与城市规划期望的多中心组团化相背离的发展趋势。总结深圳市城市空间拓展与交通设施布局互动发展历程中的经验及教训,提出多中心组团化空间结构下的交通组织模式。强调结合城市不同功能中心布局客运枢纽,重点关注全国性、区域性、全市性三个层级的客运枢纽。依托城市“三轴两带”形成骨干交通走廊,为未来空间发展预留弹性空间。基于多中心组团化空间发展愿景以及规划预测出行分析,划分六大交通政策分区,并给出不同分区的居住人口、就业岗位等指标,公共交通发展目标,以及需求管理措施等发展指引。

  15. 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...

  16. Improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study.

    Science.gov (United States)

    Lombardi, G; Colao, A; Marzullo, P; Biondi, B; Palmieri, E; Fazio, S

    2002-12-01

    We report the results of a prospective Italian multi-center study of the effects of lanreotide, a slow-release somatostatin analog, on left ventricular morphology and function and on the prevalence of ventricular arrhythmic events in 19 patients with active, newly diagnosed, uncomplicated acromegaly. Cardiac features were evaluated with Doppler-echocardiography and 24-h Holter ECG monitoring at baseline and after 6 months of lanreotide therapy. Fifteen patients (78.9%) had left ventricular hypertrophy. Lanreotide treatment significantly decreased the left ventricular mass (127.8+/-6.9 vs 140.7+/-7.1 g/m2, paffect systolic function, whereas it increased the Doppler-derived early-to-late mitral flow velocity, (E/A) ratio, of early-to-late trans-mitral flow velocity (1.34+/-0.1 vs 1.09+/-0.06, p=0.001). Stroke volume was slightly but not significantly increased after treatment, whereas systolic BP was significantly higher (134+/-14 vs 129+/-13 mmHg, p50/24 h) occurred in 16.6% of patients and were unaffected by treatment. Differently, ventricular premature beats (>50/24 h) occurred in 33.3% of patients before treatment vs 16.5%, after treatment. In conclusion, lanreotide reduced the left ventricular mass, and improved ventricular filling and ventricular arrhythmic profile.

  17. Multimodal Cognitive Enhancement Therapy for Patients with Mild Cognitive Impairment and Mild Dementia: A Multi- Center, Randomized, Controlled, Double-Blind, Crossover Trial.

    Science.gov (United States)

    Han, Ji Won; Lee, Hyeonggon; Hong, Jong Woo; Kim, Kayoung; Kim, Taehyun; Byun, Hye Jin; Ko, Ji Won; Youn, Jong Chul; Ryu, Seung-Ho; Lee, Nam-Jin; Pae, Chi-Un; Kim, Ki Woong

    2017-01-01

    We developed and evaluated the effect of Multimodal Cognitive Enhancement Therapy (MCET) consisting of cognitive training, cognitive stimulations, reality orientation, physical therapy, reminiscence therapy, and music therapy in combination in older people with mild cognitive impairment (MCI) or mild dementia. This study was a multi-center, double-blind, randomized, placebo-controlled, two-period cross-over study (two 8-week treatment phases separated by a 4-week wash-out period). Sixty-four participants with MCI or dementia whose Clinical Dementia Rating was 0.5 or 1 were randomized to the MCET group or the mock-therapy (placebo) group. Outcomes were measured at baseline, week 9, and week 21. Fifty-five patients completed the study. Mini-Mental State Examination (effect size = 0.47, p = 0.013) and Alzheimer's Disease Assessment Scale-Cognitive Subscale (effect size = 0.35, p = 0.045) scores were significantly improved in the MCET compared with mock-therapy group. Revised Memory and Behavior Problems Checklist frequency (effect size = 0.38, p = 0.046) and self-rated Quality of Life - Alzheimer's Disease (effect size = 0.39, p = 0.047) scores were significantly improved in the MCET compared with mock-therapy. MCET improved cognition, behavior, and quality of life in people with MCI or mild dementia more effectively than conventional cognitive enhancing activities did.

  18. Immunogenicity and safety of trivalent inactivated influenza vaccine: a randomized, double-blind, multi-center, phase 3 clinical trial in a vaccine-limited country.

    Science.gov (United States)

    Song, Joon Young; Cheong, Hee Jin; Woo, Heung Jeong; Wie, Seong-Heon; Lee, Jin-Soo; Chung, Moon-Hyun; Kim, Yang Ree; Jung, Sook In; Park, Kyung-Hwa; Kim, Tae Hyong; Uh, Soo-Taek; Kim, Woo Joo

    2011-02-01

    Influenza vaccines are the primary method for controlling influenza and its complications. This study was conducted as a phase 3, randomized, double-blind, controlled, multi-center trial at seven university hospitals to evaluate the immunogenicity and safety of an inactivated, split, trivalent influenza vaccine (GC501, Green Cross Corporation, Yongin, Korea), which was newly manufactured in Korea in 2008. Between September 21 and 26, a total of 329 healthy subjects were recruited for the immunogenicity analysis, while 976 subjects were enrolled for the safety analysis. The GC501 vaccine met both FDA and EMEA criteria with ≥ 80% of subjects achieving post-vaccination titers ≥ 40 for all three subtypes, even in the elderly. The vaccine was well tolerated with only mild systemic and local adverse events. In summary, GC501 showed excellent immunogenicity and a good safety profile in both young adults and the elderly. The licensure of GC501 might be an important basis in preparation for the future influenza pandemic.

  19. The C-seal trial: colorectal anastomosis protected by a biodegradable drain fixed to the anastomosis by a circular stapler, a multi-center randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bakker Ilsalien S

    2012-11-01

    Full Text Available Abstract Background Anastomotic leakage is a major complication in colorectal surgery and with an incidence of 11% the most common cause of morbidity and mortality. In order to reduce the incidence of anastomotic leakage the C-seal is developed. This intraluminal biodegradable drain is stapled to the anastomosis with a circular stapler and prevents extravasation of intracolonic content in case of an anastomotic dehiscence. The aim of this study is to evaluate the efficacy of the C-seal in reducing anastomotic leakage in stapled colorectal anastomoses, as assessed by anastomotic leakage leading to invasive treatment within 30 days postoperative. Methods The C-seal trial is a prospective multi-center randomized controlled trial with primary endpoint, anastomotic leakage leading to re-intervention within 30 days after operation. In this trial 616 patients will be randomized to the C-seal or control group (1:1, stratified by center, anastomotic height (proximal or distal of peritoneal reflection and the intention to create a temporary deviating ostomy. Interim analyses are planned after 50% and 75% of patient inclusion. Eligible patients are at least 18 years of age, have any colorectal disease requiring a colorectal anastomosis to be made with a circular stapler in an elective setting, with an ASA-classification Discussion This Randomized Clinical trial is designed to evaluate the effectiveness of the C-seal in preventing clinical anastomotic leakage. Trial registration NTR3080

  20. Hepatitis B Virus Vaccination Coverage in Medical, Nursing, and Paramedical Students: A Cross-Sectional, Multi-Centered Study in Greece.

    Science.gov (United States)

    Papagiannis, Dimitrios; Tsimtsiou, Zoi; Chatzichristodoulou, Ioanna; Adamopoulou, Maria; Kallistratos, Ilias; Pournaras, Spyros; Arvanitidou, Malamatenia; Rachiotis, George

    2016-03-15

    Students of health professions are at high risk of hepatitis B Virus (HBV) infection during their clinical training. The aim of this cross-sectional, multi-centered study was to investigate the HBV vaccination coverage in Greek medical, nursing, and paramedical students, to look into their attitudes towards the importance of vaccines and to reveal reasons associated with not being vaccinated. A self-completed, anonymous questionnaire was distributed to 2119 students of health professions in Greece, during the academic year 2013-2014. The HBV vaccination coverage of students was high (83%), being higher among medical students (88.1%, vs. 81.4% among nursing and 80.1% among paramedical students; p vaccinated during childhood. In addition, 30% of the unvaccinated students declared fear over HBV safety. Our results indicate that the healthcare students achieved higher reported immunization rates compared to the currently serving healthcare workers, but also to the students of the last decade. The fact that nursing and paramedical students have lower coverage figures underlines the importance of targeted interventions for the different subgroups of healthcare students in terms of educational programs and screening for HBV markers in order to increase HBV vaccination uptake.

  1. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival of gastric cancer with peritoneal carcinomatosis: evidence from an experimental study

    Directory of Open Access Journals (Sweden)

    Yonemura Yutaka

    2011-05-01

    Full Text Available Abstract Background Cytoreductive surgery (CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC has been considered as a promising treatment modality for gastric cancer with peritoneal carcinomatosis (PC. However, there have also been many debates regarding the efficacy and safety of this new approach. Results from experimental animal model study could help provide reliable information. This study was to investigate the safety and efficacy of CRS + HIPEC to treat gastric cancer with PC in a rabbit model. Methods VX2 tumor cells were injected into the gastric submucosa of 42 male New Zealand rabbits using a laparotomic implantation technique, to construct rabbit model of gastric cancer with PC. The rabbits were randomized into control group (n = 14, CRS alone group (n = 14 and CRS + HIPEC group (n = 14. The control group was observed for natural course of disease progression. Treatments were started on day 9 after tumor cells inoculation, including maximal removal of tumor nodules in CRS alone group, and maximal CRS plus heperthermic intraperitoneal chemoperfusion with docetaxel (10 mg/rabbit and carboplatin (40 mg/rabbit at 42.0 ± 0.5°C for 30 min in CRS + HIPEC group. The primary endpoint was overall survival (OS. The secondary endpoints were body weight, biochemistry, major organ functions and serious adverse events (SAE. Results Rabbit model of gastric cancer with PC was successfully established in all animals. The clinicopathological features of the model were similar to human gastric PC. The median OS was 24.0 d (95% confidence interval 21.8 - 26.2 d in the control group, 25.0 d (95% CI 21.3 - 28.7 d in CRS group, and 40.0 d (95% CI 34.6 - 45.4 d in CRS + HIPEC group (P = 0.00, log rank test. Compared with CRS only or control group, CRS + HIPEC could extend the OS by at least 15 d (60%. At the baseline, on the day of surgery and on day 8 after surgery, the peripheral blood cells counts, liver and kidney functions, and biochemistry

  2. Why Collect Retrospective Data?

    Science.gov (United States)

    1981-12-01

    chosen to be comparable in 1968, for a nutrition intervention that began in Village A in 1969.[5] Comparing the [5] The figure and accompanying...discussion are from Jean-Pierre Habicht and William P. Butz, "Measurement of Health and Nutrition Effects of Large-scale Nutrition Intervention Projects...villages chosen for a nutrition intervention . Source: Female Retrospective Life History Questionnaire from INCAP-RAND Survey in Guatemala

  3. {sup 177}Lu-immunotherapy of experimental peritoneal carcinomatosis shows comparable effectiveness to {sup 213}Bi-immunotherapy, but causes toxicity not observed with {sup 213}Bi

    Energy Technology Data Exchange (ETDEWEB)

    Seidl, Christof; Zoeckler, Christine; Beck, Roswitha; Senekowitsch-Schmidtke, Reingard [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); Quintanilla-Martinez, Leticia [Universitaetsklinikum Tuebingen, Institute for Pathology, Tuebingen (Germany); Bruchertseifer, Frank [Institute for Transuranium Elements, European Commission, Joint Research Centre, Karlsruhe (Germany)

    2011-02-15

    {sup 213}Bi-d9MAb-immunoconjugates targeting gastric cancer cells have effectively cured peritoneal carcinomatosis in a nude mouse model following intraperitoneal injection. Because the {beta}-emitter {sup 177}Lu has proven to be beneficial in targeted therapy, {sup 177}Lu-d9MAb was investigated in this study in order to compare its therapeutic efficacy and toxicity with those of {sup 213}Bi-d9MAb. Nude mice were inoculated intraperitoneally with HSC45-M2 gastric cancer cells expressing d9-E-cadherin and were treated intraperitoneally 1 or 8 days later with different activities of specific {sup 177}Lu-d9MAb immunoconjugates targeting d9-E-cadherin or with nonspecific {sup 177}Lu-d8MAb. Therapeutic efficacy was evaluated by monitoring survival for up to 250 days. For evaluation of toxicity, both biodistribution of {sup 177}Lu-d9MAb and blood cell counts were determined at different time points and organs were examined histopathologically. Treatment with {sup 177}Lu-immunoconjugates (1.85, 7.4, 14.8 MBq) significantly prolonged survival. As expected, treatment on day 1 after tumour cell inoculation was more effective than treatment on day 8, and specific {sup 177}Lu-d9MAb conjugates were superior to nonspecific {sup 177}Lu-d8MAb. Treatment with 7.4 MBq of {sup 177}Lu-d9MAb was most successful, with 90% of the animals surviving longer than 250 days. However, treatment with therapeutically effective activities of {sup 177}Lu-d9MAb was not free of toxic side effects. In some animals lymphoblastic lymphoma, proliferative glomerulonephritis and hepatocarcinoma were seen but were not observed after treatment with {sup 213}Bi-d9MAb at comparable therapeutic efficacy. The therapeutic efficacy of {sup 177}Lu-d9MAb conjugates in peritoneal carcinomatosis is impaired by toxic side effects. Because previous therapy with {sup 213}Bi-d9MAb revealed comparable therapeutic efficacy without toxicity it should be preferred for the treatment of peritoneal carcinomatosis. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Maria José Sá

    1995-06-01

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

  5. A Report of Disseminated Carcinomatosis of the Bone Marrow Originating from Transverse Colon Cancer Successfully Treated with Chemotherapy Using XELOX plus Bevacizumab

    Directory of Open Access Journals (Sweden)

    Masayasu Naito

    2014-07-01

    Full Text Available A 61-year-old male, who had been admitted to another hospital due to disseminated intravascular coagulation (DIC, was referred to our hospital. Total colonoscopy, abdominal dynamic CT and positron-emission tomography revealed bone metastasis and multiple lymphocytic metastases from transverse colon cancer in addition to disseminated carcinomatosis of the bone marrow (DCBM. We immediately performed chemotherapy with XELOX + bevacizumab and denosumab against DCBM from transverse colon cancer in order to avoid radical surgery. In addition, we initiated the administration of recombinant human soluble thrombomodulin for 1 week to treat DIC. The patient was able to tolerate and receive 4 cycles of chemotherapy without any severe side effects. After receiving the 4 cycles of treatment, he recovered from DIC, and the bone and multiple lymphocytic metastases disappeared.

  6. Pharmacokinetics of methotrexate in the cerebrospinal fluid after intracerebroventricular administration in patients with meningeal carcinomatosis and altered cerebrospinal fluid flow dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Miller, K.T.; Wilkinson, D.S.

    1989-01-01

    Pharmacokinetic parameters of the distribution and elimination of intracerebroventricularly administered methotrexate (MTX) were evaluated in three patients with meningeal carcinomatosis. Abnormal cerebrospinal fluid (CSF) flow dynamics, which were not otherwise clinically evident, were diagnosed by 111In-diethylenetriaminepentaacetate radionuclide imaging. Alterations in CSF flow resulted in large changes in MTX distribution. Reduced cortical convexity (type III), spinal subarachnoid (type II), or ventricular (type I) CSF flow resulted in a prolongation of the single-pass mean residence time of MTX in the peripheral compartment by as much as eightfold and a reduction in intercompartmental clearance by 94-99%. Leptomeningeal carcinomatosis can affect both CSF MTX distribution and elimination, each to a different extent, within the same patient. Total MTX clearance from the CSF was reduced by 79-93% in the patients studied. A two-compartment pharmacokinetic model, with elimination occurring from the peripheral compartment, gave values for the distribution rate constant from the central to the peripheral compartment (k12), which decreased with the extent of CSF flow abnormality. However, the elimination rate constant from the peripheral compartment (k20) was reduced to an extent apparently independent of CSF flow abnormality (percentage reduction in k12 and k20, respectively: type III, 18 and 66; type II, 67 and 86; type I, 78 and 48). Inadequate distribution and locally high concentrations of MTX within the CSF may contribute to therapeutic failure and neurotoxicity. Monitoring of MTX levels in the CSF may be deceiving when samples are drawn from the site of injection, since the distribution kinetics are altered by abnormal CSF flow dynamics.

  7. Reduction in Circulating Tumor Cell Count following Therapy with nab-Paclitaxel plus Carboplatin in a Patient with Leptomeningeal Carcinomatosis from Breast Cancer.

    Science.gov (United States)

    Stebel, Andrea

    2012-01-01

    This case study reports on a 56-year-old woman with breast adenocarcinoma and leptomeningeal metastases. After initial chemotherapy with a dose-dense regimen of doxorubicin/cyclophosphamide followed by 3 cycles of docetaxel (100 mg/m(2)), a lumpectomy was performed that revealed invasive ductal carcinoma with lymph node involvement. Because of the extent of the disease, she underwent a mastectomy. Two months after the completion of initial chemotherapy, leptomeningeal metastases were detected on December 13, 2006. After completion of whole-brain radiation therapy, she received systemic chemotherapy with a novel albumin-bound 130-nm formulation of paclitaxel (nab®-paclitaxel) at 100 mg/m(2) combined with carboplatin AUC = 6, both given weekly. Clinical response was prompt, with a reduction in the circulating tumor cell (CTC) count from 63 before treatment to 2 after the first treatment cycle. While undergoing treatment with nab-paclitaxel plus carboplatin, she reported an improvement in neurologic symptoms, including a decrease in headaches, improved cognition and balance, and an overall improved quality of life. Before the third treatment cycle, she had a CTC count of 2. Without treatment, the median survival of patients diagnosed with leptomeningeal metastases is 4-6 weeks. However, this patient survived for 4 months after the diagnosis of leptomeningeal carcinomatosis. Treatment was discontinued because of complications of urosepsis, and the patient died on April 7, 2007. Our case shows that additional treatment with weekly nab-paclitaxel combined with carboplatin (AUC6) can prolong life for some patients with leptomeningeal carcinomatosis from breast cancer.

  8. Reduction in Circulating Tumor Cell Count following Therapy with nab®-Paclitaxel plus Carboplatin in a Patient with Leptomeningeal Carcinomatosis from Breast Cancer

    Directory of Open Access Journals (Sweden)

    Andrea Stebel

    2012-01-01

    Full Text Available This case study reports on a 56-year-old woman with breast adenocarcinoma and leptomeningeal metastases. After initial chemotherapy with a dose-dense regimen of doxorubicin/cyclophosphamide followed by 3 cycles of docetaxel (100 mg/m2, a lumpectomy was performed that revealed invasive ductal carcinoma with lymph node involvement. Because of the extent of the disease, she underwent a mastectomy. Two months after the completion of initial chemotherapy, leptomeningeal metastases were detected on December 13, 2006. After completion of whole-brain radiation therapy, she received systemic chemotherapy with a novel albumin-bound 130-nm formulation of paclitaxel (nab®-paclitaxel at 100 mg/m2 combined with carboplatin AUC = 6, both given weekly. Clinical response was prompt, with a reduction in the circulating tumor cell (CTC count from 63 before treatment to 2 after the first treatment cycle. While undergoing treatment with nab-paclitaxel plus carboplatin, she reported an improvement in neurologic symptoms, including a decrease in headaches, improved cognition and balance, and an overall improved quality of life. Before the third treatment cycle, she had a CTC count of 2. Without treatment, the median survival of patients diagnosed with leptomeningeal metastases is 4–6 weeks. However, this patient survived for 4 months after the diagnosis of leptomeningeal carcinomatosis. Treatment was discontinued because of complications of urosepsis, and the patient died on April 7, 2007. Our case shows that additional treatment with weekly nab-paclitaxel combined with carboplatin (AUC6 can prolong life for some patients with leptomeningeal carcinomatosis from breast cancer.

  9. A multi-center, comparative, phase 3 study to determine the efficacy of gadofosveset-enhanced magnetic resonance angiography for evaluation of renal artery disease

    Energy Technology Data Exchange (ETDEWEB)

    McGregor, Robert [St. Boniface General Hospital, Winnipeg, Manitoba (Canada); Vymazal, Josef [Hospital Na Homolce, Prague (Czech Republic); Martinez-Lopez, Manuel [Hospital Medica Sur, Mexico City (Mexico); Neuwirth, Jiri [Faculty Hospital Motol, Prague (Czech Republic); Salgado, Perla [American British Cowdray Medical Center, Mexico City (Mexico); Beregi, Jean-Paul [Hopital Cardiologique, Lille (France); Peduto, Anthony [Westmead Hospital, Westmead New South Wales (Australia); Pena-Almaguer, Erasmo de la [Christus-Muguerza Medical Center, Monterrey, Nuevo Leon (Mexico); Slater, Greg J. [Greenslopes Private Hospital, Greenslopes, Queensland (Australia); Shamsi, Kohkan [Berlex Laboratories, Montville, NJ (United States); Parsons, Edward C. [EPIX Pharmaceuticals, Inc., Lexington, MA (United States)], E-mail: eparsons@epixpharma.com

    2008-02-15

    Purpose: To determine prospectively the safety and efficacy of the blood-pool contrast agent gadofosveset trisodium in renal artery magnetic resonance angiography (MRA). Materials and methods: Gadofosveset (0.03 mmol/kg) was administered to adult patients with known or suspected renal arterial disease in a multi-center phase 3 single dose study. The drug binds reversibly to albumin, prolonging the blood residence time, and allowing collection of images in the first-pass and steady-state phases. The combination of these images was compared to non-contrast MRA, using catheter X-ray angiography (XRA) as the standard of reference (SOR). All MRA images were collected at 1.5 T in one imaging session for direct comparison, and XRA within 30 days. Sensitivity, specificity, and accuracy for diagnosing significant disease (stenosis {>=}50%) were calculated for MRA using three independent blinded readers. Patient safety was monitored for 72-96 h. Results: A total of 145 patients at 18 centers were enrolled and received gadofosveset; the 127 with complete efficacy data entered the primary efficacy analysis. Gadofosveset-enhanced MRA led to significant improvement (p < 0.01) in sensitivity (+25%, +26%, +42%), specificity (+23%, +25%, +29%), and accuracy (+23%, +28%, +29%) over non-enhanced MRA for the three readers. The rate of uninterpretable examinations decreased from 30% to less than 2%. There were no serious adverse events, and the most common adverse events were nausea, pruritis, and headache (8% each). No significant trends in clinical chemistry parameters, nor significant changes in serum creatinine, were found following administration of gadofosveset. Conclusion: In patients with known or suspected renal arterial disease, multi-phase gadofosveset-enhanced MRA significantly improves sensitivity, specificity, and accuracy versus non-enhanced MRA. Gadofosveset was safe and well tolerated in this patient population.

  10. Mifepristone in Combination with Misoprostol vs. Low Dose Mifepristone Alone in Emergency Contraception: a Multi-center Double-blind Randomized Clinical Trial

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To compare the effectiveness and side effects of various low dose ofMi fepristone in combination with Misoprostol and low doses Mi fepristone alone in emer-gency contraceptionMaterials & Methods This is a multi-center double-blind randomized controlled clini-cal trial. A total of 899 healthy women were allocated into this study and were ran-domly divided into 3 groups. They were orally administrated with different emergen-cy contraceptives with 120 h after unprotected intercourse. Group Ⅰ (n = 300) was giv-en 25 mg Mifepristone plus 0. 2 mg Misoprostol after 24 h. Group Ⅱ (n = 299) wasgiven 10 mg Mifepristone plus 0. 2 mg Misoprostol after 24 h. Group Ⅲ (n = 300)was administrated with 10 mg Mifepristone alone. The effective rates in differentgroups were calculated with Dixon method.Results Altogether 11 pregnancies occurred, among which 2 cases were in Group Ⅰ, 2cases in Group Ⅱ, and 7 cases were in Grout Ⅲ. After correction with method fail-ure, there was only one case in Group Ⅰ, 0 case in Group Ⅱ, and 5 cases in Group Ⅲ.The contraceptive effectiveness in these groups was 95. 5%, 100% and 76. 9% respec-tively. The pregnancy rate was significantly lower in Group Ⅰ and Group Ⅱ than thatof Group Ⅲ (P< 0. 01). The side effects were slight and tolerable, and there was nosignificant difference between di fferent groups (P> 0. 05).Conclusion Use of low dose Mi fepristone (25 mg or 10 mg ) in combination with 0. 2mg Misoprostol was an effective, low side effects and safe treatment regimen foremergency contraception.

  11. Degradable Starch Microspheres Transcatheter Arterial Chemoembolization (DSM-TACE) in Intrahepatic Cholangiocellular Carcinoma (ICC): Results from a National Multi-Center Study on Safety and Efficacy

    Science.gov (United States)

    Schicho, Andreas; Pereira, Philippe L.; Pützler, Manfred; Michalik, Katharina; Albrecht, Thomas; Nolte-Ernsting, Claus; Stroszczynski, Christian; Wiggermann, Philipp

    2017-01-01

    Background The aim of this study was to evaluate the safety and efficacy of DSM (degradable starch microspheres) as an embolic agent in transarterial chemoembolization in the treatment of intrahepatic cholangiocellular carcinoma (ICC). Material/Methods This was a national, multi-center observational cohort study on the safety and efficacy of DSM-TACE using mitomycin, gemcitabine, cisplatin, doxorubicin, and carboplatin in palliative treatment of ICC. Recruitment period for the study was from January 2010 to June 2014. Primary endpoints were toxicity, safety, and response according to mRECIST criteria. Results Twenty-five DSM-TACE procedures in cases of advanced ICC were performed in seven patients. Nausea and vomiting occurred as adverse event (AE) in eight out of 25 treatments (32%), with seven of eight events (87.5%) associated with the use of gemcitabine. In 11 out of 25 treatments (44%) moderate, transient epigastric pain was registered as an adverse event (AE) within 24 hours of DSM-TACE. One case (1/25) of severe AE (4%) with thrombocytopenia led to discontinuation of the DSM-TACE-treatment. A total of 25 DSM-TACE procedures with complete clinical and imaging follow-up over a two-year-period were analyzed: objective response (OR) was achieved in three of 25 treatments (12%) Disease control (DC) was achieved in 44% (11/25) of treatments; progress was registered in 4% (1/25). Conclusions The use of DSM as an embolic agent for TACE is safe in the treatment of ICC. A standardized anti-emetic medication should be established, especially when using gemcitabine. Further prospective studies need to be conducted to find the most suitable, standardized DSM-TACE treatment regime. PMID:28192388

  12. Prevalence of mental disorders, psychosocial distress and need for psychosocial support in cancer patients – study protocol of an epidemiological multi-center study

    Directory of Open Access Journals (Sweden)

    Mehnert Anja

    2012-07-01

    Full Text Available Abstract Background Empirical studies investigating the prevalence of mental disorders and psychological distress in cancer patients have gained increasing importance during recent years, particularly with the objective to develop and implement psychosocial interventions within the cancer care system. Primary purpose of this epidemiological cross-sectional multi-center study is to detect the 4-week-, 12-month-, and lifetime prevalence rates of comorbid mental disorders and to further assess psychological distress and psychosocial support needs in cancer patients across all major tumor entities within the in- and outpatient oncological health care and rehabilitation settings in Germany. Methods/Design In this multicenter, epidemiological cross-sectional study, cancer patients across all major tumor entities will be enrolled from acute care hospitals, outpatient cancer care facilities, and rehabilitation centers in five major study centers in Germany: Freiburg, Hamburg, Heidelberg, Leipzig and Würzburg. A proportional stratified random sample based on the nationwide incidence of all cancer diagnoses in Germany is used. Patients are consecutively recruited in all centers. On the basis of a depression screener (PHQ-9 50% of the participants that score below the cutoff point of 9 and all patients scoring above are assessed using the Composite International Diagnostic Interview for Oncology (CIDI-O. In addition, all patients complete validated questionnaires measuring emotional distress, information and psychosocial support needs as well as quality of life. Discussion Epidemiological data on the prevalence of mental disorders and distress provide detailed and valid information for the estimation of the demands for the type and extent of psychosocial support interventions. The data will provide information about specific demographic, functional, cancer- and treatment-related risk factors for mental comorbidity and psychosocial distress, specific

  13. A multi-center blinded study on the efficiency of phenotypic screening methods to detect glycopeptide intermediately susceptible Staphylococcus aureus (GISA and heterogeneous GISA (h-GISA

    Directory of Open Access Journals (Sweden)

    Sloos Jacobus H

    2007-09-01

    Full Text Available Abstract Backgrounds To determine the true incidence of hGISA/GISA and its consequent clinical impact, methods must be defined that will reliably and reproducibly discriminate these resistant phenotypes from vancomycin susceptible S. aureus (VSSA. Methods This study assessed and compared the ability of eight Dutch laboratories under blinded conditions to discriminate VSSA from hGISA/GISA phenotypes and the intra- and inter-laboratory reproducibility of agar screening plates and the Etest method. A total of 25 blinded and unique strains (10 VSSA, 9 hGISA and 6 GISA were categorized by the PAP-AUC method and PFGE typed to eliminate clonal duplication. All strains were deliberately added in quadruplets to evaluate intra-laboratory variability and reproducibility of the methods. Strains were tested using three agar screening methods, Brain Heart Infusion agar (BHI + 6 μg/ml vancomycin, Mueller Hinton agar (MH + 5 μg/ml vancomycin and MH + 5 μg/ml teicoplanin and the Etest macromethod using a 2 McFarland inoculum. Results and Discussion The ability to detect the hGISA/GISA phenotypes varied significantly between methods and phenotypes. BHI vancomycin and MH vancomycin agar screens lacked the ability to detect hGISA. The MH teicoplanin agar screen was more sensitive but still inferior to Etest that had a sensitivity of 98.5% and 99.5%, for hGISA and GISA, respectively. Intra- and inter-laboratory reproducibility varied between methods with poorest performance seen with BHI vancomycin. Conclusion This is the first multi-center blinded study to be undertaken evaluating various methods to detect GISA and hGISA. These data showed that the ability of clinical laboratories to detect GISA and hGISA varied considerably, and that screening plates with vancomycin have a poor performance in detecting hGISA.

  14. Prospective multi-center registry to evaluate efficacy and safety of the newly developed diamond-like carbon-coated cobalt-chromium coronary stent system.

    Science.gov (United States)

    Ando, Kenji; Ishii, Katsuhisa; Tada, Eiji; Kataoka, Kazuaki; Hirohata, Atsushi; Goto, Kenji; Kobayashi, Katsuyuki; Tsutsui, Hiroshi; Nakahama, Makoto; Nakashima, Hitoshi; Uchikawa, Shinichiroh; Kanda, Junji; Yasuda, Satoshi; Yajima, Junji; Kitabayashi, Hiroshi; Sakurai, Shumpei; Nakanishi, Keita; Inoue, Naoto; Noike, Hirofumi; Hasebe, Terumitsu; Sato, Tetsuya; Yamasaki, Masao; Kimura, Takeshi

    2016-07-22

    The purpose of this multi-center, non-randomized, and open-label clinical trial was to determine the non-inferiority of diamond-like carbon (DLC)-coated cobalt-chromium coronary stent, the MOMO DLC coronary stent, relative to commercially available bare-metal stents (MULTI-LINK VISION(®)). Nineteen centers in Japan participated. The study cohort consisted of 99 patients from 19 Japanese centers with single or double native coronary vessel disease with de novo and restenosis lesions who met the study eligibility criteria. This cohort formed the safety analysis set. The efficacy analysis set consisted of 98 patients (one case was excluded for violating the eligibility criteria). The primary endpoint was target vessel failure (TVF) rate at 9 months after stent placement. Of the 98 efficacy analysis set patients, TVF occurred in 11 patients (11.2 %, 95 % confidence interval 5.7-19.2 %) at 9 months after the index stent implantation. The upper 95 % confidence interval for TVF of the study stent was lower than that previously reported for the commercially available MULTI-LINK VISION(®) (19.6 %), demonstrating non-inferiority of the study stent to MULTI-LINK VISION(®). All the TVF cases were related to target vascular revascularization. None of the cases developed in-stent thrombosis or myocardial infarction. The average in-stent late loss and binary restenosis rate at the 6-month follow-up angiography were 0.69 mm and 10.5 %, respectively, which are lower than the reported values for commercially available bare-metal stents. In conclusion, the current pivotal clinical study evaluating the new MOMO DLC-coated coronary stent suggested its low rates of TVF and angiographic binary restenosis, and small in-stent late loss, although the data were considered preliminary considering the small sample size and single arm study design.

  15. Treatment of Patients with Erectile Dysfunction by Shugan Yiyang Capsule(疏肝益阳胶囊):A Multi-Centered Randomized Controlled Trial

    Institute of Scientific and Technical Information of China (English)

    王琦; 杨吉相; 李国信; 夏仲元; 王斌; 李贤初; 胡海翔; 毕焕洲; 徐福松; 何映; 林天东

    2004-01-01

    Objective: To evaluate the efficacy and safety of Shugan Yiyang Capsule (SGYY, 疏肝益阳ficiency Syndrome type with or without blood stasis. Methods: A multi-centered, randomized, double-blinded, placebo-controlled trial in 304 patients was conducted by dividing them into 3 groups, who received re101), 1.0g taken three times a day for 4 weeks. Besides, 205 patients were arranged in an open-label studyand treated with SGYY 1.0 g taken three times a day for 4 weeks. The total effective rate, total remarkablyeffective rate, erection recovery rate tested by penis hardness test ring, time taken for improving erection among groups, as well as therapeutic effect between psychogenic ED group and mild arteriogenic ED group were compared. Adverse reactions related to SGYY were recorded. And a 3-month follow-up study was conducted on 105 cured patients. Results: The trial was completed in 500 patients. The total effective rate and total remarkably effective rate in the SGYY treated double-blinded group were 88.0% and 64.0% respectively, and those in the open-label group 90.5% and 65.0%, respectively, all significantly higher th an thosein the placebo (21.0%, 6.0%) and SYBS groups (60.0%, 29.0%), P<0.01. At the same time, the e rection recovery rate and improving time in SGYY group were significantly better than those in other groups ( P<0.01). No adverse reactions related to SGYY were found. The successful rate of potency to have intercourse within 3 months was over 80% (100 patients out of the 105 cured patients). Conclusion: SGYY was an effective and safe treatment for patients with psychogenic and mild arteriogenic ED of Gan stagnation and Shen deficiency Syndrome type with or without blood stasis, especially for psychogenic ED patients.

  16. The concordance of care for age related macular degeneration with the chronic care model: a multi-centered cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Stefan Markun

    Full Text Available AIMS: The aim of the study was to assess the concordance of care for age related macular degeneration with the evidence-based framework for care for chronic medical conditions known as the chronic care model. Furthermore we aimed to identify factors associated with the concordance of care with the chronic care model. METHODS: Multi-centered cross-sectional study. 169 patients beginning medical treatment for age related macular degeneration were recruited and analyzed. Patients completed the Patient Assessment of Chronic Illness Care (PACIC questionnaire, reflecting accordance to the chronic care model from a patient's perspective, the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25 and Patient Health Questionnaire (PHQ-9. Visual acuity and chronic medical conditions were assessed. Nonparametric tests and correlation analyses were performed, also multivariable regression analysis. RESULTS: The median PACIC summary score was 2.4 (interquartile range 1.75 to 3.25, the lowest PACIC subscale score was "follow-up/coordination" with a median of 1.8 (interquartile range 1.00 to 2.60. In multivariable regression analysis the presence of diabetes type 2 was strongly associated with low PACIC scores (coefficient = -0.85, p = 0.007. CONCLUSION: Generally, care for patients with age related macular degeneration by ophthalmologists is in moderate concordance with the chronic care model. Concerning follow-up and coordination of health service, large improvements are possible. Future research should answer the question how healthcare delivery can be improved effecting relevant benefits to patients with AMD.

  17. Multi-link Vision and MiniVision stent registry in Asian patients with coronary artery disease: a prospective, multi-center study

    Institute of Scientific and Technical Information of China (English)

    XU Ya-wei; HOU Yu-qing; Ashok Jain; Parvez Grant; Gudapati Ramesh; Basavappa Ramesh; Chumpol Piamsomboon; Srun Kuanprasert; Hyeon-Cheol Gwon; Yoon Haeng Cho; Haizal Haroon Kamar; WEI Yi-dong; HUANG Cong-xin; TANG Kai; CHEN Yan-qing; LI Wei-ming; YU Xue-jing; QIN Yong-wen; QI Guo-xian; QU Peng

    2007-01-01

    Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents (BMS)-Multi-link (ML) Vision / ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease (CAD) after implanting the Multi-link Vision or MiniVision stent were investigated in this study.Methods An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS- ML Vision / ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study. The average reference diameter of the lesions was (3.0±0.5) mm, and the mean length was (15.7±5.0) mm.Results The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization (TVR) were 6.8%, 3.5%and 1.4% respectively.Conclusion The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.

  18. Degradable Starch Microspheres Transcatheter Arterial Chemoembolization (DSM-TACE) in Intrahepatic Cholangiocellular Carcinoma (ICC): Results from a National Multi-Center Study on Safety and Efficacy.

    Science.gov (United States)

    Schicho, Andreas; Pereira, Philippe L; Pützler, Manfred; Michalik, Katharina; Albrecht, Thomas; Nolte-Ernsting, Claus; Stroszczynski, Christian; Wiggermann, Philipp

    2017-02-13

    BACKGROUND The aim of this study was to evaluate the safety and efficacy of DSM (degradable starch microspheres) as an embolic agent in transarterial chemoembolization in the treatment of intrahepatic cholangiocellular carcinoma (ICC). MATERIAL AND METHODS This was a national, multi-center observational cohort study on the safety and efficacy of DSM-TACE using mitomycin, gemcitabine, cisplatin, doxorubicin, and carboplatin in palliative treatment of ICC. Recruitment period for the study was from January 2010 to June 2014. Primary endpoints were toxicity, safety, and response according to mRECIST criteria. RESULTS Twenty-five DSM-TACE procedures in cases of advanced ICC were performed in seven patients. Nausea and vomiting occurred as adverse event (AE) in eight out of 25 treatments (32%), with seven of eight events (87.5%) associated with the use of gemcitabine. In 11 out of 25 treatments (44%) moderate, transient epigastric pain was registered as an adverse event (AE) within 24 hours of DSM-TACE. One case (1/25) of severe AE (4%) with thrombocytopenia led to discontinuation of the DSM-TACE-treatment. A total of 25 DSM-TACE procedures with complete clinical and imaging follow-up over a two-year-period were analyzed: objective response (OR) was achieved in three of 25 treatments (12%) Disease control (DC) was achieved in 44% (11/25) of treatments; progress was registered in 4% (1/25). CONCLUSIONS The use of DSM as an embolic agent for TACE is safe in the treatment of ICC. A standardized anti-emetic medication should be established, especially when using gemcitabine. Further prospective studies need to be conducted to find the most suitable, standardized DSM-TACE treatment regime.

  19. Multi-center evaluation of the novel fully-automated PCR-based Idylla™ BRAF Mutation Test on formalin-fixed paraffin-embedded tissue of malignant melanoma.

    Science.gov (United States)

    Melchior, Linea; Grauslund, Morten; Bellosillo, Beatriz; Montagut, Clara; Torres, Erica; Moragón, Ester; Micalessi, Isabel; Frans, Johan; Noten, Veerle; Bourgain, Claire; Vriesema, Renske; van der Geize, Robert; Cokelaere, Kristof; Vercooren, Nancy; Crul, Katrien; Rüdiger, Thomas; Buchmüller, Diana; Reijans, Martin; Jans, Caroline

    2015-12-01

    The advent of BRAF-targeted therapies led to increased survival in patients with metastatic melanomas harboring a BRAF V600 mutation (implicated in 46-48% of malignant melanomas). The Idylla(™) System (Idylla(™)), i.e., the real-time-PCR-based Idylla(™) BRAF Mutation Test performed on the fully-automated Idylla(™) platform, enables detection of the most frequent BRAF V600 mutations (V600E/E2/D, V600K/R/M) in tumor material within approximately 90 min and with 1% detection limit. Idylla(™) performance was determined in a multi-center study by analyzing BRAF mutational status of 148 archival formalin-fixed paraffin-embedded (FFPE) tumor samples from malignant melanoma patients, and comparing Idylla(™) results with assessments made by commercial or in-house routine diagnostic methods. Of the 148 samples analyzed, Idylla(™) initially recorded 7 insufficient DNA input calls and 15 results discordant with routine method results. Further analysis learned that the quality of 8 samples was insufficient for Idylla(™) testing, 1 sample had an invalid routine test result, and Idylla(™) results were confirmed in 10 samples. Hence, Idylla(™) identified all mutations present, including 7 not identified by routine methods. Idylla(™) enables fully automated BRAF V600 testing directly on FFPE tumor tissue with increased sensitivity, ease-of-use, and much shorter turnaround time compared to existing diagnostic tests, making it a tool for rapid, simple and highly reliable analysis of therapeutically relevant BRAF mutations, in particular for diagnostic units without molecular expertise and infrastructure.

  20. Hipparcos: a Retrospective

    CERN Document Server

    Perryman, Michael

    2011-01-01

    The Hipparcos satellite was launched in 1989. It was the first, and remains to date the only, attempt at performing large-scale astrometric measurements from space. Hipparcos marked a fundamentally new approach to the field of astrometry, revolutionising our knowledge of the positions, distances, and space motions of the stars in the solar neighbourhood. In this retrospective, I look back at the processes which led to the mission's acceptance, provide a short summary of the underlying measurement principles and the experiment's scientific achievements, and a conclude with a brief summary of its principal legacy - the Gaia mission.

  1. The retrospective gambler's fallacy

    Directory of Open Access Journals (Sweden)

    Daniel M. Oppenheimer

    2009-08-01

    Full Text Available The gambler's fallacy (Tune, 1964 refers to the belief that a streak is more likely to end than chance would dictate. In three studies, participants exhibited a extit{retrospective gambler's fallacy} (RGF in which an event that seems rare appears to come from a longer sequence than an event that seems more common. Study 1 demonstrates this bias for streaks, while Study 2 does so with single rare events and shows that the appearance of rarity is more important than actual rarity. Study 3 extends these findings from abstract gambling domains into real world domains to demonstrate the generalizability of the effects. The RGF follows from the law of small numbers (Tversky and Kahneman, 1971 and has many applications, from perceptions of the social world to philosophical debates about the existence of multiple universes.

  2. MEAD retrospective analysis report

    DEFF Research Database (Denmark)

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

    2003-01-01

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

  3. A multi-center study of a modified open trocar first-puncture approach in 17 350 patients for laparoscopic entry

    Institute of Scientific and Technical Information of China (English)

    LIU Hai-fang; CHEN Xu; LIU Yan

    2009-01-01

    Background Laparoscopic entry is of primary importance in laparoscopic surgery because of its potential association with serious complications such as visceral and vascular injuries. There are several approaches now available for laparoscopic entry. The present study reported a modified open trocar first-puncture approach (Yan's open technique) and validated its safety and practicability in a multi-center research.Methods The study was performed in seven gynecological endoscopy centers for 8 successive years from September 1998 to March 2006 involving 17 350 patients, who received the modified open trocar first-puncture approach developed by Dr. LIU Yan as the study group (MOT group). The "Yan's open technique" is the umbilical incision with a scalpel and then a 10-mm trocar entry into the abdominal cavity through direct trocar puncture or insertion of the cannula sheath via the opened umbilicus under no resistance. Another 4570 patients received the traditional Veress needle puncture as the control (VN group). The first puncture procedures of both groups were performed by 28 experienced gynecologic laparoscopists and 170 learners.Results In MOT group, the successful achievement rate (AR) of first puncture was 99.99% (17 348/17 350), including smooth manipulation in 17326 cases and unsmooth manipulation in 22 cases. The remaining two cases failed.First-puncture associated complications occurred in two cases (0.01%). In VN group, the successful AR of first puncture was 99.89% (4565/4570), including smooth manipulation in 4542 cases and unsmooth manipulation in 23 cases. The remaining five cases failed. First-puncture associated complications occurred in four cases (0.09%). There was no significant difference in the successful AR between the experienced gynecologic laparoscopists of the two groups (100% vs 100%, P >0.05), but the difference was significant between the learners of the two groups (99.98% vs 99.81%, P <0.05). The complication rate of VN group was

  4. [A patient with meningeal carcinomatosis accompanied by a small pituitary metastatic lesion from gastric cancer who developed cerebral salt wasting syndrome].

    Science.gov (United States)

    Izumi, Y; Sakaguchi, K; Udaka, F; Tsujimura, T; Kameyama, M

    1999-09-01

    A 68-year-old man with disturbed consciousness had repeatedly developed light-headedness and dizziness since the summer of 1996 and was admitted to a hospital for detailed examinations on October 8, 1996. On admission, he weighed 49 kg and showed subclinical hypothyroidism with low T3 syndrome. The adrenal function and serum electrolytes were normal. Since the stool samples were positive for occult blood, gastroscopy was performed. Examination of the biopsy specimens demonstrated gastric cancer. On October 21, blood examination showed hyponatremia (127 mEq/l). On October 22, marked disturbance of consciousness developed. On October 24, the serum Na level further decreased to 116 mEq/l. On November 8, he was referred to our hospital. On admission, his skin and tongue showed marked dehydration, and severe disturbance of consciousness and neck stiffness were observed. The central venous pressure was 4 cmH2O. In the cerebrospinal fluid, atypical cells were observed, and a diagnosis of meningeal carcinomatosis was made. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was excluded because of marked dehydration, a normal blood ADH level, and because plasma osmotic pressure was greater than urinary osmotic pressure. Considering the possibility of cerebral salt wasting syndrome (CSWS) or hypoadrenocorticism, Na supplementation and drip infusion of prednisolone (20 mg/day) were performed. The serum Na has normalized (140.1 mEq/l), and his consciousness improved. He died of aggravation of the general condition on December 16. Pathological examination demonstrated a small metastatic lesion in the infundibular part of the pituitary gland and a small metastatic lesion in the parenchyma of the bilateral adrenal glands. However, since neither hypotension nor hypoglycemia was observed before treatment, and the blood cortisol level and the serum K level were normal, hypoadrenocorticism was excluded. Hypoaldosteronism was also excluded because of a normal serum K

  5. EFFICACY OF ADDING FENTANYL TO LIGNOCAINE – ADRENALINE COMBINATION IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB ORTHOPEDIC SURGERIES A MULTI - CENTER STUDY

    Directory of Open Access Journals (Sweden)

    Anish M

    2015-06-01

    Full Text Available BACKGROUND: Brachial plexus block is a suitable alternative to general anesthesia for surgeries of upper limb and it can be performed even in patients who are not adequately fit for general anesthesia. The significance of brachial plexus block has increased in recent years due to renewed interest in day care surgery. Lignocaine hydrochloride has been used extensively for brachial plexus block and it has the disadvantage of having short duration of action. Opioids when added to anesthetic mixtures may improve and prolo ng the action of local anesthetics during peripheral nerve blocks. Such postoperative pain control can reduce both narcotic requirements and narcotic induced side effects. Studies have shown the efficacy of opioids as analgesic adjuvants in prolonging the duration of brachial plexus block. With this background in mind, this study was conducted to compare the onset and duration of sensory and motor block produced by a mixture of lignocaine and adrenaline with that produced by a mixture of fentanyl, lignocain e and adrenaline. Aims: To assess the effectiveness of addition of fentanyl to a mixture of lignocaine and adrenaline in prolonging the duration of analgesia and motor block for upper limb orthopedic surgeries. MATERIALS AND METHODS: This multi - center rand omized control study was conducted in two tertiary care centers in 80 patients underwent elective upper limb orthopedic surgeries and they were allocated into two groups of 40 each group L and group F. the classical approach of supraclavicular brachial ple xus block. Drug used were 30 ml of lignocaine 1.5%+adrenaline 5mcg/ml + 0.5ml normal saline in group L and 30ml of lignocaine 1.5% + adrenaline 5mcg/ml + fentanyl 50 mcg in group F. Adequacy of block was assessed by the pin prick test and temperature test. Motor power was assessed by the modified Lowett scale. Sedation was monitored using the modified Ramsay scale. An assessment was made for onset of analgesia, onset of

  6. A Prospective Multi-Center Clinical Trial to Compare Efficiency, Accuracy and Safety Of the VisionScope Imaging System Compared to MRI and Diagnostic Arthroscopy

    Science.gov (United States)

    Xerogeanes, John W.; Safran, Marc R.; Huber, Bryan; Mandelbaum, Bert R.; Robertson, William; Gambardella, Ralph A.

    2014-01-01

    Objectives: Until now, arthroscopic surgery has been the gold standard for the diagnosis of intra-articular pathology. When a patient presents with ongoing pain and/or disability despite non-operative care, MRI is commonly used as a diagnostic modality. To date, there is not a minimally-invasive option that can provide detailed information about the intra-articular pathology of a joint. VisionScope Imaging (VSI) is an office-based diagnostic modality that provides comprehensive real-time images and video of a joint with higher accuracy and reliability compared to static MR images. The purpose of this study was to compare the efficacy, accuracy and safety of VSI compared to MRI and surgical diagnostic arthroscopy. Methods: A prospective, blinded, multi-centered study was performed of all patients who had a routine surgical arthroscopy at one of the six participating clinical sites between July 2012 and May 2013. Patients were consented by the physician investigator at each site. Study inclusion criteria consisted of: suspected meniscal tears or articular cartilage damage. Patients were excluded from the study if they had (1) acute traumatic hemarthoses, (2) concomitant ligament injury, (3) active systemic infection, (4) allergy to silicone or any medication used during the procedure,. All patients had a MRI and a comprehensive physical exam prior to their surgical arthroscopy. Each patient underwent a MRI, VSI exam and surgical diagnostic arthroscopy. The attending physician completed standard forms comparing the VSI exam findings to the diagnostic arthroscopy findings on each patient. Two blinded experts unaffiliated with the study reviewed the VSI and MRI images. The arthroscopy served as the “control” comparison between the VSI and MRI findings. Results: There were 110 patients included in this study. The accuracy, sensitivity and specificity of VSI was equivalent to surgical diagnostic arthroscopy and more accurate than MRI (Table 1). When comparing VSI to

  7. Microscopic examination of intracellular organisms in bronchoalveolar lavage fluid for the diagnosis of ventilator-associated pneumonia:a prospective multi-center study

    Institute of Scientific and Technical Information of China (English)

    Liu Chang; Du Zhaohui; Zhou Qing; Hu Bo; Li Zhifeng; Yu Li; Xu Tao

    2014-01-01

    Background The presence of intracellular organisms (ICOs) in polymorphonuclear leukocytes obtained from bronchoalveolar lavage fluid (BALF) is a possible method for rapid diagnosis of ventilator-associated pneumonia (VAP).However,the validity of this diagnostic method remains controversial and the diagnostic thresholds reported by investigators were different.Our objective was to evaluate the accuracy of quantification of ICOs in BALF for the diagnosis of VAP,and to detect the best cutoff percentage of PMNs containing ICOs (PIC) in the microscopic examination of BALF for the diagnosis of VAP.Methods This was a prospective multi-center study conducted in 4 ICUs in Wuhan,China,which involved 181 patients suspected of first episode of VAP.BALF was obtained from all enrolled patients.The BALF samples underwent quantitative culture,cytological and bacteriological analysis to detect the culture results,PIC values and the morphological features of microorganisms.Definite diagnosis of VAP was based on pre-set criteria.The receiver-operating characteristic curve was used to detect the best cutoff point for PIG to diagnose VAP,and the diagnostic accuracy was calculated.Moreover,quantitative culture and Gram's stain of BALF were adopted to diagnose VAP,and their diagnostic accuracy was evaluated as well.Results There were 102 patients definitely diagnosed with VAP (VAP group),and 60 patients definitely diagnosed without VAP (no VAP group).We found that ICOs were present in 96.08% (98 out of 102) of VAP patients and 20.00% (12 out of 60) of no VAP patients.The PICs were significantly higher ((9.53±6.65)% vs.(0.52±1.33)%,P<0.01) in VAP group.In our study,the best cutoff point for PIC to diagnose VAP was 1.5%,which had a sensitivity of 94.12%,a specificity of 88.33%,a positive predictive value (PPV) of 93.20% and a negative predictive value (NPV) of 89.83%.The area under the receiveroperating characteristic curve was 0.956 (95% confidence interval,0

  8. A Randomized, Double-blind, Placebo-controlled, Multi-center, Extension Trial Evaluating the Efficacy of a New Oral Supplement in Women with Self-perceived Thinning Hair

    OpenAIRE

    Ablon, Glynis; Dayan, Steven

    2015-01-01

    Objective: The purpose of this six-month, randomized, double-blind, multi-center, placebo-controlled study was to determine if the administration of a new oral supplement will promote terminal hair growth. Design: A randomized, double-blind study. Setting: Two private practices (dermatology and facial plastics). Participants: Women 21 to 75 years of age with self-perceived thinning hair. Measurements: The primary efficacy endpoint was the change in terminal and vellus hairs in a 4cm2 target a...

  9. Leptomeningeal carcinomatosis in non-small-cell lung cancer: initial response to erlotinib followed by relapse despite continuing radiological resolution of disease.

    Science.gov (United States)

    Lee, Alvin J X; Benamore, Rachel; Hofer, Monika; Chitnis, Meenali

    2016-09-01

    A 60-year-old male was diagnosed with T3, N3, M1b epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Five months later he developed significant headaches, weakness and numbness of the left leg, and unsteadiness of gait. Magnetic resonance imaging (MRI) brain demonstrated subtle gyral enhancement indicative of early leptomeningeal infiltration. He was commenced on second-line erlotinib which improved his lower limb symptoms. Three months later he developed increased urinary frequency and redeveloped leg symptoms. MRI brain showed improvement in the gyral enhancement. Four weeks later, the patient developed new onset confusion and decrease in mobility. Examination of the cerebrospinal fluid (CSF) demonstrated leptomeningeal carcinomatosis. This case demonstrates radiological and clinical response of leptomeningeal disease to erlotinib in EGFR mutant lung cancer with subsequent clinical relapse despite continued radiological resolution of leptomeningeal disease. This suggests that CSF examination should be considered when monitoring leptomeningeal disease response following treatment as the disease can be undetectable on repeat radiological imaging.

  10. Rapamycin-enhanced mitomycin C-induced apoptotic death is mediated through the S6K1-Bad-Bak pathway in peritoneal carcinomatosis.

    Science.gov (United States)

    Song, X; Dilly, A-K; Kim, S-Y; Choudry, H A; Lee, Y J

    2014-06-05

    Peritoneal carcinomatosis (PC) is the most common secondary cancerous disease, and more effective novel regimens are needed. In this study, we identified a novel combination treatment for PC, chemotherapeutic agent mitomycin C in combination with mTOR (mammalian target of rapamycin) inhibitor rapamycin. We observed that the combination of mitomycin C and rapamycin induced synergistic cytotoxicity and apoptosis, which was mediated through an increase in caspase activation. The combination of mitomycin C and rapamycin inactivated p70 S6 ribosomal kinase (S6K1) and dephosphorylated Bad, leading to dissociation of Bcl-xL from Bak, which resulted in Bak oligomerization, mitochondria dysfunction and cytochrome c release. PF-4708671, a S6K1-specific inhibitor, enhanced the combination treatment-induced apoptosis, whereas S6K1 E389 DeltaCT-HA (S6K1 active form) dramatically decreased the induction of apoptosis. In addition, the combination treatment significantly inhibited LS174T intraperitoneal tumor growth in vivo. This study provides a preclinical rationale for apoptosis induction linked with the mTOR pathway through a combination of chemotherapeutic agents and mTOR inhibitor, and will support this combinatorial strategy to PC patients.

  11. 全聋型突发性聋药物治疗的多中心研究%Multi-center study on the treatment of sudden total deafness

    Institute of Scientific and Technical Information of China (English)

    郑虹; 戴晴晴; 周莲; 冯宁宇; 邱建华; 陈阳; 温立婷; 韩宇; 陈俊

    2013-01-01

    目的 探讨全聋型突发性聋的药物治疗.方法 采用前瞻性临床多中心、随机、单盲法研究,纳入年龄18 ~ 65周岁,病程2周内,未经任何相关医疗处理的全聋型突发性聋患者(纯音测听全部频率听阈升高,500、1000、2000、4000 Hz平均听阈≥81 dB HL).按各分中心随机数字表,随机选取四种治疗方案(巴曲酶,巴曲酶+银杏叶提取物,巴曲酶+银杏叶提取物+糖皮质激素和银杏叶提取物+糖皮质激素)中的一种对患者进行治疗.结果 2007年8月至2011年10月,全国33家医院按标准共纳入符合条件的单侧全聋型突发性聋276例,其中男135例(48.91%),女141例(51.09%);平均年龄(41.7±13.3)岁.治疗后,听力痊愈40例(14.49%),显效78例(28.26%),有效76例(27.54%),无效82例(29.71%),总有效率为70.29%.四种治疗方案中,总有效率分别为73.33%、61.43%、78.31%和67.95%,组间比较差异无统计学意义(x2=9.97,P=0.62).四组中耳聋痊愈率分别为11.11%、12.86%、16.87%和15.38%,使用激素的两组好于未使用者.全聋型突发性聋患者中耳鸣伴发率为92.39%,晕(头晕或眩晕)伴发率为44.93%,耳闷伴发率为50.36%;这些伴发症状的疗效在四种治疗方案中,组间差异无统计学意义(P值均>0.05).结论 全聋型突发性聋患者听力损失重,治疗有效率达70%,值得积极治疗;但痊愈率仅14%,医患对此应有合理预期.激素对提高耳聋痊愈率可能有一定作用,推荐使用.%Objective To assess the results of drug therapy in patients with severe idiopathic sudden sensorineural hearing loss (ISSHL) with total frequency hearing loss.Methods A prospective randomized,single blind,multi-center clinical trial was designed.The untreated patients with ISSHL were included,who had severe hearing loss (pure tone audiometry showed patients had total frequency hearing loss,and their mean auditory threshold of 500,1000,2000,4000 Hz was

  12. Intraperitoneal chemotherapy hyperthermia (HIPEC) for peritoneal carcinomatosis of ovarian cancer origin by fluid and CO2 recirculation using the closed abdomen technique (PRS-1.0 Combat): A clinical pilot study.

    Science.gov (United States)

    Sánchez-García, Susana; Villarejo-Campos, Pedro; Padilla-Valverde, David; Amo-Salas, Mariano; Martín-Fernández, Jesús

    2016-08-01

    Background This paper reports a study of 21 patients with peritoneal carcinomatosis from ovarian cancer who underwent cytoreductive surgery and HIPEC by means of PRS-1.0 Combat®, a new model for closed abdomen HIPEC aimed at improving fluid distribution with assistance from a CO2 recirculation system. This new technology has been previously shown to be successful in an experimental study (pig model) performed by our group, and has been approved for use in our hospital. Methods Twenty-one patients with peritoneal carcinomatosis of ovarian cancer origin were included in the study. Cytoreductive surgery and HIPEC were performed by a closed abdomen fluid and CO2 recirculation technique using the PRS-1.0 Combat(®) model. We analysed the intraoperative safety tolerance and post-operative morbidity and mortality during the first 30 days. Results Between November 2011 and March 2014 21 patients with epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stage II-IV, were included in the study. During the procedure there were no significant haemodynamic or analytical disturbances. Complication rates were 38.1% and 57.14% for grade III/IV and minor (grade I/II) complications, respectively. Post-operative mortality was 4.76% (one patient). Complete cytoreductive surgery and intraperitoneal chemotherapy improved overall survival and disease-free survival in women with advanced ovarian cancer. The association of intra-abdominal hyperthermia with chemotherapy (HIPEC) increased the therapeutic benefit. Conclusions This study has shown that closed abdomen intraperitoneal chemohyperthermia by a fluid and CO2 recirculation system (PRS-1.0 Combat(®)) can be a safe and feasible model for the treatment of peritoneal carcinomatosis of ovarian cancer origin.

  13. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival for patients with peritoneal carcinomatosis from colorectal cancer: a phase II study from a Chinese center.

    Directory of Open Access Journals (Sweden)

    Chao-Qun Huang

    Full Text Available Peritoneal carcinomatosis (PC is a difficult clinical challenge in colorectal cancer (CRC because conventional treatment modalities could not produce significant survival benefit, which highlights the acute need for new treatment strategies. Our previous case-control study demonstrated the potential survival advantage of cytoreductive surgery (CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC over CRS alone. This phase II study was to further investigate the efficacy and adverse events of CRS+HIPEC for Chinese patients with CRC PC.A total of 60 consecutive CRC PC patients underwent 63 procedures consisting of CRS+HIPEC and postoperative chemotherapy, all by a designated team focusing on this combined treatment modality. All the clinico-pathological information was systematically integrated into a prospective database. The primary end point was disease-specific overall survival (OS, and the secondary end points were perioperative safety profiles.By the most recent database update, the median follow-up was 29.9 (range 3.5-108.9 months. The peritoneal cancer index (PCI ≤20 was in 47.0% of patients, complete cytoreductive surgery (CC0-1 was performed in 53.0% of patients. The median OS was 16.0 (95% confidence interval [CI] 12.2-19.8 months, and the 1-, 2-, 3-, and 5-year survival rates were 70.5%, 34.2%, 22.0% and 22.0%, respectively. Mortality and grades 3 to 5 morbidity rates in postoperative 30 days were 0.0% and 30.2%, respectively. Univariate analysis identified 3 parameters with significant effects on OS: PCI ≤20, CC0-1 and adjuvant chemotherapy over 6 cycles. On multivariate analysis, however, only CC0-1 and adjuvant chemotherapy ≥6 cycles were found to be independent factors for OS benefit.CRS+HIPEC at a specialized treatment center could improve OS for selected CRC PC patients from China, with acceptable perioperative safety.

  14. Brain-derived neurotrophic factor (BDNF)-induced tropomyosin-related kinase B (Trk B) signaling is a potential therapeutic target for peritoneal carcinomatosis arising from colorectal cancer.

    Science.gov (United States)

    Tanaka, Koji; Okugawa, Yoshinaga; Toiyama, Yuji; Inoue, Yasuhiro; Saigusa, Susumu; Kawamura, Mikio; Araki, Toshimitsu; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato

    2014-01-01

    Tropomyosin-related receptor kinase B (TrkB) signaling, stimulated by brain-derived neurotrophic factor (BDNF) ligand, promotes tumor progression, and is related to the poor prognosis of various malignancies. We sought to examine the clinical relevance of BDNF/TrkB expression in colorectal cancer (CRC) tissues, its prognostic value for CRC patients, and its therapeutic potential in vitro and in vivo. Two hundred and twenty-three CRC patient specimens were used to determine both BDNF and TrkB mRNA levels. The expression of these proteins in their primary and metastatic tumors was investigated by immunohistochemistry. CRC cell lines and recombinant BDNF and K252a (a selective pharmacological pan-Trk inhibitor) were used for in vitro cell viability, migration, invasion, anoikis resistance and in vivo peritoneal metastasis assays. Tissue BDNF mRNA was associated with liver and peritoneal metastasis. Tissue TrkB mRNA was also associated with lymph node metastasis. The co-expression of BDNF and TrkB was associated with liver and peritoneal metastasis. Patients with higher BDNF, TrkB, and co-expression of BDNF and TrkB had a significantly poor prognosis. BDNF increased tumor cell viability, migration, invasion and inhibited anoikis in the TrkB-expressing CRC cell lines. These effects were suppressed by K252a. In mice injected with DLD1 co-expressing BDNF and TrkB, and subsequently treated with K252a, peritoneal metastatic nodules was found to be reduced, as compared with control mice. BDNF/TrkB signaling may thus be a potential target for treating peritoneal carcinomatosis arising from colorectal cancer.

  15. Begg orthodontic therapy in retrospect

    NARCIS (Netherlands)

    Levin, Raymond Israel

    1975-01-01

    The purpose of the investigation described in this thesis was to study in retrospect a number of changes of the dentition, its occlusion and the facial skeleton which occurred in the treatment and posttreatment periods in a sample of 30 cases treated with the Begg fixed appliance techniques. Sevente

  16. The effect of additional training on motor outcomes at discharge from recovery phase rehabilitation wards: a survey from multi-center stroke data bank in Japan.

    Directory of Open Access Journals (Sweden)

    Nariaki Shiraishi

    Full Text Available The purpose of the present study was to examine the potential benefits of additional training in patients admitted to recovery phase rehabilitation ward using the data bank of post-stroke patient registry.Subjects were 2507 inpatients admitted to recovery phase rehabilitation wards between November 2004 and November 2010. Participants were retrospectively divided into four groups based upon chart review; patients who received no additional rehabilitation, patients who were added with self-initiated off hours training, patients who were added with off hours training by ward staff, patients who received both self-initiated training and training by ward staff. Parameters for assessing outcomes included length of stay, motor/cognitive subscales of functional independent measures (FIM and motor benefit of FIM calculated by subtracting the score at admission from that at discharge.Participants were stratified into three groups depending on the motor FIM at admission (≦28, 29∼56, 57≦ for comparison. Regarding outcome variables, significant inter-group differences were observed in all items examined within the subgroup who scored 28 or less and between 29 and 56. Meanwhile no such trends were observed in the group who scored 57 or more compared with those who scored less. In a decision tree created based upon Exhaustive Chi-squared Automatic Interaction Detection method, variables chosen were the motor FIM at admission (the first node additional training (the second node, the cognitive FIM at admission(the third node.Overall the results suggest that additional training can compensate for the shortage of regular rehabilitation implemented in recovery phase rehabilitation ward, thus may contribute to improved outcomes assessed by motor FIM at discharge.

  17. The effect of water fluoride concentration on dental caries and fluorosis in five Iran provinces: A multi-center two-phase study

    Science.gov (United States)

    Ramezani, Gholamhossein; Valaie, Nasser; Rakhshan, Vahid

    2015-01-01

    Background: Water fluoride level is unknown in many regions of Iran. Besides, only few non-controlled studies world-wide have assessed the effect of water fluoride on dental fluorosis and caries. We aimed to measure the fluoride level of 76 water supplies in 54 cities and evaluate the effect of fluoride on dental caries and fluorosis in a large multi-project study. Materials and Methods: In the first phase (cross-sectional), fluoride levels of 76 water tanks in 54 cities/villages in five provinces of Iran were randomly evaluated in five subprojects. In the second phase (retrospective cohort), 1127 middle school children (563 cohort and 564 control subjects) in the high and low ends of fluoride concentration in each subproject were visited. Their decayed, missing and filled teeth (DMFT) and fluorosis states were assessed. The data were analyzed using Chi-square, Mann-Whitney U and independent-samples t-test (α = 0.05). Results: Mean fluoride level was 0.298 ± 0.340 mg/L in 54 cities/villages. Only eight water tanks had fluoride levels within the normal range and only one was higher than normal and the rest (67 tanks) were all at low levels. Overall, a significant association was observed between fluoride level and fluorosis. However, this was not the case in all areas, as in 2 of 5 provinces, the effect of fluoride on fluorosis was not confirmed. In 4 of the 5 areas studied, there was a significant link between fluoride level and DMFT. Conclusion: Extremely low fluoride levels in Iran cities are an alarming finding and need attention. Higher fluoride is likely to reduce dental caries while increasing fluorosis. This finding was not confirmed in all the areas studied. PMID:25709672

  18. Retrospect

    Science.gov (United States)

    Weaver, Anthony

    1971-01-01

    A collection of essays on education printed in The New Era during the 1920-1930 era and written by: Beatrice Ensor, A. S. Neill, G. Bernard Shaw, Adolphe Ferriere, C. G. Jung, Martin Buber, Alfred Adler, Harold Rugg, Ovide Decroly, and Paul Langevin. (SE)

  19. Therapeutic efficacy and toxicity of {sup 225}Ac-labelled vs. {sup 213}Bi-labelled tumour-homing peptides in a preclinical mouse model of peritoneal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Essler, Markus; Gaertner, Florian C.; Blechert, Birgit; Senekowitsch-Schmidtke, Reingard; Seidl, Christof [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); Neff, Frauke [Helmholtz Zentrum Muenchen, Institute of Pathology, Neuherberg (Germany); Bruchertseifer, Frank; Morgenstern, Alfred [Institute for Transuranium Elements, European Commission, Joint Research Centre, Karlsruhe (Germany)

    2012-04-15

    Targeted delivery of alpha-particle-emitting radionuclides is a promising novel option in cancer therapy. We generated stable conjugates of the vascular tumour-homing peptide F3 both with {sup 225}Ac and {sup 213}Bi that specifically bind to nucleolin on the surface of proliferating tumour cells. The aim of our study was to determine the therapeutic efficacy of {sup 225}Ac-DOTA-F3 in comparison with that of {sup 213}Bi-DTPA-F3. ID{sub 50} values of {sup 213}Bi-DTPA-F3 and {sup 225}Ac-DOTA-F3 were determined via clonogenic assays. The therapeutic efficacy of both constructs was assayed by repeated treatment of mice bearing intraperitoneal MDA-MB-435 xenograft tumours. Therapy was monitored by bioluminescence imaging. Nephrotoxic effects were analysed by histology. ID{sub 50} values of {sup 213}Bi-DTPA-F3 and {sup 225}Ac-DOTA-F3 were 53 kBq/ml and 67 Bq/ml, respectively. The median survival of control mice treated with phosphate-buffered saline was 60 days after intraperitoneal inoculation of 1 x 10{sup 7} MDA-MB-435 cells. Therapy with 6 x 1.85 kBq of {sup 225}Ac-DOTA-F3 or 6 x 1.85 MBq of {sup 213}Bi-DTPA-F3 prolonged median survival to 95 days and 97 days, respectively. While F3 labelled with short-lived {sup 213}Bi (t{sub 1/2} 46 min) reduced the tumour mass at early time-points up to 30 days after treatment, the antitumour effect of {sup 225}Ac-DOTA-F3 (t{sub 1/2} 10 days) increased at later time-points. The difference in the fraction of necrotic cells after treatment with {sup 225}Ac-DOTA-F3 (43%) and with {sup 213}Bi-DTPA-F3 (36%) was not significant. Though histological analysis of kidney samples revealed acute tubular necrosis and tubular oedema in 10-30% of animals after treatment with {sup 225}Ac-DOTA-F3 or {sup 213}Bi-DTPA-F3, protein casts were negligible (2%), indicating only minor damage to the kidney. Therapy with both {sup 225}Ac-DOTA-F3 and {sup 213}Bi-DTPA-F3 increased survival of mice with peritoneal carcinomatosis. Mild renal toxicity of both

  20. Carcinomatose das meninges: dados clínico-patológicos de 3 casos Carcinomatosis of the meninges: a report of three cases

    Directory of Open Access Journals (Sweden)

    Aristides Cheto de Queiroz

    1974-12-01

    Full Text Available Foram estudados 3 casos de carcinomatose das meninges, autopsiados no serviço de Anatomia Patológica do Hospital Prof. Edgard Santos. O quadro neurológico apresentado era proeminente e representado por sinto- matologia decorrente do envolvimento meníngeo e encefálico, razão pela qual foram considerados como portadores de meningite tuberculosa e encefalomielite. O aspecto de maior interesse neste estudo foi a discrepância entre o quadro clínico e os dados anátomo-patológicos do exame do encéfalo. A sintomatologia clínica foi proeminente, enquanto as lesões anatômicas foram apenas discretas ou moderadas e representadas por espessamento e granulosidade das meninges, com infiltração difusa do espaço subaracnoideano pela neoplasia. Nos casos 1 e 3 a neoplasia estava representada por adenocarcinoma, cujos focos primitivos foram localizados no pulmão e vesícula biliar, respectivamente. O caso 2 era um carcinoma indiferenciado do estômago, com envolvimento difuso do espaço subaracnoideano e subdural, havendo neste último extensa hemorragia recente. Os critérios diagnósticos e a maneira de disseminação desta condição são discutidos.A diffuse involvement of the meninges by carcinoma is described in three cases characterizing the so called "meningeal carcinomatosis". The neurologic symptoms were those of the chronic meningitis or encephalomyelitis, with changes in the spinal fluid. The morphologic features were identical in the three cases and represented by slight to moderate thickening of the meninges by diffuse infiltration of tumor cells and few foci of inflamatory reaction. The cases 1 and 3 were represented by well differentiated adenocarcinoma with primary site in the lung and gallbladder, respectively. In case 2 the tumor was a poorly differentiated carcinoma of stomach with diffuse involvement of the arachnoid and dura mater associated with recent hemorrhage. An interesting point was the lack of correlation between

  1. Intrathecal administration of trastuzumab for the treatment of meningeal carcinomatosis in HER2-positive metastatic breast cancer: a systematic review and pooled analysis.

    Science.gov (United States)

    Zagouri, Flora; Sergentanis, Theodoros N; Bartsch, Rupert; Berghoff, Anna S; Chrysikos, Dimosthenis; de Azambuja, Evandro; Dimopoulos, Meletios-Athanassios; Preusser, Matthias

    2013-05-01

    Leptomeningeal carcinomatosis (MC) represents an uncommon, but devasting manifestation of metastatic breast cancer. This is the first systematic review/pooled analysis to synthesize all available data evaluating the efficacy and safety of intrathecal (IT) administration of trastuzumab for the treatment of MC in HER2-positive breast cancer patients. This study was performed in accordance with the PRISMA guidelines. A total of 13 articles (17 patients) were eligible. The mean age of patients at IT trastuzumab administration was 48.2 years (SD 8.4, range 38-66). The mean total dose was 399.8 mg (SD 325.4, range 35-1,110 mg). IT trastuzumab alone or as part of combination therapies seemed to be safe; no serious adverse events were reported in 88.2 % of cases. In 68.8 % of cases, a significant clinical improvement was observed, while stabilization or progression of the disease was noticed in 31.2 % of cases. Cerebrospinal fluid (CSF) response was noted in 66.7 % of cases. The median overall survival was 13.5 months, whereas the median central nervous system progression-free survival (CNS-PFS) was 7.5 months. In 23.5 % of cases, IT trastuzumab was administered beyond CNS progression with a response noticed in 75 % of cases and a CNS-PFS of 9.4 months. The cumulative dose of IT trastuzumab given was 1,040 mg (SD 697.9, median 1,215, range 55-1,675). The protective effect of prior radio- or neurosurgery upon CNS-PFS was sizeable but did not reach formal statistical significance (HR 0.28, 95 % CI 0.06-1.37). Clinical improvement (HR 0.14, 95 % CI 0.02-0.91) and CSF response (HR 0.09, 95 % CI 0.01-0.89) were associated with longer CNS-PFS. IT trastuzumab administration seems to represent a safe and in some cases effective option for the treatment of HER2-positive breast cancer patients with leptomeningeal involvement. However, clinical trials are urgently needed to establish the definite role of IT trastuzumab in HER2-positive metastatic breast cancer patients with MC.

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

    Directory of Open Access Journals (Sweden)

    Xiao Li

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

  3. Response to Online Public Opinions under the Multi -center Governance Model%多中心治理模式下的网络舆情应对--基于服务型政府建构的逻辑

    Institute of Scientific and Technical Information of China (English)

    陶鹏

    2015-01-01

    Online public opinions are the product under the additive effects of current transitional society,democratic society and virtual society.Against the backdrop of social governance transformation and the establishment of the multi -center governance model,the so-cial phenomenon of online public opinions has shown new evolutional trend.Instrumental rationality and value rationality have domina-ted the double dimension of the development and evolution of online public opinions,leading to completely different social influences. The causes of online public opinions mainly include the internal appeal of social governance transformation,release of reverse social e-motions,in -depth catalyzation of diversified network culture and flourish of social network field.Therefore,the research strategy of public opinions under the traditional social management model should be relinquished,but to respond to the issue from the perspective of constructing a service -oriented government by conducting concept transformation under the multi -center governance model,enhan-cing the digitalized treatment against the big data background,improving the multi -center governance order and striking a new balance of the social relationship between the country and citizens.%网络舆情是当前转型社会、民主社会和虚拟社会叠加作用下的产物。在社会治道变革以及多中心治理模式得以确立的背景之下,网络舆情这一社会现象也出现了新的演进趋势。工具理性与价值理性主导了网络舆情发展演变的双重向度,使其产生出两种截然不同的社会影响。就网络舆情的产生根源来看,主要来自于社会治道变革的内在感召、反向社会情绪的释放发泄、多元网络文化的深度催化和网络社交领域的繁荣兴盛。因此,应摒弃传统社会管理模式下对网络舆情的研判思维,通过多中心治理模式下的理念变革,强化大数据背景下的数字化治理

  4. Canadian TCPS and the Enlightenment to Chinese Ethical Review of Multi-center Research%加拿大三大研究理事会政策宣言及对我国多中心伦理审查的启示

    Institute of Scientific and Technical Information of China (English)

    姜鑫; 张雪; 霍原

    2014-01-01

    In 1998 ,Tri-Council Policy Statement (TCPS) was formally adopted .In 2011 the second edition was passed .It is an important criterion of Canadian multi-center ethical review .TCPS plays an essential role in improving the efficiency and success rate of the multi-center ethical review through the construction of an appropriate decision framework of multi-center ethical review ,the attention to the communication and transparency of multi-center ethical review and the assurance of sufficient resources to support the multi-center ethical review process and to properly handle the problems at the operational level .TCPS ,which strengthens the legislation of the multi-center ethical review ,pays attention to coordinate the relationship between parties and ensures the scientific nature of the research project and the education and training of the staff ,can serve as a reference for multi-center ethical review in China .%1998年,三大研究理事会政策宣言(Tri-Council Policy Statement ,TCPS)正式通过,2011年通过了第二版,是加拿大多中心伦理审查领域的重要准则。TCPS通过构建适宜的多中心伦理审查决策框架、注意多中心伦理审查的沟通及透明度、确保充足的资源以支持多中心伦理审查进程以及妥善处理操作层面问题等途径,提高多中心伦理审查的效率与成功率。可以在强化多中心伦理审查立法、注意协调多方关系、确保研究项目的科学性以及对审查人员进行教育培训等方面为我国多中心伦理审查提供借鉴。

  5. Método laparoscópico no diagnóstico e extensão da carcinomatose peritoneal Laparoscopy in diagnosis and extension of peritoneal carcinomatosis

    Directory of Open Access Journals (Sweden)

    Ulysses Ribeiro-Júnior

    2010-09-01

    peritoneum, liver, epiíplon, pelvic cavity and other organs of the abdominal cavity, and permit to deal with ascites. AIM: To describe laparoscopic technique and method to accomplish the peritoneal carcinomatosis status and indications for peritoniectomies. METHODS: After the introduction of the trocar under direct vision in the region of the umbilicus it is possible to empty ascites to the fullest, and collect material for cytological examination, avoiding contamination with blood. If there is no ascites, peritoneal lavage can be performed. Releases adhesions and adhesions can be also done prior to the operation of the cavity and also several biopsies of parietal peritoneum, diaphragm, omentum and pelvic cavity for confirmation. To determine whether the patient is a candidate for peritoniectomy and / or intra-abdominal hyperthermic chemotherapy, it can permit the realization of index of peritoneal carcinomatosis. For this to occur is essential to use the operating table with the ability to move the positions of Trendelemburg, proclivity and sides. CONCLUSION: The laparoscopic method is good to evaluate ascites, hepatic and peritoneal metastases, and may achieve efficiency, sensitivity and specificity of 100% for these attributes. It should be performed when there is clinical suspicion of intraperitoneal dissemination, but no diagnostic imaging confirmation.

  6. Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor Carcinomatose meníngea como manifestação inicial de um adenocarcinoma de vesícula biliar com tumor de Krukenberg

    Directory of Open Access Journals (Sweden)

    Tizuko Miyagui

    2003-01-01

    Full Text Available A case of malignant neoplasm is described in which the initial manifestations were mental dysfunction and meningeal irritation, mimicking chronic or subacute meningitis. Physical examination showed cranial nerve involvement and a pelvic tumor. There was progressive deterioration, and death occurred in 2 weeks. The autopsy revealed a gallbladder adenocarcinoma, meningeal carcinomatosis, and ovarian metastasis presenting as a Krukenberg tumor. The authors emphasize the importance of including meningeal carcinomatosis as a possibility in the differential diagnosis of non-characteristic clinical pictures, as well as the importance of the cerebrospinal fluid cytologic examination, repeated as needed, in order to confirm this diagnosis.Descreve-se um caso de neoplasia maligna cuja manifestação inicial foi distúrbio de comportamento e quadro de irritação meníngea, simulando uma meningite subaguda ou crônica. Na investigação clínica foram detectados o comprometimento de pares cranianos e a presença de massa tumoral pélvica. Houve piora progressiva, com evolução para o óbito em duas semanas. No exame post-mortem foram diagnosticados adenocarcinoma de vesícula biliar com componente mucinoso, carcinomatose meníngea e metástase ovariana sob a forma de um tumor de Krukenberg. Os autores mostram a importância da inclusão da carcinomatose meníngea no diagnóstico diferencial de quadros neurológicos incaracterísticos, e a necessidade de exames citológicos do liquor, às vezes repetidos, para a confirmação desta hipótese diagnóstica.

  7. Reliability of PET/CT shape and heterogeneity features in functional and morphological components of Non-Small Cell Lung Cancer tumors: a repeatability analysis in a prospective multi-center cohort

    CERN Document Server

    Desseroit, Marie-Charlotte; Weber, Wolfgang; Siegel, Barry A; Rest, Catherine Cheze Le; Visvikis, Dimitris; Hatt, Mathieu

    2016-01-01

    Purpose: The main purpose of this study was to assess the reliability of shape and heterogeneity features in both Positron Emission Tomography (PET) and low-dose Computed Tomography (CT) components of PET/CT. A secondary objective was to investigate the impact of image quantization.Material and methods: A Health Insurance Portability and Accountability Act -compliant secondary analysis of deidentified prospectively acquired PET/CT test-retest datasets of 74 patients from multi-center Merck and ACRIN trials was performed. Metabolically active volumes were automatically delineated on PET with Fuzzy Locally Adaptive Bayesian algorithm. 3DSlicerTM was used to semi-automatically delineate the anatomical volumes on low-dose CT components. Two quantization methods were considered: a quantization into a set number of bins (quantizationB) and an alternative quantization with bins of fixed width (quantizationW). Four shape descriptors, ten first-order metrics and 26 textural features were computed. Bland-Altman analysi...

  8. A hybrid framework of first principles molecular orbital calculations and a three-dimensional integral equation theory for molecular liquids: Multi-center molecular Ornstein–Zernike self-consistent field approach

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Kentaro, E-mail: kido.kentaro@jaea.go.jp [Nuclear Safety Research Center, Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195 (Japan); Kasahara, Kento [Department of Molecular Engineering, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto 615-8510 (Japan); Yokogawa, Daisuke [Department of Chemistry, Graduate School of Science, Nagoya University, Chikusa, Nagoya 464-8602 (Japan); Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Chikusa, Nagoya 464-8062 (Japan); Sato, Hirofumi [Department of Molecular Engineering, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto 615-8510 (Japan); Elements Strategy Institute for Catalysts and Batteries (ESICB), Kyoto University, Katsura, Kyoto 615-8520 (Japan)

    2015-07-07

    In this study, we reported the development of a new quantum mechanics/molecular mechanics (QM/MM)-type framework to describe chemical processes in solution by combining standard molecular-orbital calculations with a three-dimensional formalism of integral equation theory for molecular liquids (multi-center molecular Ornstein–Zernike (MC-MOZ) method). The theoretical procedure is very similar to the 3D-reference interaction site model self-consistent field (RISM-SCF) approach. Since the MC-MOZ method is highly parallelized for computation, the present approach has the potential to be one of the most efficient procedures to treat chemical processes in solution. Benchmark tests to check the validity of this approach were performed for two solute (solute water and formaldehyde) systems and a simple S{sub N}2 reaction (Cl{sup −} + CH{sub 3}Cl → ClCH{sub 3} + Cl{sup −}) in aqueous solution. The results for solute molecular properties and solvation structures obtained by the present approach were in reasonable agreement with those obtained by other hybrid frameworks and experiments. In particular, the results of the proposed approach are in excellent agreements with those of 3D-RISM-SCF.

  9. Retrospective Evaluation of Colonoscopy Results

    Directory of Open Access Journals (Sweden)

    Yaşar M et al.

    2010-09-01

    Full Text Available Aim: The aim of this study is the retrospective evaluation of colonoscopy results between 2005 January- 2009 December in General Surgery Department of Düzce University.Materials and Methods: Admitted to our department with lower gastrointestinal symptoms, and colonoscopy is indicated 500 male and 538 female total 1038 patients were performed flexible colonoscopic examinations after bowel cleansing.Results: According to results of colonoscopic findings, 42.9% No pathology, 32.5% Hemorrhoids, 17.6% Anal fissures were detected.Conclusion: As a result of this study, half of patients admitted to our surgical clinic with lower gastrointestinal complaints have no pathology and in the other half of patients have various pathologies such as hemorrhoids and anal fissures.

  10. Retrospective Birth Dating of Cells

    Energy Technology Data Exchange (ETDEWEB)

    L.Spalding, K; Bhardwaj, R D; Buchholz, B A; Druid, H; Frisen, J

    2005-04-19

    The generation of cells in the human body has been difficult to study and our understanding of cell turnover is limited. Extensive testing of nuclear weapons resulted in a dramatic global increase in the levels of the isotope {sup 14}C in the atmosphere, followed by an exponential decrease after the test ban treaty in 1963. We show that the level of {sup 14}C in genomic DNA closely parallels atmospheric levels, and can be used to establish the time point when the DNA was synthesized and cells were born. We use this strategy to determine the age of cells in the cortex of the adult human brain, and show that whereas non-neuronal cells are exchanged, occipital neurons are as old as the individual, supporting the view that postnatal neurogenesis does not take place in this region. Retrospective birth dating is a generally applicable strategy that can be used to measure cell turnover in man under physiological and pathological conditions.

  11. The PRAISE study: A prospective, multi-center, randomized, double blinded, placebo-controlled study for the evaluation of iloprost in the early postoperative period after liver transplantation (ISRCTN12622749

    Directory of Open Access Journals (Sweden)

    Bärthel Erik

    2013-01-01

    Full Text Available Abstract Background Liver graft dysfunction can deteriorate to complete organ failure and increases perioperative morbidity and mortality after liver transplantation. Therapeutic strategies reducing the rate of graft dysfunction are of current clinical relevance. One approach is the systemic application of prostaglandins, which were demonstrated to be beneficial in reducing ischemia-reperfusion injury. Preliminary data indicate a positive effect of prostacyclin analogue iloprost on allograft viability after liver transplantation. The objective of the study is to evaluate the impact of iloprost in a multi-center trial. Methods/Design A prospective, double-blinded, randomized, placebo-controlled multicenter study in a total of 365 liver transplant recipients was designed to assess the effect of intravenous iloprost after liver transplantation. Primary endpoint will be the primary graft dysfunction characterized as presentation of one or more of the following criteria: ALAT or ASAT level > 2000 IU/ml within the first 7 postoperative days, bilirubine ≥ 10 mg/dl on postoperative day 7; INR ≥ 1.6 on postoperative day 7 or initial non-function. Secondary endpoints are parameters of post-transplant morbidity, like rates of infections, biliary complications, need of clotting factors or renal replacement therapy and the graft and patient survival. Discussion A well-established treatment concept to avoid graft dysfunction after liver transplantation does not exist at the moment. If the data of this research project confirm prior findings, iloprost would improve the general outcome after liver transplantation. Trial Registration German Clinical Trials Register: DRKS00003514. Current Controlled Trials Register: ISRCTN12622749.

  12. A MULTI-CENTER CLUSTER-RANDOMIZED TRIAL OF A MULTI-FACTORIAL INTERVENTION TO IMPROVE ANTIHYPERTENSIVE MEDICATION ADHERENCE AND BLOOD PRESSURE CONTROL AMONG PATIENTS AT HIGH CARDIOVASCULAR RISK (The COM99 study)*

    Science.gov (United States)

    Pladevall, Manel; Brotons, Carlos; Gabriel, Rafael; Arnau, Anna; Suarez, Carmen; de la Figuera, Mariano; Marquez, Emilio; Coca, Antonio; Sobrino, Javier; Divine, George; Heisler, Michele; Williams, L Keoki

    2010-01-01

    Background Medication non-adherence is common and results in preventable disease complications. This study assesses the effectiveness of a multifactorial intervention to improve both medication adherence and blood pressure control and to reduce cardiovascular events. Methods and Results In this multi-center, cluster-randomized trial, physicians from hospital-based hypertension clinics and primary care centers across Spain were randomized to receive and provide the intervention to their high-risk patients. Eligible patients were ≥50 years of age, had uncontrolled hypertension, and had an estimated 10-year cardiovascular risk greater than 30%. Physicians randomized to the intervention group counted patients’ pills, designated a family member to support adherence behavior, and provided educational information to patients. The primary outcome was blood pressure control at 6 months. Secondary outcomes included both medication adherence and a composite end-point of all cause mortality and cardiovascular-related hospitalizations. Seventy-nine physicians and 877 patients participated in the trial. The mean duration of follow-up was 39 months. Intervention patients were less likely to have an uncontrolled systolic blood pressure (odds ratio 0.62; 95% confidence interval [CI] 0.50–0.78) and were more likely to be adherent (OR 1.91; 95% CI 1.19–3.05) when compared with control group patients at 6 months. After five years 16% of the patients in the intervention group and 19% in the control group met the composite end-point (hazard ratio 0.97; 95% CI 0.67–1.39). Conclusions A multifactorial intervention to improve adherence to antihypertensive medication was effective in improving both adherence and blood pressure control, but it did not appear to improve long-term cardiovascular events. PMID:20823391

  13. Phase 3 study of. beta. -methyl-p-( sup 123 I)-iodophenyl-pentadecanoic acid, a myocardial imaging agent for evaluating fatty acid metabolism; A multi-center trial

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Kanji (Fukui Medical School, Matsuoka (Japan)); Yonekura, Yoshiharu; Nishimura, Tsunehiko; Ohtake, Tohru; Bunko, Hisashi; Tamaki, Nagara; Uehara, Toshiisa

    1992-04-01

    A multi-center trial of {beta}-methyl-p-({sup 123}I)-iodophenyl-pentadecanoic acid ({sup 123}I-BMIPP) was performed to assess its clinical usefulness in the evaluation of myocardial fatty acid metabolism in 587 patients with various heart diseases. {sup 123}I-BMIPP showed relatively decreased uptake compared with {sup 201}Tl in the myocardial lesions of 62% of patients with ischemic heart disease (IHD), 39% of those with cardiomyopathy and 32% of those with other heart diseases. In case of myocardial infarction, less uptake of {sup 123}I-BMIPP (Type B) than {sup 201}Tl was more frequently seen in patients with successful recanalization than in those without recanalization. The patients with matched distribution of the two tracers (Type E) increased in the direct proportion to the interval between the onset of myocardial infarction and the radionuclide studies. The uptake of {sup 123}I-BMIPP correlated well with myocardial viability evaluated by {sup 201}Tl exercise-redistribution studies. Type B was frequently seen in the areas with {sup 201}Tl redistribution, while Type E was seen in the fixed defect areas. In the other heart diseases studied, Type E was observed in approximately 60% of patients with dilated or secondary cardiomyopathies. Type B was seen in about 45% of patients with valvular heart diseases and myocarditis. Various types of mismatch between the two tracers were demonstrated in hypertrophic cardiomyopathy and hypertensive heart disease. It is concluded that {sup 123}I-BMIPP is a safe and useful agent for the diagnosis of various heart diseases, since it reflects myocardial fatty acid metabolism. (author)

  14. Effects of raloxifene hydrochloride on bone mineral density, bone metabolism and serum lipids in Chinese postmenopausal women with osteoporosis:a multi-center, randomized, placebo-controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    LIU Jian-li刘建立; LIU Hui刘慧; CHEN Xiao-ping陈小平; LIU Yu-juan刘玉娟; Abie Ekangaki; ZHENG Yi-man郑以漫; Adolfo Diez-Perez; Kristine Harper; ZHU Han-min朱汉民; HUANG Qi-ren黄琪仁; ZHANG Zhong-lan张忠兰; LI Hui-lin李慧林; QIN Yue-juan秦跃娟; ZHANG Ying张颖; WEI Dao-lin魏道林; LU Jing-hui陆敬辉

    2004-01-01

    Background Raloxifene has been approved for prevention and treatment of postmenopausal osteoporosis in Caucasian women. It also has some positive effects on serum lipids in Caucasians. The objective of this study was to determine the effect of raloxifene hydrochloride on lumbar spine and total hip bone mineral density (BMD), bone metabolism, and serum lipids in Chinese postmenopausal women with osteoporosis.Methods This was a multi-center, randomized, double-blind, placebo-controlled clinical trial in which 204 postmenopausal Chinese women with osteoporosis were assigned to receive raloxifene (60 mg) or placebo treatment daily for 12 months. BMD, serum bone metabolism markers, and serum lipids were measured before and after drug administration. BMD was measured by Dual-Energy X-Ray Absorptiometry (DEXA) and bone metabolism markers were analyzed by one-step enzyme-linked immunosorbent assay. Serum lipids were measured by enzymatic analysis.Results At the end of the 12-month study, lumbar spine BMD increased in both groups with a mean increase of (3.3±4.8) % in the raloxifene group and (1.0±4.9) % in the placebo group (P0.05). In the raloxifene group, the median decreases in the biochemical markers of bone metabolism serum osteocalcin and C-telopeptide were 41.7% and 61.5%, respectively. These changes were statistically significant compared with those in the placebo group (10.6% and 35.6%, P<0.001, respectively). Both total cholesterol and low-density lipoprotein cholesterol decreased significantly in the raloxifene group compared with those in the placebo group (P<0.001, respectively) and there was no significant effect of raloxifene on high-density lipoprotein cholesterol and triglycerides compared with placebo. Conclusions Raloxifene 60 mg/d for 12 months significantly increases lumbar spine and total hip BMD, significantly decreases bone turnover, and has favourable effects on serum lipids in Chinese postmenopausal women with osteoporosis.

  15. A retrospective study of pheochromocytoma

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    Larigani B

    1997-08-01

    Full Text Available Pheochromocytoma is a rare disease. A retrospective study of the signs and clinical course of this disorder was performed by evaluating medical records. Our fidings indicate that the prevalence of pheochromocytoma was equal in men and women, and most patients (56% were in their second and third decades of life. In 10% of the cases, the disease was bilateral, and in 13% it was outside the adrenal (totally para-aortic. The tumor was more common on the right side (8%, and 3.5% were familial. Almost all cases had a history of hypertension and hypertensive crises. Attack-like episodes of clinical symptoms and signs and hypertension were observed in 98%, headache in 71% and profuse perspiration in 68% of the cases. An abdominal mass was palapated in 13% of the cases, 26% had overt diabetes, 23% had ECG changes. Malignancy was observed in 4%, with metastases to the liver (n=2 lung (n=1 and spine (n=1. In the latter four cases, the metastic lesion was histologically proven to be pheochromocytoma. In three of the 28 female cases, the first hypertensive crisis occurred during pregnancy causing abortion in one case.

  16. A retrospective of VAWT technology.

    Energy Technology Data Exchange (ETDEWEB)

    Ashwill, Thomas D.; Sutherland, Herbert J. (HJS Consulting, Albuquerque, NM); Berg, Dale E.

    2012-01-01

    The study of Vertical-Axis Wind Turbine (VAWT) technology at Sandia National Laboratories started in the 1970's and concluded in the 1990's. These studies concentrated on the Darrieus configurations because of their high inherent efficiency, but other configurations (e.g., the Savonius turbine) were also examined. The Sandia VAWT program culminated with the design of the 34-m 'Test Bed' Darrieus VAWT. This turbine was designed and built to test various VAWT design concepts and to provide the necessary databases to validate analytical design codes and algorithms. Using the Test Bed as their starting point, FloWind Corp. developed a commercial VAWT product line with composite blades and an extended height-to-diameter ratio. The purpose of this paper is to discuss the design process and results of the Sandia 34-m VAWT Test Bed program and the FloWind prototype development program with an eye toward future offshore designs. This paper is our retrospective of the design, analysis, testing and commercial process. Special emphasis is given to those lessons learned that will aid in the development of an off-shore VAWT.

  17. 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.

  18. Carcinomatose leptomeníngea como primeira manifestação de adenocarcinoma pulmonar: relato de caso Leptomeningeal carcinomatosis as the first clinical manifestation of lung adenocarcinoma: case report

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    Andréa Gimenez

    2003-03-01

    Full Text Available A carcinomatose leptomeníngea é uma complicação neurológica de alguns tumores sistêmicos caracterizada por invasão multifocal das leptomeninges por células neoplásicas. Estima-se que 5% de todos os pacientes com câncer apresentem carcinomatose leptomeníngea. As manifestações clínicas são heterogêneas e caracterizam-se por sinais e sintomas relacionados a comprometimento de múltiplas áreas do sistema nervoso, particularmente nervos cranianos e raízes nervosas. O diagnóstico é baseado nos achados clínicos, exame do líquido cefalorraqueano (LCR e exames de neuroimagem. O estudo mais informativo para o diagnóstico de metástase meníngea é o exame do LCR através do qual o achado de células neoplásicas é definitivo para o diagnóstico. O intuito deste trabalho é realizar revisão da literatura a partir de descrição de um caso clínico, de um homem de 42 anos de idade, em que a primeira manifestação de neoplasia pulmonar consistiu de sintomas e sinais sugestivos de comprometimento neoplásico das leptomeninges.Leptomeningeal carcinomatosis is a neurological complication of several systemic tumors and is characterized by multifocal invasion of the meninges by neoplastic cells. It is estimated that 5% of all patients with cancer will present leptomeningeal carcinomatosis at some time during the course of the illness. Clinical manifestations are heterogeneous and present with signs and symptoms related to involvement of multiple areas of the nervous system, particularly cranial nerves and spinal roots. The diagnosis is based on suggestive clinical findings, cerebrospinal fluid (CSF testing and imaging studies. The most informative findings come from CSF where the presence of neoplastic cells is definitive for the diagnosis. The purpose of this report is to describe, along with a review of the literature, a clinical case of a 42 years old man in whom the first clinical signs of a lung cancer manifested with symptoms

  19. Superior efficacy of St John's wort extract WS® 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298

    Directory of Open Access Journals (Sweden)

    Dienel Angelika

    2006-06-01

    Full Text Available Abstract Background The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort extract WS® 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses. Methods The participants in this double-blind, randomized, placebo-controlled, multi-center clinical trial were male and female adult out-patients with an episode of mild or moderate major depressive episode (single or recurrent episode, DSM-IV criteria. As specified by the relevant guideline, the study was preceded by a medication-free run-in phase. For the 6-week treatment, 332 patients were randomized: 123 to WS® 5570 600 mg/day, 127 to WS® 5570 1200 mg/day, and 82 to placebo. The primary outcome measure was the change in total score on the Hamilton Rating Scale for Depression (HAM-D, 17-item version between baseline and endpoint. Additional measures included the number of responders, the number of patients in remission, and several other standard rating scales. Efficacy and safety were assessed after 2 and 6 weeks. The design included an interim analysis performed after randomization with the option of early termination. Results After 6 weeks of treatment, mean ± standard deviation decreases in HAM-D total scores of 11.6 ± 6.4, 10.8 ± 7.3, and 6.0 ± 8.1 points were observed for the WS® 5570 600 mg/day, 1200 mg/day and placebo groups, respectively (endpoint analysis. Secondary measures of treatment efficacy also showed that both WS® 5570 groups were statistically superior to placebo. Significantly more patients in the WS® 5570 treatment groups than in the placebo group showed treatment response and remission. WS® 5570 was consistently more effective than placebo in patients with either less severe or more severe baseline impairment. The number of patients who experienced remission was higher in the WS® 5570 1200 mg/day group than the WS® 5570 600 mg/day group. The incidence of adverse events was low in

  20. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial.

    Science.gov (United States)

    Capobianco, Robyn; Cher, Daniel

    2015-01-01

    Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (-51 mm on VAS), function (-20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.

  1. 紫草油纱治疗糖尿病足溃疡的临床研究%A Multi-center,Randomized,Double-blind,Placebo-controlled Clinical Studies on the Efficiency of ZICAOYOUSHA in Treating Diabetic Foot Ulcers

    Institute of Scientific and Technical Information of China (English)

    姚明; 葛晓东

    2013-01-01

    [Objective] To observe the clinical efficacy of ZICAOYOUSHA in treating diabetic foot ulcers.[Method] A multi-center ,randomized,double-blind,placebo-control ed study was conducted. A total of 232 patients with diabetic foot ulcers were randomly assigned the treatment group and control group,in foundation treatment at the same time,the therapy group which was treated by External Application ZICAOYOUSHA had 174 patients,the contrast group which was treated by External Application Gentamicin Emery cloth had 58 patients. Observe the aspect improvement situation in two groups separately in accordance with Wagner grading,carry out statistics processing.[Results] Two groups of curative effect indices had significant differ-ence. [Conclusion] ZICAOYOUSHA is an effective drug for external use in treating diabetic foot ulcers.%  [目的]观察紫草油纱治疗糖尿病足溃疡(diabetic foot ulcers,DFU)的临床疗效。[方法]根据患者就诊顺序依照随机法将232例DFU患者分为治疗组及对照组,在常规治疗基础上,根据溃疡面大小,治疗组选用紫草油纱覆盖溃疡面外加消毒纱布重叠包扎,对照组选用庆大霉素纱条覆盖溃疡面外加消毒纱布重叠包扎,每2d换药1次,观察两组在Wagner分级方面的改善情况。[结果]治疗组、对照组总有效率分别为89.88%、74.07%,两组比较,差异有统计学意义(P<0.05)。[结论]紫草油纱治疗DFU有良好的疗效。

  2. The retrospective chart review: important methodological considerations

    Directory of Open Access Journals (Sweden)

    Vassar Matt

    2013-11-01

    Full Text Available In this paper, we review and discuss ten common methodological mistakes found in retrospective chart reviews. The retrospective chart review is a widely applicable research methodology that can be used by healthcare disciplines as a means to direct subsequent prospective investigations. In many cases in this review, we have also provided suggestions or accessible resources that researchers can apply as a “best practices” guide when planning, conducting, or reviewing this investigative method.

  3. Efficacy and Safety of Zhuanggu Joint Capsules in Combination with Celecoxib in Knee Osteoarthritis: A Multi-center, Randomized, Double-blind, Double-dummy, and Parallel Controlled Trial

    Institute of Scientific and Technical Information of China (English)

    Xian-Long Zhang; Jing Yang; Liu Yang; Jian-Guo Liu; Xin-Yu Cai; Wei-Ming Fan; Xue-Qing Yun

    2016-01-01

    Background:Knee osteoarthritis (KOA) is a chronic joint disease that manifests as knee pain as well as different degrees of lower limb swelling,stiffness,and movement disorders.The therapeutic goal is to alleviate or eliminate pain,correct deformities,improve or restore joint functions,and improve the quality of life.This study aimed to evaluate the efficacy and safety of Zhuanggu joint capsules combined with celecoxib and the benefit of treatment with Zhuanggu alone for KOA.Methods:This multi-center,randomized,double-blind,double-dummy,parallel controlled trial,started from December 2011 to May 2014,was carried out in 6 cities,including Beijing,Shanghai,Chongqing,Changchun,Chengdu,and Nanjing.A total of 432 patients with KOA were divided into three groups (144 cases in each group).The groups were treated,respectively,with Zhuanggu joint capsules combined with celecoxib capsule simulants,Zhuanggu joint capsules combined with celecoxib capsules,and celecoxib capsules combined with Zhuanggu joint capsule simulants for 4 weeks consecutively.The improvement of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the decreased rates in each dimension of WOMAC were evaluated before and after the treatment.Intergroup and intragroup comparisons of quantitative indices were performed.Statistically significant differences were evaluated with pairwise comparisons using Chi-square test (or Fisher's exact test) and an inspection level ofα =0.0167.Results:Four weeks after treatment,the total efficacies of Zhuanggu group,combination group,and celecoxib group were 65%,80%,and 64%,respectively,with statistically significant differences among the three groups (P =0.005).Intergroup pairwise comparisons showed that the total efficacy of the combination group was significantly higher than that of the Zhuanggu (P =0.005) and celecoxib (P =0.003)groups.The difference between the latter two groups was not statistically significant (P > 0.0167).Four weeks

  4. Research on Issues of Government-Subsidized Housing from the Perspective of Multi-Center Governance%多中心治理视角下的保障性住房问题研究

    Institute of Scientific and Technical Information of China (English)

    王一

    2014-01-01

    Affordable housing project,as an important measure to rectify the market failure and resolve the housing problems of low-income groups,is an important content of the people′s livelihood guarantee.At present,China′s affordable housing con-struction has entered the institutional orbit,with varied forms as economic housing,low-cost housing,public rental housing and capped-price housing,and the housing problem of low-income families has been solved to a certain extent.But there are still some pressing problems in it,such as vague in nature,monotonousness in supply subject and absence of competition mecha-nism.The root cause can be traced to excessive dependence on government and failure to bring the role of multi-subject as mar-ket and society into play.This paper argues that priority should be given to the effective cooperation of multiple parties of govern-ment,market and society under the guidance of multi-center governance theory.Besides,with reference to the successful mod-els of developed countries like “market—relief”,“market—welfare”and limited government regulation,we should improve comprehensively the affordable housing construction system from the supply level,supervision mechanism and financing chan-nels,to ensure the effective supply and the optimization of allocation of the housing security system.%保障性住房建设作为矫正市场失灵、解决中低收入群体住房问题的重要举措是民生保障的重要内容。经过多年的改革发展,我国保障性住房建设已经步入制度化轨道,形成了包括经济适用住房、廉租住房、公共租赁房、限价房在内的不同发展模式,在一定程度上解决了中低收入家庭的住房问题。但仍存在着性质不清晰、供给主体单一、竞争机制缺乏等突出问题,从根源上来看这些问题都是由于过分依赖政府力量,而未能发挥市场、社会等多元主体共同作用所造成的后果。本文认为应在多中

  5. Effect of Marvelon on Medical Abortion: a Randomized, Double-blind and Multi-center Control Study%妈富隆提高药物流产效果的随机双盲对照研究

    Institute of Scientific and Technical Information of China (English)

    陈勤芳; 黄紫蓉; 范晓芳; 方爱华; 黄咏梅; 庄留琪

    2011-01-01

    Objective: To evaluate the clinical effect of Marvelon on the abortion induced by mifepristone and misoprostol. Methods: This was a randomized, double-blind, multi-center control study. Pregnant women meeting the criteria of medical abortion were enrolled in different outpatient centers (3 hospital) of Shanghai,China. After the gestational sac was discharged, all subjects were randomly assigned into two groups: group A based on that the subjects were administered medicine A and group B based on that the subjects was administered medicine B for the next continual 21 d. The complete abortion rate and the time of vaginal bleeding and menstruation recovery were followed up. Results: Total 414 subjects were recruited: group A——Marvelon (desogestrel ethinyl estradiol tablets) group, included 209 cases, and group B——the placebo (only starch) group, included 205 cases. Group A had significant high rate of complete abortion, short time of vaginal bleeding and menstruation recovery compared with group B (P<0.05). Conclusion: Oral administration of Marvelon for continual 21 d just after medical abortion significantly enhances the rate of complete abortion and shortens the time of vaginal bleeding and menstruation recovery.%目的:观察药物流产后及时服用妈富隆的临床效果.方法:在上海市区3个临床中心共招纳600例因非意愿妊娠要求药物流产的早孕(<49 d)健康妇女,采用随机双盲对照的多中心临床研究.各中心门诊按药物流产常规接纳对象,口服米非司酮配伍米索前列醇,孕囊排出后随机分为A组和B组,于当日起每晚加服A或B药(外包装相似)1片,连服21d,定期随访完全流产率、阴道出血时间、月经恢复情况等.结果:完全按医嘱执行并纳入资料分析的共414例,统计后揭秘A药为妈富隆(去氧孕烯炔雌醇片),209例,B药为安慰剂(不含任何药物的淀粉剂),205例,妈富隆组完全流产率高、月经恢复时间和经期出血时间短,

  6. 经鼻持续气道正压给氧多中心临床试验研究%A multi-center clinical trial of oxygen administration with nasal continuous positive airway pressure

    Institute of Scientific and Technical Information of China (English)

    持续气道正压给氧临床试验协作组

    2008-01-01

    目的 评价经鼻持续气道正压(CPAP)给氧的效果.方法 2003年1月至2007年12月首都儿科研究所(牵头)和北京市9家郊区县医院对107例因肺部疾患导致低氧血症新生儿和婴幼儿进行多中心临床试验,通过脉搏血氧仪并结合临床观察对国产的CPAP氧疗仪和普通给氧方法 (面罩、头罩)在改善血氧饱和度的效果方面进行评价.结果 CPAP治疗组46例,普通给氧组61例.应用CPAP后新生儿组在给氧后0.5 h及2 h血氧饱和度为(88.6±7.9)%及(94.4±5.0)%,普通给氧组为(82.4±5.7)%及(90.3±4.5)%,两组间差异有显著性(P<0.05).婴幼儿组在CPAP给氧后1 h血氧饱和度为(95.7±2.6)%,普通给氧组为(87.3±15.8)%,两组间差异有显著性(P<0.05).给氧后紫绀和呼吸困难程度的改善,CPAP组优于普通给氧组.结论 经鼻CPAP氧疗仪是适用于基层、安全、有效、效果优于普通给氧方法 的给氧工具.%Objective To evaluate the effect of nasal continuous positive airway pressure (CPAP).Methods A randomized controlled multi-center clinical trial was conducted during January 2003 to December 2007 in 107 newborns and infants with hypoxemia due to pulmonary diseases.These patients were hospitalized in Capital Institute of Pediatrics and 9 local hospitals.The changes of arterial oxygen saturation and clinical signs were studied after CPAP treatment and conventional oxygen therapy.Results CPAP group recruited 46 cases,conventional oxygen therapy group included 61 cases.After CPAP treatment,oxygen saturation values in newborns at 0.5 and 2 hour were (88.6±7.9)% and (94.4±5.0)%,and there was significant difference as compared with those in conventional oxygen therapy group [(82.4±5.7)% and (90.3±4.5)%].Oxygen saturation value of infants with CPAP at 1 hour was (95.7±2.6)%,and there was significant difference as compared with that in conventional oxygen therapy group[(87.3±15.8)%].Oxygen therapy alleviated the severity of cyanosis and dyspnea

  7. 慢性便秘伴发肛门直肠疼痛的全国多中心分层调查研究%Multi-centered stratified study of chronic constipation with anorectal pain in China

    Institute of Scientific and Technical Information of China (English)

    辛海威; 方秀才; 高峻; 刘诗; 肖英莲; 张军; 朱丽明; 王智凤; 柯美云

    2011-01-01

    Objective To investigate the prevalence of anorectal pain in chronic constipation (CO patients. Methods With multi-centered stratified questionnaires investigation,the face to face questionnaires investigation was carried out on the symptoms of constipation and intensity,frequency and duration of anorectal pain in CC patients. CC and anorectal pain was diagnosed according to Rome Ⅲ criteria. Results Total 921 CC patients were investigated,and 909 questionnaires were valid. Of those,there were 258 male cases and 651 female cases,the mean age was(48. 9±18. 7)years. About 15. 1%(137/909)CC patients reported anorectal pain in last six months;of those 26 cases(2. 9%)with chronic proctalgia(CP),111 cases(12. 2%)with proctalgia fugax(PF). The percentage of pain occurred frequently or regularly in CP and PF patients was 88. 5%(23/26)and 73. 9%(82/111)respectively. The pain of PF patients was milder than that of CP patients. The detection rate of CP was higher in tertiary hospitals than in primary cares(3. 6% vs 0. 6%,P= 0. 04). There was no significant difference of PF detection rate between different hospitals(P= 0. 09). The occurrence of pain was associated with anorectal symptoms,sleeping and psychosocial condition. Conclusions CC patients are frequently with anorectal pain and more common in female,which should cause extensive concern by physicians.If necessary,the prevalence of anorectal pain in general population as well as the mechanism of the symptom need further investigation.%目的 调查慢性便秘患者伴发肛门直肠疼痛情况.方法 采用全国多中心分层问卷调查,纳入慢性便秘患者后就便秘症状、肛门直肠疼痛程度、频率及持续时间等进行面对面问卷调查.慢性便秘与肛门直肠疼痛的判断均参考罗马Ⅲ诊断标准.结果 共凋查921例慢性便秘患者,有效问卷909份,其中男性258例、女性651例,平均年龄(48.9±18.7)岁.15.1%(137/909)的慢性便秘患者最近6个月有肛门直肠

  8. Uncovering the Problem-Solving Process: Cued Retrospective Reporting Versus Concurrent and Retrospective Reporting

    Science.gov (United States)

    van Gog, Tamara; Paas, Fred; Merrienboer, Jeroen J. G.; Witte, Puk

    2005-01-01

    This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The…

  9. Childhood Maltreatment in South Korea: Retrospective Study

    Science.gov (United States)

    Lee, Yanghee; Kim, Sangwon

    2011-01-01

    Objective: This study explored the prevalence of childhood maltreatment in South Korea using the retrospective version of ICAST and the associations between perceptions of abuse experienced during childhood and recent interpersonal problems and depression. Methods: 539 young persons, aged 18-24 years, from various universities, work places, and…

  10. Preparing the Collection for Retrospective Conversion.

    Science.gov (United States)

    Kroll, Carol

    1990-01-01

    Discusses the planning and preparation necessary to ensure a cost-effective and accurate retrospective conversion of school library catalogs. Suggested strategies include heavy weeding, developing accurate standardized shelf lists with an entry for each holding, and standardizing entries within a school district or region. (CLB)

  11. COMPENDEX/TEXT-PAC: RETROSPECTIVE SEARCH.

    Science.gov (United States)

    Standera, Oldrich

    The Text-Pac System is capable of generating indexes and bulletins to provide a current information service without the selectivity feature. Indexes of the accumulated data base may also be used as a basis for manual retrospective searching. The manual search involves searching computer-prepared indexes from a machine readable data base produced…

  12. Retrospective assessment of seasonal allergic symptoms

    DEFF Research Database (Denmark)

    Bodtger, U; Poulsen, Lars K.; Malling, H-J

    2003-01-01

    The history of the severity of seasonal allergic symptoms is often obtained post-seasonally as a retrospective assessment. Correct rating is essential when determining the efficacy of pharmaceutical treatment, indications for allergen-specific immunotherapy (SIT), or inclusion into controlled...

  13. 手术治疗的桡骨远端骨折多中心社会学与临床特点分析%Multi-center retrospective analysis of clinical and related sociologic characteristics of postoperative distal radius fracture patients

    Institute of Scientific and Technical Information of China (English)

    颜勇卿; 张培训; 王天兵; 陈建海; 姜保国

    2014-01-01

    目的:了解手术治疗的桡骨远端骨折患者的临床相关社会学特点.方法:采用多中心回顾性研究方法,通过病历查询及随访的方式获取资料,记录患者的性别、年龄、生活习惯、慢性病史、骨折部位以及住院时间,用SPSS15.0软件进行统计学分析.结果:共随访143例患者,男性52例,平均年龄41岁,女性91例,平均年龄61岁;社会学特点中的患者受伤特点之间差异有统计学意义;患者的致伤能量高低对住院时间有明显影响.结论:减少骨折发生和骨折危害可以从避免摔倒、增强保护意识、治疗骨质疏松相关疾病、治疗影响运动功能的内科疾病等方面考虑.桡骨远端骨折有其自身的社会学和临床特点,应根据不同特点进行防治.

  14. An analysis of 181 cases with blood stream infection caused by Streptococcus agalactiae in children from 2011 to 2015: a multi-center retrospective study%2011至2015年181例儿童无乳链球菌血流感染多中心研究

    Institute of Scientific and Technical Information of China (English)

    华春珍; 俞蕙; 庄捷秋; 李小露; 许红梅; 罗巧二; 卢洪萍; 俞惠民; 曹云

    2016-01-01

    目的 了解儿童无乳链球菌血流感染的临床特点及细菌耐药模式,为临床经验诊治提供科学依据.方法 通过实验室信息管理系统查询7家三甲医院(浙江4家、上海2家、重庆1家)2011年1月1日至2015年12月31日血液和脑脊液培养为无乳链球菌的患儿,回顾分析临床特点、耐药模式、治疗及转归.组间比较采用x2检验,t检验或非参数检验.结果 确诊无乳链球菌血流感染181例,男86例,女95例.患儿年龄1d~9岁,中位数13 d,早产儿30例.自然分娩127例(70.2%).早发型(<7 d)患儿自然分娩[81.7% (58/71)比62.3% (66/106)]、胎膜早破[25.4%(18/71)比3.8% (4/106)]、气促呻吟[43.7%(31/71)比15.1% (16/106)的发生率显著高于晚发型(7~89 d),而发热[25.4%(18/71)比85.8% (91/106)]、合并化脓性脑膜炎[29.6% (21/71)比53.8% (57/106)]的发生率显著低于晚发型(P均<0.05).78例(43.1%)患儿合并化脓性脑膜炎.159例(87.8%)患儿血培养前未使用过抗生素.菌株对青霉素、头孢曲松或头孢噻肟的敏感率分别为98.9%、99.0%、99.0%,所有菌株对万古霉素敏感,对克林霉素和红霉素的耐药率分别高达68.0%和34.0%.研究中仅39例(22.0%)采用青霉素类或头孢菌素类单药治疗,80例(45.2%)用含酶抑制剂的复合制剂,61例(34.5%)病原明确后仍应用美罗培南或头孢哌酮-舒巴坦.154例治愈或好转,19例死亡,其中13例合并化脓性脑膜炎,8例自动出院后失访.结论 儿童无乳链球菌血流感染合并化脓性脑膜炎发生率高,病死率较高,青霉素是治疗该菌感染的有效抗生素,临床应根据该菌的耐药特点合理选择抗生素.%Objective To analyze the clinical characteristics of blood stream infection caused by Streptococcus agalactiae in children and the drug-resistance of the isolates.Method All cases with Streptococcus agalactiae growth in blood or cerebrospinal fluid cultures from January 1,2011 to December 31,2015 were enrolled by checking the laboratory information system (LIS) from 7 Class 3 Grade A hospitals (4 in Zhejiang,2 in Shanghai and 1 in Chongqing).Clinical data were collected for analysis.x2 test,t test and non parametric test were used in the study.Result One hundred and eighty-one pediatric cases of blood stream infection caused by Streptococcus agalactiae were included in current study.Eighty-six cases (47.5%) were male,and with age range from one day to 9 years (media 13 days).Thirty cases (16.6%) were premature infants and 127 cases (70.2%) were born via vaginal delivery.Seventy-one cases (39.2%) had early onset (< 7 d) infections,and 106 cases (58.6%) had late onset (7-89 d) infections.Seventy-eight cases (43.1%) were complicated with purulent meningitis.Incidences of vaginal delivery(81.7% (58/71) vs.62.3% (66/106)),shortness of breath moaning (43.7% (31/71) vs.15.1% (16/106)) and preterm premature rupture of membranes (25.4% (18/71) vs.3.8% (4/106)) were higher in the early onset infection group compared with the late onset group(P all < 0.05).However,the number of cases who had fever(25.4% (18/71) vs.85.8% (91/106)) and complicated with purulent meningitis (29.6% (21/71) vs.53.8% (57/106)) in early onset infections group was less than that in the late onset group(P both <0.05).The blood cultures of most patients (87.8%) were performed before the use of antibiotics.Drug-resistant tests showed that the sensitive rates to penicillin G,ceftriaxone and cefotaxime were 98.9%,99.0% and 99.0% respectively.All strains were sensitive to vancomucine.The rates of resistance to clindamycin and erythromycin were 68.0% and 34.0%,respectively.Only 39 cases (22.0%) were treated with single antibiotics of either penicillins or cephalosporins,80 cases (45.2%) were treated with antibiotics containing β lactamase inhibitor,61 cases (34.5%) were treated with either meropenem or cefoperazone-sulbactam.One hundred and fifty-four cases were cured,while 19 died (including 13 complicated with purulent meningitis) and 8 lost to follow up after giving up of treatment.Conclusion The incidence and mortality of blood stream infection caused by Streptococcus agalactiae complicated with purulent meningitis are high in children.Penicillin is the first choice in treatment.Antibiotics should be selected accorrding to the drug-resistance test.

  15. Enhanced efficacy of combined {sup 213}Bi-DTPA-F3 and paclitaxel therapy of peritoneal carcinomatosis is mediated by enhanced induction of apoptosis and G2/M phase arrest

    Energy Technology Data Exchange (ETDEWEB)

    Vallon, Mario; Seidl, Christof; Blechert, Birgit; Li, Zhoulei; Gaertner, Florian C.; Senekowitsch-Schmidtke, Reingard; Essler, Markus [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); Gilbertz, Klaus-Peter [German Armed Forces, Institute of Radiobiology, Munich (Germany); Baumgart, Anja [Technische Universitaet Muenchen, III. Medical Department, Munich (Germany); Aichler, Michaela; Feuchtinger, Annette; Walch, Axel K. [Helmholtz Zentrum Muenchen, Institute of Pathology, Neuherberg (Germany); Bruchertseifer, Frank; Morgenstern, Alfred [Institute for Transuranium Elements, European Commission, Joint Research Centre, Karlsruhe (Germany)

    2012-12-15

    Targeted therapy with {alpha}-particle emitting radionuclides is a promising new option in cancer therapy. Stable conjugates of the vascular tumour-homing peptide F3 with the {alpha}-emitter {sup 213}Bi specifically target tumour cells. The aim of our study was to determine efficacy of combined {sup 213}Bi-diethylenetriaminepentaacetic acid (DTPA)-F3 and paclitaxel treatment compared to treatment with either {sup 213}Bi-DTPA-F3 or paclitaxel both in vitro and in vivo. Cytotoxicity of treatment with {sup 213}Bi-DTPA-F3 and paclitaxel, alone or in combination, was assayed towards OVCAR-3 cells using the alamarBlue assay, the clonogenic assay and flow cytometric analyses of the mode of cell death and cell cycle arrest. Therapeutic efficacy of the different treatment options was assayed after repeated treatment of mice bearing intraperitoneal OVCAR-3 xenograft tumours. Therapy monitoring was performed by bioluminescence imaging and histopathologic analysis. Treatment of OVCAR-3 cells in vitro with combined {sup 213}Bi-DTPA-F3 and paclitaxel resulted in enhanced cytotoxicity, induction of apoptosis and G2/M phase arrest compared to treatment with either {sup 213}Bi-DTPA-F3 or paclitaxel. Accordingly, i.p. xenograft OVCAR-3 tumours showed the best response following repeated (six times) combined therapy with {sup 213}Bi-DTPA-F3 (1.85 MBq) and paclitaxel (120 {mu}g) as demonstrated by bioluminescence imaging and histopathologic investigation of tumour spread on the mesentery of the small and large intestine. Moreover, mean survival of xenograft mice that received combined therapy with {sup 213}Bi-DTPA-F3 and paclitaxel was significantly superior to mice treated with either {sup 213}Bi-DTPA-F3 or paclitaxel alone. Combined treatment with {sup 213}Bi-DTPA-F3 and paclitaxel significantly increased mean survival of mice with peritoneal carcinomatosis of ovarian origin, thus favouring future therapeutic application. (orig.)

  16. Retrospective assessment of seasonal allergic symptoms

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Poulsen, L K; Malling, H-J

    2003-01-01

    BACKGROUND: The history of the severity of seasonal allergic symptoms is often obtained post-seasonally as a retrospective assessment. Correct rating is essential when determining the efficacy of pharmaceutical treatment, indications for allergen-specific immunotherapy (SIT), or inclusion...... into controlled clinical studies. OBJECTIVES: To investigate the agreement between in- and post-seasonal ratings of seasonal symptoms, and to investigate whether the effect of SIT could be detected retrospectively. MATERIAL AND METHODS: Thirty-five birch pollen-allergic patients were allocated to SIT or placebo...... in a double-blind study. Assessment of severity of symptoms from the nose, eyes and lungs were performed daily during the season 2000, and post-seasonally 6 months after the season in 1999 and 2000. A four-point verbal descriptor scale (VDS-4) was used at all occasions. A mean in-seasonal symptom rating...

  17. Some Notes on Retrospective Evaluation of PSHA

    Science.gov (United States)

    Taroni, Matteo; Marzocchi, Warner; Roselli, Pamela

    2016-04-01

    In usual practice, PSHA models are constructed by merging different models that are expected to sample the so-called epistemic uncertainty. The merging is usually made through a logic tree scheme where each model/branch is subjectively weighted. Noteworthy, neither the final PSHA model nor its components are usually subjected to a rigorous testing phase. Although the proper way to evaluate a model is through prospective testing (where the data are independent from the model calibration), here we discuss the benefit of the retrospective analysis of the whole PSHA model and/or of its components/branches. In particular, we i) introduce a consistent probabilistic framework for a meaningful evaluation (retrospectively and prospectively) of a PSHA model; ii) describe merits and limits of retrospective evaluation in the final assessment of PSHA model and in assisting experts to describe the epistemic uncertainty; iii) estimate the impact of aftershocks in evaluating PSHA models that are (almost always) based on declustering. All these issues are explored through real numerical examples.

  18. [Diabetic retinopathy complications--12-year retrospective study].

    Science.gov (United States)

    Ignat, Florica; Davidescu, Livia

    2002-01-01

    It is analyzed, on a retrospective study on 12 years, the incidence of diabetus melitus cases, hospitalized in the Ophthalmologic Clinic from Craiova with special mention to the frequency of the diabetic retinopathy, of it's complications and in an accordance to other general diseases, especially cardiovascular's, which contributes to the aggravation of the diabetic ocular in juries evolution. The study underlines the high incidence of the new founded cases with diabetus melitus in complicated diabetes retinopathy stage; the high frequency of ocular complications is explained, according to our statistic facts and through an insufficient treatment, sometimes incorrect and many other cases total neglected by the patients.

  19. Application of luminescence techniques in retrospective dosimetry

    DEFF Research Database (Denmark)

    Bøtter-Jensen, L.; Jungner, H.

    1999-01-01

    retrospective assessment of accident doses received by the population after a nuclear accident. The development of new luminescence techniques after the Chernobyl accident has considerably improved the sensitivity and precision in the evaluation of accident doses. This paper reviews the development work......Luminescence signals measured from minerals within bricks or ceramic samples can provide information about the absorbed radiation dose. This feature has for several years been used in dating archaeological and geological samples and recently luminescence techniques have been intensively used far...

  20. Flow cytometry: retrospective, fundamentals and recent instrumentation.

    Science.gov (United States)

    Picot, Julien; Guerin, Coralie L; Le Van Kim, Caroline; Boulanger, Chantal M

    2012-03-01

    Flow cytometry is a complete technology given to biologists to study cellular populations with high precision. This technology elegantly combines sample dimension, data acquisition speed, precision and measurement multiplicity. Beyond the statistical aspect, flow cytometry offers the possibility to physically separate sub-populations. These performances come from the common endeavor of physicists, biophysicists, biologists and computer engineers, who succeeded, by providing new concepts, to bring flow cytometry to current maturity. The aim of this paper is to present a complete retrospective of the technique and remind flow cytometry fundamentals before focusing on recent commercial instrumentation.

  1. A retrospective on the LBNL PEM project

    Energy Technology Data Exchange (ETDEWEB)

    Huber, J.S.; Moses, W.W.; Wang, G.C.; Derenzo, S.E.; Huesman,R.H.; Qi, J.; Virador, P.; Choong, W.S.; Mandelli, E.; Beuville, E.; Pedrali-Noy, M.; Krieger, B.; Meddeler, G.

    2004-11-15

    We present a retrospective on the LBNL Positron EmissionMammography (PEM) project, looking back on our design and experiences.The LBNL PEM camera utilizes detector modules that are capable ofmeasuring depth of interaction (DOI) and places them into 4 detectorbanks in a rectangular geometry. In order to build this camera, we had todevelop the DOI detector module, LSO etching, Lumirror-epoxy reflectorfor the LSO array (to achieve optimal DOI), photodiode array, custom IC,rigid-flex readout board, packaging, DOI calibration and reconstructionalgorithms for the rectangular camera geometry. We will discuss thehighlights (good and bad) of these developments.

  2. RETROSPECTIVE DATA COLLECTION: CAN STUDENTS REMEMBER?

    Directory of Open Access Journals (Sweden)

    Paul Leeming

    2015-01-01

    Full Text Available Abstract: It is not always possible or practical to gather data over a long period of time, and researchers have used retrospective data from questionnaire and interview to gain insights into change over time. There has been little discussion within SLA as to the validity of this data, and it is seemingly accepted at face value. This paper examines both qualitative and quantitative retrospective accounts of changes in self-efficacy, by collecting quantitative questionnaire data over a one-year period, and then asking students to quantitatively recollect their feelings of self-efficacy over that time frame, followed by qualitative description. Results showed that students were able to accurately recollect quantitative data, although there was a noticeable degradation in accuracy with time. Interview data suggested that students were reluctant to admit lack of ability to recall events, and sometimes produced conflicting accounts of events.  This may in part be due to the dual role of teacher and researcher adopted in this study. The implications for researchers and also for teachers are considered.

  3. Odontoma: a retrospective study of 73 cases

    Energy Technology Data Exchange (ETDEWEB)

    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2012-06-15

    The purpose of the present study was to retrospectively evaluate the clinical findings and treatment results for impacted permanent teeth associated with odontomas. We retrospectively investigated 73 odontomas in 72 patients who visited Kyungpook National University Dental Hospital from April 2004 through November 2011. The study was performed using medical records, panoramic radiographs, and pathological reports. Data gathered included age, gender, location, chief complaints, effects on dentition, and treatment of odontoma and the impacted tooth associated with odontoma. Most compound odontomas (46.7%) were found in the second decade and complex odontomas were not related to age. Odontomas showed no gender predilection. Fifty-five cases (75.3%) of odontomas were detected on routine dental radiographs. Sixty percent of compound odontomas occurred in the canine area and 57.1% of complex odontomas in the molar areas. Impaction of permanent teeth (61.6%) was the most common complication on the adjacent teeth. Most odontomas (84.9%) were removed surgically and impacted permanent teeth were managed by surgical removal (53.2%), orthodontic treatment (25.5%), or surgical repositioning (6.4%). There was a statistically significant relation between age and preservation of the impacted permanent teeth associated with odontomas (p<0.01). Early detection and treatment of odontomas increase the possibility of preservation of the impacted tooth. Therefore, it would be suggested that periodic panoramic examination during the first and second decade of life might be beneficial for the early detection and better prognosis of odontomas.

  4. 儿童原发性免疫性血小板减少症颅内出血的多中心临床研究%Multi-center clinical study on intracranial hemorrhage in children with primary immune thrombocytopenia

    Institute of Scientific and Technical Information of China (English)

    胡群; 刘爱国; 金润铭; 徐云云; 李建新; 李晖; 朱斌

    2013-01-01

    To explore the incidence,relevant clinical risk factors and prognosis of intracranial hemorrhage in children with primary immune thrombocytopenia (ITP) . Method:Retrospective analysis was conducted on 17 cases of ITP with intracranial hemorrhage admitted in four children hematologic diseases centers during 2001 to 2011. Result:The incidence of intracranial hemorrhage in children with ITP was 0. 46%. There were some risk factors for intracranial hemorrhage,such as disease course within 1 month for acute patients and longer than 1 year for chronic patients; concurrent-infection; strenuous exercise; trauma and platelet count less than 10 × 109/L. The motality of ITP with intracranial hemorrhage was 11.7% and the prognosis was fine after active treatment. Conclusion: Intracranial hemorrhage in children with ITP was a disease which could be effectively cured through active treatment. The majority of survivors did not have severe neurological sequelae.%目的:探讨我国儿童免疫性血小板减少症(ITP)颅内出血的发生率、相关临床因素及预后.方法:对四大儿童血液病中心2001-2011年收治的儿童ITP并发颅内出血者17例进行回顾性分析.结果:①ITP患儿颅内出血的发生率为0.46%.②颅内出血高危因素为急性患儿起病1个月内,慢性患儿病程1年后;并发感染、剧烈运动和外伤;血小板计数小于10×109/L.③并发颅内出血者病死率为11.7%.④积极治疗后预后良好.结论:ITP患儿的颅内出血是一种可以通过积极治疗而达到有效治愈的疾病,幸存下来的患儿多数无严重的神经系统后遗症.

  5. Hyponatremic hypertensive syndrome - a retrospective cohort study

    Science.gov (United States)

    Mukherjee, Devdeep; Sinha, Rajiv; Akhtar, Md Shakil; Saha, Agni Sekhar

    2017-01-01

    AIM To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives (combination of Nifedipine sustained release, Hydralazine and Beta Blocker). All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure. CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation produces excellent results in most of them. PMID:28101450

  6. Optically stimulated luminescence techniques in retrospective dosimetry

    DEFF Research Database (Denmark)

    Bøtter-Jensen, L.; Murray, A.S.

    2001-01-01

    Optically stimulated luminescence signals from natural quartz and feldspar are now used routinely in dating geological and archaeological materials. More recently they have also been employed in accident dosimetry, i.e. the retrospective assessment of doses received as a result of a nuclear...... accident. Since 1990 the exploration of this wide variety of applications has driven an intensive investigation and development programme at Riso, in measurement facilities and techniques. This paper reviews some of the outcomes of this programme, including (i) optimisation of stimulation and emission...... windows, and detection sensitivity, (ii) experience with various stimulation light sources, including filtered incandescent lamps (420-550 nm) and high intensity light emitting diodes (470 nm) and laser diodes (830-850 nm). We also discuss recently developed high-precision single-aliquot measurement...

  7. Nursing student medication errors: a retrospective review.

    Science.gov (United States)

    Harding, Lorill; Petrick, Teresa

    2008-01-01

    This article presents the findings of a retrospective review of medication errors made and reported by nursing students in a 4-year baccalaureate program. Data were examined in relation to the semester of the program, kind of error according to the rights of medication administration, and contributing factors. Three categories of contributing factors were identified: rights violations, system factors, and knowledge and understanding. It became apparent that system factors, or the context in which medication administration takes place, are not fully considered when students are taught about medication administration. Teaching strategies need to account for the dynamic complexity of this process and incorporate experiential knowledge. This review raised several important questions about how this information guides our practice as educators in the clinical and classroom settings and how we can work collaboratively with practice partners to influence change and increase patient safety.

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

    Science.gov (United States)

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

    2001-01-01

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

  9. Retrospective dream components and musical preferences.

    Science.gov (United States)

    Kroth, Jerry; Lamas, Jasmin; Pisca, Nicholas; Bourret, Kristy; Kollath, Miranda

    2008-08-01

    Retrospective dream components endorsed on the KJP Dream Inventory were correlated with those on the Short Test of Musical Preference for 68 graduate students in counseling psychology (11 men). Among 40 correlations, 6 were significant between preferences for Heavy Metal and Dissociative avoidance dreams (.32), Dreaming that you are dreaming (.40), Dreaming that you have fallen unconscious or asleep (.41), Recurring pleasantness (.31), and Awakening abruptly from a dream (-.31); between preferences for Rap/Hip-Hop and Sexual dreams (.27); and between preferences for Jazz and Recurring pleasantness in dreams (.33). Subjects preferring Classical music reported a higher incidence of Dreams of flying (.33) and rated higher Discontentedness in dreams (-.26). The meaning of these low values awaits research based on personality inventories and full dream reports.

  10. Intraspinal synovial cysts: A retrospective study

    Directory of Open Access Journals (Sweden)

    Acharya R

    2006-01-01

    Full Text Available Background: We report the clinical presentation, radiographic studies, intraoperative findings, histopathological analysis, and post-treatment outcome in 26 patients diagnosed with spinal synovial cysts (SSCs. Aims: To describe the clinical presentation, radiographic studies, operative findings, and postoperative follow-up in 26 patients with SSCs. Settings and Design: The study was retrospective in design, involving chart review. Individual patient data was tabulated and patterns were recognized. Materials and Methods: The charts for 26 patients who underwent surgical extirpation of SSC between April 1993 and October 2002 were retrospectively reviewed. Specifically, initial clinical presentation, pertinent radiographs (X-rays, magnetic resonance imaging, computed tomography, intraoperative findings, histopathology, and postoperative follow-up were noted. Statistical Analysis Used: Patient data was tabulated and analyzed for patterns in demographics, symptoms and histopathology. Results: SSCs were more common in females than males (17:9 ratio. Presenting symptoms were back pain with radiculopathy in 13 (50%, radicular pain in the absence of back pain in 10 (38%, and back pain without radicular pain in three (11%. In addition, 17 patients (65% had sensory deficit, and 9 (35% had motor deficit. Most SSCs occurred at the lumbar (19/26 or lumbosacral (5/26 regions, with only 2 (2/26 in the thoracic region. One patient had bilateral SSC at the L4-5 level. Intraoperatively, each cyst was located adjacent to a degenerated facet joint. These lesions could grossly be identified intraoperatively and histopathological confirmation was achieved in all the cases. Conclusions: SSCs are important lesions to consider in the differential diagnosis of lumbar epidural masses and surgical resection leads to significant improvement in the majority of cases.

  11. Retrospective Analysis of Women with Only Mastalgia

    Science.gov (United States)

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

    2016-01-01

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

  12. Space Adaptation Back Pain: A Retrospective Study

    Science.gov (United States)

    Kerstman, E. L.; Scheuring, R. A.; Barnes, M. G.; DeKorse, T. B.; Saile, L. G.

    2008-01-01

    Back pain is frequently reported by astronauts during the early phase of space flight as they adapt to the microgravity environment. However, the epidemiology of space adaptation back pain has not been well defined. The purpose of this retrospective study was to develop a case definition of space adaptation back pain, determine the incidence of space adaptation back pain, and determine the effectiveness of available treatments. Medical records from the Mercury, Apollo, Apollo-Soyuz Test Project (ASTP), Skylab, Mir, International Space Station (ISS), and Shuttle programs were reviewed. All episodes of in-flight back pain that met the criteria for space adaptation back pain were recorded. Pain characteristics, including intensity, location, and duration of the pain were noted. The effectiveness of specific treatments also was recorded. The incidence of space adaptation back pain among astronauts was determined to be 53% (384/722). Most of the affected astronauts reported mild pain (85%). Moderate pain was reported by 11% of the affected astronauts and severe pain was reported by only 4% of the affected astronauts. The most effective treatments were fetal positioning (91% effective) and the use of analgesic medications (85% effective). This retrospective study aids in the development of a case definition of space adaptation back pain and examines the epidemiology of space adaptation back pain. Space adaptation back pain is usually mild and self-limited. However, there is a risk of functional impairment and mission impact in cases of moderate or severe pain that do not respond to currently available treatments. Therefore, the development of preventive measures and more effective treatments should be pursued.

  13. Retrospective accident dosimetry using trapped charges

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. I.; Kim, J. L.; Chang, I.; Kim, B. H. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Dicentric chromosome aberrations technique scoring of aberrations in metaphases prepared from human lymphocytes is most commonly used. This is considered as a reliable technique because the sample is extracted from the individual human body itself. There are other techniques in biological dosimetry such as Fluorescence In Situ Hybridization (FISH) using translocations, premature chromosome condensation (PCC) and micronucleus assay. However the minimum detectable doses (MDD) are relatively high and sample preparation time is also relatively longer. Therefore, there is limitation in use of these techniques for the purpose of triage in a short time in case of emergency situation relating large number of persons. Electronic paramagnetic resonance (EPR) technique is based on the signal from unpaired electrons such as free radicals in irradiated materials especially tooth enamel, however it has also limitation for the purpose of triage because of difficulty of sample taking and its high MDD. Recently as physical methods, thermoluminescence (TL) and optically stimulated luminescence (OSL) technique have been attracted due to its lower MDD and simplicity of sample preparation. Density of the trapped charges is generally proportional to the radiation dose absorbed and the intensity of emitting light is also proportional to the density of trapped charges, thus it can be applied to measure radiation dose retrospectively. In this presentation, TL and OSL techniques are going to introduced and discussed as physical methods for retrospective accident dosimetry using trapped charges especially in electronic component materials. As a tool for dose reconstruction for emergency situation, thermoluminescece and optically stimulated luminescence techniques which are based on trapped charges during exposure of material are introduced. These techniques have several advantages such as high sensitivity, fast evaluation and ease to sample collection over common biological dosimetry and EPR

  14. 小儿外科重大疾病术前贫血与干预多中心调查%Multi-center epidemiological survey of preoperative anemia and intervention status of some major pediatric surgical diseases

    Institute of Scientific and Technical Information of China (English)

    林茹; 刘晋萍; 周荣华; 李鹏; 王斌; 郑珊; 舒强

    2014-01-01

    retrospectively by a standard questionnaire.The preoperative hemoglobin (Hb) of routine blood test report closest to the operation day was collected.Anemia was diagnosed as having a level of Hb under 120 g/L.The intervention measures of anemia referred to blood transfusion or supplemental erythropoietin (rHuEPO),iron and vitamins,etc.Results A total of 874 patients at six hospitals in Beijing,Shanghai,Hangzhou,Xi'an,Shenzhen and Chengdu were surveyed.Among congenital heart disease group (n =458),there were 282 boys and 176 girls with a mean age of 28.58 ±29.79 months.The total incidence rate of anemia was 60.3% (276/458),mild anemia 58.1% (266/458) and moderate anemia 2.2% (10/458).The incidence of anemia for children from welfare homes or less than 1 year of age or/and with pulmonary hypertension was significantly higher than that of total incidence rate (P =0.008,P<0.001-,P<0.001) ; Among general surgery disease group (n =416),there were 204 boys and 212 girls with an average age of 28.60 ± 32.30 months.The total incidence rate of anemia was 79.6% (331/416),mild anemia 71.4% (297/416) and moderate anemia 8.2% (34/416).The incidence of preoperative anemia differed in each area,ranging from 50% to 100%.The ratio of direct operation without any intervention measure for preoperative anemia reached over 89.1%.Except for preoperative use of rHuEPO at one hospital,few other interventions were adopted.Conclusions In some domestic areas,the incidence of preoperative anemia is relatively high for some major pediatric surgical diseases.The status of non-intervention for preoperative anemia is quite common.This phenomenon should raise a high alert.

  15. Retrospective Evaluation of Patients with Morgagni Hernia

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    Erkan Akar

    2012-07-01

    Full Text Available Aim: Morgagni hernia develops due to the defect in Larrey’s space. Intestine and ometum passes to thorax and lead to respiratory problems. Herein, we present our patients who had pulmonary symptoms and diagnosed as Morgagni hernia with clinical, radiologic and operative methods. Material and Method: Data of four patients who were diagnosed as Morgagni hernia in our clinic between 2005 and 2011 were evaluated retrospectively. Posteroanterior (PA chest graphy and thorax computed tomography were performed to all patients as diagnostic tools and thorax magnetic resonance imaging was performed to one patient additionally. Results: All patients were female with mean age of 57 years (range 42-67. Transthoracic route was used in two patients and transabdominal route was used for two patients for surgical access. When hernia sac was opened, presence of intestinal anses and omentum structures and passing to thorax via diaphragmatic defect from the right of sternum were observed. Ischemia and necrosis were not detected. Hernia sacs were not excised. Defect was closed primarily. Mean duration of hospital stay was found as 12 days (range 6-20 days. Recurrence, morbidity and mortality were not seen during average one year follow up.Discussion: Surgery is the treatment of Morgagni hernia. We consider that evaluating the patients diagnosed in adulthood in detail would be beneficial for correct decision for surgical approach and for prevention of vital complications.

  16. Stereotactic radiosurgery for glioblastoma: retrospective analysis

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    Walter Kevin A

    2009-03-01

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

  17. A retrospective metagenomics approach to studying Blastocystis.

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    Andersen, Lee O'Brien; Bonde, Ida; Nielsen, Henrik Bjørn; Stensvold, Christen Rune

    2015-07-01

    Blastocystis is a common single-celled intestinal parasitic genus, comprising several subtypes. Here, we screened data obtained by metagenomic analysis of faecal DNA for Blastocystis by searching for subtype-specific genes in coabundance gene groups, which are groups of genes that covary across a selection of 316 human faecal samples, hence representing genes originating from a single subtype. The 316 faecal samples were from 236 healthy individuals, 13 patients with Crohn's disease (CD) and 67 patients with ulcerative colitis (UC). The prevalence of Blastocystis was 20.3% in the healthy individuals and 14.9% in patients with UC. Meanwhile, Blastocystis was absent in patients with CD. Individuals with intestinal microbiota dominated by Bacteroides were much less prone to having Blastocystis-positive stool (Matthew's correlation coefficient = -0.25, P metagenomics approach. The study serves as an example of how it is possible to retrospectively investigate microbial eukaryotic communities in the gut using metagenomic datasets targeting the bacterial component of the intestinal microbiome and the interplay between these microbial communities.

  18. A RETROSPECTIVE STUDY OF BLUNT TRAUMA ABDOMEN

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    Kumawat

    2015-07-01

    Full Text Available BACKGROUND: Blunt abdominal trauma is one of the important components of poly - trauma. It requires suspicion, investigation and proper management in time, to avoid morbidity & mortality. AIM: The aim of this retrospective study spanning 5 years w.e.f. Jan, 2010 to December, 2014 in this tertiary care institute of Geetanjali Medical College & Hospital, Udaipur was to find out BTA patients in RTA, fall from height, and assault like injuries. We studied type of injuries, male - female ratio, age group, urban & rural population involvement & their operative & non - operative management. MATERIAL & METHOD S : The study is based on 273 cases of BTA; managed in this institute from admission, investigation, management & possible follow up. Observations are depicted in different tables. RESULT: Liver is most commonly involved organ followed by spleen, kidney & pancreas respectively. Initially solid organ injuries cases where treated by surgery, but than non - operative management are tried in haemostatically stable patients. Hollow visceral injuries were always managed by laparotomy & repair or resection as and when needed . Mortality occurred in 35 patients out 273 patients because of delay to reach hospital or septicemia, renal failure and shock due to multi organ failure. CONCLUSION: Close supervision with sophisticated infrastructure and quick action significantly reduces mortality.

  19. A retrospective study of spontaneous intracranial hemorrhage

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    Eka J. Wahjoepramono

    2016-02-01

    Full Text Available Spontaneous intracerebral hemorrhage (SICH is a serious disease despite progressing medical knowledge. SICH appears suddenly without warning, unlike ischemic strokes that are often preceded by a transient ischemic attack. Outcome is determined by the initial severity of the bleeding; mortality and morbidity of SICH are high. The aim of this study was to describe the characteristics of type, location, and outcome of SICH. A retrospective review was conducted on the records of 2042 cases admitted to a private hospital in Karawaci, Tangerang, between 1 January 1996 to 31 December 2008. Analysis was done on type, location, and the final outcome measures by the Glasgow Outcome Scale (GOS. The results of the study showed that the most prevalent type of SICH was hypertensive stroke, amounting to 1698 cases (83.1%, and the least commonly encountered type was dural fistula totaling  5 cases (0.3%. SICH due to hypertensive stroke frequently occurred in the basal ganglia (50.8% comprising the putamen, caudate nucleus and globus pallidus. On average, the outcome at the time of dismissal was good, where 105 cases (88.2% were GOS 4 and 5. SICH requires prompt and appropriate management. Therefore the signs and symptoms of intracranial hemorrhage should be promptly recognized and followed by appropriate ancillary examinations in order to promptly determine the management required, including possible surgical interventions.

  20. All our yesterdays: a hydrological retrospective

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    2007-01-01

    Full Text Available This paper traces the development and eventual recognition of hydrology as a scientific subject in its own right in the UK and, later, in the European Geophysical Society (EGS, now the European Geosciences Union (EGU. In the early 1960s, to facilitate decisions of executive government departments in meeting the rapidly increasing demand for industrial and domestic water supplies, a small Hydrological Research Unit (HRU was established by the UK Department of Scientific and Industrial Research(DSIR to investigate the comparative water use of forested and grassed upland catchments. These small beginnings in the HRU developed in a few years into the highly multi-disciplinary Institute of Hydrology (IH as a source of independent advice for policy makers, with a capability to undertake longer term research, monitoring and data collection than was feasible in individual government departments or in the universities. Within IH, the range of specialities included not only engineering, physics, geography, geology, meteorology and instrumentation but also pollution, plant physiology, ecology, chemistry and economics. Said quickly in retrospect, the trajectory of the growth of IH seems smooth but, in reality, it masked many struggles between competing disciplines and departments before hydrology was recognised as a subject in its own right – the science of water.

  1. Space Adaptation Back Pain: A Retrospective Study

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    Kerstman, Eric

    2009-01-01

    Astronaut back pain is frequently reported in the early phase of space flight as they adapt to microgravity. The epidemiology of space adaptation back pain (SABP) has not been well established. This presentation seeks to determine the exact incidence of SABP among astronauts, develop a case definition of SABP, delineate the nature and pattern of SABP, review available treatments and their effectiveness in relieving SABP; and identify any operational impact of SABP. A retrospective review of all available mission medical records of astronauts in the U.S. space program was performed. It was revealed that the incidence of SABP has been determined to be 53% among astronauts in the U.S. space program; most cases of SABP are mild, self-limited, or respond to available treatment; there are no currently accepted preventive measures for SABP; it is difficult to predict who will develop SABP; the precise mechanism and spinal structures responsible for SABP are uncertain; there was no documented evidence of direction operational mission impact related to SABP; and, that there was the potential for mission impact related to uncontrolled pain, sleep disturbance, or the adverse side effects pf anti-inflammatory medications

  2. Tinnitus: A hospital-based retrospective study

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    Hanifa Akhtar Laskar

    2015-01-01

    Full Text Available Aims and Objectives: To find out age, sex, laterality distribution of patients with tinnitus, to investigate the type and characteristics of associated hearing loss and to find different etiology causing tinnitus. Materials and Methods: Retrospective hospital-based study. Data collected for 154 patients who attended tinnitus clinic of Department of ENT of our institute during the year 2013. Patients with incomplete data were excluded from the study. Results: Among 154 patients included for study, 73 were male and 81 were female. The highest percentage of patients were in the middle age group of 41-50 years (27.9% followed by 31-40 years (18.83% and 51-60 years (16.2% with decreasing number of patients in both younger and elderly age group. Conclusion: Tinnitus can affect any age group but its prevalence increases with age without any gender predilection. Left ear involvement is slightly more common among unilateral tinnitus. Sensorineural hearing loss is most common factor associated but in one-sixth of the cases no cause has been found for tinnitus.

  3. Pheochromocytoma in Indian patients: A retrospective study

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    R Krishnappa

    2012-01-01

    Full Text Available Aim: To review the clinical experience on pheochromocytoma in Indian subset of patients. Materials and Methods: Ten patients diagnosed with pheochromocytoma between 2001 and 2010 at our institute were retrospectively studied for clinical, laboratory, radiological and surgical data. Results: A total of 10 patients (5 females and 5 males aged between 23 and 64 years diagnosed as pheochromocytoma were managed at our institute. The most frequent symptoms were abdominal pain (90% and hypertension (50%. The tumor was intra-adrenal in 70% and extra-adrenal in 30%. 20% were on right side and 50% on left side. CT scan of abdomen was the most widely used method for tumor localization. Among laboratory assays, 24-h urinary vanillylmandelic acid (VMA was the most widely used. None of our patients were found to be associated with hereditary pheochromocytoma syndrome. All hypertensive patients were preoperatively treated with phenoxybenzamine and propranolol. All underwent explorative laparotomy and adrenelectomy. Malignancy was reported in 40% of cases and these received adjuvant radiotherapy. Among hypertensive patients, surgery caused remission of hypertension in 60%. All patients were followed up with 24-h urinary VMA levels and CT scan of abdomen regularly. Survival ranged from 1 to 9 years. Conclusions: The present study confirms that the clinical presentation of pheochromocytoma is variable and non-specific. Often the tumor is discovered incidentally. Though pheochromocytoma is a rare tumor, proper evaluation, preoperative preparation and complete surgical excision are important for its management.

  4. (Self-)Portrait of Prof. R. C.: A Retrospective

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    Morris, Charles E., III

    2010-01-01

    This essay offers a retrospective on the four special issues of this journal (1957, 1980, 1990, 2001) dedicated to the "state of the art" of rhetorical criticism. Drawing on Oscar Wilde's "The Portrait of Mr. W. H." as allegory, the essay also functions to queer this retrospective in an ongoing effort to queer rhetorical studies. The essay closes…

  5. LAPAROSCOPIC GYNAEC SURGERIES – A RETROSPECTIVE STUDY

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    Hiremath

    2013-10-01

    Full Text Available ABSTRACT : BACKGROUND: There has been a rapid worldwide adoption of laparoscopic procedures across many surgical specialt ies, most notably in Gynaecology. Unfortunately, the increased adoption of laparoscopic surgery has also been accompanied by a corresponding rise in the rates and types of complications reported. AIMS : To audit the different types of laparoscopic surgerie s and their complications and comparison with other routes of surgery. METHODS & MATERIALS : We have retrospectively analysed 285 laparoscopic surgeries and 306 other routes of surgery which were done at our institute from July 2011 to April 2013.We admit t he patients 1 - 2 days prior to surgery and a complete medical work - up of the patient is done for elective laparoscopic surgery .We defer laparoscopy for malignant conditions, uterine size more than 20 weeks, cervix flushed to the vagina or with history of m ore than 2 pelvic surgeries. Sub - fertile women, after an initial workup, are subjected to diagnostic laparoscopy with chromopertubation. For laparoscopic cystectomies, patients with ultrasono graphy findings suggestive of benign tumours are selected. RESULT S : We have performed 285 laparoscopic procedures over this time period till date. Majority of these cases are Laparoscopic Assisted Vaginal Hysterectomies (LAVH [111 – 38.9%], followed by laparoscopic surgeries for various benign ovarian conditions ( BOC [62 – 21%] and Diagnostic Laparoscopies ( DL with or without laparoscopic ovarian drilling ( LOD [59 cases – 20.7%]. Out of 111 LAVH, 3 patients had bladder injury [2.7%] ; Out of 285 cases that underwent laparoscopic procedures, 5 [1.75%] required conversi on to laparotomy. Overall operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the laparoscopic group ( p value= 0.001 CONCLUSION : Laparoscopy is a safe route for conventional surgery, with lesser intraoperative, immediate post

  6. Neurocysticercosis in Nepal: a retrospective clinical analysis

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    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.

  7. 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.

  8. Pyoderma Gangrenosum: Retrospective Evaluation of 20 Cases

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    Zehra Aşiran Serdar

    2011-06-01

    Full Text Available Background and Design: The objective of this study is to examine the clinical properties, comorbid systemic diseases and the treatment protocols of the patients diagnosed with pyoderma gangrenosum (PG. Material and Method: Between 2003 and 2009 years, 20 patients diagnosed with pyoderma gangrenosum were evaluated in this study. The clinical properties, comorbid systemic diseases and the treatment protocols were examined retrospectively.Results: In a six-year period, 20 patients with PG (11 female and 9 male, ranging in age from 19 to 75 (mean age 45±16.39 years were evaluated. Lesions had started as papule in 3 (16% patients, as bullous in 1 (5% patient, as erythematous plaque in 1 (5% patient and as pustule in 15 (74% patients. Whereas 14 (70% patients had single lesion, the other patients had multiple lesions. The lesions were located at lower extremities in 14 (70% patients most frequently, The most frequent comorbid disease in patients with pyoderma gangrenosum was inflammatory bowel diseases (colitis ulcerosa n: 4 and Crohn disease n: 2 total n: 6, 30%. The other comorbid diseases included vitiligo (n: 1, 5%, Behcet’s disease (n: 1, 5%, hidradenitis suppurativa (n: 1, 5%, deep venous thrombosis and pulmonary embolism (n: 1, 5%, pangastritis (n: 1, 5%, acute renal failure (n: 1, 5%, systemic lupus erythematosus (n: 2, 10% and iatrogenic immunosuppression (n: 1, 5%. Systemic corticosteroid therapy was the most common treatment (n=16, 80%. The treatment response was 100% in all patients. Conclusion: In our study, inflammatory bowel diseases were the most frequent comorbid diseases with pyoderma gangrenosum. Most of cases were as single lesions located in the lower extremities and the best treatment response was achieved by the administration of systemic corticosteroids.

  9. Retrospective environmental biomonitoring - Mussel Watch expanded

    Science.gov (United States)

    Schöne, Bernd R.; Krause, Richard A.

    2016-09-01

    its chemical composition is controlled by the soft parts and that a robust interpretation of the shell record requires a detailed understanding of bivalve physiology, behavior and ecology. This review attempts to bring together the Mussel Watch and sclerochronology communities and lay the foundation of a new subdiscipline of the Mussel Watch: retrospective environmental biomonitoring. For this purpose, we provide an overview of seminal work from both fields and outline potential future research directions.

  10. 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

  11. Unilateral sensorineural hearing loss: A retrospective study

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    Divyank Bansal

    2016-01-01

    Full Text Available Background: This retrospective study was carried out to know the characteristics of patients suffering from unilateral sensorineural hearing loss (USNHL (type and degree. Aims and Objectives: (1 To know the incidence of pure USNHL (other ear being normal in patients complaining of HL. (2 To establish the type and degree of USNHL in patients. Materials and Methods: This study was conducted over a period of more than 1 year to find out the pattern of pure USNHL (other ear being normal in the patients attending ear, nose, and throat outpatient department (OPD with a complaint of HL. Pure tone audiometry data of 1800 cases between August 2014 and December 2015 with HL were analyzed for this study. Demographic characteristics were compared with types and degrees of unilateral sensorineural hearing impairment. Results: A total of 1800 OPD patients who had a complaint of HL and had undergone pure tone audigram (PTA in a period of more than 1 year in the Department of Otorhinolaryngology and Head and Neck Surgery were studied. SNHL type was the highest with 802 cases (44.55%. Out of 802 cases of SNHL, 257 (32.05% were USNHL - out of which, only 155 patients (60.31% had pure USNHL with other ear being normal; this constituted the study group, i.e., 155 patients (8.6% out of 1800. Age of patients ranged from 9 years to 76 years (mean age - 41.5 years. Male:female ratio was 1.31:1. Both ears were almost equally involved. The highest numbers of USNHL patients were seen in the age group of 31-40 years (23.87%. Most cases presented with mild (34.2%, followed by profound (31.6% USNHL. Conclusion: Our study concluded that SNHL type is the most common type (44.55% of hearing impairment among patients complaining of HL. The incidence of pure USNHL (i.e. other ear being normal was 60.31% (155/257 cases of USNHL, 19.32% (155/802 cases of SNHL, and 8.6% (155/1800 cases of PTA performed on patients complaining of HL. Limited work has been published on incidence

  12. Conservatively treated acetabular fractures: A retrospective analysis

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    Narender Kumar Magu

    2012-01-01

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

  13. Retrospective analysis of cases with Endometrial Cancer

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    Bulat Aytek Şık

    2016-12-01

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

  14. Racial Disparities in Colorectal Carcinoma Incidence, Severity and Survival Times Over 10 Years: A Retrospective Single Center Study

    Science.gov (United States)

    Arshad, Hafiz Muhammad Sharjeel; Tetangco, Eula; Shah, Natasha; Kabir, Christopher; Raddawi, Hareth

    2016-01-01

    well studied and can be used to formulate future multi-center studies to assess disease behavior.

  15. A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease

    Science.gov (United States)

    Lin, Chun-Chi; Wei, Shu-Chen; Lin, Been-Ren; Tsai, Wen-Sy; Chen, Jinn-Shiun; Hsu, Tzu-Chi; Lin, Wei-Chen; Huang, Tien-Yu; Chao, Te-Hsin; Lin, Hung-Hsin; Wong, Jau-Min

    2016-01-01

    Background/Aims With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD. Methods A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed. Results The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively). Conclusions In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount. PMID:27433147

  16. A Simple Lightning Assimilation Technique For Improving Retrospective WRF Simulations

    Science.gov (United States)

    Convective rainfall is often a large source of error in retrospective modeling applications. In particular, positive rainfall biases commonly exist during summer months due to overactive convective parameterizations. In this study, lightning assimilation was applied in the Kain...

  17. Line Defects, Tropicalization, and Multi-Centered Quiver Quantum Mechanics

    CERN Document Server

    Cordova, Clay

    2013-01-01

    We study BPS line defects in N=2 supersymmetric four-dimensional field theories. We focus on theories of "quiver type," those for which the BPS particle spectrum can be computed using quiver quantum mechanics. For a wide class of models, the renormalization group flow between defects defined in the ultraviolet and in the infrared is bijective. Using this fact, we propose a way to compute the BPS Hilbert space of a defect defined in the ultraviolet, using only infrared data. In some cases our proposal reduces to studying representations of a "framed" quiver, with one extra node representing the defect. In general, though, it is different. As applications, we derive a formula for the discontinuities in the defect renormalization group map under variations of moduli, and show that the operator product algebra of line defects contains distinguished subalgebras with universal multiplication rules. We illustrate our results in several explicit examples.

  18. Retrospective stress-forecasting of earthquakes

    Science.gov (United States)

    Gao, Yuan; Crampin, Stuart

    2015-04-01

    retrospectively stress-forecasting ~17 earthquakes ranging in magnitude from a M1.7 swarm event in N Iceland, to the 1999 M7.7 Chi-Chi Earthquake in Taiwan, and the 2004 Mw9.2 Sumatra-Andaman Earthquake (SAE). Before SAE, the changes in SWS were observed at seismic stations in Iceland at a distance of ~10,500km the width of the Eurasian Plate, from Indonesia demonstrating the 'butterfly wings' sensitivity of the New Geophysics of a critically microcracked Earth. At that time, the sensitivity of the phenomena had not been recognised, and the SAE was not stress-forecast. These results have been published at various times in various formats in various journals. This presentation displays all the results in a normalised format that allows the similarities to be recognised, confirming that observations of SWS time-delays can stress-forecast the times, magnitudes, and in some circumstances fault-breaks, of impending earthquakes. Papers referring to these developments can be found in geos.ed.ac.uk/home/scrampin/opinion. Also see abstracts in EGU2015 Sessions: Crampin & Gao (SM1.1), Liu & Crampin (NH2.5), and Crampin & Gao (GD.1).

  19. Medical imaging, PACS, and imaging informatics: retrospective.

    Science.gov (United States)

    Huang, H K

    2014-01-01

    Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd

  20. Agile kaizen managing continuous improvement far beyond retrospectives

    CERN Document Server

    Medinilla, Ángel

    2014-01-01

    Agile teams have been struggling with the concept of continuous improvement since the first Agile frameworks were developed, and still very little has been written about the practice of continuous improvement in Agile environments. Although team retrospectives have been prescribed and some practices have been introduced in order to implement and facilitate them, the truth is that most Agile teams are conducting dull retrospectives that end with a list of things that have been done wrong, just to repeat the same list two weeks later at the next meeting.Instead of listing hundreds of Japanese-la

  1. Conservative treatment of the anal carcinoma. Retrospective results - radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  2. [Conservative treatment of anal cancer. Retrospective results--radiotherapy].

    Science.gov (United States)

    Dobrowsky, W

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected: 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  3. Efficacy and Safety of Vitamin E Capsules in the Treatment of Chloasma: A Multi-Center, Randomized and Open Clinical Trial%天然维生素E胶丸治疗黄褐斑有效性与安全性的多中心随机开放临床观察

    Institute of Scientific and Technical Information of China (English)

    余土根; 郑敏; 方红; 郑益志; 刘伦飞; 丁颖果

    2012-01-01

    Objective To evaluate the efficacy and safety of vitamin E for the treatment of chloasma. Methods A multi-center,randomized and open clinical study was conducted. Seventy-nine patients with chloasma were treated with oral vitamin E 100mg,3 times daily for 12 weeks. In the treatment of 4 weeks,8 weeks and 12 weeks respectively, the subside and efficacy of skin lesions in patients were evaluated by MASI (melasma area and severity index) evaluation standard. Results Before and after treatment for 4 weeks,8 weeks and 12 weeks, the difference of MASI score were significant (P< 0.001). The total effective rate was 81.01%, about 1/5 of patients improved in the fourth weeks of treatment, and more than half of the patients obtained apparent effect in the treatment of eighth week. No serious adverse effect was foud during the observation. Conclusion The treatment for melasma with vitamin E is safe and effective.%目的 探讨天然维生素E胶丸治疗黄褐斑的有效性,并观察其安全性.方法 采用多中心、随机、开放临床研究的方法,对79例黄褐斑患者应用天然维生素E胶丸100mg,3次/d,口服治疗,疗程12周,并在治疗第4周,8周和12周随访,按照MASI评判标准评价皮损消退情况.结果 治疗前、治疗后4周、8周与12周MASI评分比较差异均有统计学意义(P均<0.001),有效率为81.01%,约1/5的患者在治疗第4周皮损出现改善,且半数以上的患者在治疗第8周取得明显治疗效果,临床观察期间未发现任何明显的不良反应.结论 使用天然维生素E胶丸治疗黄褐斑是安全有效的方法.

  4. "多中心"理论的中国化内涵及可行性探析 ——基于国家治理体系现代化的视角%The Sinicization Connotation and Feasibitity Analysis of the Theory of"Multi- Center"——Based on the Perspective of National Governance System Modernization

    Institute of Scientific and Technical Information of China (English)

    赵乾东

    2016-01-01

    The overall goal of the comprehensive deepening reform is to improve and develop the socialist system with Chinese characteristics,and promote the modernization of national governance system and governance capacity in the Eighteen Third Plenary Session of the Party's Central Committee. The national governance system and governance capacity of the country not only include the party's leadership of the country's system,strategy,but also the party and government in the governance of the country's thinking on the transformation and innovation. The theory of multi-center governance is one of the representative theories of the Western system ,and discusses the relationship among government ,market and society. In the system construction,it also gives the design of modern national governance. These theories and system design have many similarities with our country.%习近平同志在党的十八届三中全会上提出"全面深化改革的总目标是完善和发展中国特色社会主义制度,推进国家治理体系和治理能力现代化".这里所说的国家治理体系和国家治理能力不仅包括党领导人民治理国家的各项制度、方略,而且也包括党和政府在治理国家层面上思维的转变和创新."多中心"治理理论作为西方制度理性学派的代表理论之一,在理论论述上探讨了政府、市场和社会之间的相互关系,在制度建构上也给出了适合现当代国家治理的设计,这些理论和制度设计在一定程度上与我国推进国家治理体系现代化的要求有诸多相同之处,文章就试图从这些相同之处论证"多中心"理论的中国化内涵和在我国的可行性问题.

  5. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    Directory of Open Access Journals (Sweden)

    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  6. Retrospective revaluation effects following serial compound training and target extinction

    NARCIS (Netherlands)

    Effting, M.; Vervliet, B.; Kindt, M.

    2010-01-01

    Using a conditioned suppression task, two experiments examined retrospective revaluation effects after serial compound training in a release from overshadowing design. In Experiment 1, serial X → A+ training produced suppression to target A, which was enhanced when preceded by feature X, whereas X b

  7. Retrospective Revaluation Effects Following Serial Compound Training and Target Extinction

    Science.gov (United States)

    Effting, Marieke; Vervliet, Bram; Kindt, Merel

    2010-01-01

    Using a conditioned suppression task, two experiments examined retrospective revaluation effects after serial compound training in a release from overshadowing design. In Experiment 1, serial X [right arrow] A+ training produced suppression to target A, which was enhanced when preceded by feature X, whereas X by itself elicited no suppression.…

  8. Retrospective Descriptive Study of Cerebral Palsy in Nepal

    Science.gov (United States)

    Thapa, Ritesh

    2016-01-01

    There is very little data pertaining to cerebral palsy (CP) from Nepal. In this retrospective study it was observed that dyskinetic CP was seen in 29% and the sex ratio of males to females was two in the study population of children with CP. Both of these are much higher than data from developed countries. Hence, further randomized cross-sectional…

  9. Oral cancer: a retrospective study of 100 Danish cases

    DEFF Research Database (Denmark)

    Pinholt, E M; Rindum, J; Pindborg, J J

    1997-01-01

    One hundred Danes with oral cancer who were collected consecutively from 1986 to 1991 were evaluated retrospectively. The study included subjective and objective observations in 56% men and in 44% women. M:F ratio was 1.2:1. Fifty percent of the patients were non-smokers. Nine percent were women ...

  10. 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

  11. Techniques for Improved Retrospective Fine-scale Meteorology

    Science.gov (United States)

    Pleim-Xiu Land-Surface model (PX LSM) was developed for retrospective meteorological simulations to drive chemical transport models. One of the key features of the PX LSM is the indirect soil moisture and temperature nudging. The idea is to provide a three hourly 2-m temperature ...

  12. Clinical rehabilitation of the amputee : A retrospective study

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Groothoff, JW; Eisma, WH

    1996-01-01

    The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987-1991 were reviewed by retrospective analysis of medical record data. Three groups of

  13. The RASD Outstanding Reference Sources Committee: Retrospect and Prospect.

    Science.gov (United States)

    Sheets, Janet; Masters, Deborah C.

    1981-01-01

    Describes the Reference and Adult Services Division's Outstanding Reference Sources Committee procedures for preparation of the 1979 listing, discusses expansion to include nonbook sources, and provides a retrospective list of nonbook sources selected by the 1979-80 committee. Nonbook sources include microforms and databases. Six references are…

  14. Retrospective dosimetry using unheated quartz: A feasibility study

    DEFF Research Database (Denmark)

    Thomsen, Kristina Jørkov; Bøtter-Jensen, L.; Murray, A.S.

    2002-01-01

    Most attempts to apply retrospective dosimetry to building materials have made use of heated (sensitised) items such as brick or tile ceramic. Unfired materials, such as concrete, are far more widespread in the industrial environment, but unfortunately these cannot be assumed to contain a negligi...

  15. Household and workplace chemicals as retrospective luminescence dosemeters

    DEFF Research Database (Denmark)

    Thomsen, Kristina Jørkov; Bøtter-Jensen, L.; Murray, A.S.

    2002-01-01

    In the development of techniques for the retrospective assessment of the close absorbed by communities living and working adjacent to the site of a nuclear accident, attention has concentrated on the use Of natural minerals such as quartz and feldspar as dosemeters. These minerals are widely found...

  16. 蔗糖凝胶治疗细菌性阴道病的多中心、随机、双盲、平行对照Ⅲ期临床试验%Sucrose gel for treatment of bacterial vaginosis:a randomized, double-blind, multi-center, parallel-group, phase Ⅲ clinical trial

    Institute of Scientific and Technical Information of China (English)

    肖冰冰; 张岱; 陈锐; 史惠蓉; 辛晓燕; 王惠兰; 庞义存; 朱赛楠; 姚晨

    2015-01-01

    目的:通过多中心、随机、双盲、平行对照的临床研究,进一步评价蔗糖凝胶治疗细菌性阴道病的有效性及安全性. 方法:选择5个研究中心的533例细菌性阴道病患者作为研究对象,依据随机表按对照组与试验组为2:3比例随机入组,甲硝唑凝胶5. 0 g组(对照组)214例,蔗糖凝胶5. 0 g组(实验组)319例,两组均采取每日早晚各一次阴道上药,连用5 d的疗程进行治疗. 分别于治疗第7~10天、第21~30天进行疗效观察及安全性评价.结果:治疗第7~10天,甲硝唑凝胶组和蔗糖凝胶组的临床综合疗效治愈率分别为70. 53%和80. 83%,阴道分泌物涂片Nugent积分痊愈率分别为71. 50%和81. 15%,差异均有统计学意义(P0. 05). 结论:蔗糖凝胶治疗细菌性阴道病的临床综合疗效近期(治疗第7~10天)及恢复阴道菌群方面明显优于甲硝唑凝胶,远期治愈率(治疗第21~30天)与甲硝唑凝胶相当,可成为治疗细菌性阴道病的新策略.%Objective:To evaluate the cure effectiveness and safety of sucrose gel in the treatment of bacterial vaginosis through a multi-center, randomized, double-blind, parallel controlled clinical study. Methods:A clinical research method of multi-center, randomly double-blind, and dose group parallel comparison was adopted. In the study, 533 patients with bacterial vaginosis were randomly divided into two groups, which included 214 cases in the control group (5. 0 g metronidazole gel) and 319 cases in the trial group (5. 0 g sucrose gel ). The patients were treated with different medication according to the group where they were. All the cases in these two groups were treated with drugs vaginally twice in a day, morning and evening separately, for 5 days. The curative effect and safety evaluation were assessed from 7 to 10 days and 21 to 30 days after treatment respectively. Results: The efficacy of the comprehensive clinical treatment showed that the cure rate of metronidazole gel group

  17. Overview of Implant Infections in Orthopaedics Department: Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tugrul Bulut

    2014-12-01

    Full Text Available In this study, our aim was to evaluate the antibiotic susceptibility of bacteria isolated from orthopedic implant infections. Within two years operated 1996 patients in an orthopedics and traumatology clinic were retrospectively investigated. Seventy-six (76/1996, 3.8% orthopedic implant infections were detected. Isolated bacteria and their antibiotic susceptibility patterns were analyzed. The bacteries isolated from implant related infections and antibiotic sensitivity patterns were evaluated retrospectively in our orthopaedics and traumatology clinic. Staphylococcus aureus was the predominant organism (30.3%. Gram negative bacterias were isolated in 65.8% of our patients. No resistance was determined against vancomycin and linezolid in gram positive bacterias. Imipenem, amicasin and cefepim was seen as the most effective antibiotics for gram negative bacterias.

  18. Cardiac safety of citalopram: prospective trials and retrospective analyses

    DEFF Research Database (Denmark)

    Rasmussen, Søren Poul Lind; Overø, K F; Tanghøj, P

    1999-01-01

    of citalopram on ECG parameters. Results of both prospective and retrospective analyses showed that the only effect of citalopram on ECG findings is a small reduction in heart rate (... in volunteers and patients and in retrospective evaluations of all electrocardiographic (ECG) data from all clinical trials conducted from 1978 through 1996 (a total of 40 studies). A randomized, double-blind, placebo-controlled study was conducted in healthy volunteers (N = 23) to assess intraindividual...... variability of the QTc interval, as well as possible changes during treatment with placebo or citalopram, and its correlation to plasma drug levels. To document any dose-related changes, ECGs were performed at baseline and at the end of study in three randomized, double-blind, placebo- or active...

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Retrospective dosimetry analyses of reactor vessel cladding samples

    Energy Technology Data Exchange (ETDEWEB)

    Greenwood, L. R.; Soderquist, C. Z. [Battelle Pacific Northwest National Laboratory, Richland, WA 99352 (United States); Fero, A. H. [Westinghouse Electric Company, Cranberry Twp., PA 16066 (United States)

    2011-07-01

    Reactor pressure vessel cladding samples for Ringhals Units 3 and 4 in Sweden were analyzed using retrospective reactor dosimetry techniques. The objective was to provide the best estimates of the neutron fluence for comparison with neutron transport calculations. A total of 51 stainless steel samples consisting of chips weighing approximately 100 to 200 mg were removed from selected locations around the pressure vessel and were sent to Pacific Northwest National Laboratory for analysis. The samples were fully characterized and analyzed for radioactive isotopes, with special interest in the presence of Nb-93m. The RPV cladding retrospective dosimetry results will be combined with a re-evaluation of the surveillance capsule dosimetry and with ex-vessel neutron dosimetry results to form a comprehensive 3D comparison of measurements to calculations performed with 3D deterministic transport code. (authors)

  1. OSL studies of local bricks for retrospective dosimetric application

    Science.gov (United States)

    Singh, A. K.; Menon, S. N.; Kadam, S. Y.; Koul, D. K.; Datta, D.

    2016-09-01

    Luminescence properties of quartz extracted from bricks has been reported worldwide for its use in dose estimation in case of nuclear or radiological accident. Accordingly, in this study the feasibility of utilizing the optically stimulated luminescence (OSL) emission of quartz extracted from red bricks collected from three different locations in and around Mumbai, India for retrospective dosimetry was explored. Thermoluminescence and OSL characterization of the samples were carried out. The growth curve, thermal stability and equivalent dose plateau of the OSL signal suggested the signals to be well behaving. Subsequently, the dose recovery tests carried for different administered doses, using single aliquot regenerative protocol, demonstrated the feasibility of the OSL emissions of these samples for dose evaluation in retrospective dosimetry.

  2. Imagining the Twentieth Century: Retrospective, Myth, and the Colonial Question

    Directory of Open Access Journals (Sweden)

    David B MacDonald

    2007-01-01

    Full Text Available Retrospectives on the twentieth century often portray it as the most atrocious century in human history, in terms of totalising ideologies, moral abandonment, technological horror, and mass death. The nineteenth and earlier centuries, by contrast, emerge as progressive and enlightened eras, characterised by morality, rationalism, and the absence of war. Creating a dramatic contrast between old and new centuries ignores the historical reality of colonialism and violence outside Europe’s borders. This article problematises twentieth century retrospectives and their nostalgia for the past, comparing these with recent histories of colonialism and genocide. Rather than see the twentieth century as a decisive break from the past, there are important elements of continuity and evolution which should not be ignored.

  3. Retrospective dosimetry using EPR and TL techniques: a status report

    Energy Technology Data Exchange (ETDEWEB)

    Haskell, E.H.

    1996-12-31

    Methods of retrospective dosimetry, including luminescence and electron paramagnetic resonance spectroscopy (EPR), rely on measurement of accident dose absorbed by naturally occurring materials - ceramics in the case of both thermoluminescence (TL) and optically stimulated luminescence (OSL) and organic materials and bio- minerals in the case of EPR. Each of these methods relies on measurement of radiation defects resulting from accidental exposure. Since defects also result from natural sources of radiation over the lifetime of a sample, analysis is usually restricted to materials for which the natural dose may be determined and subtracted from the measured cumulative dose. Luminescence dating techniques rely heavily on an accurate assessment of cumulative dose from natural radiation sources, and dating research has provided us with the bulk of our knowledge in this area. Virtually all of the work on natural dose determination can be directly applied to retrospective techniques. With EPR techniques the cumulative dose from diagnostic x- rays is also of importance.

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

    Science.gov (United States)

    2013-01-11

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

  5. Studying time to pregnancy by use of a retrospective design

    DEFF Research Database (Denmark)

    Joffe, Michael; Key, Jane; Best, Nicky

    2005-01-01

    Biologic fertility can be measured using time to pregnancy (TTP). Retrospective designs, although lacking detailed timed information about behavior and exposure, are useful since they have a well-defined target population, often have good response rates, and are simpler and less expensive...... at the beginning of unprotected intercourse. More complete inference is possible if the study design covers the whole population, not just those who achieve a pregnancy....

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

    OpenAIRE

    2016-01-01

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

  7. A historical retrospective and the essence of strategic financial planning

    OpenAIRE

    Nestor, Olha

    2016-01-01

    The author has reviewed the historical retrospective of strategic financial planning, distinguished the concepts of “strategic financial planning”, “long-term financial planning” and “perspective financial planning” and determined that their use as synonyms is incorrect. The correctness of three-tier financial planning has been justified. The difference between financial planning, financial forecasting and budgeting has been explained. The problem of strategic financial plannin...

  8. Lateral periodontal cysts: a retrospective study of 11 cases

    OpenAIRE

    Formoso Senande, María Florencia; Barbosa de Figueiredo, Rui Pedro; Berini Aytés, Leonardo; Gay Escoda, Cosme

    2008-01-01

    Objective: To describe the clinical, radiological and histopathological features of lateral periodontal cysts among patients diagnosed in different centers (Vall d"Hebron General Hospital, Granollers General Hospital, the Teknon Medical Center, and the Master of Oral Surgery and Implantology of the University of Barcelona Dental School; Barcelona, Spain). Study design: A retrospective observational study was made of 11 lateral periodontal cysts, all of which were diagnosed following a thoroug...

  9. Prospective and Retrospective Metacognitive Abilities in Rhesus Monkeys

    Directory of Open Access Journals (Sweden)

    Jennifer Ding

    2007-06-01

    Full Text Available Metacognition refers to a knowledge of one’s own cognitive abilities and one’s aptitude to alter these abilities if necessary. Previous research from our lab shows that monkeys exhibit metacognitive abilities by accurately judging their own performance on perceptual and serial working memory tasks. The present study includes two phases during which a monkey makes retrospective and prospective judgments of confidence. In the retrospective phase of this experiment, the subject completes a recall task, and then judges his performance on the test phase by choosing from high and low-risk confidence choices. In the prospective task, the monkey makes his confidence judgment before the test, instead judging how well he learned during the study phase. An analysis of results indicates that monkeys can immediately transfer the ability to make metacognitive judgments from the serial working memory tasks in previous experiments to retrospective and prospective recall tasks in the present study. These findings underline the similarity between the non-human primate and human abilities to make confidence judgments. Further, they are the first evidence to date of a non-human primate making a prospective judgment of future performance, suggesting that the ability to use a metacognitive state to control one’s actions is not uniquely human.

  10. 金草口服液治疗小儿急性支气管炎痰热壅肺证的多中心临床研究%Multi-center Clinical Study on Jincao Oral Liquid in the Treatment of Phlegm-heat Obstructing Lung Syndrome in Children with Acute Bronchitis

    Institute of Scientific and Technical Information of China (English)

    陈曦; 马融; 胡思源; 刘虹; 黄文玉; 李荣辉; 向希雄; 闫慧敏

    2013-01-01

    OBJECTIVE: To evaluate the effectiveness and safety of Jincao oral liquid in the treatment of phlegm-heat obstructing lung syndrome in children with acute bronchitis. METHODS: Stratified random, double-blind, parallel control of positive drug and multi-center clinical study were applied. Trial group and control group were given Jincao oral liquid and Jizhi syrup respectively, 5 ml per time for children aged 1-2 years old, 10 ml children aged 3-6 years old, 15 ml children aged 7-14 years old, 3 times a day for 5 days. RESULTS: The effectiveness of Jincao oral liquid for cough, expectoration and physical signs of phlegm-heat obstructing lung syndrome in children with acute bronchitis reached 87.20% , 81.71% , 80.37% (full data analysis set) respectively, which was similar to control group. Results of full data analysis set were in line with that of program data set. There was no significant difference between therapeutic efficacies of main symptoms and therapeutic efficacies of secondary symptoms, disease, syndrome and thoracic roentgenoscopy(P>0.05). No ADR related to drug use was found. CONCLUSION: Jincao oral liquid possesses obvious effectiveness for cough, expectoration and physical signs of mild and moderate pediatric acute bronchitis, which is similar to Jizhi syrup.%目的:评价金草口服液治疗小儿急性支气管炎痰热壅肺证的有效性与安全性.方法:采用分层区组随机、双盲、阳性药平行对照、多中心临床研究的方法.试验组与对照组患者分别服用金草口服液和急支糖浆,两药的用量均为1~2岁每次5 ml;3~6岁每次10 ml;7~14岁每次15 ml.每日3次,疗程均为5d.结果:金草口服液对轻、中度小儿急性支气管炎痰热壅肺证之咳嗽、咯痰、肺部体征疗效分别达到87.20%、81.71%、80.37%(全分析数据集),与对照组相当,且全分析数据集和符合方案数据集分析结论一致.两组患儿主要症状疗效、次要症状疗效、疾病疗效、

  11. The clinical application of cardiovascular implantable electronic devices in China:a multi-center regis-try study%家庭监测功能的心血管植入型电子器械的临床应用--多中心注册研究结果

    Institute of Scientific and Technical Information of China (English)

    陈柯萍; 于波汤; 宝鹏; 张澍; 华伟; 刘欣; 杨杰孚; 宿燕岗; 梁兆光; 汪芳; 陈泗林; 梁延春

    2016-01-01

    Objective To investigate the clinical application of cardiovascular implantable electronic devices(CIED)with home monitoring(HM) function in China. Methods This study was a multi-center, pro-spective, registry study to enroll patients who underwent implantion of a pacemaker or an implantable cardioverter debrillator (including cardiac resynchronization therapy devices) with HM function. HM function was activated in all patients to allow daily remote monitoring.The third party was authorized to monitor HM data. Results From February 2009 to October 2014,a total of 5 378 patients were implanted with HM devices. Pacemaker was the most common type among HM device implantations, accounting for 68. 0%.The number of HM implantation was increasing with year, but was stable after 2012. The majority of HM devices were implanted in Beijing. Patients who lived in Beijing were also underwent insertion of the majority HM devices. 40% patients with HM devices lived in remote areas. Over a follow-up period of (711. 6 ± 486. 0) days, 445 patients were died. The mortality of all causes was 8. 3%. Conclusion CIED with HM have been widely used in domestic clinical, but still with obvi-ous regional differences. Pacemaker was the most common type among HM device implant. A new model of HM data management has been established by authorizing a third party, which can improve the information transmission ratio.%目的:了解具有家庭监测功能的心血管植入型电子器械(CIED)在国内的临床应用现状。方法本研究为前瞻性、多中心的注册研究,连续入选植入具有家庭监测功能的起搏器、植入型心律转复除颤器以及心脏再同步治疗起搏器和除颤器患者。所有患者均程控打开远程监测功能,每日收集其远程监测信息。由第三方公司负责数据收集和监测。结果2009年2月10日至2014年12月31日,323家医院参与注册研究,共5378例患者植入了具有家庭监测功能的 CIED

  12. 中国食品安全治理:食品质量链多主体多中心协同视角的分析%Governance of China's Food Security:from the Perspective of Multi-agent and Multi- center Collaborative about Food Quality Chain

    Institute of Scientific and Technical Information of China (English)

    谢康

    2014-01-01

    Food safety is a typical complex system problems , from the multi-body and multi-center perspective of food safety and quality chain ,the paper intend to analyze the main direction of China's food safety governance and coordinated control strategy. First, the food offender or offenders are similar to cellular automata , mainly rely on the information or neighborhood conduct to adjust or change the autonomous action so that the probability of occurrence of food safety is highly uncertain , dispersion and concealment. Thus , food security governance system of government regulation is necessary to play a "positive battlefield" role , but also vigorously promote polycentric system of food safety regulation, form "behind the battlefield "of food security governance, formed safety regulation of cellular automata in the food grass-roots social organizations. Second, food security governance requires not only depend on the establishment of traceability information system technology, or the conclusion of additional contracts and other institutional arrangements, but also need to mix the traced information technology and the formal and informal institutions of governance to form a complementary effect and synchronization effect, in order to improve food safety violators or offenders the probability of society punishment.%食品安全问题是一个典型的复杂系统问题,本文从多主体多中心食品安全质量链协同视角,分析中国食品安全的主要治理方向及其协同控制策略。第一,食品违规者或犯罪者类似于元胞自动机,主要依靠邻域的信息或行为来调整或改变自主行动,使食品安全发生概率具有高度不确定性、分散性和隐蔽性。因此,食品安全治理体制上既要发挥政府监管的“正面战场”作用,也要大力推动食品安全监管的多中心体制,形成食品安全治理的“敌后战场”,在基层社会组织中形成针锋相对的食品安全监管的

  13. 中国汉族人群慢性丙型肝炎病毒基因型分布规律研究%Genotypes distribution of hepatitis C virus through multi-center, large sample studies among chronic hepatitis C patients in Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    聂红明; 陈建杰; 汪蓉; 王成宝; 董慧琳; 陈逸云

    2012-01-01

    Objective To understand the distribution of hepatitis C virus (HCV) genotypes in China.Methods A national multi-center,large sample epidemiological survey was carried out and certified by an international third-party testing organization.Internationally accepted method for sequencing analysis of viral genotype was used.Results Patients were those suffered from the 4 major genotypes of chronic hepatitis C,including nine subtypes,which were dominated by genotype 1 (69.6%),with type lb in particular (accounting for 68.38% ).Among the rare gene-6,we saw more subtypes of 6a.In the south,central,and north areas,there was no significant difference seen between the south and the north areas in the distribution of the genotype 1.However,the rate of gene type 2a increased gradually from south to north.In terms of less common type of gene 3b and gene-6,they were seen mainly in the southern provinces.Conclusion In China,Patients with chronic hepatitis C had 4 HCV genotypes,with 9 subtypes.The rarely seen genotypes 3b and 6 were mainly distributed in the southern provinces.%目的 了解中国汉族人群慢性丙型肝炎病毒(HCV)基因型分布规律.方法 通过多中心、大样本流行病学调查,经具有国际认证资质的第三方检测机构,采用国际通用的测序方法分析病毒基因型.结果 共采集全国不同地区18个研究中心764例(男性384例,女性380例)患者血标本,患者平均年龄(44.9±14.3)岁,平均病程(7.7±7.3)年.最终对740例患者的病毒基因分型进行结果分析.中国慢性丙型肝炎患者共有4种主要基因型和9种亚型,其中以基因1型为主(69.6%),尤其是1b型(68.38%).在较少见的基因6型中,以6a亚型较多.以南、中、北地区划分,基因l型在南北地区的分布差异无统计学意义,基因2a型分布的比例由南向北逐渐增高;较少见的基因3b型、6型主要分布在南方省份.结论 中国汉族人群慢性丙型肝炎患者共有4

  14. L-谷氨酰胺和左旋肉碱改善维持性血液透析患者营养状况的多中心、随机临床研究%L-Glutamine and L-Carnitine in Maintenance Hemodialysis Patients to Improve Nutritional Status of the Multi-center Randomized Clinical Approach

    Institute of Scientific and Technical Information of China (English)

    张琥; 何晓峰; 汪汉东

    2011-01-01

    目的:观察L-谷氨酰胺和左旋肉碱(L-肉碱)在维持性血液透析(maintain hemodialysis,MHD)患者营养不良治疗中的作用.方法:采用多中心、随机的方法将78例MHD患者随机分成A组、B组、C组,3组患者均皮下注射重组人促红细胞生成素(erythropoietinin,EPO)6 000 U,2次/周;A组每次血液透析结束时静脉注射L-肉碱2 g,3次/周;B组每日口服L-谷氨酰胺胶囊1.5 g(分3次口服);C组联合使用L-肉碱和L-谷氨酰胺,用法不变.观察时间3个月.结果:C组患者血细胞比容(haematocrit,HCT)、血红蛋白(haemoglobin,Hb)、血浆总蛋白(plasma total protein,Tp)、血浆白蛋白(serum albumin,Alb)上升幅度明显高于A组和B组(P<0.05或P<0.01),C组血C反应蛋白(C-reactive protein,CRP)水平明显低于A组和B组(P<0.01),免疫球蛋白(IgA、IgG、IgM)水平明显高于A组及B组(P<0.01).结论:MHD患者联合使用L-谷氨酰胺和L-肉碱可显著改善患者的营养状况及免疫功能;减轻体内微炎症反应;改善对EPO的敏感性,减少用量,提高疗效;安全性较好.%Objective: To assess the efficacy of L - glutamine and L - carnitine in the treatment of maintenance hemodialysis patients with malnutrition. Methods: A multi - center approach of seventy - eight on malnutrition maintenance hemodialysis patients were randomly divided in to 3 groups: group A,group B and group C. Three groups were treated by EPO ( 6 000 u,two times each week by subcutaneous injection ). In addition,2 g of L - carnitine was infused after each hemodialysis is treatment, three times each week in group A;oral L - glutamine administration( 1.5 g,three times each day )in group B;and L - glutamine and L - carnitine coad-ministration in group C. The patients were observed for three months. Results: Compared with group A and group B, haematocrit( Hct ) and plasma total protein( Tp )and serum albumin( Alb ) and haemoglobin( Hb ) were all significantly increased( P < 0. 05 or P < 0.01 ),but the

  15. 慢性肾脏病3~5期中西医结合临床路径多中心实施的效果研究%Multi-Center Implementation of Integrative Medicine-Based Clinical Pathway for Stage 3-5 Chronic Kidney Disease

    Institute of Scientific and Technical Information of China (English)

    张蕾; 刘旭生; 蔡寸; 苏国彬

    2012-01-01

    目的 探索及评估慢性肾脏病3~5期中西医结合临床路径多中心实施的效益.方法 采用非同期历史对照,评估5家医院实施临床路径规范化管理后,患者住院天数、住院费用的改善情况.结果 路径组的平均住院天数较回顾性病案组略有缩短,存在中心效应(P=0.000),经校正后平均住院天数间差异无统计学意义(P=0.621).住院总费用较回顾性病案组稍有升高,不存在中心效应(P=0.126),组间比较差异无统计学意义(P=0.381).费用明细支出,中药费、西药费、检查费和放射费较回顾性病案组降低,中成药费、治疗费和化验费较回顾性病案组明显升高,其中中药费、放射费、化验费组间比较差异有统计学意义(P<0.05).结论 在保证临床路径执行率的情况下,慢性肾脏病3~5期临床路径能缩短住院天数.虽未能降低住院总费用水平,但费用明细支出的改变在一定程度上体现了该路径的实施目的.%Objective To explore and evaluate the benefits of the multi - center implementation of integrative medicine - based clinical pathway for stage 3-5 chronic kidney disease ( CKD ). Methods Using the historical data as the control group, we compared the improvements in the duration of hospital stay and hospital expenses were evaluated in five centers after the implementation of integrative medicine - based clinical pathways ( pathway group ). Results The duration of hospital stay was a little shortened after the implementation of the clinical pathways, showing a center effect ( P = 0. 000 ); after adjustment, no statistical significance was found between the pathway group and control group ( P =0. 621 ). The total hospital expenses in the pathway group were little higher, but was not statistically significant ( P =0. 381 ) and without center effect ( P =0. 126 ). More specifically, the costs for traditional Chinese drugs, modern drugs, examinations, and radiology were lower in the pathway

  16. Defects and diffusion in semiconductors XIII an annual retrospective

    CERN Document Server

    Fisher, D J

    2011-01-01

    This thirteenth volume in the series covering the latest results in the field includes abstracts of papers which have appeared since the publication of Annual Retrospective XII (Volumes 303-304). As well as the over 300 semiconductor-related abstracts, the issue includes the original papers: ""Effect of KCl Addition upon the Photocatalytic Activity of Zinc Sulphide"" (D.Vaya, A.Jain, S.Lodha, V.K.Sharma, S.C.Ameta), ""Localized Vibrational Mode in Manganese-Doped Zinc Sulphide and Cadmium Sulphide Nanoparticles"" (M.Ragam, N.Sankar, K.Ramachandran), ""The Effect of a Light Impurity on the Elec

  17. [Retrospective evaluation of carcinoid tumors of the appendix in children].

    Science.gov (United States)

    San Vicente, B; Bardají, C; Rigol, S; Obiols, P; Melo, M; Bella, R

    2009-04-01

    Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 appendectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendectomy was acute pain in lower right quadrant. The median tumor diameter was lower than 1 cm and the appropriate treatment was appendectomy. The prognosis was excellent in all the patients.

  18. 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.

  19. EAS Tycho Brahe prize lecture 2011. Hipparcos: a retrospective

    Science.gov (United States)

    Perryman, Michael

    2011-10-01

    The Hipparcos satellite was launched in 1989. It was the first, and remains to date the only, attempt at performing large-scale astrometric measurements from space. Hipparcos marked a fundamentally new approach to the field of astrometry, revolutionising our knowledge of the positions, distances, and space motions of the stars in the solar neighbourhood. In this retrospective, I look back at the processes which led to the mission's acceptance, provide a short summary of the underlying measurement principles and the experiment's scientific achievements, and a conclude with a brief summary of its principal legacy—the Gaia mission.

  20. Retrospective indexing (RI) - A computer-aided indexing technique

    Science.gov (United States)

    Buchan, Ronald L.

    1990-01-01

    An account is given of a method for data base-updating designated 'computer-aided indexing' (CAI) which has been very efficiently implemented at NASA's Scientific and Technical Information Facility by means of retrospective indexing. Novel terms added to the NASA Thesaurus will therefore proceed directly into both the NASA-RECON aerospace information system and its portion of the ESA-Information Retrieval Service, giving users full access to material thus indexed. If a given term appears in the title of a record, it is given special weight. An illustrative graphic representation of the CAI search strategy is presented.

  1. ECVAM retrospective validation of in vitro micronucleus test (MNT).

    Science.gov (United States)

    Corvi, Raffaella; Albertini, Silvio; Hartung, Thomas; Hoffmann, Sebastian; Maurici, Daniela; Pfuhler, Stefan; van Benthem, Jan; Vanparys, Philippe

    2008-07-01

    In the past decade several studies comparing the in vitro chromosome aberration test (CAT) and the in vitro micronucleus test (MNT) were performed. A high correlation was observed in each of the studies (>85%); however, no formal validation for the micronucleus in vitro assay had been carried out. Therefore, a working group was established by the European Centre for the Validation of Alternative Methods (ECVAM) to perform a retrospective validation of the existing data, in order to evaluate the validity of the in vitro MNT on the basis of the modular validation approach. The primary focus of this retrospective validation was on the evaluation of the potential of the in vitro MNT as alternative to the standard in vitro CAT. The working group evaluated, in a first step, the available published data and came to the conclusion that two studies [German ring trial, von der Hude, W., Kalweit, S., Engelhardt, G. et al. (2000) In-vitro micronucleus assay with Chinese hamster V79 cells: results of a collaborative study with 26 chemicals. Mutat. Res., 468, 137-163, and SFTG International Collaborative Study, Lorge, E., Thybaud, V., Aardema, M., Oliver, J., Wataka, A., Lorenzon, G. and Marzin, D. (2006) SFTG International Collaborative Study on in-vitro micronucleus test I. General conditions and overall conclusions of the study. Mutat. Res., 607, 13-36] met the criteria for a retrospective validation according to the criteria previously defined by the working group. These two studies were evaluated in depth (including the reanalysis of raw data) and provided the information required for assessing the reliability (reproducibility) of the test. For the assessment of the concordance between the in vitro MNT and the in vitro CAT, additional published data were considered. Based on this retrospective validation, the ECVAM Validation Management Team concluded that the in vitro MNT is reliable and relevant and can therefore be used as an alternative method to the in vitro CAT

  2. Defects and diffusion, theory and simulation an annual retrospective I

    CERN Document Server

    Fisher, David J

    2009-01-01

    This first volume, in a new series covering entirely general results in the fields of defects and diffusion, includes abstracts of papers which appeared between the beginning of 2008 and the end of October 2009 (journal availability permitting).This new series replaces the 'general' section which was previously part of each issue of the Metals, Ceramics and Semiconductor retrospective series. As well as 356 abstracts, the volume includes original papers on all of the usual material groups: ""Predicting Diffusion Coefficients from First Principles via Eyring's Reaction Rate Theory"" (Mantina, C

  3. Primary Hepatic Lymphoma: A Retrospective, Multicenter Rare Cancer Network Study

    Science.gov (United States)

    Ugurluer, Gamze; Miller, Robert C.; Li, Yexiong; Thariat, Juliette; Ghadjar, Pirus; Schick, Ulrike; Ozsahin, Mahmut

    2016-01-01

    Primary hepatic lymphoma (PHL) is a rare malignancy. We aimed to assess the clinical profile, outcome and prognostic factors in PHL through the Rare Cancer Network (RCN). A retrospective analysis of 41 patients was performed. Median age was 62 years (range, 23-86 years) with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5% of patients had fever, 17.1% weight loss, and 9.8% night sweats. The most common radiological presentation was multiple lesions. Liver function tests were elevated in 56.1% of patients. The most common histopathological diagnosis was diffuse large B-cell lymphoma (65.9%). Most of the patients received Chop-like (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimens; 4 patients received radiotherapy (dose range, 30.6-40.0 Gy). Median survival was 163 months, and 5- and 10-year overall survival rates were 77 and 59%, respectively. The 5- and 10-year disease-free and lymphoma-specific survival rates were 69, 56, 87 and 70%, respectively. Multivariate analysis revealed that fever, weight loss, and normal hemoglobin level were the independent factors influencing the outcome. In this retrospective multicenter RCN study, patients with PHL had a relatively better prognosis than that reported elsewhere. Multicenter prospective studies are still warranted to establish treatment guidelines, outcome, and prognostic factors. PMID:27746888

  4. Surgery for posttraumatic syringomyelia: a retrospective study of seven patients

    Institute of Scientific and Technical Information of China (English)

    CAO Fei; YANG Xiao-feng; LIU Wei-guo; LI Gu; ZHENG Xue-sheng; WEN Liang

    2007-01-01

    Objective: To analyze retrospectively the clinical symptoms, signs, radiological findings and results of treatment of posttraumatic syringomyelia.Methods: The data of 7 patients with posttraumatic syringomyelia confirmed by computerized tomography(CT) and magnetic resonance imaging (MRI) in our hospital between 1999 and 2004 were reviewed retrospectively. The patients underwent decompressive laminectomy or syringo-subarachnoid (S-S) shunting with microsurgery. Long-term follow-up was available (range:13-65 months).Results: The major clinical manifestations of posttraumatic syringomyelia usually included the onset of increasing signs and the development of new symptoms after an apparently stable period. The clinical symptoms included pain, sensory disturbance, weakness, and problems in autonomic nerves. Syrinx existed merely at the cervical level in 4 cases and extended downward to the thoracic levels in the other 3 cases. One case underwent decompressive laminectomy, 6 cases were treated by S-S shunting. During the early postoperative period, all the patients showed an improvement of symptoms of syrinx without major complication or death. The decreased size or collapse of the syrinx was demonstrated by postoperative MRI.Conclusions: Posttraumatic syringomyelia is a disabling sequela of spinal cord injury, developing months to years after spinal injury. MRI is the standard diagnostic technique for syringomyelia. The patients with posttraumatic syringomyelia combined with progressive neurological deterioration should be treated with operations. S-S shunting procedure is effective in some patients with posttraumatic syringomyelia. Decompressive procedure may be an alternative primary surgical treatment for patients with kyphosis and cord compression.

  5. Retrospective evaluation of the echinococcosis cases regarding histopathological aspects

    Directory of Open Access Journals (Sweden)

    Tümay Özgür

    2013-12-01

    Full Text Available Objective: Retrospective evaluation of 28 cases, diagnosedas hydatid cyst pathologically in our centre pathologylaboratory, from surgical departments was the objectiveof the study.Methods: 28 cases diagnosed as hydatid cyst in ourhospital have been reviewed retrospectively and patients’age, gender and localizations of disease have been determined.Results: Based on histopathologic evaluation hydatidcyst cases were localized mostly on liver 19 (68%,followed by lung 7 (24%, glutea 1 (3.5% and axilla 1(3.5%. 15 (54% of the patients were male and 13 (46%were female. The age range of the cases were 7-73, whilethe median age of males were 30.2±19.5 years, the medianage of females were 35.9±19.2. Necrosis has beendetermined in 2 (7.1% of cases in pathologic evaluationof hydatid cyst.Conclusion: The pathologic evaluation of all cystic surgicalspecimens should include the careful examinationof the elements of this parasite especially where hydatidcyst is endemic.Key words; Hydatid cyst, pathologic findings, echinococcosis

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

    Directory of Open Access Journals (Sweden)

    Semih ARICI

    2014-03-01

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

  7. A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

    Science.gov (United States)

    Ucpunar, Hanifi; Sevencan, Ahmet; Balioglu, Mehmet Bulent; Albayrak, Akif; Polat, Veli

    2016-01-01

    Study Design Retrospective study. Purpose To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. Overview of Literature Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. Methods Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. Results We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). Conclusions We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups. PMID:27114761

  8. Background music as a quasi clock in retrospective duration judgments.

    Science.gov (United States)

    Bailey, Nicole; Areni, Charles S

    2006-04-01

    The segmentation-change model of time perception proposes that individuals engaged in cognitive tasks during a given interval of time retrospectively estimate duration by recalling events that occurred during the interval and inferring each event's duration. Previous research suggests that individuals can recall the number of songs heard during an interval and infer the length of each song, exactly the conditions that foster estimates of duration based on the segmentation-change model. The results of a laboratory experiment indicated that subjects who solved word-search puzzles for 20 min. estimated the duration of the interval to be longer when 8 short songs (background, regardless of whether the musical format was Contemporary Dance or New Age. Assuming each song represented a distinct segment in memory, these results are consistent with the segmentation-change model. These results suggest that background music may not always reduce estimates of duration by drawing attention away from the passage of time. Instead, background music may actually expand the subjective length of an interval by creating accessible traces in memory, which are retrospectively used to infer duration.

  9. Primary hepatic lymphoma: a retrospective, multicenter Rare Cancer Network study

    Directory of Open Access Journals (Sweden)

    Gamze Ugurluer

    2016-10-01

    Full Text Available Primary hepatic lymphoma (PHL is a rare malignancy. We aimed to assess the clinical profile, outcome and prognostic factors in PHL through the Rare Cancer Network (RCN. A retrospective analysis of 41 patients was performed. Median age was 62 years (range, 23- 86 years with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5% of patients had fever, 17.1% weight loss, and 9.8% night sweats. The most common radiological presentation was multiple lesions. Liver function tests were elevated in 56.1% of patients. The most common histopathological diagnosis was diffuse large B-cell lymphoma (65.9%. Most of the patients received Chop-like (cyclophosphamide, doxorubicin, vincristine, and prednisone regimens; 4 patients received radiotherapy (dose range, 30.6-40.0 Gy. Median survival was 163 months, and 5- and 10-year overall survival rates were 77 and 59%, respectively. The 5- and 10-year disease-free and lymphoma-specific survival rates were 69, 56, 87 and 70%, respectively. Multivariate analysis revealed that fever, weight loss, and normal hemoglobin level were the independent factors influencing the outcome. In this retrospective multicenter RCN study, patients with PHL had a relatively better prognosis than that reported elsewhere. Multicenter prospective studies are still warranted to establish treatment guidelines, outcome, and prognostic factors.

  10. The Chernobyl experience in the area of retrospective dosimetry.

    Science.gov (United States)

    Chumak, Vadim V

    2012-03-01

    The Chernobyl accident, which occurred on 26 April 1986 at a nuclear power plant located less than 150 km north of Kiev, was the largest nuclear accident to date. The unprecedented scale of the accident was determined not only by the amount of released activity, but also by the number of workers and of the general public involved, and therefore exposed to increased doses of ionising radiation. Due to the unexpected and large scale of the accident, dosimetry techniques and practices were far from the optimum; personal dosimetry of cleanup workers (liquidators) was not complete, and there were no direct measurements of the exposures of members of the public. As a result, an acute need for retrospective dose assessment was dictated by radiation protection and research considerations. In response, substantial efforts have been made to reconstruct doses for the main exposed cohorts, using a broad variety of newly developed methods: analytical, biological and physical (electron paramagnetic resonance spectroscopy of teeth, thermoluminescence of quartz) and modelling. This paper reviews the extensive experience gained by the National Research Center for Radiation Medicine, Academy of Medical Sciences, Ukraine in the field of retrospective dosimetry of large cohorts of exposed population and professionals. These dose reconstruction projects were implemented, in particular, in the framework of epidemiological studies, designed to follow-up the medical consequences of the Chernobyl accident and study health effects of ionizing radiation, particularly Ukrainian-American studies of cataracts and leukaemia among liquidators.

  11. Pemphigus Vulgaris and Infections: A Retrospective Study on 155 Patients

    Directory of Open Access Journals (Sweden)

    Nafiseh Esmaili

    2013-01-01

    Full Text Available Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68 males, 87 females admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155 pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37 cases of oral candidiasis and 15 cases of localized herpes simplex were recorded. Totally, 94 cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended.

  12. Treatment of Chronic Heart Failure by Shencao Tongmai Granule: a Multi-centered, Double-blinded,Randomized, Parallel Controlled Trial%参草通脉颗粒治疗慢性心力衰竭的多中心随机双盲平行对照研究

    Institute of Scientific and Technical Information of China (English)

    王辰; 张艳; 宫丽鸿

    2012-01-01

    Objective To assess the clinical effects and safety of Shencao Tongmai Granule (STG) in treatment of patients with chronic heart failure (CHF) (NYHA functional class Ⅱ - Ⅲ) of qi deficiency blood stasis and water retention syndrome (QDBSWRS). Methods This was a multi-centered, double blinded, randomized, and placebo parallel controlled study. A total of 280 CHF patients of QDBSWRS were randomly assigned to the trial group and the control group in the ratio of 1:1. All patients received Western medicine (WM) treatment such as ACEI, diuretics, Digoxin Elixirs, and so on. Additionally, patients in the trial group took STG while those in the control group took the placebo. The therapeutic course for all was twelve weeks. The NYHA functional classification, Chinese medicine (CM) syndrome integral, and left ventricular ejection fraction (LVEF) were compared between the two groups. The safety assessment was also carried out. Results Totally 265 patients completed this trial (138 cases in the trial group and 127 cases in the control group). The effective rate of NYHA functional classification and CM syndrome integral were obviously higher in the trial group than in the control group (94. 20% vs 55.90%, 97.83% vs 70.08% respectively), showing statistical difference (P0.05). The LVEF both increased in the two groups when compared with before treatment (P<0.05). The post-treatment increment of LVEF was obviously higher in the trial group than in the control group (6. 55% ±6.23% vs 3.14% ±4.99%, P<0.05). The rate of adverse reaction was 0.71 % in the two groups (1/140). Conclusion STG showed good therapeutic effectiveness and safety in treating CMF patients of QDBSWRS.%目的 评价参草通脉颗粒治疗慢性心力衰竭[美国纽约心脏病学会(NYHA)分级Ⅱ、Ⅲ级]气虚血瘀水停证的有效性与安全性.方法 本研究为多中心、随机、双盲、安慰剂平行对照研究.280例气虚血瘀水停型慢性心力衰竭患者以1:1比例随机分为

  13. 格列吡嗪控释片治疗2型糖尿病有效性和安全性的多中心临床研究%Effect and safety of glipizide GITS in the therapy of type 2 diabetes: a multi-center clinical study

    Institute of Scientific and Technical Information of China (English)

    瑞易宁临床研究协作组

    2011-01-01

    目的 评价格列吡嗪控释片(瑞易宁)治疗2型糖尿病的有效性、安全性.方法 为多中心、开放性临床观察性研究.675例患者完成了本研究.对单纯生活方式干预(n=134)或已用非胰岛素促泌剂(n=305)治疗,但血糖控制不佳的患者,加用瑞易宁;对已用其他磺脲类或格列奈类促泌剂(n=236)治疗,但血糖控制不佳、安全性不好或生活质量受影响的患者,停用原促泌剂,改用瑞易宁.瑞易宁治疗12周后,评价其有效性、安全性和对生活质量的影响.结果 应用瑞易宁治疗后,糖化血红蛋白(Hb)A1c下降(1.48±1.20)%,空腹血糖下降(2.47±1.38)mmol/L,餐后血糖下降(3.64±2.63)mmol/L(P值均为0.0000);52.21%的患者HbA1c<6.5%,83.21%的患者HbA1c<7.0%.治疗期间轻度低血糖发生率为4.59%,严重低血糖发生率为0.15%.原促泌剂治疗组改用瑞易宁后低血糖显著减少,99%以上的患者认为瑞易宁较其他促泌剂更为简单易行,生活质量提高,更愿意选用瑞易宁治疗.结论 在2型糖尿病治疗中,瑞易宁为一疗效显著、安全性好、能提高患者生活质量的口服降糖药,可广泛用于临床.%Objective To investigate the effect and safety of glipizide GITS in the therapy of type 2diabetes. Methods A total of 675 type 2 diabetic patients were included in this multi-center, open-labeled and self-controlled clinical study. Patients with inadequate glycemic control by life style intervention (n=134)or non-insulin secretagogues(n=305) were added glipizide GITS therapy for 12 weeks. Patients with inadequate glycemic control,poor safety or low life quality by other secretagogues(n =236)were changed to glipizide GITS therapy for 12 weeks. Results After treatment by glipizide GITS,HbA1c of these patients decreased (1.48 ±1.20) % ( P = 0. 0000 ), fasting blood glucose decreased ( 2.47 ± 1.38 ) mmol/L ( P= 0. 0000 ), postprandial blood glucose decreased (3.64 ±2.63)mmol/L(P = 0.0000).52. 21% patients

  14. 聚苯乙烯磺酸钙治疗慢性肾脏病高钾血症患者的多中心临床研究%Calcium polystyrene sulfonate in treating hyperkalemia patients with chronic kidney disease: a multi-center clinical study

    Institute of Scientific and Technical Information of China (English)

    李晓; 徐钢; 林洪丽; 胡昭; 余学清; 邢昌赢; 梅长林; 左力; 倪兆慧

    2013-01-01

    potassium levels in all visits during the treatment and after discontinuation of calcium polystyrene sulfonate were all significantly decreased comparing to the baseline level (all P < 0.01).At the same time,serum levels of sodium,phosphorus,calcium showed no significant changes during the treatment.Constipation (9.2%) was the commonest side effect.There was no treatment-related serious adverse effect.Conclusions This single-arm,open,multi-center clinical study shows that calcium polystyrene sulfonate is effective and safe in treating hyperkalemia due to chronic kidney disease.

  15. 阿达木单抗联合甲氨蝶呤治疗类风湿关节炎的多中心、随机、双盲、安慰剂对照临床研究%Adalimumab plus methotrexate for the treatment of rheumatoid arthritis: a multi-center randomized, double-blind, placebo-controlled clinical study

    Institute of Scientific and Technical Information of China (English)

    黄烽; 赵东宝; 吴东海; 张奉春; 鲍春德; 陶怡; 古洁若; 徐建华; 朱平; 徐沪济; 张志毅

    2009-01-01

    现结核病.在双盲期,有3例(1.2%)受试者出现了严重不良事件,但研究者判定与药物无关或可能无关.在开放期,有8例(2.7%)受试者出现了严重不良事件,其中3例判定与药物无关或可能无关.结论 阿达木单抗联合MTX治疗RA的疗效优于单用MTX,可显著提高治疗有效率并持续改善症状、体征、实验室炎性活动指标,减少功能障碍并提高整体生活质量,同时具有良好的安全性与耐受性.%Obiective To investigate the efficacy and safety of adalimumab plus methotrexate (MTX)for the treatment of rheumatoid arthritis(RA).Methods This is a multi-center,randomized,doable-blind, parallel-group, and placebo-controlled clinical study, included a total of 302 cases of active rheumatoid arthritis, randomized into three groups of observation: 40 mg adalimumab (121 cases), 80 mg adalimumab ( 121 cases), or placebo (60 cases). Upon enrollment, all subjects had been previously treated with MTX for at least 3 months, and their doses of drug had remained stable for at least 28 days. The double-blind phase lasted for 12 weeks, during which the subjects were administered with adalimumab or placebo subcutaneously every other week. Then the subjects entered into another 12 weeks of open-label study, which included subcutaneous injection of 40 mg adalimumab every other week. In both the double-blind and the open-label periods, all subjects were maintained concomitantly with MTX that had already been used before this study. The primary efficacy variables were evaluated on basis of American College of Rheumatology (ACR)20 response rate at week 12. The secondary efficacy variables included: ACR20 response rate at week 24; ACR50 and ACR70 response rates at weeks 12 and 24 ; and changes at weeks 12 and 24 compared with baseline observations for tender and swollen joint counts, as well as the assessment of pain with visual analog scale (VAS), the physician's and the patient's global assessment of disease activity (VAS), and the

  16. Evaluation the efficacy and safety of estradiol and drospirenone tablets in the treatment of menopausal symptoms among postmenopausal Chinese healthy women:a randomized,multi-center,double-blind,placebo-controlled clinical study%雌二醇屈螺酮片治疗绝经后妇女绝经相关症状的多中心临床研究

    Institute of Scientific and Technical Information of China (English)

    周远征; 林守清; 孙丽洲; 林金芳; 杨欣; 张莉嘉; 乔杰; 王泽华; 许燕雪; 熊正爱

    2011-01-01

    .Methods Total 244 postmenopausal Chinese healthy women who had moderate to severe hot flushes were randomly assigned for 16 weeks in this randomized multi-center double-blind placebo-controlled study.During the trial.the follow-up visits were conducted at week 4,8,12,16 of treatment and 2 weeks after treatment respectively.Height,weight,vital signs,hot flushes,other relevant menopausal symptoms and vaginal bleeding were observed in each follow-up visit,while the clinical global impression scale Was assessed at 16 weeks as well.Results It showed that hot flushes were reduced significantly more in observation group than that in placebo group ( P<0.01 ), although both treatments were effective. The absolute values of mean severity index of total hot flushes decreased by - 0. 6± 0. 5 in observation group and - 0. 4 ± 0. 4 in placebo group from baseline respectively, which reached significant difference ( P < 0. 05 ). However, the absolute values of mean severity index of moderate to severe hot flushes decreased by - 0. 6± 0. 8 in observation group and -0. 3± 0.6 in placebo group from baseline respectively, which had no significant difference (P > 0. 05 ).After 16 weeks treatment, it also showed that estradiol and drospirenone had significant better efficacy than placebo on moderate to severe sweating, vaginal dryness and clinical global impression scale (P <0. 01 ).During the trial, blood pressure in observation group was stable. The rate of vaginal bleeding in observation group was higher than that in the placebo group, especially during the week 4 to week 8 when 48. 9% (87/178) in observation group and 10. 7% (6/56) in placebo group of patients bled. Although the cumulative amenorrhea rate of observation group was lower than that of placebo group in each cycle (28 days), it increased gradually along with duration of the treatment. The commonest adverse event in observation group was breast tenderness which accounted for 12.0% (22/183 ). The level of serum potassium

  17. A multi-center comparison of smooth muscle autoantibodies and mitochondrial autoantibodies in 154 laboratories of China%中国154家实验室检测抗平滑肌抗体和抗线粒体抗体的比对分析

    Institute of Scientific and Technical Information of China (English)

    邓垂文; 胡朝军; 白依娜; 董晓娟; 李萍; 李丽君; 宋宁; 史艳萍; 张奉春

    2014-01-01

    Objective Survey and analyses the current situation of autoantibodies testing of ASMA and AMA in China for evidence of further improvement of detecting quality.Methods Survey study.154 laboratories (at least participated in one item) participated voluntarily in the study of multi-center comparison of autoantibodies testing of autoimmune liver diseases.The samples (serum liquid) were prepared by the group of Clinical promotion and translational application research of key technology of diagnosis and treatment of autoimmune diseases of the Research Special Fund for Public Welfare Industry of Health ("the group" for short),including 5 ASMA samples and 5 AMA samples (for AMA-M2,too),which were mailed to laboratories under normal temperature on 15th Dec 2012.The laboratories were required to detect the samples using their routine methods before 31th Dec 2012,and mail the results and methods in a special form back to our group before 14th Jan 2013.The group preformed analysis of the results by Excel,including coincidence rate and titer report rate.Results The reference results of the samples were ASMA-1 positive,others negative,AMA-3 and-4 positive for both AMA and M2,others negative for both AMA and M2.The laboratories that eventually participated in ASMA,AMA and AMA-M2 were 103,103 and 138,and the positive coincidence rate were 57.3%,66.5% and 93.5%,meanwhile the negative coincidence rate were 96.8% 、99.0% 和1 97.8%,respectively,lndirect immunofluorescence (IIF) was the most common method for detection of ASMA and AMA,while low positive coincidence rate was found in the testing of ASMA and AMA,57.6% and 65.2%,respectively.In addition,only 39.1% and 43.5% labs reported the titer results of ASMA and AMA.About 57.0% of the labs reported results of AMA and AMA-M2 at the same time.Conclusions In 2012,the positive coincidence rate of ASMA and AMA are not satisfying in clinical labs of China,while the negative coincidence rate of them and the

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  19. Clinical value of acoustic voice measures: a retrospective study.

    Science.gov (United States)

    Werth, Katrin; Voigt, Daniel; Döllinger, Michael; Eysholdt, Ulrich; Lohscheller, Jörg

    2010-08-01

    Within this study a retrospective analysis of clinical voice perturbation measures, Dysphonia Severity Index and subjective perceived hoarseness was performed to determine their value under clinical aspects. The study included the data of 580 healthy and 1,700 pathologic voices, which were investigated under the following aspects. The relevant parameters were identified and their interrelation determined. Group differences between healthy and pathologic voices were figured out and investigated if voice quality measures allowed an automatic diagnosis of voice disorders. The analysis revealed significant changes between the clinical groups, which indicate the diagnostic relevance of voice quality measures. However, an individual diagnosis of the underlying voice disorder failed due to a vast spread of the parameter values within the respective groups. Classification accuracies of 75-90% were achieved. The high misclassification rate of up to 25% implied that in voice disorder diagnosis, the individual interpretation of the parameter values has to be done carefully.

  20. Children's vomiting following posterior fossa surgery: A retrospective study

    Directory of Open Access Journals (Sweden)

    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  1. Retrospective Biodosimetry of an Occupational Overexposure-Case Study.

    Science.gov (United States)

    Beaton-Green, L A; Barr, T; Ainsbury, E A; Wilkins, R C

    2016-12-01

    In 2014, Health Canada was approached by the Canadian Nuclear Safety Commission to conduct biodosimetry for a possible overexposure 4 y prior to assessment. Dose estimates were determined by means of two cytogenetic assays, the dicentric chromosome assay (DCA) and translocations as measured by the fluorescent in situ hybridization (FISH). As dicentrics are considered to be unstable over time, the results of the DCA were adjusted to account for the time elapsed between the suspected exposure and sampling. The frequency of damage was then compared to Health Canada's calibration curves, respectively, to calculate dose. In addition, the translocation data were corrected for age-related increases in background. With a half-life of 36 months for dicentric chromosomes taken into consideration, the dose estimates from both assays were in agreement. Due to the uncertainty in the half-life of dicentrics, the FISH assay is considered to be more reliable as a technique for retrospective biodosimetry.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. A retrospective study: osteoporosis and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    H. June Kuczynski

    1989-09-01

    Full Text Available The purpose of this stud y was to determine i f women who undergo hormone replacement therapy postmenopausally, will demonstrate less osteoporosis than women who do not undergo H R T. The osteoporosis subjects were 195 women who volunteered to participate in an NIHsponsored double-blind clinical trial entitled Safely and Efficacy of Fluoride Therapy in Osteoporosis. A convenience sample of 78 controls was obtained by inviting women seeking regular medical attention to join an epidemiological investigation of osteoporosis. The data were analyzed using Chisquare and Student’s t-ratio. The study concludes that future retrospective and prospective analyses appreciate the com plexity of the problem in terms of individual risk for osteoporosis.

  4. [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.

  5. Retrospective analysis of duodenal injuries: A comprehensive overview

    Directory of Open Access Journals (Sweden)

    Sanjay Pandey

    2011-01-01

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

  6. [Retrospective study on Latrodectus stings in Bahia, Brazil].

    Science.gov (United States)

    Lira-da-Silva, R M; Matos, G B; Sampaio, R O; Nunes, T B

    1995-01-01

    This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29 year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours.

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

    Directory of Open Access Journals (Sweden)

    Jamil Al-Swiahb

    2016-01-01

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

  8. Coblation cryptolysis to treat tonsil stones: a retrospective case series.

    Science.gov (United States)

    Chang, Christopher Y; Thrasher, Richard

    2012-06-01

    We introduce a novel and potentially effective approach in the treatment of tonsil stones using Coblation technology. A retrospective pilot case series was performed demonstrating the effectiveness of a technique that we call Coblation tonsil cryptolysis. This technique is unique in that it can be performed in adult patients without sedation using only local anesthesia, much like laser tonsil cryptolysis. As with laser cryptolysis, pain is significant for only a few days and most adults can resume normal diet and activity within 1 week. In contrast, tonsillectomy entails significant morbidity for several weeks. However, Coblation avoids the significant disadvantages of laser use, including the potential for airway fire, retinal damage from reflected scatter, dealing with plume from vaporized tissues, oral/facial burns, and the high cost of purchasing and maintaining laser equipment. After a single session of Coblation tonsil cryptolysis, a significant decrease and even elimination of tonsil stones can potentially be achieved.

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

    Science.gov (United States)

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

    2002-02-01

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

  10. Developments and retrospectives in Lie theory algebraic methods

    CERN Document Server

    Penkov, Ivan; Wolf, Joseph

    2014-01-01

    This volume reviews and updates a prominent series of workshops in representation/Lie theory, and reflects the widespread influence of those  workshops in such areas as harmonic analysis, representation theory, differential geometry, algebraic geometry, and mathematical physics.  Many of the contributors have had leading roles in both the classical and modern developments of Lie theory and its applications. This Work, entitled Developments and Retrospectives in Lie Theory, and comprising 26 articles, is organized in two volumes: Algebraic Methods and Geometric and Analytic Methods. This is the Algebraic Methods volume. The Lie Theory Workshop series, founded by Joe Wolf and Ivan Penkov and joined shortly thereafter by Geoff Mason, has been running for over two decades. Travel to the workshops has usually been supported by the NSF, and local universities have provided hospitality. The workshop talks have been seminal in describing new perspectives in the field covering broad areas of current research.  Mos...

  11. Developments and retrospectives in Lie theory geometric and analytic methods

    CERN Document Server

    Penkov, Ivan; Wolf, Joseph

    2014-01-01

    This volume reviews and updates a prominent series of workshops in representation/Lie theory, and reflects the widespread influence of those  workshops in such areas as harmonic analysis, representation theory, differential geometry, algebraic geometry, and mathematical physics.  Many of the contributors have had leading roles in both the classical and modern developments of Lie theory and its applications. This Work, entitled Developments and Retrospectives in Lie Theory, and comprising 26 articles, is organized in two volumes: Algebraic Methods and Geometric and Analytic Methods. This is the Geometric and Analytic Methods volume. The Lie Theory Workshop series, founded by Joe Wolf and Ivan Penkov and joined shortly thereafter by Geoff Mason, has been running for over two decades. Travel to the workshops has usually been supported by the NSF, and local universities have provided hospitality. The workshop talks have been seminal in describing new perspectives in the field covering broad areas of current re...

  12. 'Schizoid' personality and antisocial conduct: a retrospective case not study.

    Science.gov (United States)

    Wolff, S; Cull, A

    1986-08-01

    A retrospective case not analysis for 30 boys diagnosed as having a 'schizoid' personality disorder (Asperger's syndrome) in childhood, and for 30 matched clinic attenders (with systematic follow-up data for 19 matched pairs), showed the incidence of antisocial conduct to be the same in the two groups. However, the 'schizoid' boys stole less often and had fewer alcohol problems. In this group antisocial conduct was less related to family disruption and social disadvantage, and more to an unusual fantasy life. Clinical descriptions of a series of 'schizoid' boys and girls with conspicuous antisocial conduct follow. They suggest that characteristic patterns of antisocial conduct in such children are persistent expressions of hostility and, especially in girls, pathological lying, for which environmental circumstances provide no explanation.

  13. Accuracy of retrospective reports of infections during pregnancy

    DEFF Research Database (Denmark)

    Voldsgaard, Peter; Schiffman, Jason; Mednick, Sarnoff;

    2002-01-01

    A large body of research suggests a relationship between maternal influenza and the development of schizophrenia in the adult offspring. Some researchers, however, have questioned this association. A study by Crow and Done (1992) asserts that prenatal exposure to influenza does not cause schizoph......A large body of research suggests a relationship between maternal influenza and the development of schizophrenia in the adult offspring. Some researchers, however, have questioned this association. A study by Crow and Done (1992) asserts that prenatal exposure to influenza does not cause...... schizophrenia. The methodology employed by Crow and Done may account for their null findings. Crow and colleagues assessed influenza by asking mothers at the time of birth to recall influenza infections experienced during pregnancy. Such retrospective recall may bias reporting. We assessed influenza symptoms...

  14. Beach-goer behavior during a retrospectively detected algal ...

    Science.gov (United States)

    Algal blooms occur among nutrient rich, warm surface waters and may adversely impact recreational beaches. During July – September 2003, a prospective study of beachgoers was conducted on weekends at a public beach on a Great Lake in the United States. We measured each beachgoer’s activity at the start and end of their beach visit and the environmental factors: water and air temperature, wind speed and wave height at the study site each day. At the time, there was no notification of algal blooms; we retrospectively evaluated the presence of algal blooms using MERIS data from the Envisat-1 satellite. A total of 2840 people participated in the study over 16 study days. The majority (55%) were female, and 751 (26%) were < 18 years of age. An algal bloom was detected retrospectively by remotely sensed satellite imagery during August 16 – 24. This peak bloom period (PB) included 4 study days. During PB study days, more study participants 226/742 (31%) reported body contact with the water compared to contact 531/2098 (25%) on non-peak days. During the 4 PB days, of the environmental factors, only mean water temperature was significantly different, 250 C vs. 230 C (p<0.05) from other days.These results suggest that beachgoer body contact with water was not deterred by the presence of an algal bloom, and that interventions to actively discourage water contact during a bloom are needed to reduce exposure to blooms. This is an abstract of a proposed presentation and

  15. Luminescence characterization of dental ceramics for individual retrospective dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Correcher, V.; Gomesdarocha, R. [CIEMAT, Av. Complutense 40, 28040 Madrid (Spain); Garcia G, J. [Consejo Superior de Investigaciones Cientificas, Museo Nacional de Ciencias Naturales, Jose Gutierrez Abascal 2, 28006 Madrid (Spain); Rivera M, T., E-mail: v.correcher@ciemat.es [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria 694, 11500 Mexico D. F. (Mexico)

    2015-10-15

    Full text: Ceramic materials in general and dental crowns in particular exhibit thermoluminescence (Tl) properties and are of interest in the field of individual retrospective dosimetry. This property could be potentially employed to provide a means of determining cumulative exposure to external gamma radiation arising from accidents or large-scale incidents (radiological terrorism) involving population groups where conventional monitoring has not been established. The thermal stability and dose effect of the UV-blue Tl emission of a well characterized Spanish samples (by means of cathodoluminescence and electron-probe microanalysis) are here reported. It displays (i) an excellent linearity in the range of 0.12 - 9.6 Gy, (II) good stability of the Tl signal of 0.6, 1.2 and 2.4 Gy irradiated samples after 6 months of storage showing an initial rapid decay (ca. 30%) maintaining the stability from 30 days onwards. It means that the electron population decreases asymptotically by the X - axis and the involved electrons are located in deeper traps at room temperature. (III) The reusability performed on the dental ceramic, involving successive cycles of irradiation (1.2 Gy) followed by readout (up to 500 degrees C), exhibited a negligible variation in the Tl response, when measured six times. (IV) The tests of thermal stability at different temperatures (in the range of 100-240 degrees C) confirms a continuum in the trap distribution with progressive changes in the glow curve shape, intensity and temperature position of the maximum peak. Therefore, these preliminary results suggest that dental ceramics could be used as suitable dosimeters in retrospective conditions. (Author)

  16. A retrospective study of oral lichen planus in paediatric population

    Directory of Open Access Journals (Sweden)

    Kabita Chatterjee

    2012-01-01

    Full Text Available Aim: Well documented cases of oral lichen planus, a cell mediated immune condition is infrequently reported in paediatric population. This study was undertaken to obtain epidemiological data retrospectively and also to explore the possibility of any association that might exist among the clinical and histopathological features in paediatric patients suffering from oral lichen planus. Subjects and Methods: A retrospective study was carried out on 22 patients, younger than 18 years with clinical and histopathological diagnosis of oral lichen planus over a period of 14 years. The clinical characteristics and histopathological features were observed. The statistical analysis of the data was performed using Statistical Analysis Software (SAS, Version 9.1. Results: Analysis of data of 22 patients revealed that the average age of patient is 15.18 years with equal male and female predilection. The most common site is buccal mucosa (50% and most frequent clinical form is erosive (63.64%. Focusing on the histopathological findings, parakeratosis was found in 86.36% of the cases, acanthosis in 63.64% of cases, moderate basal cell degeneration was identified in 63.64% of cases and dense lymphocytic infiltration at juxtaepithelial connective tissue region was found in 59.09% of cases. Conclusions: Oral lichen planus in paediatric population is rare and appeared between 8 to 18 years of age. There is no significant gender predominance. The most common clinical form is erosive, manifesting mainly in buccal mucosa. Histopathological findings characteristic of oral lichen planus in paediatric patients include parakeratosis, acanthosis, liquefaction degeneration of basal cells and lymphocytic infiltration in the subepithelial layer.

  17. Retrospective cohort of trisomy 18 (Edwards syndrome in southern Brazil

    Directory of Open Access Journals (Sweden)

    Daniela Denardin

    Full Text Available CONTEXT AND OBJECTIVE:Trisomy 18 (T18, or Edwards syndrome, is a chromosomal disease characterized by a broad clinical picture and a poor prognosis. Our aim was to describe clinical, radiological and survival data of a cohort of patients prenatally diagnosed with T18.DESIGN AND SETTING:Retrospective single cohort in the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas (HMIPV.METHODS:All sequential patients with T18 registered at the Fetal Medicine Service of HMIPV between January 2005 and September 2013 were considered. We gathered their clinical, radiological and survival data and used the Kaplan-Meier test for survival analysis.RESULTS:Ten patients were diagnosed with T18, of whom seven (70% were female. The majority (90% were referred due to malformations seen on ultrasound. The mean gestational age at the first evaluation was 25.5 weeks. At karyotyping, the defects were considered multiple in only four patients (40%. All the fetuses presented full trisomy of chromosome 18. The main abnormality observed was congenital heart disease (n = 7. Intrauterine death occurred in half of the patients (50%. All live patients (n = 5 were born through cesarean section presenting low weight and low Apgar scores. The median length of survival after birth was 18 days.CONCLUSIONS:T18 is associated with a high risk of fetal and neonatal death. The majority of the patients present major malformations identified through ultrasound, such as congenital heart defects, which could help in identifying such cases prenatally.

  18. Cerebral mycosis: 7-year retrospective series in a tertiary center.

    Science.gov (United States)

    Raparia, Kirtee; Powell, Suzanne Z; Cernoch, Pat; Takei, Hidehiro

    2010-06-01

    This study focuses on the epidemiology, clinical manifestations, risk factors, diagnosis and outcome of all cases of central nervous system (CNS) fungal infections in a tertiary center. Medical records of 18 patients of culture-proven CNS fungal infections were retrospectively reviewed from 2000 to 2007, including 12 isolated from the cerebrospinal fluid (CSF) and seven from tissue biopsy. Patient demographic data included 10 males and eight females. The mean age was 55 years (range: 24-89 years). All but one patient were immunocompromised. Fungal organisms isolated from CSF included: Cryptococcous neoformans (8 patients), Coccidioides immitis (3 patients), and Aspergillus versicolor (1 patient). Histopathology of seven biopsy cases revealed groups of pigmented golden-brown fungal forms in three cases; three cases showed septate fungi, two of which had melanin in their walls; and one case showed multiple round spherules. These cases on microbiological cultures grew Coccidioides immitis (1 patient), Aspergillus fumigatus (1 patient), Cladophialophora bantiana (2 patients), Fonsecaea monophora (1 patient) and Scedosporium apiospermum (2 patients). Five of the seven fungal organisms isolated from tissue biopsies were dematiaceous fungi. Twelve patients died after a period of a few weeks to months, two were lost to follow-up, and four are alive with severe neurological sequelae. CNS fungal infections in our cohort were more common in patients post-transplant and with hematologic malignancies. In our series, rare dematiaceous fungi are emerging agents for cerebral mycosis. The outcome of CNS fungal infections is poor despite vigorous antifungal therapy.

  19. Anorectal malignant melanomas: Retrospective experience with surgical management

    Institute of Scientific and Technical Information of China (English)

    Xu Che; Dong-Bing Zhao; Yong-Kai Wu; Cheng-Feng Wang; Jian-Qiang Cai; Yong-Fu Shao; Ping Zhao

    2011-01-01

    AIM: To present the experience and outcomes of the surgical treatment for the patients with anorectal melanoma from the Cancer Hospital, Chinese Academy of Medical Sciences. METHODS: Medical records of the diagnosis, surgery, and follow-up of 56 patients with anorectal melanoma who underwent surgery between 1975 and 2008 were retrospectively reviewed. The factors predictive for the survival rate of these patients were identified using multivariate analysis. RESULTS: The 5-year survival rate of the 56 patients with anorectal melanoma was 20%, 36 patients underwent abdominoperineal resection (APR) and 20 patients underwent wide local excision (WLE). The rates of local recurrence of the APR and WLE groups were 16.13% (5/36) and 68.75% (13/20), (P = 0.001), and the median survival time was 22 mo and 21 mo, respectively (P = 0.481). Univariate survival analysis demonstrated that the number of tumor and the depth of invasion had significant effects on the survival (P < 0.05). Multivariate analysis showed that the number of tumor [P = 0.017, 95% confidence interval (CI) = 1.273-11.075] and the depth of invasion (P = 0.015, 95% CI = 1.249-7.591) were independent prognostic factors influencing the survival rate. CONCLUSION: Complete or R0 resection is the first choice of treatment for anorectal melanoma, prognosis is poor regardless of surgical approach, and early diagnosis is the key to improved survival rate for patients with anorectal melanoma.

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

    Science.gov (United States)

    Taveira, Alvaro D

    2008-07-01

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

  1. Bisphosphonates in Langerhans Cell Histiocytosis: An International Retrospective Case Series

    Science.gov (United States)

    Chellapandian, Deepak; Makras, Polyzois; Kaltsas, Gregory; van den Bos, Cor; Naccache, Lamia; Rampal, Raajit; Carret, Anne-Sophie; Weitzman, Sheila; Egeler, R. Maarten; Abla, Oussama

    2016-01-01

    Background Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH), which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results Ten patients (77%) had a single system bone disease, and 3 (23%) had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years). Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve (92%) achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years). One patient did not respond. No major adverse effects were reported in this series. Conclusion Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted. PMID:27413525

  2. Clinical Profile of Extraocular Muscle Palsy: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Suman Adhikari, BOptom

    2013-12-01

    Full Text Available Background: The sixth cranial nerve has been found to be the most commonly affected in previous studies of cranial nerve palsies. This study was carried out to determine the most common nerve involved in extraocular muscle (EOM palsies and the most common cause of EOM palsy in Nepal.Methods: The diagnosed cases of third, fourth, or sixth nerve palsy for 10 years (2000-2010 at the B.P. Koirala Lions Center for Ophthalmic Studies outpatient department were included in the study. A retrospective review of patients’ records was performed, and the causes of EOM palsy were grouped as: vascular, trauma, tumor,aneurysm, undetermined, and others. Recovery of the palsy was evaluated by reviewing the records of the patients who were followed up one month after the initial visit.Results: A total of 838 patients was included in the study. The average patient age was 37 years. The sixth nerve was most commonly affected (n=458, 54.65%, and the most common etiology was undetermined (n=408, 48.68%. Among the cases where the cause of palsy was known, the largest number of patients had trauma (n=188, 16.46%.Conclusion: It was concluded that in Nepal, the most commonly affected cranial nerve is the sixth nerve, in accordance with the other studies done in the past in different parts of the world. Most of the cases of cranial nerve palsy were found to have no specific cause and were not associated with diagnosed systemic disease.

  3. Methadone and perinatal outcomes: a retrospective cohort study.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-02-01

    OBJECTIVE: The purpose of this study was to examine the relationship among methadone maintenance treatment, perinatal outcomes, and neonatal abstinence syndrome. STUDY DESIGN: This was a retrospective cohort study of 61,030 singleton births at a large maternity hospital from 2000-2007. RESULTS: There were 618 (1%) women on methadone at delivery. Methadone-exposed women were more likely to be younger, to book late for antenatal care, and to be smokers. Methadone exposure was associated with an increased risk of very preterm birth <32 weeks of gestation (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.40-4.34), being small for gestational age <10th percentile (aOR, 3.27; 95% CI, 2.49-4.28), admission to the neonatal unit (aOR, 9.14; 95% CI, 7.21-11.57), and diagnosis of a major congenital anomaly (aOR, 1.94; 95% CI, 1.10-3.43). There was a dose-response relationship between methadone and neonatal abstinence syndrome. CONCLUSION: Methadone exposure is associated with an increased risk of adverse perinatal outcomes, even when known adverse sociodemographic factors have been accounted for. Methadone dose at delivery is 1 of the determinants of neonatal abstinence syndrome.

  4. 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.

  5. Thyroid dysfunction in type 2 diabetes mellitus: A retrospective study

    Directory of Open Access Journals (Sweden)

    Laloo Demitrost

    2012-01-01

    Full Text Available Introduction: Type 2 diabetes mellitus (DM is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. However, the prevalence of thyroid dysfunction in these patients has not been investigated. Aims and Objectives: To find the prevalence of thyroid dysfunction in type 2 DM in Manipur, India. Materials and Methods: In this retrospective study, data of 202 Type 2 DM patients who attended the diabetic clinic of the Regional Institute of Medical Sciences, Imphal from January 2011 to July 2012, and whose thyroid stimulating hormone (TSH level was investigated were included. The inclusion criteria are known cases of type 2 DM. Exclusion criteria are patients with previous history of hypothyroidism and those on drugs affecting the thyroid profile. Results: Out the 202 type 2 DM patients for the study of which 61 are males and 141 are females, 139 (68.8% are euthyroid, 33 (16.3% have subclinical hypothyroidism (10 males and 23 females, 23 (11.4% have hypothyroidism (6 males and 17 females, 4 (2% have subclinical hyperthyroidism and 3 (1.5% are hyperthyroidism cases. Maximum cases were of hypothyroidism (subclinical and clinical seen in the age group of 45-64 years. Patients with BMI > 25 were at increased risk of having hypothyroidism (P < 0.016. Conclusion: Prevalence of hypothyroidism is quite high in type 2 DM patients above 45 years and more so if their BMI is over 25.

  6. Chloral hydrate sedation in radiology: retrospective audit of reduced dose

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, Jennifer [Children' s University Hospital, Radiology Department, Dublin (Ireland); Royal Children' s Hospital, Department of Medical Imaging, Parkville, Victoria (Australia); Heaslip, Ingrid; Ryan, Stephanie [Children' s University Hospital, Radiology Department, Dublin (Ireland)

    2012-03-15

    Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P < 0.001). Sedation was successful in 96.7%, and more frequently successful in infants (98.3%) than children >1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

  7. CLINICAL STUDY OF ACUTE POISONING: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Praveen

    2014-11-01

    Full Text Available : OBJECTIVES: To determine the common agents, clinical features and outcomes of acute poisoning. MATERIALS AND METHODS: A retrospective study of patients of acute poisoning of more than 14 years age admitted through emergency with a history of intentional, self-inflicted and suicidal poisoning in SRMS-IMS from Jan 2010 to Dec 2012. RESULTS: A total of 58 cases were included with a common age of affection 16 to 25 years and male to female ratio 1.63: 1. Poisoning cases occur throughout the year with maximum prevalence in May and minimum in June. Organophosphorus was the most common poison followed by aluminium phosphide. Vomiting was the most common symptoms followed by altered sensorium. 70.68% patients were discharged, 20.68% expired and 8.62% left against medical advice. Aluminium phosphide was the most common toxin consumed by dead patients. CONCLUSION: Acute poisoning is commonly affecting young population and is caused by variety of toxin. High mortality is associated with aluminum phosphide.

  8. Evaluating semantic metamemory: Retrospective confidence judgements on the information subtest.

    Science.gov (United States)

    Ladowsky-Brooks, Ricki L

    2016-12-12

    The current research explored the potential value of adding a supplementary measure of metamemory to the Information subtest of the Wechsler Adult Intelligence Scale - Third Edition (WAIS-III in Study 1) or Fourth Edition (WAIS-IV in Study 2) in order to assess its relationship to other neuropsychological measures and to brain injury. After completing the Information subtest, neuropsychological examinees were asked to make retrospective confidence judgements (RCJ) by rating their answer certainty in the original order of item administration. In Study 1 (N = 52) and study 2 (N = 30), correct answers were rated with significantly more certainty than wrong answers (termed a "confidence gap"), and in both studies, higher confidence for wrong answers was significantly correlated with poorer performance on the Wisconsin Card Sorting Test (for categories completed r = -.58 in Study 1, and r = -.47 in Study 2; for perseverative errors r = .44 in Study 1, and r = .45 in Study 2). In both studies, a number of examinees with positive CT findings had a very small or reversed confidence gap. These findings suggest that semantic metamemory is sensitive to executive functioning and brain injury and should be assessed in the neuropsychological examination.

  9. Anaesthesia for foetoscopic Laser ablation- a retrospective study

    Directory of Open Access Journals (Sweden)

    Vaishali Kumbhar

    2016-01-01

    Full Text Available Background and Aims: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS and twin reversed arterial perfusion syndrome (TRAP. Foetoscopic LASER ablation (FLA is the treatment of choice in reducing foetal mortality related to this. Methods: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management. Thirty-four patients received subarachnoid block, three combined spinal-epidural block, three general anaesthesia and one local anaesthesia with sedation. Nitroglycerine 5 mg patch was used for tocolysis 1 h before the procedure and continued for 24-48 h postoperatively. Results: Bupivacaine was used in 34 patients, and ropivacaine in three patients. Mean dose of bupivacaine 0.5% was 2.43 ± 0.32 ml and ropivacaine 0.75% was 2.85 ± 0.19 ml. The mean duration of surgery was 117.07 ± 28 min. Mild hypotension occurred in all patients under spinal anaesthesia and was treated with vasopressors. The foetal outcome among all 41 patients were 13 delivered live twins, 15 had a single live baby with intrauterine death of other twin baby. In 12 patients, both babies were intrauterine death. One patient was lost for follow-up. Conclusion: Foetoscopic procedures can be done under central neuraxial block, however occasionally general anaesthesia may be required.

  10. Anaesthesia for foetoscopic Laser ablation- a retrospective study

    Science.gov (United States)

    Kumbhar, Vaishali; Radhika, M; Gundappa, Parameswara; Simha, Jayashree; Radhakrishnan, Prathima

    2016-01-01

    Background and Aims: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion syndrome (TRAP). Foetoscopic LASER ablation (FLA) is the treatment of choice in reducing foetal mortality related to this. Methods: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management. Thirty-four patients received subarachnoid block, three combined spinal-epidural block, three general anaesthesia and one local anaesthesia with sedation. Nitroglycerine 5 mg patch was used for tocolysis 1 h before the procedure and continued for 24–48 h postoperatively. Results: Bupivacaine was used in 34 patients, and ropivacaine in three patients. Mean dose of bupivacaine 0.5% was 2.43 ± 0.32 ml and ropivacaine 0.75% was 2.85 ± 0.19 ml. The mean duration of surgery was 117.07 ± 28 min. Mild hypotension occurred in all patients under spinal anaesthesia and was treated with vasopressors. The foetal outcome among all 41 patients were 13 delivered live twins, 15 had a single live baby with intrauterine death of other twin baby. In 12 patients, both babies were intrauterine death. One patient was lost for follow-up. Conclusion: Foetoscopic procedures can be done under central neuraxial block, however occasionally general anaesthesia may be required. PMID:28003695

  11. Dementia deaths in hospice: a retrospective case note audit.

    Science.gov (United States)

    Vries, Kay de; Nowell, Allyson

    2011-12-01

    Dementia is now recognized as a progressive terminal illness and it is established that people with dementia have significant palliative care needs as they approach the end of life. However, population prevalence studies suggest that very few people with dementia access hospice services in the UK. The literature further suggests that hospice staff may be inadequately prepared to care for people with dementia. A retrospective internal case note audit covering a 3-month period of referrals was undertaken in one hospice in the south of England as part of work to establish staff education requirements arising from patient make-up. Only patients over the age of 65 were included. Of the 288 case notes audited, 9% of the patients had either been diagnosed with dementia or suffered with dementia as a comorbidity. The results of the audit suggest that the number of people with dementia referred to hospice services may have increased in the last decade. This is in keeping with expectations and future predictions resulting from increased disease surveillance and an increasingly ageing population.

  12. Who are Sleeping in Sleep Laboratory? A Retrospective Study

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    Mine Ayşe Altun Emirza

    2012-03-01

    Full Text Available OBJECTIVE: Aim of this study is to compare the results of gold standard in diagnosing sleep disorders polysomnography (PSG with the physician’s preliminary diagnosis and complaints of patients in our data of sleep laboratory. METHODS: 656 patients who made PSG were included in the study. All of the patients age, gender, comorbid chronic disease, complaints, preliminary diagnosis and PSG diagnosis were evaluated retrospectively. RESULTS: In our study, the average age of patients was 56 and 43% women 57% were male. Complaints of patients were snoring, fatigue, stopped breath during sleep, insomnia, headache, daytime sleepiness, restless legs and abnormal behaviors during sleep. According to preliminary diagnoses and PSG diagnoses; Obstructive Sleep Apnea Syndrome (OSAS, narcolepsy, REM behavior disorder (RBD reduced (p 0.05. Sleep disorders in patients was accompanied by chronic diseases, hypertension (34.3%, diabetes (12.8%, Chronic Obstructive Pulmonary Disease (COPD (1.2%, epilepsy (1.8%, Parkinson's disease (3.5%, dementia (3.2%, depression (18.4%, cardiovascular disease (13.3% and cerebrovascular disease (4.9%. 9%. CONCLUSION: We are offering a good clinical history and physical examination with the correct interpretation of PSG for the differential diagnosis can be made true, accurate diagnoses and appropriate treatment modalities in our patients.

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

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

    2014-02-01

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

  14. Bilateral Traumatic Intracranial Hematomas and its Outcome: a Retrospective Study.

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    Pandey, Sharad; Sharma, Vivek; Singh, Kulwant; Pandey, Deepa; Sharma, Mukesh; Patil, Deepak Bhanudas; Shende, Neeraj; Chauhan, Richa Singh

    2017-02-01

    The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88.29 % (n = 83) were males and 11.70 % (n = 11) were females. Commonest mode of injury was road traffic accident in 56.38 % (n = 53) followed by fall from height in 29.78 % (n = 28). In our study, 25.53 % patients had epidural hematoma (EDH) with intracerebral hematoma (ICH) or contusion (n = 24), followed by EDH with subarachnoid hemorrhage (SAH) in 18.08 % (n = 17). At the time of discharge, all those patients managed conservatively had good Glasgow outcome scale (GOS) while with surgical intervention 58 % patients had good GOS, 19 % had moderate disability, and 9 % remained with severe disability. In cases of bilateral hematomas, EDH is most common and should be managed in neurosurgical emergency. Other combinations of bilateral intracranial hematomas should be managed according to the surgical indication and serial CT imaging.

  15. A retrospective study of nine cases of Acanthamoeba keratitis

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    Tetsuya Mutoh

    2010-10-01

    Full Text Available Tetsuya Mutoh, Isao Ishikawa, Yukihiro Matsumoto, Makoto ChikudaDokkyo Medical University Koshigaya Hospital, Saitama, JapanPurpose: To evaluate the clinical features of Acanthamoeba keratitis in nine patients diagnosed at Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.Methods: In nine eyes of nine patients, Acanthamoeba keratitis was diagnosed by direct light microscopy of corneal scrapings stained by the Parker ink-potassium hydroxide method between September 2006 and September 2009. Their clinical features and course were studied retrospectively. Antifungal eye drops, systemic antifungal therapy, and surgical debridement of the corneal lesions were performed in all patients.Results: At presentation, the clinical stage was initial in six cases, transient in one case, and complete in two cases. The patients were all contact lens wearers who had washed their lens storage cases with tap water. After treatment, final visual acuity was improved in six cases, unchanged in one case, and worse in two cases. The patient with the worst final vision (hand motion had rheumatoid arthritis and was taking oral prednisolone, which led to corneal perforation and prevented adequate debridement from being done.Conclusion: Acanthamoeba keratitis is closely related to wearing contact lenses and washing the lens storage case with tap water. Although final visual acuity improved after treatment in most patients, insufficient surgical debridement resulted in a poor visual prognosis.Keywords: surgical debridement, Acanthamoeba keratitis, contact lens wearers

  16. Oral Piercing and Oral Diseases: A Short Time Retrospective Study

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    Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D. Inchingolo, Antonio Palladino, Angelo M. Inchingolo, Gianna Dipalma

    2011-01-01

    Full Text Available Body piercing indicates the puncturing of a part of the body in which jewelry may be worn. In recent years, oral piercing is increasingly popular especially among young people. Body piercing has to be considered as a surgical procedure to all intents and purposes and, as such, has to be performed only by qualified personnel able to assure high standards of professionalism in facilities subject to sanitary inspections.The aim of the present work is to verify what risks patients may be exposed to and what complications may occur after a healthcare professional performs oral piercing.Our retrospective study includes 108 patients (74 males and 34 females aged between 14 and 39 years, who had oral piercing done 12±4 months earlier. All the patients underwent clinical examination to reveal the possible presence of late complications. After piercing, none of the 108 patients developed widespread complications.Although all patients said they had followed the piercers' instructions, 96% of them reported postoperative local complications such as bleeding within 12 hours of piercing (90%, perilesional edema for 3±2 days after piercing surgery (80%, and persistent mucosal atrophy (70%.

  17. A retrospective evaluation of term infants treated with surfactant therapy

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    Özge Sürmeli-Onay

    2015-04-01

    Full Text Available Aim: To investigate the clinical and therapeutic characteristics and outcomes of term infants who received surfactant therapy (ST for severe respiratory failure in our neonatal intensive care unit (NICU. Methods: The medical records of term infants (gestational age ≥ 370/7 weeks who received ST between 2003-2012 in NICU of Hacettepe University Ihsan Dogramaci Children’s Hospital were evaluated retrospectively. Results: During ten years period, 32 term infants received ST; the mean gestational age was 38.1 ± 0.88 wk and the mean birth weight was 2,936 ± 665 g. The underlying lung diseases were severe congenital pneumonia (CP in 13 (40.6%, acute respiratory distress syndrome (ARDS in 5 (15.6%, meconium aspiration syndrome (MAS in 5 (15.6%, congenital diaphragmatic hernia (CDH in 4 (12.5%, respiratory distress syndrome in 3 (9.4% and pulmonary hemorrhage in 2 (6.3% infants. The median time of the first dose of ST was 7.75 (0.5-216 hours. Pulmonary hypertension accompanied the primary lung disease in 9 (28.1% infants. Mortality rate was 25%. Conclusion: In term infants, CP, ARDS and MAS were the main causes of respiratory failure requiring ST. However, further prospective studies are needed for defining optimal strategies of ST in term infants with respiratory failure.

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

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    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.

  19. A Retrospective Review of Iatrogenic Skin and Soft Tissue Injuries

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    Tae Geun Lee

    2012-07-01

    Full Text Available Background Even though the quality of medical and surgical care has improved remarkablyover time, iatrogenic injuries that require surgical treatment including injuries caused by castand elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequentlyoccur. The goal of this study was to estimate the incidence and analyze the distribution ofiatrogenic injuries referred to our department.Methods A retrospective clinical review was performed from April 2006 to November 2010. Intotal, 196 patients (116 females and 80 males were referred to the plastic surgery departmentfor the treatment of iatrogenic injuries. We analyzed the types and anatomic locations ofiatrogenic complications, along with therapeutic results.Results An extravasation injury (65 cases, 37.4% was the most common iatrogeniccomplication in our study sample, followed by splint-induced skin ulceration, dopamineinducednecrosis, prefabricated pneumatic walking brace-related wounds and elasticbandage-induced wounds. Among these, prefabricated pneumatic walking brace-relatedcomplication incidence increased the most during the 5-year study period.Conclusions The awareness of the very common iatrogenic complications and its causes mayallow physicians to reduce their occurrence and allow for earlier detection and referral to aplastic surgeon. We believe this is the first study to analyze iatrogenic complications referredto a plastic surgery department in a hospital unit.

  20. A retrospective study of patient outcomes and satisfaction following pinnaplasty

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    Hope N

    2016-05-01

    Full Text Available Nicholas Hope,1 Caroline P Smith,1 Jim R Cullen,2 Neil McCluney2 1Northern Ireland Medical and Dental Training Agency, Belfast, 2Head and Neck Unit, Altnagelvin Area Hospital, Derry, Northern Ireland, UK Introduction: Up to 5% of all children have prominent ears. Psychological distress and bullying adversely affect these children and can cause significant social exclusion. In times of austerity, cosmetic procedures such as surgical correction of prominent ears are felt to be an unnecessary cost to the health service. Materials and methods: A retrospective case note review of all patients undergoing pinnaplasty was undertaken. Postoperative outcomes were compared against the Royal College of Surgeons of England standards. The Glasgow Benefit Inventory, a validated post-intervention questionnaire, was then posted out to all patients. Results: A total of 72 patients were identified. Average age at procedure was 13 years. Eleven patients were above the age of 19 years. Twenty-eight patients were male and forty-four female. Sixty-two cases underwent bilateral pinnaplasty. No patients developed hematoma, and there were no readmissions within 30 days of surgery. Twenty-nine patients responded to the questionnaire (40%, of whom 27 reported a positive impact on their psychosocial well-being with a mean score of 36. Conclusion: Pinnaplasty offers patients an opportunity to alleviate the psychological distress of bullying and harassment secondary to the appearance of prominent ears. Keywords: bullying, Glasgow Benefit Inventory, hematomas, prominent ears, psychological distress

  1. COMPARATIVE RETROSPECTIVE STUDY ON ANAESTHESIA APPROACHES FOR LUMBAR SPINE SURGERY

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    Rangalakshmi S

    2016-07-01

    Full Text Available OBJECTIVE Lumbar spinal surgeries have been performed with either spinal or general anaesthesia. In this study, we aimed to evaluate the superiority of either spinal or general anaesthesia on lumbar spine surgery. METHODS After approval of institutional ethical committee, we retrospectively analysed 270 patients (ASA I and II undergoing surgery of lumbar spine from 2009 to 2015 by one surgeon. Of these 150 patients underwent general anaesthesia with controlled ventilation, 120 patients were offered spinal anaesthesia with conscious sedation. Patient records were reviewed to obtain demographic features, type of anaesthesia, baseline heart rate, mean arterial pressure, intraoperative maximum heart rate, mean arterial pressure, duration of surgery, amount of intravenous fluids, intraoperative blood loss, incidence of perioperative complications such as bleeding, nausea, vomiting, hypotension, bradycardia, and postoperative analgesic consumption. RESULTS Patient characteristics including baseline/intraoperative mean arterial pressure and heart rate values did not differ between groups. However, the spinal anaesthesia group experienced significantly shorter durations in the operating room and had a lower incidence of nausea, vomiting. Analgesic consumptions in general anaesthesia group was significantly higher than in spinal anaesthesia group. CONCLUSION The present study revealed that spinal anaesthesia is a safe and effective alternative to general anaesthesia for patients undergoing single level or two level lumbar laminectomy, discectomy, or even instrumentation below L2 level and has the advantage of decreased nausea, antiemetic, analgesic requirements, and fewer complications. It also ensures better postoperative recovery when compared to general anaesthesia

  2. A retrospective approach to testing the DNA barcoding method.

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    David G Chapple

    Full Text Available A decade ago, DNA barcoding was proposed as a standardised method for identifying existing species and speeding the discovery of new species. Yet, despite its numerous successes across a range of taxa, its frequent failures have brought into question its accuracy as a short-cut taxonomic method. We use a retrospective approach, applying the method to the classification of New Zealand skinks as it stood in 1977 (primarily based upon morphological characters, and compare it to the current taxonomy reached using both morphological and molecular approaches. For the 1977 dataset, DNA barcoding had moderate-high success in identifying specimens (78-98%, and correctly flagging specimens that have since been confirmed as distinct taxa (77-100%. But most matching methods failed to detect the species complexes that were present in 1977. For the current dataset, there was moderate-high success in identifying specimens (53-99%. For both datasets, the capacity to discover new species was dependent on the methodological approach used. Species delimitation in New Zealand skinks was hindered by the absence of either a local or global barcoding gap, a result of recent speciation events and hybridisation. Whilst DNA barcoding is potentially useful for specimen identification and species discovery in New Zealand skinks, its error rate could hinder the progress of documenting biodiversity in this group. We suggest that integrated taxonomic approaches are more effective at discovering and describing biodiversity.

  3. Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

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    Ramakrishna Pai Jakribettu

    2015-01-01

    Full Text Available Dengue is one of the arthropod-borne (arbo viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05 to 0.0001. Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05 to 0.0001. Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients, required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

  4. Narcolepsy and pregnancy: a retrospective European evaluation of 249 pregnancies.

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    Maurovich-Horvat, Eszter; Kemlink, David; Högl, Birgit; Frauscher, Birgit; Ehrmann, Laura; Geisler, Peter; Ettenhuber, Katharina; Mayer, Geert; Peraita-Adrados, Rosa; Calvo, Elena; Lammers, Gert Jan; Van der Heide, Astrid; Ferini-Strambi, Luigi; Plazzi, Giuseppe; Poli, Francesca; Dauvilliers, Yves; Jennum, Poul; Leonthin, Helle; Mathis, Johannes; Wierzbicka, Aleksandra; Puertas, Francisco J; Beitinger, Pierre A; Arnulf, Isabelle; Riha, Renata L; Tormášiová, Maria; Slonková, Jana; Nevšímalová, Sona; Sonka, Karel

    2013-10-01

    In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P narcolepsy-cataplexy during pregnancy had impaired glucose metabolism and anaemia. Three patients experienced cataplexy during delivery. The rate of caesarean sections was higher in the narcolepsy-cataplexy group compared to the narcolepsy group (P narcolepsy in 60.1% of those with narcolepsy during pregnancy. This study reports more obstetric complications in patients with narcolepsy-cataplexy during pregnancy; however, these were not severe. This group also had a higher BMI and higher incidence of impaired glucose metabolism during pregnancy. Caesarian section was conducted more frequently in narcolepsy-cataplexy patients, despite cataplexy being a rare event during delivery. Furthermore, symptoms of narcolepsy may render care of the infant more difficult.

  5. "Hardware breakage in spine surgery (A retrospective clinical study "

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    "Sadat MM

    2001-11-01

    Full Text Available This was a retrospective review of a consecutive series of patients with spinal disease in year 2000, who underwent posterior fusion and instrumentation with Harrington distraction and Cotrel-Dobousset system to evaluate causes of hardware failure. Many cases of clinical failure has been observed in spinal instrumentation used in spinal disorder like spondylolisthesis, fractures, deformities, … . Thirty six cases that were operated because of spinal disorders like spondylolisthesis, fractures, deformities, …, were included in this study. Seventeen of this cases had breakage of device. Factors like age at surgery, type of instrumentation, angles before and after surgery and …, were compared in two groups of patients. The most common instrument breakage was pedicle screw breakage. Pseudoarthrosis was the main factor that was presented in failure group (P value<0.001. Other important causes were, age of patient at surgery (P value=0.04, pedicle screw placement off center in the sagittal or coronal plane of the pedicle (P value=0.04. Instrumentation loads increased significantly as a direct result of variations in surgical technique that produce pseudoarthrosis, pedicle screw placement off center in the sagittal plane of the pedicle, or using less than 6 mm diameter screw. This factor can be prevented with meticulous surgical technique and using proper devices.

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

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    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.

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

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    Cemal Hacı

    2016-09-01

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

  8. Herpes Zoster in Healthy Children: A Retrospective Study

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    Birgül Tepe

    2016-06-01

    Full Text Available Objective: Herpes zoster is an acute dermatomal viral infection caused by the reactivation of varicella zoster virus. While it is commonly seen among elderly and immunocompromised individuals, it is rare in healthy children. The aim of this study was to evaluate the clinical features, treatment and complications of healthy children with herpes zoster. Methods: Thirty one patients aged between 0-16 years who were admitted to our clinic with the diagnosis of herpes zoster, between January 2014 and December 2014, were evaluated retrospectively for age, gender, month of admission, complaint, history of chickenpox infection or varicella vaccination, triggering factors, dermatomal involvement, complications and treatment. Results: Among 31 patients with diagnosis of herpes zoster, 19 were boys (61.3% and 12 were girls (38.7%. The mean of age was 9.12±4.4 years. Twenty patients had thoracic (64.5%, six had lumbar (19.4% and five had cervical involvements (16.2%. The most frequent symptoms were pruritus and pain, respectively. Six patients were administered topical treatment and 25 patients were treated with both systemic and topical treatments. Complication was not observed. Conclusion: Herpes zoster is also being encountered increasingly in healthy children nowadays. It is benign and generally no complications are observed. Incidence can vary because of geographic and socioeconomic differences like vaccination programs.

  9. The Cambridge Structural Database in retrospect and prospect.

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    Groom, Colin R; Allen, Frank H

    2014-01-13

    The Cambridge Crystallographic Data Centre (CCDC) was established in 1965 to record numerical, chemical and bibliographic data relating to published organic and metal-organic crystal structures. The Cambridge Structural Database (CSD) now stores data for nearly 700,000 structures and is a comprehensive and fully retrospective historical archive of small-molecule crystallography. Nearly 40,000 new structures are added each year. As X-ray crystallography celebrates its centenary as a subject, and the CCDC approaches its own 50th year, this article traces the origins of the CCDC as a publicly funded organization and its onward development into a self-financing charitable institution. Principally, however, we describe the growth of the CSD and its extensive associated software system, and summarize its impact and value as a basis for research in structural chemistry, materials science and the life sciences, including drug discovery and drug development. Finally, the article considers the CCDC's funding model in relation to open access and open data paradigms.

  10. Frequency of orthopedic diseases in horses: A retrospective study

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    Kovač Milomir

    2002-01-01

    Full Text Available This retrospective study determined the frequency of orthopedic diseases in horses. It was possible to establish 141 specific orthopedic diagnoses in 1955 horses with lameness. In 14.58 % horses, multiple pathologic orthopedic changes were determined. In 61.84 % cases, the pathologic changes were present on the thoracic limb, 28,86 % on the pelvic limb and other parts of the oganism (neck, spine, muscles in 9.29 % cases. Pathologic changes on the tendons, ligaments, tendon sheats, bursae and muscles were determined in 31.51 % cases. Diseases of the hoof were present in 25.82 % cases. According to our investigation the most frequent orthopedic diseases are: podarthritis (acute, chronic, septic (5.04 %, navicular disease (4.69 %, tendinitis m. flexor digitalis superfacialis (4.51 %, kissing spine syndrom (4.30 % periarthritis et osteoarthrosis tarsi (3.30 %, distal metacarpal/metatarzophalengeal tendovaginitis (3.30 % and high suspensory ligament desmitis (3.12 %. Most frequent fractures were diagnosed on the metacarpal/metatarsal bone II and IV (2.56 %. Osteochondrossis dissecans was most frequently determined in the tarsocrural (1.26 % and the metacarpophalengeal joint (1.56 %.

  11. A retrospective study of 377 biopsies with a provisional

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    Taxiarchis G. KONTOGIANNIS

    2014-08-01

    Full Text Available Residual cysts (RC are radicular cysts left behind after tooth extraction. Many jaw lesions of non-odontogenic inflammatory origin may mimic the residual cyst. Aim: Τo record and discuss the prevalence and the features of jaw lesions mimicking RC, from the specimen with a provisional diagnosis of RC submitted for pathologic examination. Materials & Methods: The biopsy request forms of all lesions submitted for pathologic examination with the clinical diagnosis of RC, during a 14-year period, and the respective final pathology reports, were retrospectively studied. Selected clinical features were recorded. Results: 377 cases were retrieved. In 42 of them (11.1% the pathologic diagnosis was of a non-inflammatory odontogenic lesion. The most commonly misdiagnosed lesion was the odontogenic keratocyst (45.26%, while one ameloblastoma and 2 malignancies (metastatic tumor and malignant spindle cell tumor were also found. Conclusions: A lesion clinically diagnosed as a RC stands 1 out of 10 possibilities to be a non-odontogenic inflammatory lesion including malignant neoplasms. Thus, all lesions with clinical and radiographic features consistent with a RC must be enucleated and examined.

  12. Localized severe scleroderma: a retrospective study of 26 pediatric patients.

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    Beltramelli, Matilde; Vercellesi, Paolo; Frasin, Adina; Gelmetti, Carlo; Corona, Fabrizia

    2010-01-01

    Juvenile localized scleroderma includes different conditions characterized by skin hardening with increased collagen deposition. Although juvenile localized scleroderma is considered a relatively benign disease, lesions may extend through the dermis, subcutaneous tissue, muscles, and the underlying bone, leading to significant functional and cosmetic deformities. Furthermore, extracutaneous manifestations are described. We retrospectively analyzed a cohort of 26 patients with severe Juvenile localized scleroderma with particular attention to clinical features, therapy, and long-term outcome. A subgroup of three patients has been further evaluated with infrared thermography. Our findings were consistent with the current literature for demographic, laboratory, and clinical characteristics at disease onset, but, with our patients, the prevalence of extracutaneous manifestations was higher, thus confirming the potential for severe juvenile localized scleroderma to affect organs other than the skin, without increased risk of development toward systemic sclerosis. Correlation between various treatments and clinical endpoint showed that systemic therapy lead to a better outcome: in particular, methotrexate appeared the most effective drug, capable in halting the progression of the disease and sometimes inducing its regression.

  13. A RETROSPECTIVE STUDY ON ACCEPTABILITY AND COMPLICATIONS OF PPIUCD INSERTION

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    Runjun

    2016-04-01

    Full Text Available BACKGROUND Purpose: To study the acceptance level of Post-Partum Intrauterine Contraceptive Device (PPIUCD insertion among women attending tertiary level hospital for delivery between January 2013 to July 2015 in relation to age, parity and mode of delivery, safety and their complaints/complications during followup visit. METHOD This is a retrospective study done in a tertiary care centre, Jorhat Medical College and Hospital, Assam, between January 2013 to July 2015. Women who had accepted PPIUCD after delivery (Vaginally or by Lower Segment Caesarean section were included in this study. The entire PPIUCD inserted patients were followed up to 6 weeks and 6 months after delivery. With the help of data collected, relevant parameters and data are critically analysed in our study. RESULTS Acceptance of PPIUCD showed an increasing trend, acceptance was more among patients undergoing caesarean section; 43.86% of the acceptors were in the age group of 21-25 years. More than 50% of the total acceptors in the study came for followup. The main complaints at followup were missing thread and bleeding. The main causes of removal were bleeding and pressure from family. CONCLUSION The acceptance of PPIUCD was high in this study. The PPIUCD was demonstrably safe having no serious complication reported after insertion or during followup and low rates of expulsion. The method may be particularly beneficial in our setting where women do not come for postnatal contraception counselling and usage.

  14. Ovarian endometriomas and IVF: a retrospective case-control study

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    Guidetti Daniela

    2011-06-01

    Full Text Available Abstract We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112 were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142. Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins.

  15. Bronchial Artery Embolization for Massive Hemoptysis: a Retrospective Study

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    Ali Fani

    2013-05-01

    Full Text Available   Introduction: To assess the efficacy and safety of bronchial artery embolization in the treatment of massive hemoptysis.   Materials and Methods: A retrospective study on 46 patients (26 males and 20 females who were referred to the Razavi Hospital from April 2009 to May 2012 with massive hemoptysis and had bronchial artery embolization procedures. General characteristics of the patients including age, gender, etiology, and thorax computed tomograms, findings of bronchial angiographic, results of the embolization, complications related to bronchial artery embolization and clinical outcome during follow-up were reviewed. Results: The etiology included previous pulmonary tuberculosis in 20 cases, previous tuberculosis with bronchiectasis in 16 cases, bronchiectasis in 6 cases, and active pulmonary tuberculosis in one case. No identifiable causes could be detected in three patients. Moreover, massive hemoptysis was successfully and immediately controlled following the embolization procedure in all patients. One patient developed recurrent hemoptysis during one month following the procedure and was treated by re-embolization. No major procedure–related complication such as bronchial infarction was identified However none of the patientsexperienced neurological complications. Conclusion: Bronchial artery embolization is a safe and effective means of controlling massive hemoptysis and should be regarded as the first-line treatment for this condition.

  16. Perianal fistula: retrospective study of surgical treatment of 241 cases

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    Drager Luciano Ferreira

    1998-01-01

    Full Text Available Perianal fistula, usually has a criptoglandular etiology, developing from a perianal abscess and communicating the anal mucosa with the perianal skin. The aim of this paper is to study retrospectively 241 cases of perianal fistula (172 men and 69 women; 2,5:1 aging from 7 and 80 years old (average: 37,4 years, operated on at the Hospital da Clínicas - UFMG, from 1977 to 1996. The surgical techniques and post-operative outcome have been analysed. Perianal abscesses with spontaneous drainage were the predominant etiology (132 patients; 54,8%. Eighty percent were submitted to fistulectomy as the first surgical treatment. Among early complications (78; 32,4%, local pain was the most frequent (60; 24,9%. Among the late complications (136; 56,4% fistula recurrence (101; 41,9% was the most frequent. There were 141 reoperations in 80 patients. Fistulectomy was the predominant surgical technique employed for the treatment (101; 71,6%. The average hospitalization time was 6,3 days until 1990 and 1,5 day from 1991 to 1996, after the advent of day-surgery beds in HC-UFMG. The surgical treatment of perianal fístula has a significant rate of post-operative complications and a high recurrence rate, in spite of the short stay in hospital.

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

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    Chitprapassorn Thienvibul

    2015-01-01

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

  18. Leprosy Reaction in Thai Population: A 20-Year Retrospective Study

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    Poonkiat Suchonwanit

    2015-01-01

    Full Text Available Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity. Objective. To analyze and identify the risk factors which contribute to leprosy reactions. Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions. Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%. The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen. Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients.

  19. Retrospectively evaluated preinjury personality traits influence postconcussion symptoms.

    Science.gov (United States)

    Yuen, Kit-Man; Tsai, Yi-Hsin; Lin, Wei-Chi; Yang, Chi-Cheng; Huang, Sheng-Jean

    2016-01-01

    Postconcussion symptoms (PCS) are not uncommon following mild traumatic brain injury (mTBI). Personality traits have always been viewed as one of the most important explanations for persistent postconcussion symptoms (PPCS). Unfortunately, studies on the association between preinjury personality traits and the PPCS are still limited. This study thus aimed to examine the relationship between the preinjury personality and PCS in patients with mTBI. A total of 106 participants including 53 healthy participants were recruited. All participants complete the modified Checklist of Postconcussion Symptoms and the Health, Personality, & Habit Scale. Participants were evaluated within 4 weeks and at 4 months, respectively, after injury. The results showed patients reported significantly more PCS than healthy participants did within 4 weeks postinjury. A significant positive association between PCS and retrospectively evaluated preinjury personality was found. Specifically, patients who reported that their preinjury personality was depressive or anxious-related presented more PCS. This study might be the first to directly demonstrate that preinjury personality traits are closely linked to PCS reporting in patients with mTBI. Importantly, PCS reporting might be associated with different personality traits at different periods after injuries, and thus, a careful evaluation for personality characteristics is merited after mTBI.

  20. RETROSPECTIVE REVIEW OF MORTALITY IN GIANT PACIFIC OCTOPUS (ENTEROCTOPUS DOFLEINI).

    Science.gov (United States)

    Seeley, Kathryn E; Clayton, Leigh A; Hadfield, Catherine A; Muth, Dillon; Mankowski, Joseph L; Kelly, Kathleen M

    2016-03-01

    The giant Pacific octopus (Enteroctopus dofleini) is a popular exhibit species in public display aquaria, but information on health and disease is limited. This retrospective review evaluates time in collection and describes antemortem clinical signs and pathology of giant Pacific octopuses in an aquarium setting. Between March 2004 and December 2013, there were 19 mortalities: eight males, 10 females, and one individual whose sex was not recorded. Average time spent in collection for all octopuses was 375 ± 173 days (males 351 ± 148 days, females 410 ± 196 days). Ten (52.6%) of the octopuses were sexually mature at the time of death, six (31.6%) were not sexually mature, and reproductive status could not be determined in three octopuses (15.8%). Minimal changes were noted on gross necropsy but branchitis was histologically evident in 14 octopuses, often in conjunction with amoeboid or flagellate parasites. Senescence, parasitism, and husbandry were all important contributors to mortality and should be considered when caring for captive octopuses.

  1. Retrospective forecast of ETAS model with daily parameters estimate

    Science.gov (United States)

    Falcone, Giuseppe; Murru, Maura; Console, Rodolfo; Marzocchi, Warner; Zhuang, Jiancang

    2016-04-01

    We present a retrospective ETAS (Epidemic Type of Aftershock Sequence) model based on the daily updating of free parameters during the background, the learning and the test phase of a seismic sequence. The idea was born after the 2011 Tohoku-Oki earthquake. The CSEP (Collaboratory for the Study of Earthquake Predictability) Center in Japan provided an appropriate testing benchmark for the five 1-day submitted models. Of all the models, only one was able to successfully predict the number of events that really happened. This result was verified using both the real time and the revised catalogs. The main cause of the failure was in the underestimation of the forecasted events, due to model parameters maintained fixed during the test. Moreover, the absence in the learning catalog of an event similar to the magnitude of the mainshock (M9.0), which drastically changed the seismicity in the area, made the learning parameters not suitable to describe the real seismicity. As an example of this methodological development we show the evolution of the model parameters during the last two strong seismic sequences in Italy: the 2009 L'Aquila and the 2012 Reggio Emilia episodes. The achievement of the model with daily updated parameters is compared with that of same model where the parameters remain fixed during the test time.

  2. Hypokalaemia: common things occur commonly – a retrospective survey

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    Reid, Alasdair; Jones, Gareth; Isles, Chris

    2012-01-01

    Objectives To define the causes of hypokalaemia in an unselected adult population. Design Retrospective survey of biochemistry database. Setting District general hospital in southwest Scotland. Participants and main outcome measures There were 187,704 measurements of urea and electrolytes in 2010. Sixty-one patients had serum potassium feeding syndrome and inadequate potassium supplementation when patients were nil by mouth (37%). In 25% of patients a transient and profound fall in serum potassium appeared to coincide with their acute illness. Acute alcohol intoxication and/or alcohol withdrawal were prominent features in 11% of patients. More than one cause was commonly present. There were no cases of Bartter's, Gitelman's or Liddle's syndromes or of hypokalaemic periodic paralysis in this study. Conclusions Severe hypokalaemia <2.5 mmol/L occurs at least once a week in a district general hospital with a catchment population of around 150,000, suggesting there may be around 300 cases a week in the UK (population around 50,000,000). Diuretics, vomiting and diarrhoea are commonly implicated as are nutritional causes, acute illness and alcohol. Bartter's, Gitelman's, Liddle's syndrome and hypokalaemic period paralysis are all extremely uncommon. PMID:23323198

  3. Electrophysiological Studies in Patients with Pulmonary Hypertension: A Retrospective Investigation

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    Dirk Bandorski

    2014-01-01

    Full Text Available Few studies have investigated patients with pulmonary hypertension and arrhythmias. Data on electrophysiological studies in these patients are rare. In a retrospective dual-centre design, we analysed data from patients with indications for electrophysiological study. Fifty-five patients with pulmonary hypertension were included (Dana Point Classification: group 1: 14, group 2: 23, group 3: 4, group 4: 8, group 5: 2, and 4 patients with exercised-induced pulmonary hypertension. Clinical data, 6-minute walk distance, laboratory values, and echocardiography were collected/performed. Nonsustained ventricular tachycardia was the most frequent indication (n=15 for an electrophysiological study, followed by atrial flutter (n=14. In summary 36 ablations were performed and 25 of them were successful (atrial flutter 12 of 14 and atrioventricular nodal reentrant tachycardia 4 of 4. Fluoroscopy time was 16 ± 14.4 minutes. Electrophysiological studies in patients with pulmonary hypertension are feasible and safe. Ablation procedures are as effective in these patients as in non-PAH patients with atrial flutter and atrioventricular nodal reentrant tachycardia and should be performed likewise. The prognostic relevance of ventricular stimulations and inducible ventricular tachycardias in these patients is still unclear and requires further investigation.

  4. Herbal Medicines and Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study

    Science.gov (United States)

    Rasekhjahromi, Athar; Alipour, Farzaneh; Maalhagh, Mehrnoosh; Sobhanian, Saeed

    2016-01-01

    Background. The aim of this study was to assess the association between herbal medication and OHSS. Methods. This retrospective cohort study was conducted with 101 polycystic ovary syndrome patients. 66 patients took conventional pharmacological medications and 35 took herbal medications. Data were analyzed by statistical test including Fisher's Exact and binominal logistic regression. P < 0.05 was considered significant. Results. Of the 101 females, 53 were married and 48 were single. There was no significant association between the groups in marriage. No significant association was found in mean age between the two groups (23.9 ± 5.8 years in the control group versus 26.3 ± 6.7 years in the case group). There was a significant difference between the two groups .After adding the dependent (OHSS prevalence) and independent (marriage and group) variables into the model, the Hosmer-Lemeshow test showed suitability. Variances analyzed with this model ranged between 29.4% and 40.7%. Conclusion. The indiscriminate use of herbs is correlated with OHSS. Because patients increasingly consume herbs, they should be aware of potential side effects. However, appropriate dosages of herbs could be obtained for use instead of conventional treatments, which often have side effects. PMID:27688772

  5. Surgical outcome in monocular elevation deficit: A retrospective interventional study

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    Bandyopadhyay Rakhi

    2008-01-01

    Full Text Available Background and Aim: Monocular elevation deficiency (MED is characterized by a unilateral defect in elevation, caused by paretic, restrictive or combined etiology. Treatment of this multifactorial entity is therefore varied. In this study, we performed different surgical procedures in patients of MED and evaluated their outcome, based on ocular alignment, improvement in elevation and binocular functions. Study Design: Retrospective interventional study. Materials and Methods: Twenty-eight patients were included in this study, from June 2003 to August 2006. Five patients underwent Knapp procedure, with or without horizontal squint surgery, 17 patients had inferior rectus recession, with or without horizontal squint surgery, three patients had combined inferior rectus recession and Knapp procedure and three patients had inferior rectus recession combined with contralateral superior rectus or inferior oblique surgery. The choice of procedure was based on the results of forced duction test (FDT. Results: Forced duction test was positive in 23 cases (82%. Twenty-four of 28 patients (86% were aligned to within 10 prism diopters. Elevation improved in 10 patients (36% from no elevation above primary position (-4 to only slight limitation of elevation (-1. Five patients had preoperative binocular vision and none gained it postoperatively. No significant postoperative complications or duction abnormalities were observed during the follow-up period. Conclusion: Management of MED depends upon selection of the correct surgical technique based on employing the results of FDT, for a satisfactory outcome.

  6. Retrospective study on structural neuroimaging in first-episode psychosis

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    Ricardo Coentre

    2016-05-01

    Full Text Available Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT and magnetic resonance imaging (MRI in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years, consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification. No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

  7. 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.

  8. Farming tractor fatalities in Virginia: an 11-year retrospective review.

    Science.gov (United States)

    Fulcher, James; Noller, Anna; Kay, Deborah

    2012-12-01

    This retrospective case review examines farm tractor-related deaths in the Commonwealth of Virginia for an 11-year period, from 1997 to 2007. This study compares decedent's demographic information, toxicology results, and medical histories.A vast majority of farm tractor-related deaths were male (98%) and white (91%). The average age was 60 years with most deaths occurring between the ages of 40 and 80 years. Ethanol use was observed in 9% of all cases with 7% of cases being more than 0.08% wt/vol ethanol, which is the legal limit in Virginia to operate a motor vehicle.The more mountainous, Western District Office of the Chief Medical Examiner composed 60% of total cases with 43% of these western cases related to tractor use on a natural slope or incline. The deaths in other districts were all less than 13% natural slope or incline related, reflecting the topography of these areas.These findings confirm much of what observation would suggest; accidents with farming tractors typically involve older white men. Operating a tractor on steep inclines is dangerous as many tractors do not have adequate rollover protection. The use of ethanol is dangerous when using any heavy equipment.This study provides an initial look at tractor-related deaths in Virginia, and more research is needed in this area to improve safety mechanisms on this machinery.

  9. A retrospective study of 102 patients with pemphigus

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    Mahmut Sami Metin

    2015-06-01

    Full Text Available Background and Design: Pemphigus is a severe and life-threatening chronic autoimmune mucocutaneous blistering disease. The aim of this study was to evaluate and analyze the course, prognostic factors and epidemiological, clinical and therapeutic features of pemphigus in patients followed between 2004 and 2013. Materials and Methods: We performed a 10-years retrospective study of patients diagnosed with pemphigus in Erzurum. The parameters evaluated include age, sex, diagnostic methods, duration of hospitalizations, distribution of lesions, duration and therapeutic doses. Results: The results showed that the estimated annual incidence rate was 1.31 cases per 100,000 person-years. The male to female ratio was 1.081. The mean age at onset of the disease was 48 years (range, 7–95 years. Thirty six patients had only skin lesions and sixty-six cases had both skin and oral mucosal lesions. The majority of the patients (58.8% with pemphigus were treated with middle or high-dose corticosteroids (40–160 mg/day. Conclusions: Pemphigus vulgaris is the most common clinical subtype in Erzurum and the mean age of the disease onset in the present study was found to be a decade earlier than in other parts of the world. The patients with both oral mucosa and skin involvement required higher corticosteroid doses and longer hospitalization time when compared to the patients with oral mucosa involvement alone.

  10. A RETROSPECTIVE STUDY OF BILATERAL ALVEOLAR BONE GRAFTING

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To evaluate the treatment results of bilateral alveolar bone grafting (BABG) in patients with bilateral complete clefts of lip and palate.Methods. A retrospective study was performed in 66 bilateral complete cleft lip and palate patients who received the procedure of BABG, among them 15 were primary BABG and 51 were secondary BABG. The patients were further divided into three groups according to age and eruption stage of the canine at the time of surgery. The result of BABG was evaluated on the radiographs. Results. (1)The overall success rate of BABG was 75.0%, with 83.3% and 72.5% for primary and secondary BABG respectively; (2)The marginal bone level was found to be significantly higher in the youngest age group than in the other groups both for primary and secondary BABG; (3)For both primary and secondary BABG, Group C (patients' age more than 16 years) had the least optimal success rate, with 66.7% and 65.4% respectively. Conclusion. Simultaneous primary palate repair and BABG is safe and feasible procedure for treating unoperated bilateral complete cleft lip and cleft palate patients. For both primary and secondary BABG, significantly better results can be achieved if the operation is performed before eruption of the canine.

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

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    Roeder, John L.

    2005-01-01

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

  12. RisoeScan 1.0 - User manual and toolset for retrospective validation

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    Helt-Hansen, J

    2004-12-01

    The RisoeScan software is used for dose measurements with radiochromic films that color visibly. This report consists of two documents for use with the RisoeScan software. The User Manual tells how to use the program and the Toolset for Retrospective Validation describes how to perform a retrospective validation of the software. (au)

  13. BISPHOSPHONATES IN LANGERHANS CELL HISTIOCYTOSIS: AN INTERNATIONAL RETROSPECTIVE CASE SERIES

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    Deepak Chellapandian

    2016-07-01

    Full Text Available Background: Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH, which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method: We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results: Ten patients (77% had a single system bone disease, and 3 (23% had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years. Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve  (92% achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years. One patient did not respond. No major adverse effects were reported in this series.  Conclusion: Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted.

  14. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

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    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  15. Retrospective Study of a Series of Choanal Atresia Patients

    Science.gov (United States)

    Manica, Denise; Schweiger, Cláudia; Netto, Cátia C Saleh; Kuhl, Gabriel

    2013-01-01

    Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms. Methods Retrospective study. Results Eighteen patients were included: 12 (66.6%) presented bilateral atresia, of which 77.8% were mixed bony-membranous type and 22.2% were pure bony type. From the 12 patients with bilateral atresia, 10 presented related malformations, 3 of whom had CHARGE syndrome (coloboma, heart defects, choanal atresia, retardation of growth and development, genitourinary problems, ear abnormalities). From the remaining 6 patients with unilateral atresia, only 2 showed malformations, 1 renal and 1 cardiac. All patients with unilateral atresia needed only 1 surgical procedure, and patients with the bilateral form needed a median of 2.85 interventions (p = 0.003). The median age of surgical procedure in the unilateral group was 6 years, ranging from 6 months to 18 years, and in the bilateral group was 25 days, ranging from 6 days to 6 years (p = 0.003). The median interval between diagnosis and surgery was 9 months in the unilateral group, ranging from 1 month to 18 years, and in the bilateral group was 1 day, ranging from 1 day to 2 months (p = 0.001). Discussion and Conclusions Success rates with the endoscopic approach vary from 62 to 100%. Nonetheless, most of these reports present results without considering the number of compromised sides. In our opinion, unilateral and bilateral cases involve distinct patients (taking into account the related malformations), have diverging clinical presentations, and show discrepant restenosis rates and therefore could be considered in different groups of analysis. PMID:25992054

  16. Pharmaceutical and chemical pediatric poisoning in Kuwait: a retrospective survey

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    Abahussain EA

    2010-03-01

    Full Text Available Past studies of pediatric poisoning in Kuwait have suggested differences at hospital level which could impact on the implementation of public health interventions. The objective was to compare pediatric poisoning admissions at general hospitals in Kuwait. Methods: Retrospective survey of all pediatric poisoning cases at the six general hospitals from January 2004 to December 2005. Case data were documented using ICD-10 criteria and the poisoning severity score. Aggregated data was also obtained from five private hospitals.Results: 978 children were admitted in public hospitals over 2004 and 2005 (no fatalities being 1.8% and 1.6% of all pediatric admissions (private hospitals admitted 293 cases. The majority of the poisoning cases came from Jahra hospital (>35%, the median age was 2.3 yrs, 93% of cases were under 6 yrs old and 71% were Kuwaiti. Two thirds of cases involved pharmaceuticals although this varied between hospitals with a tendency for more severe cases with chemical poisoning (p=0.011. Kerosene was an important problem at Jahra hospital (34.7% of chemical exposures. Non-opioid analgesics constituted 22.3% of medication exposures with hormones and drugs affecting the autonomic nervous system also common with some difference in pattern between institutions.Conclusion: Case demographics do not vary significantly between the hospitals but there are differences in the nature of toxic agents to which children are exposed suggesting that preventive and educational programs could be targeted to specific areas for maximal effect particularly with regard to household chemical and kerosene exposures.

  17. Vaccination of patients with diabetes mellitus--a retrospective study.

    Science.gov (United States)

    Mad'ar, Rastislav; Benesová, Dagmar; Brandejská, Dana; Cermáková, Miriam; Dvorková, Alena; Gazárková, Olga; Jakubalová, Silvana; Kochová, Ilona; Lastovicková, Jana; Nebáznivá, Dagmar; Orolinová, Marta; Polomis, Karel; Rehka, Václav; Sattranová, Ludmila; Schejbalová, Miriam; Slámová, Alena; Skalleová, Deanna; Sevcíková, Hana; Tkadlecová, Hana; Tmejová, Marta; Trmal, Josef; Turková, Dagmar

    2011-06-01

    402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated'against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%)--- 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient. Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any ri-k- provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent. There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.

  18. Retrospective survey on therapeutic efficacy of Qigong in Korea.

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    Lee, Myeong Soo; Hong, Sung-Soo; Lim, Hyun-Ja; Kim, Hye-Jung; Woo, Won-Hong; Moon, Sun-Rock

    2003-01-01

    Qigong is a complementary intervention for preventing and curing disease, and protecting and improving health through regulation of body and mind. Recently, we have been studying the psychoneuroimmunological effects of Qigong on the promotion of health. However, there are not many studies on the therapeutic efficacy of Qigong on various symptoms in Korea, hence the need to survey the clinical efficacy of Qigong. To evaluate the impact of Qigong in health care we categorized its effectiveness on the basis of ten years of subjects' memoranda. Among the 768 subjects, the motivation for doing Qigong was mostly to attend to health problems (81.5%), and males were more likely to use Qigong than females. The most improved symptoms were associated with psychological and musculoskeletal problems. Furthermore 66.9% of subjects reported improvements of perceived physical health and 40.3% of perceived psychological health. Other symptoms reduced by Qigong were pain (43.1%), fatigue (22.1%), and insomnia (8.7%). Wound healing was also surveyed (n = 332), and 84% of respondents reported improvement in recovery time, 66.6% reported reduced inflammation after Qigong and 50.3% reported no scarring as compared to before. In addition, 59.9% of respondents reported an increase in resistance to the common cold after four months of Qigong. The limitation of the study is that it is a retrospective survey on the basis of trainees' experiences of Qigong. Although this may constitute a potential bias, the study despite its limitations does provide precious empirical evidence of the effectiveness of Qigong.

  19. Incidence and clinical outcome of renal amyloidosis: A retrospective study

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    Emad Abdallah

    2013-01-01

    Full Text Available The kidneys are affected in almost all patients with amyloid A in secondary amyloidosis (AA amyloidosis but less frequently in immunoglobulin light chains in primary systemic amyloidosis (AL amyloidosis. In this study, we present the incidence, etiology, clinical manifestations, biochemical features and clinical course of renal amyloidosis. We conducted a retrospective study on a group of 40 cases with renal biopsy-proven amyloidosis. They constituted 2.5% of the total cases of renal biopsies performed in the Theodor Bilharz Research Institute, Cairo, Egypt, during the period from February 2003 to May 2009. The mean age (30 males, ten females was 36.51 ± 10.32 years. Thirty-two of the cases had secondary AA amyloidosis and eight cases had primary AL amyloidosis. The causes of secondary amyloidosis were as follows: 12 (30% familial Mediterranean fever (FMF, eight (20% pulmonary tuberculosis, four (10% chronic osteomyelitis, four (10% bronchiectasis, three (7% rheumatoid arthritis and one (2% rheumatic heart disease. The eight cases of primary AL amyloidosis comprised of five cases that were associated with myloma (13% and three (8% cases that were idiopathic. Among the 23 patients with AA amyloidosis, after six months of treatment with colchicine, the proteinuria improved, serum albumin level increased and edema disappeared in 13 patients. In four cases of AA amyloidosis who were clinically and biochemically normal after cholchicine therapy, a second renal biopsy disclosed decreased amyloid deposition compared with the first biopsy. In the three renal transplanted patients who had amyloidosis secondary to FMF and were treated with colchicines, AA amyloidosis did not recur in the transplanted kidney. It might be possible that in AL amyloidosis, treatment with methotrexate, melphalan and prednisolone may improve survival. The incidence of renal amyloidosis is increasing and colchicine can be used in secondary amyloidosis as it may have an effect

  20. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

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    Pinto, José Antonio

    2016-03-01

    Full Text Available Introduction Obstructive sleep apnea (OSA is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women with a mean age of 50.05 years (range 19–75 years. The prevalence of comorbidities were hypertension (39%, obesity (34%, depression (19%, gastroesophageal reflux disease (GERD (18%, diabetes mellitus (15%, hypercholesterolemia (10%, asthma (4%, and no comorbidities (33%. Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.

  1. Pemphigoid gestationis: a retrospective study in southwest Iran.

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    Sima Rassai

    2013-06-01

    Full Text Available Pemphigoid gestationis (PG is a rare autoimmune bullous dermatosis of pregnancy usually presents in the second or third trimester. It is characterized by pruritic, urticarial plaques with the development of tense vesicles and bullae within the lesions. Pathogenesis of PG is not fully established, however, most patients develop circulating autoantibodies targeting the bullous pemphigoid (BP 180 antigen. The aim of this work is to draw a profile of the epidemiology, clinical aspects, treatment and evolution of the disease by studying hospital series. We retrospectively investigated the 13 patients who were diagnosed with PG based on hospital data at the Referral Center of Southwest Iran located in Ahvaz city between March 2002 and March 2011. The age of onset was 21 to 40 years (mean age: 27.5 years. The onset of the disease occurred in the second trimester of pregnancy in 6 patients and in the third trimester of pregnancy in 4 patients. One patient had a flare up of disease during the first trimester and two out of cases in puerperium period. In all cases, pruritus was the first symptom, followed by an erythematous vesiculobullous eruption.  The diagnosis of PG was confirmed by skin biopsy. Ten out of the patients treated with oral corticosteroids (0.5-1 mg/kg/day, one of the patients underwent oral corticosteroids plus topical glucocorticoid and the last patient treated with topical glucocorticoid. PG remains a rare dermatosis of pregnancy. Our series had two particularities compared to other studies: high frequency in primigravida and the frequent involvement of the face. Additionally our study demonstrated that improvement could occur faster and provide acceptable management if the treatment of the patients would be implemented sooner.

  2. A Retrospective Introduction to Religious Education: An Interpretive Approach

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    Jackson Robert

    2016-12-01

    Full Text Available The author takes a retrospective look at his book Religious Education: An Interpretive Approach, first published in 1997, and now available to readers, open access, via the European Wergeland Centre website (http://www.theewc.org/Content/Library/Research-Development/Literature/Introducing-Religious-Education-an-Interpretive-Approach. He tells a personal story of teaching, broadcasting and research, moving from the design of a methodology for studying the religions of minority groups in Britain to identifying the main concepts used for teaching about religions to children and young people in an engaging way, which relates to their own personal and social experience. The article, explains the key concept of representation – looking, for example, at how religions are often represented in ways that play down their internal diversity. Next the concept of interpretation is considered, emphasising the activity through which learners can compare and contrast the use of language by religious believers with their own nearest equivalent language uses, in trying, with sensitivity, to get as close as possible to their meanings. Finally, the process of reflexivity is explained; this gives learners an opportunity for three activities – to re-assess their understanding of their own world view (called edification in the interpretive approach, to make a distanced critique of beliefs and ideas they have studied, and to evaluate the methods that they have been using to learn about the religious meanings of others. Finally the author illustrates how the key concepts from the interpretive approach have been adapted for use in field research studies on teaching and learning about religions.

  3. Bat Rabies in France: A 24-Year Retrospective Epidemiological Study

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    Picard-Meyer, Evelyne; Robardet, Emmanuelle; Arthur, Laurent; Larcher, Gérald; Harbusch, Christine; Servat, Alexandre; Cliquet, Florence

    2014-01-01

    Since bat rabies surveillance was first implemented in France in 1989, 48 autochthonous rabies cases without human contamination have been reported using routine diagnosis methods. In this retrospective study, data on bats submitted for rabies testing were analysed in order to better understand the epidemiology of EBLV-1 in bats in France and to investigate some epidemiological trends. Of the 3176 bats submitted for rabies diagnosis from 1989 to 2013, 1.96% (48/2447 analysed) were diagnosed positive. Among the twelve recognised virus species within the Lyssavirus genus, two species were isolated in France. 47 positive bats were morphologically identified as Eptesicus serotinus and were shown to be infected by both the EBLV-1a and the EBLV-1b lineages. Isolation of BBLV in Myotis nattereri was reported once in the north-east of France in 2012. The phylogenetic characterisation of all 47 French EBLV-1 isolates sampled between 1989 and 2013 and the French BBLV sample against 21 referenced partial nucleoprotein sequences confirmed the low genetic diversity of EBLV-1 despite its extensive geographical range. Statistical analysis performed on the serotine bat data collected from 1989 to 2013 showed seasonal variation of rabies occurrence with a significantly higher proportion of positive samples detected during the autumn compared to the spring and the summer period (34% of positive bats detected in autumn, 15% in summer, 13% in spring and 12% in winter). In this study, we have provided the details of the geographical distribution of EBLV-1a in the south-west of France and the north-south division of EBLV-1b with its subdivisions into three phylogenetic groups: group B1 in the north-west, group B2 in the centre and group B3 in the north-east of France. PMID:24892287

  4. 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.

  5. Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.

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    Proczko, Monika; Kaska, Lukasz; Twardowski, Pawel; Stepaniak, Pieter

    2016-02-01

    While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and ERABS periods in an academic hospital. The primary endpoint was the length of stay in hospital. The secondary endpoints were turnover times-the time required for preparing the operating room for the next case, induction time (from induction of anesthesia until a patient is ready for surgery), surgical time (duration of surgery), procedure time (duration of stay in the operating room), and the incidence of re-admissions, re-operations and complications during admission and within 30 days after surgery. Of a total of 374 patients, 228 and 146 received surgery following the pre-ERABS and ERABS protocols, respectively. The length of hospital stay was significantly shortened from 3.7 (95 % confidence interval [CI] 3.1-4.7) days to 2.1 (95 % CI 1.6-2.6) days (P surgery, respectively (P < 0.001 for both), by introducing the ERABS protocol. Induction times were reduced from 15.2 (95 % CI 14.3-16.1) min to 12.5 (95 % CI 11.7-13.3) min (P < 0.001).Turnover times were shortened significantly from 38 (95 % CI 44-32) min to 11 (95 % CI 8-14) min. The incidence of re-operations, re-admissions and complications did not change.

  6. The Retrospective Evaluation of Childhood Psoriasis Clinically and Demographic Features

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    Ayşe Serap Karadağ

    2013-03-01

    Full Text Available Objective: This study was aimed to define the clinical and demographic findings of psoriasis in childhood. Methods: In this retrospective study, the data from 64 children with psoriasis admitted at the our dermatology clinic between January 2007 and January 2011 were included whose data were fully. Results: Of the patients, 37 (57.8% were boys and 27 (42.2% were girls. Mean age of the children was 10.08 ±3.98 years (3-16. In 10 (15% cases, a positive family history was detected. The most frequent localizations at onset were trunk (46.9%, scalp (28.1%, knee-elbow (10.9% and extremities (7.9%, respectively. The most commonly seen clinical types were plaque (68.8%, guttate (20.3%, palmoplantar (9.4%, pustular (1.6%, respectively. Nine children had nail involvement. Out of all patients, 21.9% had upper respiratory tract infections and 9.4% had emotional stres. Four cases were diagnosed with depression. Of the cases, two cases were on non-steroid anti-inflammatory medication, and 4 of them were on antibiotics. Systemic treatments were given to 21.9% of the cases besides topical treatments. Conclusion: The epidemiological studies of psoriasis during childhood period for different countries have been reported. In this study, the ratio shows differences when compared to those previous studies. There are few epidemiologic studies for Turkey. We believe that further epidemiological studies including large number of patients' groups will contribute the diagnosis and treatment of the disease.

  7. Breast composition measurements using retrospective standard mammogram form (SMF)

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    Highnam, R [Siemens Molecular Imaging Ltd, Hythe Bridge Street, Oxford (United Kingdom); Pan, X [Siemens Molecular Imaging Ltd, Hythe Bridge Street, Oxford (United Kingdom); Warren, R [Addenbrooke' s Hospital, Cambridge (United Kingdom); Jeffreys, M [Massey University, Wellington (New Zealand); Smith, G Davey [Clinical Epidemiology, University of Bristol (United Kingdom); Brady, M [Engineering Science, University of Oxford (United Kingdom)

    2006-06-07

    The standard mammogram form (SMF) representation of an x-ray mammogram is a standardized, quantitative representation of the breast from which the volume of non-fat tissue and breast density can be easily estimated, both of which are of significant interest in determining breast cancer risk. Previous theoretical analysis of SMF had suggested that a complete and substantial set of calibration data (such as mAs and kVp) would be needed to generate realistic breast composition measures and yet there are many interesting trials that have retrospectively collected images with no calibration data. The main contribution of this paper is to revisit our previous theoretical analysis of SMF with respect to errors in the calibration data and to show how and why that theoretical analysis did not match the results from the practical implementations of SMF. In particular, we show how by estimating breast thickness for every image we are, effectively, compensating for any errors in the calibration data. To illustrate our findings, the current implementation of SMF (version 2.2{beta}) was run over 4028 digitized film-screen mammograms taken from six sites over the years 1988-2002 with and without using the known calibration data. Results show that the SMF implementation running without any calibration data at all generates results which display a strong relationship with when running with a complete set of calibration data, and, most importantly, to an expert's visual assessment of breast composition using established techniques. SMF shows considerable promise in being of major use in large epidemiological studies related to breast cancer which require the automated analysis of large numbers of films from many years previously where little or no calibration data is available.

  8. Myomectomy at time of cesarean delivery: a retrospective cohort study

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    Tabsh Khalil MA

    2004-07-01

    Full Text Available Abstract Background Myomectomy at time of cesarean delivery is traditionally discouraged because of the risk of hemorrhage. A retrospective cohort study was performed to determine whether myomectomy at time of cesarean delivery leads to an increased incidence of intrapartum and short-term postpartum complications. Methods A computer search of medical records from May 1991 to April 2001 identified a total of 111 women who underwent myomectomy at time of cesarean delivery and 257 women with documented fibroids during the index pregnancy who underwent cesarean delivery alone. Charts were reviewed for the following outcome variables: change in hematocrit from preoperative to postoperative period, length of operation, length of postpartum stay, incidence of postpartum fever, and incidence of hemorrhage. Hemorrhage was defined as a change in hematocrit of 10 points or the need for intraoperative blood transfusion. Results The incidence of hemorrhage in the study group was 12.6% as compared with 12.8% in the control group (p = 0.95. There was also no statistically significant increase in the incidence of postpartum fever, operating time, and length of postpartum stay. No patient in either group required hysterectomy or embolization. Size of fibroid did not appear to affect the incidence of hemorrhage. After stratifying the procedures by type of fibroid removed, intramural myomectomy was found to be associated with a 21.2% incidence of hemorrhage compared with 12.8% in the control group, but this difference was not statistically significant (p = 0.08. This study had 80% power to detect a two-fold increase in the overall incidence of hemorrhage. Conclusion In selected patients, myomectomy during cesarean delivery does not appear to result in an increased risk of intrapartum or short-term postpartum morbidity.

  9. Tuberculosis of hip in children: A retrospective analysis

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    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.

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

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    Natasha E C G Davies

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

  11. RETROSPECTIVE VIEW OF DEPRECIATION AS AN ECONOMIC CATEGORY

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    Sigidov Y. I.

    2016-03-01

    Full Text Available Depreciation is the many-sided complex concept affecting many aspects of activity of business structures. The correct calculation of depreciation is necessary for obtaining full and objective information on reproduction process in the organization. With more detailed consideration of a question of charge of depreciation in developed with - temporary conditions, it is necessary to consider development of depreciation in the context of development of national schools of accounting. In this article, historical aspects of development of depreciation are investigated. The retrospective of concept and methods of charge of depreciation is represented, beginning from the XIV century worldwide. Various points of view on methods of charge of depreciation of such scientists, as V. Armuzzi, Zh.G. Kursel-Senel, Ya.V. Sokolov, Zh.B. Dyumarshe, D. S. Lewis, O. Shmalenbakh, A.P. Rudanovsky, A.K. Roshchakhovsky, etc. are considered. It is specified that the concept of depreciation was known to accountants of early Christian Rome. Gradually there was a change of approach to interpretation of the concept "depreciation". Within the French school allocated concept of broad and narrow depreciation, two options of a covering of depreciation expenses were offered, research of influence of fiscal policy on depreciation was conducted. The German school connected charge of depreciation with depreciation of property and need of formation of a sinking fund. Within maneuvers of Anglo-American school considered that depreciation has to be charged at the expense of profit in the sum only approximately equal to wear. Within domestic scientific thought, two main schools adhering to various opinions were allocated. For elaboration of uniform approach during the Soviet period in accounting there were accounts "Sinking fund", "Depreciation of fixed assets" that allowed to track a special-purpose character of use of a sinking fund. That is not true for operating book of accounts

  12. E P I DEMIOLOGY OF PAEDIATRIC BURNS: A RETROSPECTIVE STUDY

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    Jangpreet Singh

    2015-04-01

    Full Text Available BACKGROUND: Burn injuries are a major cause of morbidity and mortality in children. These are the third most common injury causing death in children, following motor vehicle accidents and drowning accidents. AIM: To study the Epidemiological parameters for assessment of morbidity & mortality rate in pediatric burns and to form effective preventive strategy. MATERIAL AND METHODS: The study was done at the Department of Surgery, PIMS, Jalandhar. Total 50 patients (n=50 up to age of 12 years, were included in the study retrospectively. Data regarding age, sex, demographic distribution, seasonal variation, Total body surface area (TBSA involved, type and place of burn injury, parent’s occupation, family size and mortality rate were noted and analysed. RESULT S: Total 50 patients (n =50 of which 32 were males and 18 females were included in the study. Mean age of burn injuries was 3.6 years. Scalds burns were the most common cause of burns followed by thermal burns. It involved mostly upper limbs (67%, anterio r trunk (56%, lower limbs (53%, face (4%, and posterior trunk including buttocks (16% . The time lapse from injury to presentation to hospital ranged from 1 hour to 3 weeks. Total body surface area burnt was ranged from 2 – 60%. Mean hospital duration was 12 . 4 days. Complications ranged from wound sepsis in 11 patients (22%, contractures of fingers in 3 patients ( 6 % and hypertrophic scarring in 8 patients (16% . After healing of wounds, patients were advised pressure garments and oil massage and night splint age regularly for six months. CONCLUSION: Children constitute a vulnerable group of burns. Most injuries occur in the home setting where effective control measures can be adopted. Advances have also made in resuscitation, intensive care, antimicrobi als, vascular access, nutritional support, and skin banking. Splintage, physiotherapy, massage and pressure garments also help in reducing the morbidity and overall long term burden over

  13. Co-morbidity in bipolar disorder: A retrospective study

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    Ravindra Neelakanthappa Munoli

    2014-01-01

    Full Text Available Background: Bipolar disorder is a relatively common, long-term, and disabling psychiatric illness that is associated with high levels of functional impairment, morbidity, mortality, and an increased risk of suicide. Psychiatric co-morbidity in bipolar disorder ranges from 57.3% to 74.3%, whereas medical co-morbidity varies from 2.7-70%. Indian scenario in this aspect is not clear. Materials and Methods: The objective was to ascertain the prevalence of physical and psychiatric co-morbidities in patients attending a tertiary care center over a period of 1 year and its relationship with socio-demographic and clinical variables. One hundred and twenty-five case record files were included in the review. OPCRIT software was used for re-establishing the diagnosis of bipolar disorder, which yielded 120 cases. A semi-structured pro-forma, specifically designed for the study, was used to collect the socio-demographic and clinical details. Results: Co-morbid psychiatric disorders were found in 52 (43.3% of the sample, whereas co-morbid physical illness was present in 77 (64.2% patients. The most common psychiatric disorder associated was substance use disorder (27.5%, whereas co-morbid cardiovascular disorder was the most frequent physical diagnosis in the sample (20%. Discussion: The prevalence of co-morbid psychiatric disorders in bipolar patients was lower than that reported in western literature. It could be related to retrospective nature of study or reflect true lower prevalence rates. Also, certain disorders such as eating disorders were absent in our sample, and migraine diagnosis was very infrequent.

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

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    Victor

    2015-06-01

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

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

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    Marcos Lopes

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

  16. Cystosarcoma phyllodes: Pathological enigma: A retrospective review of 162 cases

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    R P Narayanakar

    2015-01-01

    Full Text Available Purpose: Phyllodes tumor (PT is a rare fibroepithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B, borderline (BL, and locally recurrent to malignant (M and metastatic type. The aim of our study was to analyze the clinicopathological factors, compare treatment options, and evaluate outcome in patients with PT. Methods: We retrospectively reviewed 162 women with PT. The surgical intervention varied from simple excision (lumpectomy/wide local excision (WLE in benign cases to simple/modified radical or radical mastectomy (SM/MRM/RM in malignant and recurrent tumors. Results: Out of 162 patients, B, BL, and M were 95 (58.64%, 29 (18%, and 38 (23.45%, respectively. Mean age, duration of lump, and size were 38 ± 8 years, 28 ± 10 months, and 12 ± 5 cm, respectively. Recurrence rate with B, BL, and M was 15.78%, 41.37%, and 55.26%, respectively (P = 0.00001. As compared to WLE (22%, SM (23.8%, and MRM/RM (14.2%, recurrence was higher with lumpectomy (48.9% (P = 0.004. Positive correlation was found between recurrence rate with the size of tumor (P = 0.008 and also number of recurrence with holoprosencephaly (P = 0.047. There was no association between the number of recurrences and size of tumor (P = 0.63. Malignant PT was seen in 38 (24% and distant metastasis was seen in 7 (18%. Mean duration of follow-up was 42 months. Conclusion: WLE with negative margins should be the initial surgery for PT. The role of adjuvant radiotherapy and chemotherapy is uncertain. PT is pathological enigma. Till date, no factors can accurately predict the recurrence and outcome. PT is known for unpredictable behavior and high recurrence rates, hence long-term follow-up is advised.

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

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    Francisco José Tortosa Vallecillos

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

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

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    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.

  19. Retrospective study of prognostic factors in pediatric invasive pneumococcal disease

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    Peng, Chun-Chih; Chang, Hung-Yang; Huang, Daniel Tsung-Ning; Chang, Lung; Lei, Wei-Te

    2017-01-01

    Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion, S. pneumoniae remains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission

  20. Childhood Learning Disabilities and Atypical Dementia: A Retrospective Chart Review.

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    Alon Seifan

    Full Text Available To further our understanding of the association between self-reported childhood learning disabilities (LDs and atypical dementia phenotypes (Atypical Dementia, including logopenic primary progressive aphasia (L-PPA, Posterior Cortical Atrophy (PCA, and Dysexecutive-type Alzheimer's Disease (AD.This retrospective case series analysis of 678 comprehensive neuropsychological assessments compared rates of self-reported LD between dementia patients diagnosed with Typical AD and those diagnosed with Atypical Dementia. 105 cases with neuroimaging or CSF data available and at least one neurology follow-up were identified as having been diagnosed by the neuropsychologist with any form of neurodegenerative dementia. These cases were subject to a consensus diagnostic process among three dementia experts using validated clinical criteria for AD and PPA. LD was considered Probable if two or more statements consistent with prior LD were documented within the Social & Developmental History of the initial neuropsychological evaluation.85 subjects (Typical AD n=68, Atypical AD n=17 were included in the final analysis. In logistic regression models adjusted for age, gender, handedness, education and symptom duration, patients with Probable LD, compared to patients without Probable LD, were significantly more likely to be diagnosed with Atypical Dementia vs. Typical AD (OR 13.1, 95% CI 1.3-128.4. All three of the L-PPA cases reporting a childhood LD endorsed childhood difficulty with language. By contrast, both PCA cases reporting Probable childhood LD endorsed difficulty with attention and/or math.In people who develop dementia, childhood LD may predispose to atypical phenotypes. Future studies are required to confirm whether atypical neurodevelopment predisposes to regional-specific neuropathology in AD and other dementias.

  1. Respiratory Distress in Neonatal Intensive Care Unit: A Retrospective Evaluation

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    Ali Annagur

    2012-04-01

    Full Text Available Purpose: To determine the demographic characteristics of the newborns with respiratory difficulties, frequency of neonatal disease, analyze of the prognostic factors and effectiveness of treatment who were hospitalized in neonatal intensive care unit (NICU. Methods: In this study, file records of the newborns who were hospitalized in NICU of Meram Medical School were analyzed retrospectively. Results: Of the 771 newborns, 225 who admitted due to respiratory distress in 2008 and of the 692 newborns, 282 who admitted due to respiratory distress in 2009. Mean birth weight was 1954±972 gr in 2008, and 2140±1009 gr in 2009. Mean pregnancy weeks were 32,4±5,0 in 2008 and 33,4±4,9 in 2009. Diagnosis of patients were sepsis (77,8%, respiratory distress syndrome (RDS (40,4%, pneumothorax (20,9%, patent ductus arteriosus (PDA (12,4%, meconium aspiration syndrome (MAS (6,2%, intraventricular hemorrhage (IVH (5,3%, pneumonia (3,6%, retinopathy of prematurely (ROP (3,1%, bronchopulmonary dysplasia (BPD (2,7% and transient tachypne of newborn (TTN (2,2% in 2008. In 2009, percentage of the diagnosis was 69,5% sepsis, 33,3% RDS, 17,0% PDA, 16,0% pneumothorax, 10,3% pneumonia, 8,2% IVH, 6% TTN, 5,3% BPD, 3,2% MAS and 3,2% ROP. 33.7% of the patients were died in 2009 and 43,6% of them in 2008. Conclusion: The newborns with respiratory distress who admitted to the hospital must be evaluated according to the pregnancy week, way of birth and accompanying problems during first examination and convenient transportation of the ones who need to be cared in advanced center where an intensive care support can be applied to decrease mortality and morbidity of newborns distress. [Cukurova Med J 2012; 37(2.000: 90-97

  2. CLINICOPATHOLOGICAL STUDY OF LICHENOID REACTIONS: A RETROSPECTIVE ANALYSIS

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    Ravikant

    2015-04-01

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

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

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    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

  4. Toxicity after radiochemotherapy for glioblastoma using temozolomide - a retrospective evaluation

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    Niewald Marcus

    2011-10-01

    Full Text Available Abstract Purpose Retrospective evaluation of toxicity and results after radiochemotherapy for glioblastoma. Methods 46 patients with histopathologically proven glioblastoma received simultaneous radiochemotherapy (RCT. The mean age at the beginning of therapy was 59 years, the mean Karnofsky performance index 80%. 44 patients had been operated on before radiotherapy, two had not. A total dose of 60 Gy was applied in daily single fractions of 2.0 Gy within six weeks, 75 mg/m2/day Temozolomide were given orally during the whole radiotherapy period. Results A local progression could be diagnosed in 34/46 patients (70%. The median survival time amounted to 13.6 months resulting in one-year and two-year survival probabilities of 48% and 8%, respectively. Radiotherapy could be applied completely in 89% of the patients. Chemotherapy could be completed according to schedule only in 56.5%, the main reason being blood toxicity (50% of the interruptions. Most of those patients suffered from leucopenia and/or thrombopenia grade III and IV CTC (Common toxicity criteria. Further reasons were an unfavourable general health status or a rise of liver enzymes. The mean duration of thrombopenia and leucopenia amounted to 64 and 20 days. In two patients, blood cell counts remained abnormal until death. In two patients we noticed a rise of liver enzymes. In one of these in the healing phase of hepatitis a rise of ASAT and ALAT CTC grade IV was diagnosed. These values normalized after termination of temozolomide medication. One patient died of pneumonia during therapy. Conclusion Our survival data were well within the range taken from the literature. However, we noticed a considerable frequency and intensity of side effects to bone marrow and liver. These lead to the recommendations that regular examinations of blood cell count and liver enzymes should be performed during therapy and temozolomide should not be applied or application should be terminated according to

  5. Neoadjuvant chemotherapy and pathologic response: a retrospective cohort

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    Andrade, Diocésio Alves Pinto de [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Zucca-Matthes, Gustavo; Vieira, René Aloísio da Costa [Hospital de Câncer de Barretos, Barretos, SP (Brazil); Andrade, Cristiane Thomaz de Aquino Exel de [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Costa, Allini Mafra da [Hospital de Câncer de Barretos, Barretos, SP (Brazil); Monteiro, Aurélio Julião de Castro [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Lago, Lissandra Dal [Institut Jules Bordet, Brussels (Belgium); Nunes, João Soares [Hospital de Câncer de Barretos, Barretos, SP (Brazil)

    2013-07-01

    To evaluate the complete pathologic response attained by patients diagnosed with locally advanced breast cancer submitted to neoadjuvant chemotherapy based on the doxorubicin/ cyclophosphamide regimen followed by paclitaxel. A retrospective cohort of patients with locally advanced breast cancer, admitted to the Hospital de Câncer de Barretos between 2006 and 2008 submitted to the doxorubicin/cyclophosphamide protocol followed by paclitaxel (4 cycles of doxorubicin 60mg/m{sup 2} and cyclophosphamide 600mg/m{sup 2} every 21 days; 4 cycles of paclitaxel 175mg/m{sup 2} every 21 days). The following variables were assessed: age, menopause, performance status, initial clinical staging, anthropometric data, chemotherapy (dose – duration), toxicity profile, post-treatment staging, surgery, pathologic complete response rate, disease-free survival, and pathological characteristics (type and histological degree, hormonal profile and lymph node involvement). Statistical analysis was performed using a 5% level of significance. Of the 434 patients evaluated, 136 were excluded due to error in staging or because they had received another type of chemotherapy. Median age was 50 years, all with performance status 0-1. Median initial clinical size of tumor was 65mm and the median final clinical size of the tumor was 22mm. Fifty-one (17.1%) patients experienced a pathologic complete response. Those with a negative hormonal profile or who were triple-negative (negative Her-2 and hormonal profile) experienced a favorable impact on the pathologic complete response. Neoadjuvant chemotherapy with doxorubicin/ cyclophosphamide followed by paclitaxel provided a pathologic complete response in the population studied in accordance with that observed in the literature. Triple-negative patients had a greater chance of attaining this response.

  6. A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

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    Andersen, Kristian; Nørholt, Sven Erik; Küseler, Annelise

    2012-01-01

    A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla......A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla...

  7. Comparison between retrospective gating and ECG triggering in magnetic resonance velocity mapping

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    Søndergaard, L; Ståhlberg, F; Thomsen, C

    1993-01-01

    ECG-triggered cinematographic studies of the cardiovascular system are hampered by several technical restrictions such as the inability to image end-diastole, ghosting, varying signal intensity, and phase contributions from eddy currents. Retrospective gating may solve these problems, but involves...... of flow pulses. However, by reducing the time window retrospectively gated flow measurements were in good agreement with those that are ECG triggered. When fulfilling the demand of a narrow time window for interpolation, retrospective gating offers several advantages in MR velocity mapping....

  8. Adverse effect profile of trichlormethiazide: a retrospective observational study

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    Nishida Yayoi

    2011-05-01

    Full Text Available Abstract Background Trichlormethiazide, a thiazide diuretic, was introduced in 1960 and remains one of the most frequently used diuretics for treating hypertension in Japan. While numerous clinical trials have indicated important side effects of thiazides, e.g., adverse effects on electrolytes and uric acid, very few data exist on serum electrolyte levels in patients with trichlormethiazide treatment. We performed a retrospective cohort study to assess the adverse effects of trichlormethiazide, focusing on serum electrolyte and uric acid levels. Methods We used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and July 31, 2010, to identify cohorts of new trichlormethiazide users (n = 99 for 1 mg, n = 61 for 2 mg daily dosage and an equal number of non-users (control. We used propensity-score matching to adjust for differences between users and control for each dosage, and compared serum chemical data including serum sodium, potassium, uric acid, creatinine and urea nitrogen. The mean exposure of trichlormethiazide of 1 mg and 2 mg users was 58 days and 64 days, respectively. Results The mean age was 66 years, and 55% of trichlormethiazide users of the 1 mg dose were female. In trichlormethiazide users of the 2 mg dose, the mean age was 68 years, and 43% of users were female. There were no statistically significant differences in all covariates (age, sex, comorbid diseases, past drugs, and current antihypertensive drugs between trichlormethiazide users and controls for both doses. In trichlormethiazide users of the 2 mg dose, the reduction of serum potassium level and the elevation of serum uric acid level were significant compared with control, whereas changes of mean serum sodium, creatinine and urea nitrogen levels were not significant. In trichlormethiazide users of the 1 mg dose, all tests showed no statistically significant change from baseline to during the exposure period in

  9. Four-year retrospective look for acute scrotal pathologies

    Science.gov (United States)

    Ayvaz, Olga Devrim; Celayir, Aysenur Cerrah; Moralioglu, Serdar; Bosnali, Oktav; Pektas, Osman Zeki; Pelin, Ahmet Koray; Caman, Sefik

    2015-01-01

    OBJECTIVE: A group of diseases in the scrotum setting forth by the sudden swelling and redness and pain consist of acute scrotal pathologies. The most common causes of acute scrotum in children are epididymitis, epididymo-orchitis, orchitis, testicular torsion, torsion of the appendix testis, incarcerated inguinal hernia and traumatic hydro/hematocele. In this study; we aim to evaulate patients with acute scrotal pathologies who were interned in our department. METHODS: All hospital data of cases who were interned at our deparment due to acute scrotum in between June 2010-June 2014 were evaluated retrospectively. Cases with incarcerated inguinal herni were excluded in this study. RESULTS: In a 4-year-period 114 cases were interned in our department with acute scrotum. Mean age of the patients was 7.6±4.577 years (min: 1m-max: 18yrs). Doppler US was performed in 112 patients to evaluate the blood flow while in 2 patients applied after normal office hours were evaluated without Doppler US and operated under emergency conditions. The patients had received diagnosis of epididymitis/epididymo-orchitis/orchitis (n=83 cases; 72.8%), testicular torsion (n=24; 21.1%), torsion of the appendix testis (n=2; 1.8%) with and traumatic hydrocele/ hematocele (n=5; 4.4%). While detorsion was performed in 18 (75%) cases with testicular torsion and orchiectomy in 6 (25%) cases. Histopathological evaluation of orchiectomy specimens revealed hemorrhagic necrosis and hemorrhagic infarction or ischemic changes. Normal testicular size and vascularity were detected in 11 (61.1%) cases with detorsioned testis as detected by follow-up Doppler US. Late orchiectomy was performed in 7 cases (38.9%) with complete atrophy due to lack of blood supply. CONCLUSION: Although Doppler US is very helpful for differential diagnosis of patients with acute scrotum who applied early period, if Doppler US will lead to a waste of time, direct surgery without delay will reduce the risk of testicular loss. PMID

  10. Criminal poisoning of commuters in Bangladesh: prospective and retrospective study.

    Science.gov (United States)

    Majumder, M Mahbub Alam; Basher, Ariful; Faiz, M Abul; Kuch, Ulrich; Pogoda, Werner; Kauert, Gerold F; Toennes, Stefan W

    2008-08-25

    Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cu