Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience

Energy Technology Data Exchange (ETDEWEB)

Steingruber, I.E. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)]. E-mail: iris.steingruber@uibk.ac.at; Neuhauser, B. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Seiler, R. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Greiner, A. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Chemelli, A. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Kopf, H. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Walch, C. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Waldenberger, P. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Jaschke, W. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Czermak, B. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)

2006-09-15

Objective: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. Material and methods: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. Results: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. Conclusion: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.

Emergent Awake tracheostomy--The five-year experience at an urban tertiary care center.

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Fang, Christina H; Friedman, Remy; White, Priscilla E; Mady, Leila J; Kalyoussef, Evelyne

2015-11-01

There are few studies that discuss the issues surrounding emergent awake tracheostomy. We aim to review the indications, anesthesia used, complications, and outcomes of patients undergoing urgent awake tracheostomy. Chart review. Medical charts of patients who underwent an emergent awake tracheostomy at our institution-affiliated tertiary care center over a 5-year period from 2009 to 2014 were reviewed. Data were collected from inpatient, outpatient, and operative records. Sixty-eight patients underwent emergent awake tracheostomy. Over half presented with hoarseness (n=37, 54.4%) and/or stridor (n=37, 54.4%). Acute upper airway obstruction secondary to malignancy was the most common indication and accounted for 58 cases (85.3%). Thirty-nine (70.1%) of the 55 patients with squamous cell carcinoma presented with advanced disease (stage III or IV). Other indications included glottic or subglottic stenosis (4.4%), failure to intubate (2.9%), and other (7.4%). Local anesthesia was used alone in 35.3% of cases and in combination with conscious sedation in 64.7% of cases. Mild bleeding occurred postoperatively in five patients (7.4%). There were no other postoperative complications. Nineteen patients were lost to follow-up. The mean follow-up of 49 patients was 7.2 weeks, ranging from 2 to 261 weeks. Long-term complications occurred in three patients and included tracheitis 7.4% and suprastomal granuloma 2.9%. Eleven patients (22%) were decannulated at a mean of 11.8 months following tracheostomy. Emergent awake tracheostomy should be considered in patients with impeding airway obstruction and is a safe and effective method to secure an airway in these patients. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Proceeding of the Seminar of Research Result of Multipurpose Reactor Center Year of 1997/1998

International Nuclear Information System (INIS)

Jujuratisbela, U.

1998-08-01

The proceeding contained papers presented in seminar on research results of Multipurpose Reactor Center year 1997/1998 held on June 9-10, 1998 in Serpong, Indonesia. These papers are the significant result of research activities conducted in the Multipurpose Reactor Center, National Atomic Energy Agency during fiscal year of 1997/1998. There are 37 article which have separated index. (ID)

Sentinel node biopsy in breast cancer: five years experience from Denmark

DEFF Research Database (Denmark)

Christiansen, Peter; Balslev, E.; Jensen, D.

2008-01-01

INTRODUCTION: Danish experience from the first five years with sentinel lymph node biopsy (SLNB) as a routine staging procedure in early breast cancer is reported. METHODS: During the period January 1, 2002 to December 31, 2006, 14 923 patients were diagnosed at Danish breast surgical centers...... certified for the sentinel node method. SLNB was performed in 8 338 patients (55.9%). The fraction increased steadily from 43% in 2002 to 67% in 2006. The median follow-up was 1.7 year (range 0-5.2 years). RESULTS: Patients staged with SLNB were younger, had more often BCS, had smaller tumor size, were more...... often hormone receptor positive, and had lower grade, than patients staged with lymph node dissection (ALND). Blue dye and radio colloid were used in combination in 82%. Lymphoscintigraphy was performed in 61%, and frozen section was performed in 87%. Originally, peritumoral injection of tracer was most...

Longitudinal determinants of depression among World Trade Center Health Registry enrollees, 14-15 years after the 9/11 attacks.

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Jacobson, Melanie H; Norman, Christina; Nguyen, Angela; Brackbill, Robert M

2018-03-15

Exposure to the September 11, 2001 (9/11) terrorist attacks has been found to be associated with posttraumatic stress disorder (PTSD) and comorbid PTSD and depression up to 10-11 years post-disaster. However, little is known about the longitudinal predictors of mental health conditions over time. We examined longitudinal determinants of depression within strata of PTSD among 21,258 enrollees of the World Trade Center Health Registry who completed four questionnaires over 14 years of follow-up (Wave 1 in 2003-04; Wave 2 in 2005-06; Wave 3 in 2011-12; and Wave 4 in 2015-16). PTSD status was measured using the PTSD checklist on all four waves and defined as a score of ≥ 44; depression was assessed using the 8-item Patient Health Questionnaire at Waves 3 and 4 and defined as a score of ≥ 10. Across Waves 3 and 4, 18.6% experienced depression, and it was more common among those who ever had PTSD (56.1%) compared with those who had not (5.6%). Across PTSD strata, predictors of depression included low income, unemployment, low social integration and support, post-9/11 traumatic life events, and chronic physical illness. These factors also decreased the likelihood of recovering from depression. Depression symptoms were not measured at Waves 1 and 2; data was self-reported. These findings highlight the substantial burden of depression in a trauma-exposed population 14-15 years post-disaster, especially among those with PTSD. Similar life stressors predicted the course of depression among those with and without PTSD which may inform public health and clinical interventions. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Meningitis and Meningoencephalitis among Israel Defense Force Soldiers: 20 Years Experience at the Hadassah Medical Centers.

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Pikkel, Yoav Y; Ben-Hur, Tamir; Eliahou, Ruth; Honig, Asaf

2015-11-01

Meningitis and meningoencephalitis pose major risks of morbidity and mortality. To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt. Scopus) due to meningitis and meningoencephalitis from January 1993 to January 2014 were included in this retrospective study. Clinical, laboratory and radiologic data were reviewed from their hospital and army medical corps files. Attention was given to patients' military job description, i.e., combat vs. non-combat soldier, soldiers in training, and medical personnel. We identified 97 cases of suspected meningitis or meningoencephalitis. Six were mistakenly filed and these patients were found to have other disorders. Four soldiers were diagnosed with epidural abscess and five with meningitis due to non-infectious in flammatory diseases. Eighty-two soldiers in active and reserve duty had infectious meningitis or meningoencephalitis. Of these, 46 (56.1%) were combat soldiers and 31 (37.8%) non-combat; 20 (29.2%) were soldiers in training, 10 (12.2%) were training staff and 8 (9.8%) were medical staff. The main pathogens were enteroviruses, Epstein-Barr virus an d Neisseria meningitidis. In our series, soldiers in training, combat soldiers and medical personnel had meningitis and meningoencephalitis more than other soldiers. Enteroviruses are highly infectious pathogens and can cause outbreaks. N. meningitidis among IDF soldiers is still a concern. Early and aggressive treatment with steroids should be considered especially in robust meningoencephalitis cases.

Bulgaria: INIS Center - 45 years experience

International Nuclear Information System (INIS)

Georgieva, Albena

2015-01-01

Bulgaria is one of 35 countries in the world operating nuclear power plants. Bulgaria's nuclear program was launched in 1956 with the construction of an IRT-2000 research reactor at the Institute for Nuclear Research and Nuclear Energy (INRNE), which was commissioned in 1961. The reactor is now under reconstruction. In 1960, construction of the first Bulgarian nuclear power plant started. At the moment, there are 6 power units at the Kozloduy NPP site; 4 of them (VVER-440/B-230) under decommissioning and 2 (VVER-1000/B-320) in operation. Several storage facilities for radioactive waste, mainly from the Kozloduy NPP and from various sources of ionizing radiation in medicine and industry are also in operation. The Kozloduy NPP, INRNE, Sofia University, the Technical University, and the State Enterprise Radioactive Waste are the main generators of nuclear information in Bulgaria and the main consumers of INIS products. The Bulgarian INIS Center, therefore, maintains continuous and effective cooperation with these Institutions

The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

Energy Technology Data Exchange (ETDEWEB)

Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O. [Depts. of Radiology, Obstetrics and Gynecology, and Urology, Cumhuriyet Univ. School of Medicine, Sivas (Turkey)

2007-09-15

Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction.

The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

International Nuclear Information System (INIS)

Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O.

2007-01-01

Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction

Laparoscopic isthmocele treatment - single center experience.

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Ciebiera, Michał; Ciebiera, Magdalena; Czekańska-Rawska, Magdalena; Jakiel, Grzegorz

2017-01-01

A cesarean section is the most frequently performed surgery in modern obstetrics. In case of an incorrect wound healing process there is a risk of a persistent uterine wall defect. Nowadays, due to the high frequency of cesarean sections, obstetricians have to deal with the threat of uterine rupture due to pathological wound healing. It has been proven that isthmocele can cause abnormal uterine bleeding (AUB), pelvic pain (PP), and secondary infertility (SI), and can be a place of improper pregnancy placement. This article presents our experience with isthmocele treatment. We describe our diagnostic process scheme, method of corrective surgery and main therapeutic outcomes. In this manuscript we present a single center's experience in isthmocele therapy. We have operated on 16 patients who suffered from abnormal uterine bleeding, pain disorders or secondary infertility possibly due to a cesarean scar defect. The results obtained in our center are promising. In 9 of 11 (81.8%) women with abnormal bleeding we obtained complete resolution of symptoms. We had slightly worse results in the case of pelvic pain. In 4 (66.6%) of 6 patients the pain resolved completely. We have obtained 7 pregnancies in 11 (63.6%) patients operated on due to secondary infertility. In our opinion, laparoscopic treatment seems to be currently one of the most effective methods in isthmocele therapy. Further investigation is necessary to determine the indications for surgery, suitable treatment strategies and appropriate care.

CANDU 9 Design improvements based on experience feedback

International Nuclear Information System (INIS)

Yu, S. K. W.; Bonechi, M.; Snell, V. G.

2000-01-01

An evolutionary approach utilizing advance technologies has been implenented for the enhancement introduced in the CANDU 9 Nuclear Power Plant (NPP) design. The design of these systems and associated equipment has also benfited from experience feedback from operating CANDU stations and from including advanced products from CANDU engineering and research programs. This paper highlights the design features that contribute to the safety improvements of the CANDU 9 design, summarizes the analysis results which demonstrate the improved performance and also emphasizes design features which reduce operation and maintenance (Q and M) costs. The safety design features highlighted include the increased use of passive devices and heat sinks to achieve extensive system simplification; this also improves reliability and reduces maintenance workloads. System features that contribute to improved operability are also described. The CANDU 9 Control Center provides plant staff with enhanced operating, maintenance and diagnostics features which significantly improve operability, testing and maintainability due to the integration of human factors engineering with a systematic design process. (author)

A Four-Year Experience of Symptomatic Intracranial Hemorrhage Following Intravenous Tissue Plasminogen Activator at a Comprehensive Stroke Center.

Science.gov (United States)

Orlando, Alessandro; Wagner, Jeffrey C; Fanale, Christopher V; Whaley, Michelle; McCarthy, Kathryn L; Bar-Or, David

2016-04-01

To describe the 4-year experience of symptomatic intracranial hemorrhage (sICH) rate at a high-volume comprehensive stroke center. All admitted adult (≥18 years) patients presenting with an ischemic stroke from 2010 to 2013 were included in this study. The primary outcome was sICH, defined as any hemorrhage with neurological deterioration (change in National Institutes of Health Stroke Scale score ≥4) within 36 hours of intravenous tissue plasminogen activator (IV-tPA) treatment, or any hemorrhage resulting in death. Secondary outcomes were in-hospital mortality and having a favorable modified Rankin Scale (mRS) score (≤2). A total of 1925 did not receive intravascular (IV) or intra-arterial (IA) therapy; only 451 received IV therapy; and 175 received both IV and IA therapies. In IV-only patients, the overall rate of sICH was 2.2%; in IV and IA patients, the rate was 5.7%; and in patients who received no therapy, the rate was .4%. The IV-only group had an sICH rate of .9% in 2013. There were no differences in the adjusted odds of dying in the hospital between the study groups. IV-only treatment offered significantly better odds of achieving a favorable functional outcome, compared to no therapy, among patients with moderate stroke severity, whereas IV and IA treatments offered significantly better odds among patients with severe strokes. The odds of achieving a favorable functional outcome by discharge were decreased by 97% if patients suffered an sICH (OR = .03, 95%CI = .004, .19). Despite an increased risk of sICH with IV-tPA, treatment with IV-tPA continues to be associated with increased odds of a favorable discharge mRS. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Therapeutic plasma exchange in a single center: Ibni Sina experience.

Science.gov (United States)

Arslan, Onder; Arat, Mutlu; Tek, Ibrahim; Ayyildiz, Erol; Ilhan, Osman

2004-06-01

The number of therapeutic procedures is increasing steadily year by year with growing collaboration of departments other than Hematology. In the aim to demonstrate our single center activity we analyzed our data since four years. Between years 1998 and 2001, 658 therapeutic plasma exchange (TPE) procedures were performed on 158 patients. Median age and male/female ratio were 37 (range, 15-87) and 80/78, respectively. Main indications were myastenia gravis (n=55, 34%), TTP (n=13, 8.5%), post ABO mismatched allogeneic hematopoietic cell transplantation aregeneratoric anemia (n=6, 7.5%), progressive systemic sclerosis (n=10, 6.5%), multiple myeloma (n=10, 6.5%), Gullian Barre Syndrome (n=9, 5.9%), multiple sclerosis (n=7, 4.6%), Waldenström Macroglobulinemia (n=5, 3.4%), polymyositis (n=4, 2.7%), sepsis and disseminated intravascular coagulation (n=4, 2.7%). Departments who referred the majority of the patients for TPE were neurology (n=199), hematology (n=153), immunology (n=78), intensive care unit (n=78) and thorax surgery (n=51). The median TPE procedure per patient was 4 (range, 1-50). All the procedures were performed on continuous flow cell separators and median plasma volume processed per cycle was 2471 ml (range 436-5000). The replacement fluids used were 3% hydroxyethylstarch (HES) (24%), 5% albumin (35%), fresh frozen plasma (25%), and HES and albumin (16%). HES was tolerated well even as a sole replacement fluid with acceptable minor side effects. In three patients with progressing hypoalbuminemia HES was replaced or combined with 5% albumin. Close monitoring of serum albumin and fibrinogen levels after repeated procedures is mandatory. In our four years of TPE experience we have increased our collaboration with other departments. 3% HES+/-5% Albumin is a feasible, well tolerated and cost effective replacement fluid combination especially for short-term plasma exchange therapy.

DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11).

Science.gov (United States)

Bromet, E J; Hobbs, M J; Clouston, S A P; Gonzalez, A; Kotov, R; Luft, B J

2016-03-01

Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11-13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.

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

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Hyun Il Seo

2017-01-01

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

9 Office of Regions and Center Operations LANS -

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Department of Transportation — The 9 Office of Regions and Center Operations LANS located at regional offices is the backbone that provides connectivity to systems including servers, workstations,...

A clinicopathologic study of glomerular disease: A single-center, five-year retrospective study from Northwest India

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Pankaj Beniwal

2016-01-01

Full Text Available Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 702 renal biopsies performed between 2008 and 2013 were reviewed of which 80 were excluded from the study because of having insufficient records or if the biopsies were taken from an allograft. The study included 411 males (66.1 % and 211 females (33.9% with an age range of 12-70 years (mean 30.34 ± 7.04 years. Majority of the biopsies (93.9% showed some form of glomerulonephritis (GN, either primary (79.4% or secondary glomerular disease (SGD (14.5%. Minimal change disease (MCD was the most common type of primary GN (26.5% of primary GN, followed by membranous nephropathy (MN; 18.8% and focal and segmental glomerulosclerosis (FSGS; 13.2%. Lupus nephritis (LN was the most frequent SGD (52.2% of secondary GN. Amyloidosis was found in 41.1% and diabetic glomerulosclerosis in 4.4%. LN was also the second most common diagnosis in females after MCD, seen in 19.4% of females. MCD followed by membranoproliferative GN and diffuse proliferative GN were the most common entities in individuals <20 years of age. In the 20-39 years age group, MN was the most common pathology seen. MN was again the most common pathology seen in patients aged above 40 years followed by amyloidosis and FSGS. In this study, MCD was the most common primary GN observed overall from this part of India. MN was the most common GN in individuals above 20 years of age presenting with the nephrotic syndrome. The geographical and regional differences in the pattern of GNs point to the necessity of having a central biopsy registry.

A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

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Rakhee Sodhi

2016-03-01

Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

Spent fuel storage facility at science and technical center 'Sosny': Experience of ten years activity

International Nuclear Information System (INIS)

Chigrinov, S.; Goulo, V.; Lunev, A.; Belousov, N.; Salnikov, L.; Boiko, L.

2000-01-01

Spent fuel storage of the Academic Science and Technical Center in Minsk is in operation already more then 10 years. In the paper aspects of its design, operation practice, problems and decisions for future are discussed. (author)

Congenital heart defects: the 10-year experience at a single center.

Science.gov (United States)

Aydin, Emine; Aypar, Ebru; Oktem, Ahmet; Ozyuncu, Ozgur; Yurdakok, Murat; Guvener, Murat; Demircin, Metin; Beksac, M Sinan

2018-06-18

We aimed to evaluate congenital heart disease (CHD) cases according to EUROCAT subgroup classification that were diagnosed during the prenatal period in our center. CHDs that were prenatally diagnosed using ultrasonography and confirmed by fetal echocardiography were reviewed over a 10-year period. Subgroup classification was finalized at the post-partum period in terms of the EUROCAT guide 1.3. Congenital heart defect subtypes and obstetric outcomes (gestational week at delivery, birth weight, gender, extracardiac structural abnormalities, karyotype results if performed) were analyzed. The data of 180 cases with CHD was examined. Left ventricular outflow tract obstruction (LVOT) was the most common CHD subtype (57/180; 31.6%), which included 48, five, and four cases of hypoplastic left heart syndrome (HLHS), coarctation of the aorta, and aortic valve atresia/stenosis, respectively. Eighteen pregnancies were terminated; the most common CHD subtype among patients of terminated pregnancies was hypoplastic left heart syndrome (HLHS) (n = 7, 38.8%). The most common extracardiac malformations were a single umbilical artery, esophageal atresia, and situs inversus in our study group. Eighteen of the 96 (18.75%) neonates with CHD died during the neonatal period. The most common CHD subtype was HLHS (7/18; 38%) among the newborns who died after birth. Prenatal diagnosis of a CHD and subgroup classification is very important for clinical decision making, including prenatal management, recommendations for termination of the pregnancy, postnatal management of the patient, and for early referral to pediatric cardiology and cardiovascular surgery centers.

Choledochal cysts: our ten year experience.

LENUS (Irish Health Repository)

Cianci, F

2012-04-01

We present our experience in the management of choledochal cysts from 1999 to 2009. A retrospective review of all charts with a diagnosis of choledochal cysts in our institution in this ten-year period. Data was collated using Excel. A total of 17 patients were diagnosed with choledochal cyst: 9 females and 8 males. The average age at diagnosis was 28 months (range from 0 to 9 years). The most common presenting symptoms were obstructive jaundice 6 (35%) and abdominal pain and vomiting 4 (23%). Ultrasound (US) was the initial diagnostic test in all cases with 4 patients requiring further investigations. All patients underwent Roux-en-Y Hepaticojejunostomy. The average length of stay was 11 days. Patients were followed up with Liver Function Tests (LFTS) and US 4-6 weeks post-operatively. Three patients developed complications including post-op collection, high drain output requiring blood transfusion and adhesive bowel obstruction. Our overall experience with choledochal cyst patients has been a positive one with effective management and low complication rates.

Value of diagnostic and therapeutic laparoscopy for patients with blunt abdominal trauma: A 10-year medical center experience.

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Lin, Heng-Fu; Chen, Ying-Da; Chen, Shyr-Chyr

2018-01-01

Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006-2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B. The clinical outcomes of the 2 groups were compared. There were 139 patients in group A and 126 patients in group B. Group A patients were more severely injured (mean injury severity score of 23.3 vs. 18.9, P .05). Laparoscopy is a feasible and safe tool for the diagnosis and treatment of hemodynamically stable patients with blunt abdominal trauma who require surgery.

Retrospective Evaluation of Children with Congenital Pulmonary Airway Malformation: A Single Center Experience of 20 Years.

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Ortac, Ragip; Diniz, Gulden; Yildirim, Hulya Tosun; Aktas, Safiye; Karaca, Irfan

2016-01-01

Congenital pulmonary airway malformation (CPAM) is an uncommon congenital abnormality of the lungs that generally presents during prenatal period or early childhood. In this study, we aimed to evaluate clinical and pathologic findings of the children with CPAMs who were referred to our center between 1992 and 2011. We reviewed 19 children with CPAM, who were diagnosed and treated at the Izmir Dr. Behçet Uz Children's Hospital between 1992 and 2011. All of them are alive and have been still followed up by our center. The study population consisted of 9 boys (47.4%) and 10 girls (52.6%) with a mean age of 3.26 (1 month - 13 years). Most newborns had respiratory distress, while recurrent pulmonary infections were detected in older children. Surgical treatment was performed on patients with subtypes I (n = 4; 21.1%), II (n = 8; 42.1%), III (n = 5; 26.3%), and IV (n = 2; 10.5%). In 13 cases (63.4%), lesions were located in the right lung and in almost all cases lesions were confined to one lobe. A one-month- old child with type I CPAM had multiple lesions involving two lobes and in only a newborn with type II CPAM, lesions were located bilaterally. There was no type 0 cases in this series. All cases were treated with lobectomy without any complication. In the present study, a realistic comprehensive picture of CPAM in a central children's hospital has been provided. In addition, we want to emphasize that complications and unnecessary medical treatment could be reduced with early surgery.

International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

Directory of Open Access Journals (Sweden)

Chengquan Zhao

2015-01-01

Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

Liver transplantation utilizing old donor organs: a German single-center experience.

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Rauchfuss, F; Voigt, R; Dittmar, Y; Heise, M; Settmacher, U

2010-01-01

Due to the current profound lack of suitable donor organs, transplant centers are increasingly forced to accept so-called marginal organs. One criterion for marginal donors is the donor age >65 years. We have presented herein the impact of higher donor age on graft and patient survival. Since 2004, 230 liver transplantations have been performed at our center, including 54 donor organs (23.5%) from individuals >65 years of age. We performed a retrospective analysis of recipient and graft survivals. The overall 1-year mortality was 22.2% (12/54) among recipients of organs from older donors versus 19.5% among recipients whose donors were donor organs were grouped according to age, the 1-year mortality in patients receiving organs from donors aged 65-69 years was 30% (6/20); 70-74 years, 29.4% (5/17); and donors >75 years, 5.9% (1/17). There was no significant correlation between mortality rate and the number of additional criteria of a marginal donor organ. The current lack of donor organs forces transplant centers to accept organs from older individuals; increasingly older patients are being recruited for the donor pool. Our results showed that older organs may be transplanted with acceptable outcomes. This observation was consistent with data from the current literature. It should be emphasized, however, that caution is advised when considering the acceptance of older organs for patients with hepatitis C-related cirrhosis.

Culture and diet among Chinese American children aged 9–13 years: A qualitative study

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This study examined Chinese American children's behaviors, food preferences, and cultural influences on their diet. Qualitative individual interviews were conducted with twenty-five Chinese American children aged 9-13 years in community centers and Chinese schools in Houston, TX using constructs fro...

Pancreas transplantation with grafts from donors deceased after circulatory death (DCD) : 5 years single center experience

NARCIS (Netherlands)

Kopp, Wouter H; Lam, Hwai-Ding; Schaapherder, Alexander F M; Huurman, Volkert A L; van der Boog, Paul; de Koning, Eelco; de Fijter, Johan W; Baranski, Andrzej; Braat, Andries E

2017-01-01

INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to

Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States.

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2015-01-01

The National Consortium of Torture Treatment Programs conducted a large voluntary research project among torture rehabilitation centers in the United States (US). Its goal is to fill the void in the literature on demographic and diagnostic data of torture survivors across a large country. Twenty-three centers across the US collaborated over six years, utilizing training and making decisions via conference calls and webinars. A data use agreement signed by all the participating centers governed plans and the use of the data. This study reports on torture survivors from 125 countries, 109 of which signed the United Nations Convention against Torture (UNCAT). Of the 9,025 torture survivors represented, most came from Africa and Asia and reported an average of 3.5 types of torture. Asylum seekers have different immigration experiences and show significantly higher rates of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) than refugees. Torture survivors at high risk of PTSD and MDD in this sample reported three or more types of torture, reported rape, and had the immigration status of asylum seeker. At one and two years after beginning treatment, both asylum seekers and refugees reported increased rates of employment and improvements in their immigration status. This longitudinal project provides basic data on a large number of torture survivors who accessed services in the US, and provides a foundation for long-term follow up on immigration status, employment status, diagnostic status, medical diagnoses, and eventually, the effectiveness of treatment for torture survivors in the US. This article shares demographic and diagnostic findings useful for informing programmatic and policy decisions. However, these findings on refugees and asylum seekers in the US may not reflect the experience in other receiving countries. Collaboration with other researchers across continents is required to provide a much needed, more complete picture of torture

Surgical management of rectal foreign bodies: a 10-year single-center experience

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Kokemohr Pia

2017-05-01

Full Text Available Patients with a rectal foreign body (RFB are still a rare entity in general surgery departments but with an increasing incidence over the last years. This case is sometimes difficult to treat, and due to a lack of standardized treatment options, the aim of the study was to present our clinical experiences with the diagnostic and therapeutic approach to RFBs and a review of the currently available literature.

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

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Elusta Ahmed

2008-01-01

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

User-Centered Design of Serious Games for Older Adults Following 3 Years of Experience With Exergames for Seniors: A Study Design.

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Brox, Ellen; Konstantinidis, Stathis Th; Evertsen, Gunn

2017-01-11

Seniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors' use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach. In this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs. An initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions. A total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the UCD methods produce a valid outcome. By

9+ The Year-Round School.

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American Association of School Administrators, Washington, DC.

The 9-month school year with a 3-month summer vacation had its origin in our earlier agrarian life. Today's teacher shortages, overcrowded schools, and pressures to learn demand extensions of the school year. This publication analyzes five programs: (1) a staggered-vacation school year for all, (2) a full 48-week school year for all, (3) a…

The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease.

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Glazier, Kenneth D; Palance, Adam L; Griffel, Louis H; Das, Kiron M

2005-01-01

To report the 10-year experience of a single center in treating patients with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6-mercaptopurine (6-MP). The charts of 285 patients with IBD (Crohn's disease 160 and ulcerative colitis 125) receiving 6-MP were reviewed. Clinical response, subsequent breakthrough while taking 6-MP, and relapse rates when 6-MP was discontinued and side effects were assessed. Ninety-three percent of the patients were taking 50 to 75 mg/day of 6-MP. Complete remission was achieved in 62%, partial remission in 14.5%, and failure to achieve remission in 23.5% of the patients. Of complete responders, 27.5% had breakthrough while continuing 6-MP. Nine percent of those that achieved a complete remission experienced a relapse after 6-MP was discontinued. Side effects included leukopenia (11.2%), abnormal liver function tests (3.8%), various infections, including pneumonia (3.1%), pancreatitis (2.5%), nausea (2.1%), headache (2.8%), fever (1.4%), hair loss (1%), and rash (0.7%). Two cancers occurred while taking 6-MP: melanoma on the finger and a fatal colonic lymphoma. Four patients continued 6-MP throughout pregnancies and had normal outcomes. In our experience 6-MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommended higher dosage (1-1.5 mg/kg per day), when leukopenia was more frequent. Serious side effects, although rare, need to be monitored.

Experience based reliability centered maintenance

International Nuclear Information System (INIS)

Haenninen, S.; Laakso, K.

1993-03-01

The systematic analysis and documentation of operating experiences should be included in a living NPP life management program. Failure mode and effects and maintenance effects analyses are suitable methods for analysis of the failure and corrective maintenance experiences of equipment. Combined use of the information on occurred functional failures and the decision tree logic of the reliability centered maintenance identifies applicable and effective preventive maintenance tasks of equipment in an old plant. In this study the electrical motor drives of closing and isolation valves (MOV) of TVO and Loviisa nuclear power plants were selected to serve as pilot study objects. The study was limited to valve drives having actuators manufactured by AUMA in Germany. The fault and maintenance history of MOVs from 1981 up to and including October 1991 in different safety and process systems at TVO 1 and 2 nuclear power units was at first analyzed in a systematic way. The scope of the components studied was 81 MOVs in safety-related systems and 127 other MOVs per each TVO unit. In the case of the Loviisa plant, the observation period was limited to three years, i.e. from February 1989 up to February 1992. The scope of the Loviisa 1 and 2 components studied was 44 respectively 95 MOVs. (25 refs., 22 figs., 8 tabs.)

Chronic probable PTSD in police responders in the world trade center health registry ten to eleven years after 9/11.

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Cone, James E; Li, Jiehui; Kornblith, Erica; Gocheva, Vihra; Stellman, Steven D; Shaikh, Annum; Schwarzer, Ralf; Bowler, Rosemarie M

2015-05-01

Police enrolled in the World Trade Center Health Registry (WTCHR) demonstrated increased probable posttraumatic stress disorder (PTSD) after the terrorist attack of 9/11/2001. Police enrollees without pre-9/11 PTSD were studied. Probable PTSD was assessed by Posttraumatic Stress Check List (PCL). Risk factors for chronic, new onset or resolved PTSD were assessed using multinomial logistic regression. Half of police with probable PTSD in 2003-2007 continued to have probable PTSD in 2011-2012. Women had higher prevalence of PTSD than men (15.5% vs. 10.3%, P = 0.008). Risk factors for chronic PTSD included decreased social support, unemployment, 2+ life stressors in last 12 months, 2+ life-threatening events since 9/11, 2+ injuries during the 9/11 attacks, and unmet mental health needs. Police responders to the WTC attacks continue to bear a high mental health burden. Improved early access to mental health treatment for police exposed to disasters may be needed. © 2015 Wiley Periodicals, Inc.

Adrenal trauma: Elvis Presley Memorial Trauma Center experience.

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Mehrazin, Reza; Derweesh, Ithaar H; Kincade, Matthew C; Thomas, Adam C; Gold, Robert; Wake, Robert W

2007-11-01

Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma. We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at Memphis who had adrenal gland injuries from January 1991 through March 2006. Each chart was reviewed with attention to the demographics, associated injuries, complications, and outcomes. Patients were stratified into two subgroups according to age (35 years or younger and older than 35 years) to allow for an age-based comparison between the two groups. Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients, 125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their injury diagnosed during exploratory laparotomy. Right-sided injuries predominated (78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy. Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic steroid therapy. Patients older than 35 years were more likely to have complications such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age of 35 years or younger was associated with a significantly increased incidence of liver lacerations. Adrenal gland injury is uncommon, although mostly associated with greater injury severity. Although adding to morbidity, most are self-limited and do not require intervention.

Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

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Ruscelli, Paolo; Buccoliero, Farncesco; Mazzocato, Susanna; Belfiori, Giulio; Rabuini, Claudio; Sperti, Pierluigi; Rimini, Massimiliano

2017-01-01

The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C. Form 732 Trauma, 356(48.6%) of patients were submitted to a surgical procedure, all the other patient 376(51.4%) underwent an non operative management .Overall mortality was 9.8% (72), mortality in the surgery group was 15.4% eheras in the non operative group was 4.5%; the relative risk of mortality, measured by the odds ratio waith a 95% confidence interval, was 3.417(2.023-5.772) for rhe surgery group; patient over 40 years old has a statistically significant higher mortality. In our series the overall mortality rate of non operative management group was 4.5%, instead in unstable patients, the surgery group, the mortality was 15.3%; the overall mortality mortality rate after the application of our protocol is 9.8%, Although surgery continues to be the standard for hemodically unstable patients with blunt hepatic and splenic trauma. In our experience AAST Organ Injury Scale was useless for the therapeutic decision making process after the CT scan if a source of bleeding was detected and immediate angiography was performed in order to control and solve it. In our experience the AAST Organ Injury Scale was useless for the therapeutic decision making process, The results suggest that the only criteria of choice for therapeutici strategy was the hemodynamic stability, Nonoperative managem,ent can be applied only following

Clinical characteristics of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years: A single-center experience.

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Chen, Yi-Chen; Tung, Yi-Ching; Liu, Shih-Yao; Lee, Cheng-Ting; Tsai, Wen-Yu

2017-05-01

Cases of type 1 diabetes mellitus in children aged younger than 6 years in Taiwan has increased in the past 10 years. This retrospective study aimed to review the management experience of such patients in a single center. From January 2004 to June 2015, 52 newly diagnosed diabetic children younger than 6 years who had regular follow-up for > 1 year were enrolled, as well as 94 older diabetic children for comparison. Their medical records were thoroughly reviewed. The most common symptoms and signs were polyuria, polydipsia, dry lips, weight loss, and nocturia. Among the children younger than 6 years, 87% had ketoacidosis upon diagnosis-significantly higher than that of the older age group-and 88% had at least one islet cell autoantibody detected. Their serum C-peptide levels were significantly lower and the frequency of insulin autoantibodies detected was significantly higher compared with the older age group (37% vs. 10%). The remission rate of the young diabetic patients was significantly lower than that of the older age group (40% vs. 59%), but there was no difference in time of onset and duration of remission between the two groups. Autoimmune destruction of pancreatic β-cells is an important cause of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years. These patients usually have a low insulin reserve and severe ketoacidosis upon diagnosis. A high index of suspicion in the presence of classic symptoms of diabetes in young children is important to prevent complications. Copyright © 2016. Published by Elsevier B.V.

Whipple procedure: a review of a 7-year clinical experience in a referral center for hepatobiliary and pancreas diseases.

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Saraee, Amir; Vahedian-Ardakani, Jalal; Saraee, Ehsan; Pakzad, Roshanak; Wadji, Massoud Baghai

2015-03-11

Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors. Allen. O Whipple was the first to describe pancreaticoduodenectomy in 1935 as a modified procedure. This article is a case series with respect to the 7-year experience of the Whipple procedure in Firoozgar Teaching Hospital. Patient surgery details were gathered from the surgical records of the operating room and their clinical records from the hospital archives. Data was analyzed with SPSS software (version 16.0.1). Those patients, whose tumor had invaded the superior mesenteric artery, had extensive portal vein involvement or distant metastasis was considered as unresectable. The first Whipple procedure was recorded in our hospital in 2008. From 2008 till 20 March 2014, 70 cases were collected and analyzed. The mean age of cases was 58.4 years, the mean hospital stay length was 12.9 days (±6.23 days), mean operation time was 376 min (±37.3 min),. The most common presenting symptom was jaundice (78.6 %). Delayed gastric emptying was the most common post-operative complication. The most prevalent cause of reoperation was intra-abdominal abscess. Major morbidities of these patients consisted of cardiac arrhythmias (21.4%) and pneumonia (10%). Minor complications were wound infection (17.1%) and delayed gastric emptying (32.9%). The statistics revealed pancreatic anastomosis failure as 2.9% and a decrease in mortality rate from 50% during the first years of this study to 16% to 20% during the last years. In this case series, the time of operation decreased during the recent years .Analysis shows a correlation between operation time and pack cell transfused during the operation, but no correlation was found between operation time and post-operation hospitalization course. It is true that hospital setting, socioeconomic level of the patients including their compliance, and the expertise of the surgeons and surgical staff

Survival in pediatric lung transplantation: The effect of center volume and expertise.

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Khan, Muhammad S; Zhang, Wei; Taylor, Rachel A; Dean McKenzie, E; Mallory, George B; Schecter, Marc G; Morales, David L S; Heinle, Jeffrey S; Adachi, Iki

2015-08-01

Institutional operative volume has been shown to impact outcomes of various procedures including lung transplantation (LTx). We sought to determine whether this holds true with pediatric LTx by comparing outcomes of adult centers (with larger overall volume) to those of pediatric centers (with smaller volume but more pediatric-specific experience). A retrospective analysis of the Organ Procurement and Transplant Network data was performed. Centers were categorized as either adult (LTx volume predominantly in adult patients), high-volume pediatric (HVP, ≥4 LTxs/year), or low-volume pediatric (LVP, HVP 3 [5%], LVP 8 [13%]). Although adult centers had larger overall LTx volume, their pediatric experiences were severely limited (median 1/year). In younger children, HVP centers were significantly better than LVP centers for patient survival (half-life: 7.3 vs 2.9 years, p = 0.002). Similarly, in older children and adolescents, HVP centers were significantly better than adult centers for patient survival (half-life: 4.6 vs 2.5 years, p = 0.001). Of note, even LVP centers tended to have longer patient survival than adult centers (p = 0.064). Multivariable analysis identified adult centers as an independent risk factor for graft failure (hazard ratio: 1.5, p < 0.001) as with LVP (hazard ratio: 1.3, p = 0.0078). Despite larger overall clinical volume, outcomes among pediatric LTx recipients in adult centers are not superior to those of pediatric centers. Not only center volume but pediatric-specific experience has an impact on outcomes in pediatric LTx. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Peritoneal dialysis and peritonitis rate: Kuwait, four years' experience.

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Alyousef, Anas M; Abdou, Salah M; Mansour, Yasser S; Radi, Ahmad D

2016-01-01

Peritoneal dialysis (PD) program was established in Farwaniya Hospital Kidney Center, Kuwait, in February 2011. Patient recruitment for this modality of treatment was growing steadily. One of the major complications of PD is peritonitis. There is a belief that PD therapy is inferior and carries more complications than hemodialysis, we aimed to show that PD is a good and a non-inferior option for dialysis therapy with comparable outcome in both patient and technique survival. This was a retrospective analysis of all patients who were on PD from February 2011 to December 2014. Peritonitis rate, exit site infection rate, and all-cause mortality rate were all assessed for this period. Peritonitis rate during the 1 st year, 2011, was 0.92 incidents/year. This number had progressively declined in the following years; in 2012, it was 0.65 incidents/year; in 2013, it was 0.58 incidents/year; and in 2014, it was 0.38 incidents/year. This improvement in the rate of peritonitis incidence could be explained by better education of patients and meticulous supervision of the nursing staff. Farwaniya Hospital Kidney Center had an all-cause mortality rate of 9.3% among patients on renal replacement therapy in 2011. In 2012, all-cause mortality rate increased to 17.1%. The following year, 2013, it decreased to 14.3%, and in 2014, all-cause mortality rate dropped further to 7.6%. All-cause mortality rate among PD patients was zero in 2011. In 2012, the all-cause mortality rate in PD was 11.54%, and in 2013, it decreased to 10.52%. Then, again in 2014, the all-cause mortality rate among PD patients was zero. This improvement in all-cause mortality rate could be explained by the better medical care offered to the end-stage renal disease patients, in particular PD patients, in Farwaniya Hospital Kidney Center.

Percutaneous occlusion of vascular malformations in pediatric and adult patients: 20-year experience of a single center.

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Pereira-da-Silva, Tiago; Martins, José Diogo; de Sousa, Lídia; Fiarresga, António; Trigo Pereira, Conceição; Cruz Ferreira, Rui; Ferreira Pinto, Fátima

2016-02-01

A case series on different vascular malformations (VM) treated with percutaneous occlusion in children and adults is presented. Percutaneous occlusion is usually the preferred treatment method for VM. Previous series have mostly focused on single types of devices and/or VM. Retrospective analysis of all patients who underwent percutaneous occlusion of VM in a single center, from 1995 to 2014, excluding patent ductus arteriosus. Clinical and angiographic data, procedural details, implanted devices, and complications were assessed. Procedural success was defined as effective device deployment with none or minimal residual flow. Predictors of procedural failure and complications were determined by multivariate analysis. A total of 123 VM were intervened in 47 patients with median age of 12 years (25 days-76 years). The VM included 55 pulmonary arteriovenous fistulae, 39 aortopulmonary collaterals, 10 systemic venovenous collaterals, 8 peripheral arteriovenous fistulae, 5 Blalock-Taussig shunts, 4 coronary fistulae, and 2 Fontan fenestrations. The 143 devices used included 80 vascular plugs, 38 coils, 22 duct occluders, and 3 foramen ovale or atrial septal defect occluders. Median vessel size was 4.5 (2.0-16.0) mm and device/vessel size ratio was 1.4 (1.1-2.0). Successful occlusion was achieved in 118 (95.9%) VM, including three reinterventions. Four (3.3%) clinically relevant complications occurred, without permanent sequelae. Lower body weight was independently associated with procedural failure and complications. To our knowledge, this is the largest series on different VM occluded percutaneously in children and adults, excluding patent ductus arteriosus. Percutaneous occlusion was effective and safe, using different devices. © 2015 Wiley Periodicals, Inc.

Assessment of the Patient-Centered and Family-Centered Care Experience of Total Joint Replacement Patients Using a Shadowing Technique.

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Marcus-Aiyeku, Ulanda; DeBari, Margaret; Salmond, Susan

2015-01-01

In 2030, when baby boomers reach 65 years of age and represent 18% of the population, it is anticipated that 67 million adults will have a diagnosis of arthritis increasing the demand for total hip and knee arthroplasty. With the growing emphasis on patient- and family-centered care, the aim of this project was to assess the patient experience of patients and families throughout the entire spectrum of the total joint replacement service line care at a university regional trauma hospital. A shadowing methodology as defined by the Institute for Health Improvement was utilized. Eight patient/family groups undergoing total joint replacements were shadowed. The mapped care experience included time, caregiver, activity, shadower observations, and impressions. Findings revealed inconsistencies in the delivery of patient- and family-centered care. Communication and interactions were predominantly provider-centric, with a focus on care routines versus the patient and family, and anticipation that care would be medically directed.

Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia.

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Rajagopal, Revathi; Abd-Ghafar, Sayyidatul; Ganesan, Dharmendra; Bustam Mainudin, Anita Zarina; Wong, Kum Thong; Ramli, Norlisah; Jawin, Vida; Lum, Su Han; Yap, Tsiao Yi; Bouffet, Eric; Qaddoumi, Ibrahim; Krishnan, Shekhar; Ariffin, Hany; Abdullah, Wan Ariffin

2017-04-01

Pediatric medulloblastoma (MB) treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE) for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100%) in the average-risk group, and 5-year overall survival (± SE) in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) and 58.3% ± 18.6% (95% CI, 31.3% to 100%), respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE) of 47.6% ± 12.1% (95% CI, 28.9% to 78.4%) and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%), respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer Registry and pathology reports, inadequate long

Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

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Hassan Al-Thani

2016-07-01

Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil.

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Schweiger, Cláudia; Manica, Denise; Becker, Carolina Fischer; Abreu, Larissa Santos Perez; Manzini, Michelle; Sekine, Leo; Kuhl, Gabriel

Children may require tracheostomy due to many different health conditions. Over the last 40 years, indications of tracheostomy have endorsed substantial modifications. To evaluate pediatric patients warranted tracheostomy at our Hospital, in regard to their indications, associated comorbidities, complications and decannulation rates. Retrospective study concerning patients under 18 years of age undergoing tracheostomy in a tertiary health care center, from January 2006 to November 2015. 123 children required a tracheostomy after ENT evaluation during the study period. A proportion of 63% was male, and 56% was under one year of age. Glossoptosis was the most common indication (30%), followed by subglottic stenosis (16%) and pharyngomalacia (11%). The mortality rate was 31%. By the end of this review, 35 children (28.4%) had been decannulated, and the fewer the number of comorbidities, the greater the decannulation rate (0.77±0.84 vs. 1.7±1.00 comorbidities; pneurological conditions in this cohort. Our decannulation rate is slightly below other series, probably because of the greater amount of patients with comorbidities. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Ecology-centered experiences among children and adolescents: A qualitative and quantitative analysis

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Orton, Judy

The present research involved two studies that considered ecology-centered experiences (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the opportunity to learn about ecology through ecology-centered experiences. To do this, I carried out a yearlong ethnographic study at an urban community garden located in a large city in the Southeastern United States. Through participant observations and informal interviews of community garden staff and participants, I found children had opportunities to learn about ecology through ecology-centered experiences (e.g., interaction with animals) along with other experiences (e.g., playing games, reading books). In light of previous research that shows urban children have diminished ecological thought---a pattern of thought that privileges the relationship between living things---because of their lack of ecology-centered experiences (Coley, 2012), the present study may have implications for urban children to learn about ecology. As an extension of Study 1, I carried out a second study (Study 2) to investigate how ecology-centered experiences contribute to adolescents' environmental attitudes and behaviors in light of other contextual factors, namely environmental responsibility support, ecological thought, age and gender. Study 2 addressed three research questions. First, does ecological thought---a pattern of thought that privileges the relationship between living things---predict environmental attitudes and behaviors (EAB)? Results showed ecological thought did not predict EAB, an important finding considering the latent assumptions of previous research about the relationship between these two factors (e.g., Brugger, Kaiser, & Roczen, 2011). Second, do two types of contextual support, ecology-centered experiences (i.e., experiences with

The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center.

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Kim, Jong Seung; Oh, Jong Seok; Kwon, Sam Hyun

2016-06-01

Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.

CUBED: South Dakota 2010 Research Center For Dusel Experiments

International Nuclear Information System (INIS)

Keller, Christina; Alton, Drew; Bai Xinhau; Durben, Dan; Heise, Jaret; Hong Haiping; Howard, Stan; Jiang Chaoyang; Keeter, Kara; McTaggart, Robert; Medlin, Dana; Mei Dongming; Petukhov, Andre; Rauber, Joel; Roggenthen, Bill; Spaans, Jason; Sun Yongchen; Szczerbinska, Barbara; Thomas, Keenan; Zehfus, Michael

2010-01-01

With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

Management of vestibular schwannomas with linear accelerator-based stereotactic radiosurgery: a single center experience.

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Sager, Omer; Beyzadeoglu, Murat; Dincoglan, Ferrat; Demiral, Selcuk; Uysal, Bora; Gamsiz, Hakan; Oysul, Kaan; Dirican, Bahar; Sirin, Sait

2013-01-01

The primary goal of treatment for vestibular schwannoma is to achieve local control without comprimising regional cranial nerve function. Stereotactic radiosurgery has emerged as a viable therapeutic option for vestibular schwannoma. The aim of the study is to report our 15-year single center experience using linear accelerator-based stereotactic radiosurgery in the management of patients with vestibular schwannoma. Between July 1998 and January 2013, 68 patients with unilateral vestibular schwannoma were treated using stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. All patients underwent high-precision stereotactic radiosurgery using a linear accelerator with 6-MV photons. Median follow-up time was 51 months (range, 9-107). Median age was 45 years (range, 20-77). Median dose was 12 Gy (range, 10-13) prescribed to the 85%-95% isodose line encompassing the target volume. Local tumor control in patients with periodic follow-up imaging was 96.1%. Overall hearing preservation rate was 76.5%. Linear accelerator-based stereotactic radiosurgery offers a safe and effective treatment for patients with vestibular schwannoma by providing high local control rates along with improved quality of life through well-preserved hearing function.

7 CFR 985.9 - Marketing year.

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2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing year. 985.9 Section 985.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE MARKETING ORDER REGULATING THE...

Renal and obstetric outcomes in pregnancy after kidney transplantation: Twelve-year experience in a Singapore transplant center.

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Kwek, Jia Liang; Tey, Vanessa; Yang, Liying; Kanagalingam, Devendra; Kee, Terence

2015-09-01

Renal and obstetric outcomes in pregnancy after kidney transplantation in Singapore were last studied in 2002. A review of these outcomes in Singapore is now timely following advances in transplant and obstetric medicine. The aim was to evaluate the renal and obstetric outcomes in pregnancy after kidney transplantation in a Singapore tertiary center. Kidney transplant recipients who underwent pregnancy after transplantation at Singapore General Hospital between January 2001 and December 2012 were identified. Data on demographics, comorbidities and clinical outcomes were collected. There were 10 pregnancies identified in nine recipients. The median age of recipient at childbearing was 34.6 years (IQR, 32.8-36.8) and the median interval from transplantation to conception was 69 months (IQR, 38-97). There was no difference between the median pre-pregnancy estimated glomerular filtration rate (eGFR) (47.9 mL/min/1.73 m(2); IQR, 38.4-56.8) and median eGFR at time of last post-partum follow up (43.9 mL/min/1.73 m(2); IQR, 34.5-48.7, P = 0.549). Borderline allograft rejection occurred in one recipient (10.0%) 36 days after birth due to non-adherence to immunosuppressive medication, with subsequent allograft loss 37 months after birth. No mortalities were recorded during the study period. All the 10 pregnancies (100%) ended in singleton live births. Pre-eclampsia occurred in five pregnancies (50.0%), and there were seven (70.0%) preterm deliveries. The median gestational age was 35.4 weeks (IQR, 32.6-38.2) and the median birthweight was 2353 g (IQR, 1811-2648). Post-transplantation pregnancies ended successfully with no significant worsening of allograft function, but they were associated with risks to both recipients and newborns. © 2015 Japan Society of Obstetrics and Gynecology.

A single center 26-year experience with treatment of esophageal achalasia: is there an optimal method?

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Pastor, Aimee C; Mills, Jessica; Marcon, Margaret A; Himidan, Sharifa; Kim, Peter C W

2009-07-01

Treatment modalities for achalasia are evolving and remain controversial. Herein, we report the relative efficacy and outcomes after dilatation or myotomy in children with achalasia. A retrospective analysis of all children treated for achalasia at a tertiary center from 1981 to 2007 was performed (n = 40). Demographics, presenting symptoms, perioperative parameters, and outcomes were analyzed using t tests and chi(2) statistics. Thirty patients were initially treated by esophageal dilatation (ED), whereas 10 were treated by laparoscopic or open Heller myotomy (HM). Both groups were similar with respect to age (10.6 vs 12.4 years; P = .19). There were 18 males and 12 females in the ED group, compared to 5 males and 5 females in the HM group (P = .72). Mean duration of symptoms before diagnosis, including dysphagia, vomiting, food sticking, chest pain, and weight loss, was 15.9 months for ED and 10.7 months for HM (P = .41). Mean time from diagnosis to initial intervention was 76 days in ED vs 86 days in HM (P = .78). Subsequent interventions by myotomy or both dilatation and myotomy were required in 9 (30%) of 30 patients in the ED group and 2 (20%) of 10 patients in the HM group (P = .70). A clear transition from open to laparoscopic approach occurred between 1995 and 2001. Mean operating times were comparable (186.3 vs 156.0 minutes; P = .48). Of 14 laparoscopic myotomies, 11 (79%) had fundoplication, and 2 (18%) of the 11 were converted to open procedure. Intraoperative mucosal perforation rates were similar between open and laparoscopic groups (17% vs 18%). At follow-up, 32% of ED patients vs 43% HM had complete symptom relief (mean follow-up duration, 75.2 months; SD, 196.5). Both dilatation and myotomy are effective immediate treatment of achalasia. A clear transition to and preference for laparoscopic approach has occurred in the treatment of achalasia in children.

Pediatric Liver Transplantation: Our Experiences.

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Basturk, Ahmet; Yılmaz, Aygen; Sayar, Ersin; Dinçhan, Ayhan; Aliosmanoğlu, İbrahim; Erbiş, Halil; Aydınlı, Bülent; Artan, Reha

2016-10-01

The aim of our study was to evaluate our liver transplant pediatric patients and to report our experience in the complications and the long-term follow-up results. Patients between the ages of 0 and 18 years, who had liver transplantation in the organ transplantation center of our university hospital between 1997 and 2016, were included in the study. The age, sex, indications for the liver transplantation, complications after the transplantation, and long-term follow-up findings were retrospectively evaluated. The obtained results were analyzed with statistical methods. In our organ transplantation center, 62 pediatric liver transplantations were carried out since 1997. The mean age of our patients was 7.3 years (6.5 months-17 years). The 4 most common reasons for liver transplantation were: Wilson's disease (n=10; 16.3%), biliary atresia (n=9; 14.5%), progressive familial intrahepatic cholestasis (n=8; 12.9%), and cryptogenic cirrhosis (n=7; 11.3%). The mortality rate after transplantation was 19.6% (12 of the total 62 patients). The observed acute and chronic rejection rates were 34% and 4.9%, respectively. Thrombosis (9.6%) was observed in the hepatic artery (4.8%) and portal vein (4.8%). Bile leakage and biliary stricture rates were 31% and 11%, respectively. 1-year and 5-year survival rates of our patients were 87% and 84%, respectively. The morbidity and mortality rates in our organ transplantation center, regarding pediatric liver transplantations, are consistent with the literature.

10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center.

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Chen, Jenny T; Nayar, Harry S; Rao, Venkat K

2017-09-01

In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

Report on administrative work at radiation safety center in fiscal year 2000

Energy Technology Data Exchange (ETDEWEB)

Uda, Tatsuhiko; Sakuma, Yoichi; Kawano, Takao; Yamanishi, Hirokuni; Shinotsuka, Kazunori; Asakura, Yamato; Miyake, Hitoshi

2002-05-01

National Institute for Fusion Science constructed Large Helical Device (LHD) which is the largest magnetic confinement plasma experimental device using super conductive magnet coils. It took eight years to construct and the first plasma shot had been carried out on March 1998. Since then plasma confinement experiments have been improved. This is the report of administrative work at the radiation safety center considering radiation protection for workers at the LHD and related devices, and radiation monitoring in the site. Major scope is as follows. (1) Radiation measurement and dose monitoring in the radiation controlled area and in the site using particularly developed monitoring system named as Radiation Monitoring System Applicable to Fusion Experiments (RMSAFE). (2) Establishment of education and registration system for radiation workers and access control system for the LHD controlled area. I hope that as like the published report of fiscal year 1999, the present report will be helpful for management of future radiation protection in the research institute. (author)

Acute pancreatitis during pregnancy, 7-year experience of a tertiary referral center.

Science.gov (United States)

Vilallonga, Ramón; Calero-Lillo, Aránzazu; Charco, Ramón; Balsells, Joaquim

2014-01-01

Acute pancreatitis is a common cause of acute abdomen in pregnant women. The purpose of this study was to determine the frequency at our institution and its management and outcomes. A retrospective analysis of a database of cases presented in 7 consecutive years at a tertiary center was performed. Between December 2002 and August 2009, there were 19 cases of acute pancreatitis in pregnant women, 85% with a biliary etiology. The highest frequency was in the third trimester of pregnancy (62.5% cases). In cases of gallstone pancreatitis, 43.6% of pregnant women had had previous episodes before pregnancy. A total of 52.6% of the patients were readmitted for a recurrent episode of pancreatitis during their pregnancy. Overall, 26.3% of the patients received antibiotic treatment and 26.3% parenteral nutrition. Laparoscopic cholecystectomy was performed during the 2nd trimester in two patients (10.5%). There was no significant maternal morbidity. Acute pancreatitis in pregnant women usually has a benign course with proper treatment. In cases of biliary origin, it appears that a surgical approach is suitable during the second trimester of pregnancy. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia

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Revathi Rajagopal

2017-04-01

Full Text Available Purpose: Pediatric medulloblastoma (MB treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Methods: Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Results: Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4% in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100% in the average-risk group, and 5-year overall survival (± SE in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4% and 58.3% ± 18.6% (95% CI, 31.3% to 100%, respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE of 47.6% ± 12.1% (95% CI, 28.9% to 78.4% and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%, respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. Conclusion: The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer

Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India

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Mohammad Shahbaaz Khan

2013-01-01

Full Text Available Background: Cardiac myxoma is the most common benign intracardiac tumor. We studied its clinical presentation, morbidity, mortality and recurrence following surgery over a period of 9 years. Materials and Methods: This study was performed at cardiothoracic and vascular surgery department of a tertiary level hospital of eastern India, Seth Sukhlal Karnani Memorial hospital, Institute of Post Graduate Medical Education and Research Kolkata. Near 6000 cardiac cases were operated at our center over this period. Preoperative diagnosis was made with clinical presentation and preoperative echocardiography. Complete tumor excision was done and all patients were followed up for recurrence and complications. Result: A total of 38 cases of cardiac myxoma were operated over a period from October 2002 to October 2011. Cardiac myxoma constituted about 0.6% of all cardiac cases operated at our institute. This most commonly presented at fifth decade of life. Of these, 35 cases were left atrial and 2 cases were right atrial, and 1 case was having both atrial involvements. The left atrial myxoma mostly presented as mitral stenosis and very few presented with embolic and constitutional symptoms. No death or recurrence was observed during the follow up period. Conclusion: Cardiac myxomas form a very small percentage of the cardiac cases. A high index of suspicion is essential for diagnosis. Echocardiography is the ideal diagnostic tool as also for follow-up. Immediate surgical treatment is indicated in all patients. Cardiac myxomas can be excised with a low rate of mortality and morbidity.

Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil,

Directory of Open Access Journals (Sweden)

Cláudia Schweiger

Full Text Available Abstract Introduction: Children may require tracheostomy due to many different health conditions. Over the last 40 years, indications of tracheostomy have endorsed substantial modifications. Objective: To evaluate pediatric patients warranted tracheostomy at our Hospital, in regard to their indications, associated comorbidities, complications and decannulation rates. Methods: Retrospective study concerning patients under 18 years of age undergoing tracheostomy in a tertiary health care center, from January 2006 to November 2015. Results: 123 children required a tracheostomy after ENT evaluation during the study period. A proportion of 63% was male, and 56% was under one year of age. Glossoptosis was the most common indication (30%, followed by subglottic stenosis (16% and pharyngomalacia (11%. The mortality rate was 31%. By the end of this review, 35 children (28.4% had been decannulated, and the fewer the number of comorbidities, the greater the decannulation rate (0.77 ± 0.84 vs. 1.7 ± 1.00 comorbidities; p < 0.001. Conclusion: Tracheostomy in children is a relatively frequent procedure at our hospital. The most common indications are glossoptosis and subglottic stenosis. A high mortality rate was found, potentially substantiated by the high number of critical care patients with chronic neurological conditions in this cohort. Our decannulation rate is slightly below other series, probably because of the greater amount of patients with comorbidities.

The Ross Procedure in Pediatric Patients: A 20-Year Experience of Ross Procedure in a Single Institution.

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Yoon, Dong Woog; Yang, Ji-Hyuk; Jun, Tae-Gook; Park, Pyo Won

2017-08-01

The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. Between June 1995 and January 2016, 16 consecutive patients (mean age, 6.0±5.9 years; range, 16 days to 17.4 years) underwent either a Ross operation (n=9) or a Ross-Konno operation (n=7). The study included 12 males and 4 females, with a median follow-up period of 47 months (range, 6 to 256 months). There were no cases of in-hospital or late mortality. Six reoperations were performed in 5 patients. Four patients underwent right ventricular-pulmonary artery (RV-PA) conduit replacement. Two patients underwent concomitant replacement of the pulmonary autograft and RV-PA conduit 10 years and 8 years after the Ross operation, respectively. The rate of freedom from adverse outcomes of the pulmonary autograft was 88% and 70% at 5 and 10 years, respectively. The rate of freedom from valve-related reoperations was 79% and 63% at 5 and 10 years, respectively. Pulmonary autografts demonstrated good durability with low mortality. The Ross/Ross-Konno procedure is a good option that can be performed safely in pediatric patients with aortic valve disease, even in a small-volume center.

[Overweight, obesity and chronic mal nutrition in 6 to 9 year-old children in Peru, 2009-2010].

Science.gov (United States)

Pajuelo-Ramírez, Jaime; Sánchez-Abanto, José; Alvarez-Dongo, Doris; Tarqui-Mamani, Carolina; Agüero-Zamora, Rosa

2013-01-01

To determine the prevalence of overweight, obesity and chronic malnutrition in 6- to 9-year-old children in Peru. A cross-cutting study based on the 2009-2010 National Household Survey. The size/age ratio was analyzed with references of the National Center for Health Statistic (NCSH) and the World Health Organization (WHO), considering less than two standard deviations for chronic malnutrition (CM); and the Must and WHO reference tables to measure the body mass index with 85 to 95 percentile values for overweight and above 95 for obesity. With Must as reference, overweight was 12.1% and obesity 9.4%, and according to WHO overweight and obesity were 10.2 and 11.3% respectively. The prevalence of CM according to NCSH and WHO is 15.4 and 17.8% respectively. The highest prevalence of CM is in the north (25.2%), center (22.9%) and south of (19%) the Highland, while obesity is more present in the south coast (28%), Metropolitan Lima (22.8%) and the central Coast (22.5%). Of all the children with CM, 6.5% has overweight and 1.2% obesity. CM is decreasing because size averages have improved, however obesity has doubled. The presence of CM and obesity in children aged 6 to 9 years old in different regions of Peru poses a challenge in the planning of food and nutrition policies.

Heart retransplantation: a 23-year single-center clinical experience.

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Schnetzler, B; Pavie, A; Dorent, R; Camproux, A C; Leger, P; Delcourt, A; Gandjbakhch, I

1998-04-01

The main causes of allograft failure after cardiac transplantation are primary graft dysfunction, intractable acute rejection, and coronary graft disease. Despite the important progress in the last several years in graft preservation, surgical techniques, immunosuppression, and treatment of coronary graft disease, retransplantation in selected cases is the only way to achieve long-term recipient survival. We compare here in a case-control study 24 retransplantations with 47 first transplants in patients matched for date of transplantation. Between 1973 and 1996, 1,063 patients underwent cardiac transplantation in our institution. In this cohort, 22 patients had a total of 24 retransplantations (2 second-time retransplantations). The causes of retransplantations were primary graft failure (n=4), acute rejection (n=7), coronary graft disease (n=11), and miscellaneous (n=2). Survival at 1 and 5 years of patients with retransplantations is 45.5% and 31.2%, and survival of control patients is 59.4% and 38.8% (p=0.07). An interval between first transplantation and retransplantation shorter (n=11) or longer (n=13) than 1 year is associated with a 1-year survival of 27.3% and 61.5% and a 4-year survival of 27.3% and 46%, respectively (not significant). Intervals shorter than 1 year between first transplantation and retransplantation were exclusively secondary to primary graft failure or intractable acute rejection. In the face of lack of donor grafts, these and other data indicate that retransplantation should be considered cautiously, especially when the interval between the first transplantation and retransplantation is short.

Vaginismus in Iran: A Single Center Report of 7 Years Experience.

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Akhavan-Taghavi, Mohammad Hossein; Asghari-Moghaddam, Mohammad Ali; Froutan, Seyed Kazem; Jadid-Milani, Maryam

2015-11-01

Vaginismus is a sexual disorder that can cause painful intercourse. Although several studies have shown a relationship between higher education and socio-economic level of women with vaginismus, the relationship between demographic characteristics and other variables remains unclear. The present study was conducted to determine the demographic characteristics of women with vaginismus, coming to family health clinic, between 2007 and 2013. This study is a cross-sectional study that was conducted on 115 clinical records, from early 2007 until the end of 2013, that have received a diagnosis of vaginismus. In these clinical records, the data on female and male age, education and employment, duration of marriage, type of marriage (traditional, virtual, etc.), being a virgin, erectile dysfunction of husband, information of families, sexual satisfaction, marital satisfaction, residential, non-medical types of medical treatment and hymenectomy were derived. The results showed that the average age of women was 29 ± 5 years and the average age of the spouses was 33 ± 6 years. Undergraduate education most prominent among women (52%) and spouses (42%). In terms of employment status, most women were housewives (54%) and the majority of male were employees (54%). The most frequent form of marriage was traditional (80%). The maximum elapsed time of marriage was between 1 - 3 years (43%). In most women, the first attempt for intercourse was from the second day of marriage to the end of the first week (73%). Hymenectomy was done by 9% of women. Totally, 45% of the men, the wives of whom were suffering from vaginismus, experienced erectile dysfunction. In 37% of couples, their sexual life was satisfactory. The most referred specialist for treatment was the urologist (17%). In 27% of women with vaginismus, numerous references to a variety of medical specialists and psychologists were also recorded. Of the total, 7% of couples experienced traditional and non-academic treatments. As

Contemporary Parenteral Antiplatelet Bridging Strategies: A Single-Center Real-World Experience at a Tertiary Care Center.

Science.gov (United States)

Stern, Gretchen; Rimsans, Jessica; Qamar, Arman; Vaduganathan, Muthiah; Bhatt, Deepak L

2018-03-13

Oral antiplatelet therapy may require interruption soon after percutaneous coronary intervention (PCI) or acute coronary syndrome. The optimal parenteral antiplatelet bridge strategy with glycoprotein IIb/IIIa inhibitors or cangrelor, a P2Y12 inhibitor, is unclear. We explore real-world use of cangrelor or eptifibatide for antiplatelet bridging at a large tertiary-care center. Thirty-one patients (9 eptifibatide, 20 cangrelor, and 2 both) received bridge therapy from October 2015 to June 2017. Primary bridge therapy indications included surgery (68%), limited enteral access/absorption (16%), and high-perceived bleed risk (16%). Median duration of bridge therapy was 61 (20-100) hours for cangrelor and 83 (19-98) hours for eptifibatide. Severe/life-threatening bleeding or stent thrombosis was not observed. GUSTO-defined bleeding occurred in 30% (cangrelor) and 27% (eptifibatide). Initial dosing errors occurred in 23% of patients. Death during hospitalization occurred in 16% of patients. Parenteral antiplatelet bridging was used for ~3 days in this single-center, tertiary care experience, commonly for unplanned surgery following PCI. Despite high-risk presentations with >15% in-hospital mortality, efficacy profiles were reassuring with no identified stent thrombosis, but bleeding and dosing errors were common. Antiplatelet bridging should only be used in well-selected patients at the appropriate dose for the minimal necessary duration.

Are drowned donors marginal donors? A single pediatric center experience.

Science.gov (United States)

Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A

2017-09-01

Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Report on administrative work at radiation safety center in fiscal year 2001

Energy Technology Data Exchange (ETDEWEB)

Uda, Tatsuhiko; Asakura, Yamato; Sakuma, Yoichi; Kawano, Takao; Yamanishi, Hirokuni; Sugiyama, Takahiko; Miyake, Hitoshi

2003-03-01

National Institute for Fusion Science constructed Large Helical Device (LHD) which is the largest magnetic confinement plasma experimental device using super conductive magnet coils. It took eight years to construct and the first plasma shot had been carried out on March 1998. In the experiments high plasma temperature and improved plasma confinement have been achieved. This is the report of administrative work at the radiation safety center considering radiation protection for workers at the LHD and related devices, and radiation monitoring in the site. Major scope is as follows. (1) Radiation measurement and dose monitoring in the radiation controlled area and in the site using particularly developed monitoring system named as Radiation Monitoring System Applicable to Fusion Experiments (RMSAFE). (2) Establishment of education and registration system for radiation workers and access control system for the LHD controlled area. I hope that as like the published reports of fiscal year 1999 and 2000, the present report will be helpful for management of future radiation protection in the research institute. (author)

Report on administrative work at radiation safety center in fiscal year 2003

International Nuclear Information System (INIS)

Uda, Tatsuhiko; Asakura, Yamato; Sakuma, Yoichi; Kawano, Takao; Yamanishi, Hirokuni; Sugiyama, Takahiko; Nishimura, Kiyohiko; Miyake, Hitoshi

2005-06-01

National Institute for Fusion Science constructed the Large Helical Device (LHD) which is the largest magnetic confinement plasma experimental device using super conductive magnet coils system. It took eight years to construct and the first plasma shot was carried out on March 1998. Since then high temperature plasma and improved plasma confinement experiments have been achieved. This is the report on administrative work at the radiation safety center considering radiation protection for workers at the LHD and the Compact Helical Device (CHS), and radiation measurement and monitoring in the site. Major scope is as follows. (1) Radiation (X ray) dose measurement and monitoring in the radiation controlled area and in the site using particularly developed monitoring system named as Radiation Monitoring System Applicable to Fusion Experiments (RMSAFE). (2) Establishment of education and registration system for radiation workers and accessing control system for the LHD controlled area. As same as the published annual reports from fiscal year 1999 to 2002, this report will be helpful for the future radiation safety management in the research institute. (author)

ECTOPIC CUSHING SYNDROME: A 10-YEAR EXPERIENCE FROM A TERTIARY CARE CENTER IN SOUTHERN INDIA.

Science.gov (United States)

Sathyakumar, Samantha; Paul, Thomas Vizhalil; Asha, Hesargatta Shyamsunder; Gnanamuthu, Birla Roy; Paul, M J; Abraham, Deepak Thomas; Rajaratnam, Simon; Thomas, Nihal

2017-08-01

Ectopic adrenocorticotropic hormone (ACTH) secretion is a less common cause of Cushing syndrome and is seen in 5 to 10% of cases with endogenous hypercortisolemia. We hereby describe our experience of patients with ectopic ACTH syndrome, who have been managed over the past 10 years at a tertiary care center in Southern India. The inpatient and outpatient records of patients from 2006 to 2015 were retrospectively reviewed. The clinical features, clinical history, biochemical values, imaging features, including radiologic findings and positron emission tomography scans, management, details of follow-up, and outcomes, were documented. We compared the biochemical findings in these patients with 20 consecutive patients with Cushing disease (Cushing syndrome of pituitary origin). A total of 21 patients were studied. The median age at presentation was 34 years (range, 19 to 55 years). Seven patients had thymic carcinoid, 7 had bronchial carcinoid, 3 had lung malignancies, 2 had medullary carcinoma thyroid, 1 patient had a pancreatic neuroendocrine tumor, and 1 patient had an occult source of ACTH. The most common clinical features at presentation were muscle weakness (95%), hyperpigmentation (90%), facial puffiness (76%), easy bruising (61%), edema (57%), and striae (52%). Extensive acne was seen in a large number of patients (43%). Only 3 patients (14%) had central obesity. The median 8 am cortisol was 55.5 μg/dL (range, 3.8 to 131 μg/dL), median 8 am ACTH was 207 pg/mL (range, 31.1 to 703 pg/mL), and the median 24-hour urinary free cortisol was 2,484 μg (range, 248 to 25,438 μg). Basal cortisol and ACTH, as well as midnight cortisol and ACTH level, were markedly higher in patients with ectopic Cushing syndrome as compared to patients with Cushing disease. Twelve of 21 patients had developed life-threatening infections by follow-up. Nine patients had undergone surgical intervention to address the primary tumor. However, only 1 patient exhibited a complete cure on

Meaning reconstruction in the face of terror: An examination of recovery and posttraumatic growth among victims of the 9/11 World Trade Center attacks.

Science.gov (United States)

Richardson, Katherine M

2015-01-01

This study examines the relationship between meaning reconstruction with posttraumatic growth and depreciation in the aftermath of terrorist trauma and loss. A group of individuals (n=118) who were personally affected by the September 11, 2001 terrorist attacks were surveyed about their experiences and administered the Posttraumatic Growth Inventory and Impact of Event scales. Subjects were volunteer docents at the Tribute World Trade Center Visitor Center. Results revealed that ability to make sense of one's 9/11 experience was related to recovery but not to posttraumatic growth, whereas ability to find some benefit in the experience was related to growth. In addition, location in downtown Manhattan on September 11, 2001 was related to higher levels of posttraumatic depreciation. Findings suggest that two aspects of meaning reconstruction are differentially related to recovery and posttraumatic growth.

A 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE

Directory of Open Access Journals (Sweden)

E. V. Shlyakhto

2016-01-01

Full Text Available Aim. To estimate the results of 6-year experience of heart transplantation (HT in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old. We used biventricular assist device (BIVAD, Berlin Heart Excor support in 7 heart transplant candidates before HT. 19 patients (29% received thymoglobulin, whereas 46 patients (71% had basiliximab to induce immunosuppression.Results. Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7% after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure for tricuspid valve repair was carried out in 3 cases (4.6%. Venovenous hemodiafi ltration was used in 11 patients (16.9%. A total of 598 endomyocardial biopsies (EMB were performed after HT. Evidence of cellular rejection (R1 and R2 was presented in 286 biopsies (48%. The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions. The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.

Creating Authentic Geoscience Research Experiences for Underrepresented Students in Two-Year Undergraduate Programs

Science.gov (United States)

Liou-Mark, J.; Blake, R.

2014-12-01

With community college and two-year program students playing pivotal roles in advancing the nation's STEM agenda now and throughout the remainder of this young millennia, it is incumbent on educators to devise innovative and sustainable STEM initiatives to attract, retain, graduate, and elevate these students to four-year programs and beyond. Involving these students in comprehensive, holistic research experiences is one approach that has paid tremendous dividends. The New York City College of Technology (City Tech) was recently awarded a National Science Foundation Research Experiences for Undergraduates (REU) supplemental grant to integrate a community college/two-year program component into its existing REU program. The program created an inviting and supportive community of scholars for these students, nurtured them through strong, dynamic mentoring, provided them with the support structures needed for successful scholarship, and challenged them to attain the same research prominence as their Bachelor degree program companions. Along with their colleagues, the community college/two-year program students were given an opportunity to conduct intensive satellite and ground-based remote sensing research at the National Oceanic and Atmospheric Administration Cooperative Remote Sensing Science and Technology Center (NOAA-CREST) at City College and its CREST Institute Center for Remote Sensing and Earth System Science (ReSESS) at City Tech. This presentation highlights the challenges, the rewards, and the lessons learned from this necessary and timely experiment. Preliminary results indicate that this paradigm for geoscience inclusion and high expectation has been remarkably successful. (The program is supported by NSF REU grant #1062934.)

WORRIES OF THE CANCER PATIENTS: THE EXPERIENCE OF THE EDUCATION CENTER OF THE INSTITUTO NACIONAL DE CANCEROLOGIA

OpenAIRE

Contreras-Cruz Ana Cecilia; Castro-Camargo Gladys Juliette; Puerto-Jiménez Devi Nereira

2015-01-01

Introduction: to know the characteristics and worries of the cancer patients allows imparting an adequate attention to their needs in order to answer the experience of living with cancer. Objective: to identify the main worries of the cancer patients expressed to contact the center. Methods: selection for one year of cancer patients who attended to the education center for the patients and their families of the Instituto Nacional de Cancerología (INC). Field diaries were ...

Surgical treatment of bronchiectasis: A review of 20 years of experience

Directory of Open Access Journals (Sweden)

D. Coutinho

2016-03-01

Full Text Available Background: Bronchiectasis is defined as an abnormal and irreversible dilation and distortion of the bronchi, which has numerous causes. Surgical treatment of this disease is usually reserved for focal disease and when the medical treatment is no longer effective. We report our center experience and outcomes in bronchiectasis surgery during the last 20 years. Methods: Between 1994 and 2014, sixty-nine patients underwent surgical resection for bronchiectasis. Patient demographics, presenting symptoms, indications for surgical treatment, type of lung resection, morbidity and mortality, as well as clinical follow-up and outcomes were analyzed. Results: From the 69 patients included, 31 (44.9% were male and 38 (55.1% were female. Surgery was indicated because of unsuccessful medical therapy in 33 patients (47.8%, haemoptysis in 22 patients (31.9%, nondiagnostic lung mass in 9 patients (13.0% and lung abscess in 5 patients (7.3%. The surgical procedures were lobectomy in 45 (65.2% patients, pneumonectomy in 10 (14.5% patients, bilobectomy in 8 (11.6% patients, lobectomy plus segmentectomy in 3 (4.3% patients and only segmentectomy in 3 (4.3% patients. Morbidity rate was 14.5% and there was no perioperative mortality. The follow-up was possible in 60 patients, with an outcome reported as excellent in 44 (73.3% patients, as improved in 11 (18.3% and as unchanged in 5 (8.3%. Conclusion: Although the number of patients with bronchiectasis referred for surgical treatment has decreased, pulmonary resection still plays a significant role. Surgical resection of localized bronchiectasis is a safe procedure with proven improvement of quality of life for the majority of patients. Keywords: Bronchiectasis, Thoracic surgery

Mountain biking injuries requiring trauma center admission: a 10-year regional trauma system experience.

Science.gov (United States)

Kim, Peter T W; Jangra, Dalbhir; Ritchie, Alec H; Lower, Mary Ellen; Kasic, Sharon; Brown, D Ross; Baldwin, Greg A; Simons, Richard K

2006-02-01

Mountain biking has become an increasingly popular recreational and competitive sport with increasingly recognized risks. The purpose of this study was to review a population based approach to serious injuries requiring trauma center admission related to mountain biking, identify trends and develop directions for related injury prevention programs. Three trauma centers in the Greater Vancouver area exclusively serve a major mountain bike park and the North Shore Mountains biking trails. The Trauma Registries and the patient charts were reviewed for mountain bike injuries from 1992 to 2002. The data were analyzed according to demographics, distribution, and severity of injuries, and need for operative intervention. Findings were reviewed with injury prevention experts and regional and national mountain-biking stakeholders to provide direction to injury prevention programs. A total of 1,037 patients were identified as having bicycling-related injuries. Of these, 399 patients sustained 1,092 injuries while mountain biking. There was a threefold increase in the incidence of mountain biking injuries over a 10-year period. Young males were most commonly affected. Orthopedic injuries were most common (46.5%) followed by head (12.2%), spine (12%), chest (10.3%), facial (10.2%), abdominal (5.4%), genitourinary (2.2%), and neck injuries (1%). High operative rate was observed: 38% of injuries and 66% of patients required surgery. One patient died from his injuries. Injury prevention programs were developed and successfully engaged the target population. Mountain biking is a growing cause of serious injuries. Young males are principally at risk and serious injuries result from intended activity and despite protective equipment. Injury prevention programs were developed to address these concerns.

Ten years experience with a large computerized TLD-personnel monitoring system

International Nuclear Information System (INIS)

Duftschmid, K.E.

1986-01-01

It is now ten years since our Institute for Radiation Protection has fully replaced its filmdosimetry service by a computerized automated TLD system. Presently more than 13000 radiation workers are monthly monitored by three automated TLD readers linked to the computer center. The paper describes system hardware and software and experience gained in long-term routine operation. In particular the introduction of the new ICRU quantities for personnel dosimetry in the existing TLD system is discussed. (Author)

Forty years of 9Sr in situ migration: importance of soil characterization in modeling transport phenomena

International Nuclear Information System (INIS)

Fernandez, J.M.; Piault, E.; Macouillard, D.; Juncos, C.

2006-01-01

In 1960 experiments were carried out on the transfer of 9 Sr between soil, grapes and wine. The experiments were conducted in situ on a piece of land limited by two control strips. The 9 Sr migration over the last 40 years was studied by performing radiological and physico-chemical characterizations of the soil on eight 70 cm deep cores. The vertical migration modeling of 9 Sr required the definition of a triple layer conceptual model integrating the rainwater infiltration at constant flux as the only external factor of influence. Afterwards the importance of a detailed soil characterization for modeling was discussed and satisfactory simulation of the 9 Sr vertical transport was obtained and showed a calculated migration rate of about 1.0 cm year -1 in full agreement with the in situ measured values. The discussion was regarding some of the key parameters such as granulometry, organic matter content (in the Van Genuchten parameter determination), Kd and the efficient rainwater infiltration. Besides the experimental data, simplifying assumptions in modeling such as water-soil redistribution calculation and factual discontinuities in conceptual model were examined

NASA Glenn Research Center Experience with "LENR Phenomenon"

Science.gov (United States)

Wrbanek, Susan Y.; Fralick, Gustave C.; Wrbanek, John D.; Niedra, Janis M.

2012-01-01

Since 1989 NASA Glenn Research Center (GRC) has performed some small-scale limited experiments that show evidence of effects claimed by some to be evidence of Low Energy Nuclear Reactions (LENR). The research at GRC has involved observations and work on measurement techniques for observing the temperature effects in reactions of isotopes of hydrogen with palladium hydrides. The various experiments performed involved loading Pd with gaseous H2 and D2, and exposing Pd thin films to multi-bubble sonoluminescence in regular and deuterated water. An overview of these experiments and their results will be presented.

NASA Glenn Research Center Experience with LENR Phenomenon

Science.gov (United States)

Wrbanek, Susan Y.; Fralick, Gustave C.; Wrbanek, John D.; Niedra, Janis M.

2012-01-01

Since 1989 NASA Glenn Research Center (GRC) has performed some small-scale limited experiments that show evidence of effects claimed by some to be evidence of Low Energy Nuclear Reactions (LENR). The research at GRC has involved observations and work on measurement techniques for observing the temperature effects in reactions of isotopes of hydrogen with palladium hydrides. The various experiments performed involved loading Pd with gaseous H2 and D2, and exposing Pd thin films to multi-bubble sonoluminescence in regular and deuterated water. An overview of these experiments and their results will be presented.

Fort Collins Science Center-Fiscal year 2009 science accomplishments

Science.gov (United States)

Wilson, Juliette T.

2010-01-01

Public land and natural resource managers in the United States are confronted with increasingly complex decisions that have important ramifications for both ecological and human systems. The scientists and technical professionals at the U.S. Geological Survey Fort Collins Science Center?many of whom are at the forefront of their fields?possess a unique blend of ecological, socioeconomic, and technological expertise. Because of this diverse talent, Fort Collins Science Center staff are able to apply a systems approach to investigating complicated ecological problems in a way that helps answer critical management questions. In addition, the Fort Collins Science Center has a long record of working closely with the academic community through cooperative agreements and other collaborations. The Fort Collins Science Center is deeply engaged with other U.S. Geological Survey science centers and partners throughout the Department of the Interior. As a regular practice, we incorporate the expertise of these partners in providing a full complement of ?the right people? to effectively tackle the multifaceted research problems of today's resource-management world. In Fiscal Year 2009, the Fort Collins Science Center's scientific and technical professionals continued research vital to Department of the Interior's science and management needs. Fort Collins Science Center work also supported the science needs of other Federal and State agencies as well as non-government organizations. Specifically, Fort Collins Science Center research and technical assistance focused on client and partner needs and goals in the areas of biological information management and delivery, enterprise information, fisheries and aquatic systems, invasive species, status and trends of biological resources (including human dimensions), terrestrial ecosystems, and wildlife resources. In the process, Fort Collins Science Center science addressed natural-science information needs identified in the U

Bidirectional Associations between Peer Relations and Attention Problems from 9 to 16 Years.

Science.gov (United States)

Ji, Linqin; Pan, Bin; Zhang, Wenxin; Zhang, Liang; Chen, Liang; Deater-Deckard, Kirby

2018-05-12

We examined the bidirectional relations between peer relations and attention problems from middle childhood through adolescence. Using data from the Longitudinal Study of Chinese Children and Adolescents (LSCCA, N = 2157, 51.9% male), three key aspects of peer relations (acceptance, rejection, and victimization) were assessed annually from 9 to 16 years of age. Attention problems were assessed at 9 and 15 years. Latent growth modeling indicated that greater attention problems at age 9 were linked with a lower intercept for peer acceptance, and higher intercepts for rejection and victimization. Also, prior lower acceptance and greater rejection and victimization, along with a higher increase over time in rejection and lower decrease over time in victimization, predicted attention problems at age 15. Cross-lagged analysis showed that attention problems were associated with less subsequent peer acceptance and greater subsequent rejection and victimization. Only peer rejection (but neither victimization nor acceptance) predicted more subsequent attention problems. Findings point to bidirectional associations between attention problems and peer relations in the developmental transition across adolescence. Evidence for differential bidirectionality of attention problems with the multiple peer experience (group versus dyadic; good versus bad) emerged, and future replications are needed.

International Experience of the Establishing Technology Transfer Centers at the Universities

Directory of Open Access Journals (Sweden)

Lysenko, V.S.

2015-01-01

Full Text Available The analysis of the experience of creation and operation of technology transfer centers on the basis of US universities with the aim of using positive methods for the creation of such centers in Ukraine is presented.

[REPORTING CRITICAL LAB RESULTS, A CHALLENGE FOR THE LAB AND THE PHYSICIAN - A SUMMARY OF FOUR YEARS OF EXPERIENCE IN MEIR MEDICAL CENTER LABORATORIES].

Science.gov (United States)

Rashid, Gloria; Goldman, Jacob; Weinstein, Doron; Tohami, Tali; Neumark, Eran; Weiss, Eli

2015-08-01

Critical laboratory results require prompt reporting to the attending physician, as they may indicate that a patient is in a life-threatening condition. Although this important subject has been covered in many publications, it needs more attention from our healthcare organizations, which have no official policy on the subject. Matching expectations between the doctor and the laboratory needs to be better defined. The aim of this work was to inform the community of doctors and laboratories about the multiple problems concerning the reporting of critical laboratory results, to create a platform for exchanging views and ideas, and to build an extensive infrastructure for developing a unified plan to address this important issue. We present the results of four years of experience of reporting critical laboratory values at the Meir Medical Center Laboratories. The idea leading this work was to present the relatively low rate of critical results reported by the laboratories in 2010, sharing the problems discovered while investigating the situation in depth, and presenting the solutions that enabled us to obtain the desired results within four years. Gradual implementation of these improvements resulted in critical value reporting increasing from 55% in 2010 to 95% currently. We suggest a model for improving critical laboratory values reporting based on our 4-year experience, which emphasizes: (1) The importance of selecting proper tests and values for critical results; (2) The significance of using technology and computerized measures to support the process; and (3) Developing quick procedures for monitoring and controlling the process.

An Exploration of Hispanic Mothers' Culturally Sustaining Experiences at an Informal Science Center

Science.gov (United States)

Weiland, Ingrid

2015-01-01

Science education reform focuses on learner-centered instruction within contexts that support learners' sociocultural experiences. The purpose of this study was to explore Hispanic mothers' experiences as accompanying adults at an informal science center within the context of culturally sustaining experiences, which include the fluidity…

Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

Energy Technology Data Exchange (ETDEWEB)

Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

2010-10-15

The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

9+ years of disposal experience at the Waste Isolation Pilot Plant (WIPP)

International Nuclear Information System (INIS)

Rempe, Norbert T.; Nelson, Roger A.

2008-01-01

With almost a decade of operating experience, the Waste Isolation Pilot Plant (WIPP) has established an enviable record by clearly demonstrating that a deep geologic repository for unconditioned radioactive waste in rock salt can be operated safely and in compliance with very complex regulations. WIPP has disposed of contact-handled transuranic (TRU) waste since 1999 and remote-handled TRU waste since 2007. Emplacement methods range from directly stacking unshielded 0.21-4.5 m 3 containers inside disposal rooms to remotely inserting highly radioactive 0.89 m 3 canisters into horizontally drilled holes (shield plugs placed in front of canisters protect workers inside active disposal rooms). More than 100 000 waste containers have been emplaced, and one-third of WIPP's authorized repository capacity of 175,000 m 3 has already been consumed. Principal surface operations are conducted in the waste handling building, which is divided into CH and RH waste handling areas. Four vertical shafts extend from the surface to the disposal horizon, 655 m below the surface in a 1000 m thick sequence of Permian bedded salt. The waste disposal area of about 0.5 km 2 is divided into ten panels, each consisting of seven rooms. Vertical closure (creep) rates in disposal rooms range up to 10 cm per year. While one panel is being filled with waste, the next one is being mined. Mined salt is raised to the surface in the salt shaft, and waste is lowered down the waste shaft. Both of these shafts also serve as principal access for personnel and materials. Underground ventilation is divided into separate flow paths, allowing simultaneous mining and disposal. A filter building near the exhaust shaft provides the capability to filter the exhaust air (in reduced ventilation mode) through HEPA filters before release to the atmosphere. WIPP operations have not exposed employees or the public to radiation doses beyond natural background variability. They consistently meet or exceed regulatory

Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

Energy Technology Data Exchange (ETDEWEB)

Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Koutcher, Lawrence; Wolden, Suzanne L.; Zelefsky, Michael J.; Rowan, Nicholas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Sherman, Eric J.; Fury, Matthew G.; Pfister, David G. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shi Weiji; Zhang Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lee, Nancy Y., E-mail: Leen2@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2012-01-01

Purpose: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia {>=}Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

Experiment data report for LOFT anticipated transient without scram Experiment L9-4

International Nuclear Information System (INIS)

Batt, D.L.; Divine, J.M.; McKenna, K.J.

1982-11-01

Selected pertinent and uninterpreted data from the fourth anticipated transient with multiple failures experiment (Experiment L9-4) conducted on September 24, 1982, in the Loss-of-Fluid Test (LOFT) facility are presented. The LOFT facility is a 50-MW(t) pressurized water reactor (PWR) system with instruments that measure and provide data on the system's thermal-hydraulic and nuclear conditions. The operation of the LOFT system is typical of large [approx. 1000 MW(e)], commercial PWR operations. Experiment L9-4 simulated a loss-of-offsite-power anticipated transient without reactor scram. The loss-of-offsite-power accident led to an increase in the primary coolant system temperature and pressure. The experiment safety relief valve opened and was able to limit and control the pressure transient. In addition, subsequent heat generation was dissipated by the auxiliary feedwater flow in the secondary coolant system until the reactor was scrammed at experiment termination

The natural history of Becker expandable breast implants: a single-center 10-year experience.

Science.gov (United States)

Sindali, Katia; Davis, Marcus; Mughal, Maleeha; Orkar, Kusu S

2013-09-01

Use of Becker expandable breast implants in single-stage breast surgery is a well-established technique; however, replacement with fixed-volume implants is common. The authors sought to analyze the long-term natural history of these implants over a wide range of surgical indications. A retrospective review of 330 consecutive patients who underwent 384 Becker expander breast reconstructions over a 10-year period in a dedicated plastic surgery unit was undertaken. Implant indication, Becker type, volume and site, complications, expander lifespan, and explant reasons were assessed. Two hundred twenty-eight patients (267 implants) and 102 patients (117 implants) underwent implantation for congenital deformities and breast cancer reconstruction, respectively. One hundred eighty-seven (48 percent) were explanted at a median period of 13.0 months (range, 9.0 to 26.0 months), 149 (39 percent) for aesthetic reasons and 38 (10 percent) for complications. Complication rates were higher in breast cancer reconstruction compared with congenital patients (19.6 percent versus 7.9 percent; p = 0.002), driven by an increased rate of wound complications (13.7 percent versus 4.4 percent; p = 0.003). Cancer-related surgery and advancing age were the only predictors of complication risk. The overall Becker expander retention rate was 24.9 percent and 46.8 percent at 150 months in the cancer reconstruction and congenital groups, respectively. Forty-seven percent of Becker implants were retained long term after congenital corrective surgery; only 25 percent were retained after postmastectomy reconstruction. Poor aesthetics was driving the exchange for fixed-volume implants, indicating that after breast cancer reconstruction, Becker expanders were being used as part of a two-stage reconstructive strategy.

Examining the Fundamental Obstructs of Adopting Cloud Computing for 9-1-1 Dispatch Centers in the USA

Science.gov (United States)

Osman, Abdulaziz

2016-01-01

The purpose of this research study was to examine the unknown fears of embracing cloud computing which stretches across measurements like fear of change from leaders and the complexity of the technology in 9-1-1 dispatch centers in USA. The problem that was addressed in the study was that many 9-1-1 dispatch centers in USA are still using old…

Surgical treatment of chronic pancreatitis--a 14 years experience.

Science.gov (United States)

Stroescu, C; Dima, S; Scarlat, A; Ivanov, B; Bouaru, O; Ionescu, M; Vasilescu, C; Popescu, I

2010-01-01

Operative treatment of chronic pancreatitis is indicated for patients with intractable pain after failed medical and endoscopic treatment, or in the presence of complications of the disease. This study evaluates a single-center experience with operative management of chronic pancreatitis over a period of time of 14 years, regarding indication, surgical technique, early and late results. The records of 265 consecutive patients who underwent surgery for chronic pancreatitis between 1995 and 2008 were retrospectively reviewed and analyzed. Long-term outcomes were assessed by patient survey, with a median follow-up of 40 months. 265 patients underwent 275 operations for chronic pancreatitis with the main indication abdominal pain (46.8%), followed by suspected malignancy in 24.8% and recurrent episodes of acute pancreatitis in 18.6%. Resection procedures 54.5% (150), drainage procedures 1.09% (3), bypass and denervation procedures 44.36% (122) and exploratory laparotomy 3.27% (9) were performed with an overall morbidity of 22% and an in-hospital mortality rate of 2.64%. After a median follow-up of 40 months survival information was available for 137 patients (51.69%) with a 5-and actuarial survival rate of 74.7% and quality of life improvement in most patients, especially in the resected group. Our results suggest that in chronic pancreatitis the type of surgery has to be individualized in each patient (resection VS drainage) and organ preserving operations are safe and effective in providing long-term pain relief and in treating CP-related complications

Outcomes in Lung Cancer: 9-Year Experience From a Tertiary Cancer Center in India

OpenAIRE

Aditya Navile Murali; Venkatraman Radhakrishnan; Trivadi S. Ganesan; Rejiv Rajendranath; Prasanth Ganesan; Ganesarajah Selvaluxmy; Rajaraman Swaminathan; Shirley Sundersingh; Arvind Krishnamurthy; Tenali Gnana Sagar

2017-01-01

Purpose: Lung cancer is the most common cause of cancer mortality in the world. There are limited studies on survival outcomes of lung cancer in developing countries such as India. This study analyzed the outcomes of patients with lung cancer who underwent treatment at Cancer Institute (WIA), Chennai, India, between 2006 and 2015 to determine survival outcomes and identify prognostic factors. Patients and Methods: In all, 678 patients with lung cancer underwent treatment. Median age was 58 ye...

Bituminization of radioactive wastes at the Nuclear Research Center Karlsruhe. Experience from plant operation and development work

Energy Technology Data Exchange (ETDEWEB)

Hild, W; Kluger, W; Krause, H

1976-05-01

A summary is given of the main operational experience gained at the Nuclear Research Center Karlsruhe in 4 years operation of the bituminization plant for evaporator concentrates from low- and medium level wastes. At the same time some of the essential results are compiled that have been obtained in the R + D activities on bituminization.

Identifying groups at risk for 1-year membership termination from a fitness center at enrollment

Directory of Open Access Journals (Sweden)

Stephanie A. Hooker

2016-12-01

Full Text Available The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a healthy, (b unhealthy, (c poor psychological wellness, and (d poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007 and the unhealthy group (OR = 2.40, p = 0.037 were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01. Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention.

Morphological characteristic of surgically removed cardiac myxomas: 25-YEAR EXPERIENCE IN V.I. SHUMAKOV FEDERAL RESEARCH CENTER OF TRANSPLANTOLOGY AND ARTIFICIAL ORGANS

Directory of Open Access Journals (Sweden)

I. M. Iljinsky

2017-01-01

Full Text Available Analysis of intracardiac space-occupying lesions, surgically removed at V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs over 25 years (in the period from 1992 until 2016 was carried out. During that period 134 patients underwent surgery. Preoperative clinical diagnosis before surgery was heart myxoma. From 134 patients, only in 115 (85.8% patients the removed intracardiac lesions were myxomas: left atrium – 103 (89.7% patients, right atrium – 10 (8.7%, right ventricle – 2 (1.8% and mitral valve – 1 (0.8% patient. 9 patients had thrombi in the heart, 10 patients had not myxomas, but other benign and malignant heart tumors. This article presents macroscopic, histolological and ultrastructural characteristic of cardiac myxomas. Recurrence of the left atrium myxoma occurred in 2 patients. They were re-operated in four and six years after the first removal of myxoma. 2 patients died during hospital period. One patient with atherosclerosis of the coronary arteries as a concurrent disease died of embolization of the stent coronary artery with myxoma particles with the development of acute heart failure. Death of the 2nd patient was not directly related to the surgery, and was due to the acute heart failure as well in connection with the presence of concurrent disease, coronary heart disease.

Surgical treatment of aortic valve endocarditis: a 26-year experience

Directory of Open Access Journals (Sweden)

Taylan Adademir

2014-03-01

Full Text Available Objective: We have retrospectively analyzed the results of the operations made for aortic valve endocarditis in a single center in 26 years. Methods: From June 1985 to January 2011, 174 patients were operated for aortic valve endocarditis. One hundred and thirty-eight (79.3% patients were male and the mean age was 39.3±14.4 (9-77 years. Twenty-seven (15.5% patients had prosthetic valve endocarditis. The mean duration of follow-up was 7.3±4.2 years (0.1-18.2 adding up to a total of 1030.8 patient/years. Results: Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%. In-hospital mortality occurred in 27 (15.5% cases. Postoperatively, 25 (14.4% patients had low cardiac output and 17 (9.8% heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up. Conclusion: Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low.

Chest trauma in children, single center experience.

Science.gov (United States)

Ismail, Mohamed Fouad; al-Refaie, Reda Ibrahim

2012-10-01

Trauma is the leading cause of mortality in children over one year of age in industrialized countries. In this retrospective study we reviewed all chest trauma in pediatric patients admitted to Mansoura University Emergency Hospital from January 1997 to January 2007. Our hospital received 472 patients under the age of 18. Male patients were 374 with a mean age of 9.2±4.9 years. Causes were penetrating trauma (2.1%) and blunt trauma (97.9%). The trauma was pedestrian injuries (38.3%), motor vehicle (28.1%), motorcycle crash (19.9%), falling from height (6.7%), animal trauma (2.9%), and sports injury (1.2%). Type of injury was pulmonary contusions (27.1%) and lacerations (6.9%), rib fractures (23.9%), flail chest (2.5%), hemothorax (18%), hemopneumothorax (11.8%), pneumothorax (23.7%), surgical emphysema (6.1%), tracheobronchial injury (5.3%), and diaphragm injury (2.1%). Associated lesions were head injuries (38.9%), bone fractures (33.5%), and abdominal injuries (16.7%). Management was conservative (29.9%), tube thoracostomy (58.1%), and thoracotomy (12.1%). Mortality rate was 7.2% and multiple trauma was the main cause of death (82.3%) (Ptrauma is the most common cause of pediatric chest trauma and often due to pedestrian injuries. Rib fractures and pulmonary contusions are the most frequent injuries. Delay in diagnosis and multiple trauma are associated with high incidence of mortality. Copyright © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved.

Disparities in the experience and treatment of dental caries among children aged 9-18 years: the cross-sectional study of Korean National Health and Nutrition Examination Survey (2012-2013).

Science.gov (United States)

Kim, Juyeong; Choi, Young; Park, Sohee; Kim, Jeong Lim; Lee, Tae-Hoon; Cho, Kyoung Hee; Park, Eun-Cheol

2016-06-07

The aim of this study is to examine the association between parental socioeconomic status (SES) and the experience as well as treatment of dental caries among children aged 9 to 18 years. Data from 1253 children aged 9-18 years from the Korean National Health and Nutrition Examination Survey (2012-2013) were analyzed. Parental socioeconomic status was measured using household income level and maternal educational level. The decayed, missing, and filled teeth (DMFT) index was used to measure experience of dental caries (DMFT ≥ 1). Non-treatment of dental caries was measured according to whether the participants who experienced dental caries used a dental service at a dental clinic to treat caries during the previous year. Logistic regression was used to investigate the association between parental socioeconomic status and the experience of dental caries as well as the association between parental socioeconomic status and the non-treatment of dental caries among children that have experienced caries. A total of 808 subjects (64.5 %) experienced dental caries among 1253 participants, and 582 of these 808 subjects (72.0 %) did not receive treatment among those having experience of dental caries. Parental socioeconomic status was not associated with experience of dental caries. However, those from low- and middle-income households were less likely to receive treatment than those from high-income households (odds ratio [OR] 2.11 [95 % confidence interval (CI) 1.16-3.86], OR 2.14 [95 % CI 1.27-3.62]). In particular, those from low- and middle-income households who had regular dental checkups were more likely to have untreated caries than those from high-income households (OR 3.58 [95 % CI 1.25-10.24]). This study demonstrates the parental household income-related disparities in children's dental health treatment. Efforts should be made to lower financial barriers to dental health services, particularly among those from low-income households, in order to reduce

Increasing Counseling Center Utilization: Yeshiva University's Experience

Science.gov (United States)

Schwartz, Victor; Nissel, Chaim; Eisenberg, Daniel; Kay, Jerald; Brown, Joshua T.

2012-01-01

Yeshiva University established a counseling center during the 2004-2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment--stigma. To combat…

Implementation of a national detection plan of neonatal hypothyroidism. First year of experience from population sample

International Nuclear Information System (INIS)

Aznarez, A.; Balter, H.; Giambruno, G.

1992-01-01

The experience of the first year of development from a detection program of congenital hypothyroidism is presented. The radioimmunoassay of TSH from heel capillary blood, obtained before the discharge of new-born baby in two obstetrics assistance centers of Medicine Faculty is also studied. (C.G.C.)

Experiment data report for LOFT anticipated transient-without-scram Experiment L9-3

International Nuclear Information System (INIS)

Bayless, P.D.; Divine, J.M.

1982-05-01

Selected pertinent and uninterpreted data from the third anticipated transient with multiple failures experiment (Experiment L9-3) conducted in the Loss-of-Fluid Test (LOFT) facility are presented. The LOFT facility is a 50-MW(t) pressurized water reactor (PWR) system with instruments that measure and provide data on the system thermal-hydraulic and nuclear conditions. The operation of the LOFT system is typical of large [approx. 1000 MW(e)], commercial PWR operations. Experiment L9-3 simulated a loss-of-feedwater anticipated transient without scram. The loss-of-feedwater accident led to an increase in the primary coolant system temperature and pressure. Both the experiment power-operated relief valve (PORV) and safety relief valve opened and were able to limit and control the pressure transient. The plant was then recovered with the control rods still withdrawn by injecting 7200-ppM borated water, manually cycling the PORV and feeding and bleeding the steam generator

Transcatheter closure of patent ductus arteriosus using Flipper coil and Amplatzer Duct Occluder: Ten-year experience from a single center

Directory of Open Access Journals (Sweden)

Đukić Milan

2017-01-01

Full Text Available Introduction/Objective. Transcatheter closure is a well-established procedure for treatment of patent ductus arteriosus (PDA. We aimed to make a comparison between transcatheter PDA occlusion with Flipper coil and Amplatzer Duct Occluder (ADO and to determine the incidence and significance of procedural complications. Methods. Between November 2004 and October 2014, 148 patients were eligible for transcatheter PDA closure at the University Children’s Hospital in Belgrade, Serbia. The median age was 5.9 years (the range of 0.9 years to 17.3 years and the median weight was 21 kg (the range of 8.8 kg to 94 kg. Follow-up evaluations with Doppler echocardiogram were performed at one day, three months, and one and two years after the PDA occlusion. Results. Median narrowest PDA diameter was 1.5 mm (the range of 0.5 mm to 5.6 mm. Flipper coil was used for PDA closure in 84 (59.2% and ADO in 58 patients (40.8%. There was no significant difference in the rate of immediate complete closure between the coil and the ADO group (86.9% vs. 75.9%, p = 0.089, but a significantly higher rate of complete closure was achieved with ADO at one day (83.3% vs. 98.3%, p = 0.004, three months (85.7% vs. 100%, p = 0.002, and both one and two years after the implantation (91.7% vs. 100%, p = 0.041. In total, 12 complications occurred during the procedure, seven of which with coil and five with ADO occlusion of PDA. Conclusion. Transcatheter closure of PDA using both coils and ADOs is a very safe and effective procedure. ADO proved superior to coil in terms of complete closure rate as early as one day after the procedure.

Analysis of JUPITER experiment in ZPPR-9

Energy Technology Data Exchange (ETDEWEB)

NONE

1980-09-15

Information and data from the ZPPR-9 reactor JUPITER experiment are presented concerning a general description of data and methods; criticality; reaction rate ratio and reaction rate distribution; Doppler and sample reactivity worth; sodium void worth; and control rod worth.

Diffuse intrinsic pontine glioma in children and adolescents: a single-center experience.

Science.gov (United States)

Vallero, Stefano Gabriele; Bertin, Daniele; Basso, Maria Eleonora; Pittana, Laura Stefania; Mussano, Anna; Fagioli, Franca

2014-06-01

Patients with diffuse intrinsic pontine glioma (DIPG) have a very poor prognosis. Only radiotherapy (XRT) has proven to be effective in delaying the disease progression. Several chemotherapy schedules have been applied so far, but none demonstrated significant improvements in progression and survival. We retrospectively analyzed the clinical data of children diagnosed with DIPG at our center (Pediatric Hospital "Regina Margherita," Turin, Italy) between 1999 and 2013. Progression-free survival (PFS) and overall survival (OS) were used to describe the outcomes. Twenty-four children were included in our report. Patients diagnosed before March 2003 (n = 12) were treated with XRT and vincristine (VCR); the remaining 12 patients received XRT and temozolomide (TMZ). Progression-free survival was 18.8 % at 1 year (SE = 7.6 %), while overall survival was 44.1 % at 1 year (SE = 9.9 %). Median PFS was 8.1 months, whereas median OS was 11.2 months. No statistically significant difference in PFS or OS was evidenced between the two treatment groups. Radiotherapy followed by VCR or TMZ allows obtaining results that are in line with previous reports, with no advantages over other similar treatment schedules. DIPGs are challenging tumors with a dismal outcome. Further research and newer therapies are urgently needed in order to achieve improvements in survival.

Percutaneous nephrolithotomy for staghorn calculi: a single center's experience over 15 years.

Science.gov (United States)

Soucy, Frédéric; Ko, Raymond; Duvdevani, Mordechai; Nott, Linda; Denstedt, John D; Razvi, Hassan

2009-10-01

Percutaneous nephrolithotomy (PCNL) for staghorn calculi is one of the more challenging endourologic procedures. Although excellent stone-free rates are universally reported in the literature, complication rates vary widely, especially related to the need for blood transfusion. The purpose of this study was to evaluate the outcomes of PCNL for patients with staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Between July 1990 and December 2005, 1338 patients underwent PCNL for renal stone disease at our institution. Among this group, 509 procedures were performed for patients with a partial or complete staghorn calculus. Data analysis included procedure time, length of hospital stay, number of access tracts, transfusion rates, other early and late complications, and stone-free status. Mean patient age was 53.8 years (range 4-84 yrs). The average procedure time was 104 minutes. Sixteen percent of the cases needed multiple access tracts (range 2-5), with the lower calix being the most commonly used in 64.1%, followed by the upper calix in 18.5% and the middle calix in 17.4%. Various intracorporeal lithotriptors were used, including ultrasound, pneumatic, electrohydraulic, and holmium:yttrium-aluminium-garnet laser. The transfusion rate among this group was 0.8%. There was no statistically significant difference in transfusion rates (0.7%-1.2% P = 0.24) or other major complications in patients who were treated with either a single tract or among those needing multiple tracts. Stone-free rates at hospital discharge and at 3 months follow-up were 78% and 91%, respectively. PCNL is a safe and effective procedure in the management of staghorn calculi, with outcomes similar to those reported for percutaneous management of smaller volume nonstaghorn stones. Attention to accurate tract selection and placement as well as possession of the full array of endourologic equipment are essential to achieving an excellent outcome.

Classic intrafascial supracervical hysterectomy (CISH): 10-year experience.

Science.gov (United States)

Morrison, John E; Jacobs, Volker R

2006-01-01

We report and review herein our 10-year experience with classic intrafascial supracervical hysterectomy focusing on our long-term experience, evolution of the operative technique, and increased use of this technique. We performed a parallel, observational study with retrospective data to evaluate classic intrafascial supracervical hysterectomy, a laparoscopic hysterectomy technique, at Fayette Medical Center, a community hospital in Northwestern Alabama, USA. Patients comprised a consecutive series of 579 over a 10-year period from November 1992 through November 2002. The classic intrafascial supracervical hysterectomy technique, similar to standard supracervical hysterectomy, leaves the cardinal ligament, uterosacral ligament, vascular supply, and innervation to the upper vagina and cervix intact, but unlike supracervical hysterectomy removes the transition zone and endocervical canal. For 579 patients, the average age was 45.4 years (range, 22 to 92), follow-up was 75.3 months (range, 17 to 137), operating room time was 69 minutes (range, 44 to 370), blood loss was 72 mL (range, 10 to 765), length of hospital stay was 23.2 hours (range, 14 hours to 5 days), time to return to work was 13.2 days (range, 3 to 28). Complications include 11 cervical bleedings, 1 uterine artery bleeding, 1 pelvic hematoma, 1 postoperative ileus, and 16 mucoceles of the cervical stump. Three patients were converted from a laparoscopic to an open procedure (0.52%). Long-term follow-up of up to 137 months shows no adverse events thus far. Classic intrafascial supracervical hysterectomy is a safe procedure with a low short- and long-term complication rate. It has a short recuperation period and high patient satisfaction. It is the procedure of choice when hysterectomy is indicated for benign disease.

Menstrual Characteristics and Related Problems in 9-18 Year- Old Turkish School Girls.

Science.gov (United States)

Yücel, Gül; Kendirci, Mustafa; Gül, Ülkü

2018-03-14

To determine the cross-sectional characteristics of menstruating girls, dysmenorrhea and the frequencies of related problems. Descripitive, cross-sectional study. Randomly selected primary, junior and high schools in the city center of Kayseri. 2000 female adolescents of ages between 9 and 18 years. We used a questionnaire addressing the epidemiological characteristics of menstruation, such as age at menarche, duration of menstrual intervals, average days of bleeding, and any menstrual problems and their frequencies. This study consists of a sufficient number of participants from all age groups. Of the participant (n= 2000) girls, 63.7% (n: 1274) had started menstruating. The mean age at menarche was 12.74 ± 1.03 years. With a prevalence of 84.8% (n: 1080), dysmenorrhea was the most prevalent menstrual problem and the average pain score was 5.87 ± 2.45. Of the menstruating girls, 34% (n: 439) used painkillers, the most commonly used was acetaminophen; during their period the prevalence of non-medical methods to relieve pain was % 35.2; the rate of seeking medical help for dysmenorrhea was 9.3 % (n: 119). In menstruating participants, 90.8 % was discussed their menstrual problems with their mothers. The rate of school absenteeism in menstruating girls was 15.9 % in general and 18 % in those with dysmenorrhea. Problems related to menstruation are common in adolescents and these problems affect their social life. In adolescent girls, the most common menstrual problem is dysmenorrhea and it affects school performance and attendance. Girls with menstrual problems showed a low rate of seeking medical help. Copyright © 2018. Published by Elsevier Inc.

An orthopaedic geriatric rehabilitation unit: the first two years experience.

Science.gov (United States)

Sainsbury, R; Gillespie, W J; Armour, P C; Newman, E F

1986-08-13

Experience of the first two years of an orthopaedic geriatric rehabilitation unit is described. There were 325 admissions comprising 271 females and 54 males. The predominant diagnosis was fracture of the proximal femur. Average length of stay in the unit was 43 days for males and 36.7 days for females. 75.9% of patients admitted from home returned there and 66.1% of patients admitted from residential care returned to similar accommodation. In the first year there was a fall of 13.5 days in the average length of stay for elderly females with proximal femoral fracture, resulting in 2175 less bed days for this diagnosis. This improvement has continued.

Injury patterns of child abuse: Experience of two Level 1 pediatric trauma centers.

Science.gov (United States)

Yu, Yangyang R; DeMello, Annalyn S; Greeley, Christopher S; Cox, Charles S; Naik-Mathuria, Bindi J; Wesson, David E

2018-05-01

This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0-12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6-5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4-5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8-8.8). Although 76% of head injuries occurred in infants <1year, children ages 1-4years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p<0.001). Child abuse accounts for a large proportion of trauma fatalities in children under 5years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority. Retrospective Review. II. Copyright © 2018. Published by Elsevier Inc.

30 years of experience in safe transportation of nuclear materials

International Nuclear Information System (INIS)

Kaneko, K.

2004-01-01

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

30 years of experience in safe transportation of nuclear materials

Energy Technology Data Exchange (ETDEWEB)

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

2004-07-01

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

Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

Science.gov (United States)

Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

2017-12-01

Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Ten-year single-center experience of the ketogenic diet: factors influencing efficacy, tolerability, and compliance.

Science.gov (United States)

Wibisono, Cinthya; Rowe, Natalie; Beavis, Erin; Kepreotes, Helen; Mackie, Fiona E; Lawson, John A; Cardamone, Michael

2015-04-01

To evaluate the efficacy, tolerability, and compliance of 3 ketogenic diets, the classical ketogenic diet, medium-chain triglyceride (MCT), and modified Atkins diet. A single-center, retrospective study of 48 children with intractable epilepsy receiving ketogenic diets from 2003 to 2012. Patient demographics, epilepsy history, nutritional management, and side effects were collated. Compliance and tolerability were assessed by recording reasons for diet modification and cessation. The value of potassium citrate supplementation for preventing nephrolithiasis was reviewed. Median age at ketogenic diet initiation was 3.8 years (IQR: 2.3-7 years). The majority had intractable epilepsy, and 33 of the 48 children (69%) had epileptic encephalopathies. Three (6%) patients became seizure free, 35 (73%) reported Diet duration or ketogenic diet type did not predict reduction in seizures (P = .381; P = .272). Constipation (n = 31, 65%) was very common. Food refusal (n = 3, 6%) and poor parental compliance (n = 5, 10%) were common reasons cited for cessation. There were lower rates of side effects for modified Atkins diet. Diet cessation was greatest for MCT; however, 3 patients on MCT ceased therapy because adequate seizure control was achieved. Nephrolithiasis was reported in 1 patient before potassium citrate was used and 2 patients noncompliant with potassium citrate supplementation developed hypercalciuria. The 3 ketogenic diets were comparably effective in seizure control and generally well-tolerated. Potassium citrate supplementation is an effective prophylactic supplement for the prevention of nephrolithiasis. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Clean Energy Application Centers: Annual Metrics Report for Fiscal Year 2012

Energy Technology Data Exchange (ETDEWEB)

Schweitzer, Martin [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2014-02-01

Between fiscal year (FY) 2010 and 2013, the U.S. Department of Energy (DOE) funded nine Clean Energy Application Centers (CEACs) with national coverage to promote and assist in transforming the market for Combined Heat and Power (CHP), Waste Heat to Power CHP, and district energy (DE) with CHP1. Prior to that, similar services were provided by eight Regional Application Centers (RACs). The key services that the CEACs provided were market assessments, education and outreach, and technical assistance. There were eight regional CEACs, each of which served a specific area of the country, and a separate center operated by the International District Energy Association (IDEA) which supported the regional centers with technical assistance, education, training, publicity, and outreach related to district energy with CHP. Oak Ridge National Laboratory (ORNL) has performed four previous studies of CEAC activities. The first one examined what the centers had done each year from the initiation of the program through FY 2008; the second addressed center activities for FY 2009; the third one focused on what was accomplished in FY 2010; and the fourth looked at the CEACs’ FY 2011 accomplishments, with a heightened emphasis on the adoption of CHP\\DE technologies and the activities thought to be most closely related to CHP/DE development and use. The most recent study, documented in this report, examines CEAC activities in FY 2012.

Thirty Years of Pancreas Transplantation at Leiden University Medical Center : Long-Term Follow-Up in a Large Eurotransplant Center

NARCIS (Netherlands)

Kopp, Wouter H; Verhagen, Merel J J; Blok, Joris J; Huurman, Volkert A L; de Fijter, Johan W; de Koning, Eelco J; Putter, Hein; Baranski, Andzrej G; Schaapherder, Alexander F M; Braat, Andries E; Ringers, Jan

2015-01-01

BACKGROUND: An overview of 30 years of pancreas transplantation at a high volume center. Analysis of patient survival- and graft survival-associated risk factors. METHODS: All pancreas transplantations performed in our center from January 1, 1984, till December 31, 2012, were evaluated. Covariates

Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience.

Science.gov (United States)

Gobin, Y Pierre; Dunkel, Ira J; Marr, Brian P; Brodie, Scott E; Abramson, David H

2011-06-01

To determine whether intra-arterial chemotherapy is safe and effective in advanced intraocular retinoblastoma. Retinoblastoma often presents with advanced intraocular disease and, despite conventional treatment with intravenous chemotherapy and external beam radiation therapy, may still require enucleation. Single-arm, prospective registry from May 30, 2006, to May 30, 2010, at an ophthalmic oncology referral center with ambulatory care. A total of 95 eyes of 78 patients with unilateral or bilateral retinoblastoma were treated. The intervention was selective catheterization of the ophthalmic artery and injection of chemotherapy, usually melphalan with or without topotecan. Drug dosage was determined by age and angioanatomy. The main outcome measures were procedural success, event-free (enucleation or radiotherapy) ocular survival, and ocular and extraocular complications. Catheterization succeeded in 98.5% of procedures. There were 289 chemotherapy injections (median, 3 per eye). The Kaplan-Meier estimates of ocular event-free survival rates at 2 years were 70.0% (95% confidence interval, 57.9%-82.2%) for all eyes, 81.7% (95% confidence interval, 66.8%-96.6%) for eyes that received intra-arterial chemotherapy as primary treatment, and 58.4% (95% confidence interval, 39.5%-77.2%) for eyes that had previous treatment failure with intravenous chemotherapy and/or external beam radiation therapy. There were no permanent extraocular complications. Our experience suggests that intra-arterial chemotherapy is safe and effective in the treatment of advanced intraocular retinoblastoma.

LAPAROSCOPIC PANCREATIC RESECTION. FROM ENUCLEATION TO PANCREATODUODENECTOMY. 11-YEAR EXPERIENCE

Directory of Open Access Journals (Sweden)

Marcel Autran Cesar MACHADO

Full Text Available Context Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Results Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6% were performed totally laparoscopic; 4 (4.2% needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%. Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons.

A novel patient-centered "intention-to-treat" metric of U.S. lung transplant center performance.

Science.gov (United States)

Maldonado, Dawn A; RoyChoudhury, Arindam; Lederer, David J

2018-01-01

Despite the importance of pretransplantation outcomes, 1-year posttransplantation survival is typically considered the primary metric of lung transplant center performance in the United States. We designed a novel lung transplant center performance metric that incorporates both pre- and posttransplantation survival time. We performed an ecologic study of 12 187 lung transplant candidates listed at 56 U.S. lung transplant centers between 2006 and 2012. We calculated an "intention-to-treat" survival (ITTS) metric as the percentage of waiting list candidates surviving at least 1 year after transplantation. The median center-level 1-year posttransplantation survival rate was 84.1%, and the median center-level ITTS was 66.9% (mean absolute difference 19.6%, 95% limits of agreement 4.3 to 35.1%). All but 10 centers had ITTS values that were significantly lower than 1-year posttransplantation survival rates. Observed ITTS was significantly lower than expected ITTS for 7 centers. These data show that one third of lung transplant candidates do not survive 1 year after transplantation, and that 12% of centers have lower than expected ITTS. An "intention-to-treat" survival metric may provide a more realistic expectation of patient outcomes at transplant centers and may be of value to transplant centers and policymakers. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Characteristics predicting laparoscopic skill in medical students: nine years' experience in a single center.

Science.gov (United States)

Nomura, Tsutomu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Itsuo; Nakamura, Yoshiharu; Kanazawa, Yoshikazu; Makino, Hiroshi; Mamada, Yasuhiro; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

2018-01-01

We introduced laparoscopic simulator training for medical students in 2007. This study was designed to identify factors that predict the laparoscopic skill of medical students, to identify intergenerational differences in abilities, and to estimate the variability of results in each training group. Our ultimate goal was to determine the optimal educational program for teaching laparoscopic surgery to medical students. Between 2007 and 2015, a total of 270 fifth-year medical students were enrolled in this observational study. Before training, the participants were asked questions about their interest in laparoscopic surgery, experience with playing video games, confidence about driving, and manual dexterity. After the training, aspects of their competence (execution time, instrument path length, and economy of instrument movement) were assessed. Multiple regression analysis identified significant effects of manual dexterity, gender, and confidence about driving on the results of the training. The training results have significantly improved over recent years. The variability among the results in each training group was relatively small. We identified the characteristics of medical students with excellent laparoscopic skills. We observed educational benefits from interactions between medical students within each training group. Our study suggests that selection and grouping are important to the success of modern programs designed to train medical students in laparoscopic surgery.

9th PEF status colloquium from March 9-11, 1993 at the Nuclear Research Center Karlsruhe

International Nuclear Information System (INIS)

Horsch, F.; Filby, W.G.; Fund, N.; Gross, S.; Kaendler, G.; Reinhardt, W.

1993-04-01

During the 9-11th of March 1993 the ninth status report of the project ''European Research Centre for Air Pollution Prevention Measures'' (PEF) took place at the Nuclear Research Center Karlsruhe. Progress reports on the following topics were presented: investigation into damage and elucidation of the causes and effects of forest decline (task 1A); research into atmospheric dispersion, conversion and deposition of airborne pollutants (task 2); development and optimization of industrial-technical processes to reduce or avoid emissions (task 3); and providing instruments and making recommendations to the industrial and political sectors (task 4). (orig./BBR) [de

Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

Science.gov (United States)

Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

2013-01-01

Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

Impact of 5 years of lean six sigma in a University Medical Center.

Science.gov (United States)

Niemeijer, Gerard C; Trip, Albert; de Jong, Laura J; Wendt, Klaus W; Does, Ronald J M M

2012-01-01

Lean Six Sigma (LSS) is an originally industry-based methodology for cost reduction and quality improvement. In more recent years, LSS was introduced in health care as well. This article describes the experiences of the University Medical Center Groningen, the second largest hospital in the Netherlands, with LSS. It was introduced in 2007 to create the financial possibility to develop innovations. In this article, we describe how LSS was introduced, and how it developed in the following years. We zoom in at the traumatology department, where all main processes have been analyzed and improved. An evaluation after 5 years shows that LSS helped indeed reducing cost and improving quality. Moreover, it aided the transition of the organization from purely problem oriented to more process oriented, which in turn is helpful in eliminating waste and finding solutions for difficult problems. A major benefit of the program is that own employees are trained to become project leaders for improvement. Several people from the primary process were thus stimulated and equipped to become role models for continuous improvement.

The first 5 years since trauma center designation in the Hong Kong Special Administrative Region, People's Republic of China.

Science.gov (United States)

Leung, Gilberto Ka Kit; Chang, Annice; Cheung, F C; Ho, H F; Ho, Wendy; Hui, S M; Kam, C W; Lai, Albert; Lam, K W; Leung, M; Liu, S H; Lo, C B; Mok, Francis; Rainer, Timothy H; Shen, W Y; So, F L; Wong, Gordon; Wu, Amy; Yeung, Janice; Yuen, W K

2011-05-01

In 1994, the Hong Kong Special Administrative Region (HKSAR) introduced plans to implement a trauma system based on the recommendations outlined by Professor Donald Trunkey in his report to the local Hospital Authority. Five government-subsidized public hospitals were subsequently designated as trauma centers in 2003. This article reviews the initial experience in these five centers. Prospective trauma registries from January 2004 to December 2008 were reviewed. Primary clinical outcome measures were hospital mortality. The Trauma and Injury Severity Score methodology was used for benchmarking with the Major Trauma Outcome Study (MTOS) database. The majority (83.3%) of the 10,462 patients suffered from blunt trauma. Severe injury, defined as Injury Severity Score>15, occurred in 29.7% of patients. The leading causes of trauma were motor vehicle collisions and falls, with crude hospital mortality rates of 6.9% and 10.7%, respectively. The M-statistic was 0.95, indicating comparable case-mix with the MTOS. The worst outcome occurred in the first year. Significant improvement was seen in patients with penetrating injuries. By 2008, these patients had significantly higher survival rates than expected (Z-statistic=0.85). Although the overall mortality rates for blunt trauma were higher than expected, the difference was no longer statistically significant from the second year onward. The case-mix of trauma patients in the HKSAR is comparable with that of the MTOS. A young trauma system relatively unburdened by dissimilar reimbursement and patient access issues may achieve significant improvement and satisfactory patient outcomes. Our findings may serve as a useful benchmark for HK and other Southeast Asian cities and trauma systems to establish local coefficients for future evaluations.

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center*

Science.gov (United States)

Ferreira, Flávia Regina; Ogawa, Marilia Marufuji; Nascimento, Luiz Fernando Costa; Tomimori, Jane

2014-01-01

BACKGROUND Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure - 46.9%. CONCLUSION This study allowed

The Komplast Experiment: Space Environmental Effects after 12 Years in LEO (and Counting)

Science.gov (United States)

Golden, J. L.; Shaevich, S.; Aleksandrov, N. G.; Shumov, A. E.; Novikov, L. S.; Alred, J. A.; Shindo, D. J.; Kravchenko, M.

2014-01-01

The Komplast materials experiment was designed by the Khrunichev Space Center, together with other Russian scientific institutes, and has been carried out by Mission Control Moscow since 1998. The purpose is to study the effect of the low earth orbit (LEO) environment on exposed samples of various spacecraft materials. The Komplast experiment began with the launch of the first International Space Station (ISS) module on November 20, 1998. Two of eight experiment panels were retrieved during Russian extravehicular activity in February 2011 after 12 years of LEO exposure, and were subsequently returned to Earth by Space Shuttle "Discovery" on the STS-133/ULF-5 mission. The retrieved panels contained an experiment to detect micrometeoroid and orbital debris (MMOD) impacts, radiation sensors, a temperature sensor, several pieces of electrical cable, both carbon composite and adhesive-bonded samples, and many samples made from elastomeric and fluoroplastic materials. Our investigation is complete and a summary of the results obtained from this uniquely long-duration exposure experiment will be presented.

RCOP: Research Center for Optical Physics

Science.gov (United States)

Tabibi, Bagher M. (Principal Investigator)

1996-01-01

During the five years since its inception, Research Center for Optical Physics (RCOP) has excelled in the goals stated in the original proposal: 1) training of the scientists and engineers needed for the twenty-first century with special emphasis on underrepresented citizens and 2) research and technological development in areas of relevance to NASA. In the category of research training, there have been 16 Bachelors degrees and 9 Masters degrees awarded to African American students working in RCOP during the last five years. RCOP has also provided research experience to undergraduate and high school students through a number of outreach programs held during the summer and the academic year. RCOP has also been instrumental in the development of the Ph.D. program in physics which is in its fourth year at Hampton. There are currently over 40 graduate students in the program and 9 African American graduate students, working in RCOP, that have satisfied all of the requirements for Ph.D. candidancy and are working on their dissertation research. At least three of these students will be awarded their doctoral degrees during 1997. RCOP has also excelled in research and technological development. During the first five years of existence, RCOP researchers have generated well over $3 M in research funding that directly supports the Center. Close ties with NASA Langley and NASA Lewis have been established, and collaborations with NASA scientists, URC's and other universities as well as with industry have been developed. This success is evidenced by the rate of publishing research results in refereed journals, which now exceeds that of the goals in the original proposal (approx. 2 publications per faculty per year). Also, two patents have been awarded to RCOP scientists.

Looking Back at 25 Years With NASA's EOSDIS Distributed Active Archive Centers

Science.gov (United States)

Behnke, J.; Kittel, D.

2017-12-01

NASA's Earth Observing System Data and Information System (EOSDIS) has been a central component of the NASA Earth observation program since the 1990's. The data collected by NASA's remote sensing instruments represent a significant public investment in research. EOSDIS provides free and open access to this data to a worldwide public research community. EOSDIS manages a wide range of Earth science discipline data that include cryosphere, land cover change, polar processes, field campaigns, ocean surface, digital elevation, atmosphere dynamics and composition, and inter-disciplinary research, among many others. From the very beginning, EOSDIS was conceived as a system built on partnerships between NASA Centers, US agencies and academia. As originally conceived, the EOSDIS comprised of organizations to process and disseminate remote sensing and in situ data and provide services to a wide variety of users. These organizations are known as the Distributed Active Archive Centers (DAACs). Because of their active role in NASA mission science and with the science community, the DAACs represent a distinct departure from the run-of-the-mill data center. The purpose of this paper is to highlight this distinction and to describe the experiences, strategies, and lessons learned from the operation of the DAACs. Today, there are 12 DAACs geographically distributed across the US that serve over 3 million users and distributed over 1.5 billion Earth science data products. Managed by NASA's Earth Science Data and Information System (ESDIS) Project at Goddard Space Flight Center, the DAACs each support different Earth science disciplines allowing for the customized support to user communities. The ESDIS Project provides the infrastructure support for the entire EOSDIS system, which has grown to 23 petabytes. The DAACs have improved performance as they have grown over the years, while costs are tightly controlled. We have several recommendations about curation, level of service

Urology Residents' Experience and Attitude Toward Surgical Simulation: Presenting our 4-Year Experience With a Multi-institutional, Multi-modality Simulation Model.

Science.gov (United States)

Chow, Alexander K; Sherer, Benjamin A; Yura, Emily; Kielb, Stephanie; Kocjancic, Ervin; Eggener, Scott; Turk, Thomas; Park, Sangtae; Psutka, Sarah; Abern, Michael; Latchamsetty, Kalyan C; Coogan, Christopher L

2017-11-01

To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. Residents from 6 area urology training programs rotated through simulation stations in 4 consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate, ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer, vasectomy, and Urolift. Faculty members provided teaching assistance, objective scoring, and verbal feedback. Participants completed a nonvalidated questionnaire evaluating utility of the workshop and soliciting suggestions for improvement. Sixty-three of 75 participants (84%) (postgraduate years 1-6) completed the exit questionnaire. Median rating of exercise usefulness on a scale of 1-10 ranged from 7.5 to 9. On a scale of 0-10, cumulative median scores of the course remained high over 4 years: time limit per station (9; interquartile range [IQR] 2), faculty instruction (9, IQR 2), ease of use (9, IQR 2), face validity (8, IQR 3), and overall course (9, IQR 2). On multivariate analysis, there was no difference in rating of domains between postgraduate years. Sixty-seven percent (42/63) believe that simulation training should be a requirement of Urology residency. Ninety-seven percent (63/65) viewed the laboratory as beneficial to their education. This workshop model is a valuable training experience for residents. Most participants believe that surgical simulation is beneficial and should be a requirement for Urology residency. High ratings of usefulness for each exercise demonstrated excellent face validity provided by the course. Copyright © 2017 Elsevier Inc. All rights reserved.

LANSCE '90: The Manuel Lujan Jr. Neutron Scattering Center

International Nuclear Information System (INIS)

Pynn, R.

1990-01-01

This paper describes progress that has been made at the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) during the past two years. Presently, LANSCE provides a higher peak neutron flux than any other pulsed spallation neutron source. There are seven spectrometers for neutron scattering experiments that are operated for a national user program sponsored by the US Department of Energy. Two more spectrometers are under construction. Plans have been made to raise the number of beam holes available for instrumentation and to improve the efficiency of the target/moderator system. 9 refs., 4 figs

Single-Center Experience Using Marginal Liver Grafts in Korea.

Science.gov (United States)

Park, P-J; Yu, Y-D; Yoon, Y-I; Kim, S-R; Kim, D-S

2018-05-01

Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017. Only patients undergoing deceased-donor LTs were analyzed. Marginal grafts were defined as livers from donors >60 years of age, livers from donors with serum sodium levels >155 mEq, graft steatosis >30%, livers with cold ischemia time ≥12 hours, livers from donors who were hepatitis B or C virus positive, livers recovered from donation after cardiac death, and livers split between 2 recipients. Patients receiving marginal grafts (marginal group) were compared with patients receiving standard grafts (standard group). A total of 106 patients underwent deceased-donor LT. There were 55 patients in the standard group and 51 patients in the marginal group. There were no significant differences in terms of age, sex, Model for End-Stage Liver Disease score, underlying liver disease, presence of hepatocellular carcinoma, and hospital stay between the 2 groups. Although the incidence of acute cellular rejection, cytomegalovirus infection, and postoperative complications was similar between the 2 groups, the incidence of early allograft dysfunction was higher in the marginal group. With a median follow-up of 26 months, the 1-, 3-, and 5-year overall and graft (death-censored) survivals in the marginal group were 85.5%, 75%, and 69.2% and 85.9%, 83.6%, and 77.2%, respectively. Patient overall survival and graft survival (death-censored) were significantly lower in the marginal group (P = .023 and P = .048, respectively). On multivariate analysis, receiving a marginal graft (hazard ratio [HR

Activities and experience of the Federal Resource Center for Organizing Comprehensive Support for Children with ASD

Directory of Open Access Journals (Sweden)

Khaustov A.V.

2016-12-01

Full Text Available This article presents basic activities and experience of the Federal Resource Center for Organizing Comprehensive Sup¬port for Children with ASD of Moscow state university of psychology & education, amassed during 22 years of practice. Some statistic data on the center’s activity are displayed. Emphasis is done on multidirectional work and developing ways of interdepartmental and networking interaction for the sake of founding a system of complex support for autistic children in Russian Federation.

Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack.

Science.gov (United States)

Brackbill, Robert M; Hadler, James L; DiGrande, Laura; Ekenga, Christine C; Farfel, Mark R; Friedman, Stephen; Perlman, Sharon E; Stellman, Steven D; Walker, Deborah J; Wu, David; Yu, Shengchao; Thorpe, Lorna E

2009-08-05

The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster. To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack. Longitudinal cohort study with wave 1 (W1) enrollment of 71,437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46,322 adults (68%) completed the wave 2 (W2) survey in 2006-2007. Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score > or = 44). Of W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2. Acute and prolonged exposures were both

Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

International Nuclear Information System (INIS)

Balboni, Tracy A.; Chen, M.-H.; Harris, Jay R.; Recht, Abram; Stevenson, Mary Ann; D'Amico, Anthony V.

2007-01-01

Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

Factors affecting mortality after penetrating cardiac injuries: 10-year experience at urban level I trauma center.

Science.gov (United States)

Mina, Michael J; Jhunjhunwala, Rashi; Gelbard, Rondi B; Dougherty, Stacy D; Carr, Jacquelyn S; Dente, Christopher J; Nicholas, Jeffrey M; Wyrzykowski, Amy D; Salomone, Jeffrey P; Vercruysse, Gary A; Feliciano, David V; Morse, Bryan C

2017-06-01

Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, level I trauma center. Over the 10-year study, 80 PCI patients survived to reach the hospital. Of the 21 factors analyzed, prehospital cardiopulmonary resuscitation (odds ratio [OR] = 30), scene time greater than 10 minutes (OR = 58), resuscitative thoracotomy (OR = 19), and massive left hemothorax (OR = 15) had the greatest impact on mortality. Cardiac tamponade physiology demonstrated a "protective" effect for survivors to the hospital (OR = .08). Trauma surgeons can improve mortality after PCI by minimizing time to the operating room for early control of hemorrhage. In PCI patients, tamponade may provide a physiologic advantage (lower mortality) compared to exsanguination. Copyright © 2016 Elsevier Inc. All rights reserved.

Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

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Orton, Judy

2013-01-01

The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

Cooperation on impingement wastage experiment of Mod. 9Cr-1Mo steel using SWAT-1R sodium-water reaction test facility

International Nuclear Information System (INIS)

Beauchamp, F.; Allou, A.; Nishimura, M.; Umeda, R.

2013-01-01

Conclusion: • 6 experiments were carried out in the SWAT-1R facility of JAEA Oarai R&D Center to study the wastage resistance of the Mod. 9Cr-1Mo steel (T91) straight tubes. • These experiments were performed under the cooperation between CEA and JAEA. • The experiments were conducted successfully: - all the tubes were punctured by the reaction jet, - wastage and steam/water leak rates were obtained, - experimental results brought some new determining sets of wastage data on T91. • This fruitful cooperation has contributed to: - expanding the wastage database on T91, - upgrading wastage rates prediction from modelling, - the safety demonstration of future steam generators units

Operative Treatment of Hepatic Hydatid Cysts: A Single Center Experience in Israel, a Nonendemic Country

Science.gov (United States)

Maoz, Daniel; Greif, Franklin; Chen, Jacob

2013-01-01

Background. Hydatid cyst disease is a zoonosis caused by Echinococcus genera. The disease is endemic to certain rural areas in the world. Operative treatment is the main component in curing hydatid cysts of the liver. Objective. Describing the unique characteristics of the hydatid cyst patients in Israel, a nonendemic country. Methods. Data was collected form 29 patients treated operatively in Rabin Medical Center from 1994 to 2007. Results. The study included 18 females and 11 males with an average age of 54.9 years. Fifty-two% of the patients immigrated as children from Arab countries to Israel, 21% were Arab-Israelis leaving in the north and center of Israel, and 24% immigrated from the former Communist Bloc. Pericystectomy was performed in 20/29, and cyst unroofing was performed in 9/29. Hydatid cysts average size was 10.7 cm, and the cysts were located in the right or left or involved both lobes in 62%, 28%, and 10% of the lesions, respectively. Postoperative mortality occurred in one case, and severe morbidity occurred in 4 patients. Conclusions. Hydatid cyst disease in Israel is uncommon and is mostly seen in distinct 3 demographic groups. Despite the relatively low patient volume, good results in terms of morbidity, mortality, and recurrence were achieved. PMID:24175100

Four-year experience with methotrexate exposures.

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LoVecchio, Frank; Katz, Kenneth; Watts, David; Wood, Ian

2008-09-01

Unintentional methotrexate (MTX) acute oral overdose is rarely reported. We conducted a retrospective chart review of all human exposure calls (>150,000 charts) for MTX ingestions reported to our Poison Center during 2000-2003. Thirteen patients met the criteria. The average amount of MTX ingested was 13.03 mg (data from 7 cases), and the average patient age was 43 years (20 months to 80 years). No significant toxicities occurred. Although intravenous MTX toxicity can be severe, this does not appear to be a phenomenon associated with either acute unintentional or suicidal oral ingestion.

[Infective endocarditis. 5-years experience in a third-level reference center in Yucatan, Mexico].

Science.gov (United States)

Vega-Sánchez, Angel Emmanuel; Santaularia-Tomas, Miguel; Pérez-Román, Diana Isabel; Cortés-Telles, Arturo

2016-01-01

Infective endocarditis is a disease with high morbidity and mortality. The clinical characteristics differ among populations. Therefore it is important to know the characteristics of the disease in our region. This is an observational study that included all patients diagnosed with infective endocarditis from 1 January 2009 until 31 December 2014. The data are showed as frequencies and percentages altogether with medians with interquartile range. 10 cases were included. The median age was 34 years (IQR 26-41). Several risk factors were identified and included: previous valvular heart disease, patients with chronic kidney disease who have had a vascular access and previous history of immunological disease. The native mitral valve was the most affected. The size of vegetations had a median length of 14 mm (IQR 9.3-16). Streptococcus alpha hemolytic was the most common organism. In-hospital mortality rate was 10 %. The behavior of the disease is similar to other national series. We identify risk factors that could be related to the type of morbidities in the region.

Experiences of a secondary laboratory of dosimetric calibration from the radiation protection and hygiene center CPHR in its first year of work and the procedures for quality assessment used in the calibration and quality control service

International Nuclear Information System (INIS)

Morales, J.A.; Campa, R.; Jova Sed, L.

1996-01-01

Experiences of a secondary laboratory of dosimetric calibration from the Radiation Protection and Hygiene Center (CPHR) in first year of work and the procedures for quality assessment used in the calibration and quality control service of radiotherapeutic equipment. For the yield calibration of the calibrated sources an ionometric method was used using ionizing chambers coupled to electrometers. Those determination were based on dosimetric American Association of Physicists in Medicine (AAPM)

Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia

Science.gov (United States)

2012-01-01

Background Students may encounter difficulties when they have to apply clinical skills trained in their pre-clinical studies in clerkships. Early clinical exposure in the pre-clinical phase has been recommended to reduce these transition problems. The aim of this study is to explore differences in students' experiences during the first clerkships between students exclusively trained in a skills laboratory and peers for whom part of their skills training was substituted by early clinical experiences (ECE). Methods Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software. Results Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication. Conclusion In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships. PMID:22640419

Vertical Jump and Leg Power Normative Data for Colombian Schoolchildren Aged 9-17.9 Years: The FUPRECOL Study.

Science.gov (United States)

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge E; Lobelo, Felipe; Cadore, Eduardo L; Alonso-Martinez, Alicia M; Izquierdo, Mikel

2017-04-01

Ramírez-Vélez, R, Correa-Bautista, JE, Lobelo, F, Cadore, EL, Alonso-Martinez, AM, and Izquierdo, M. Vertical jump and leg power normative data for Colombian schoolchildren aged 9-17.9 years: the FUPRECOL study. J Strength Cond Res 31(4): 990-998, 2017-The aims of the present study were to generate normative vertical jump height and predicted peak power (Ppeak) data for 9- to 17.9-year-olds and to investigate between-sex and age group differences in these measures. This was a cross-sectional study of 7,614 healthy schoolchildren (boys n = 3,258 and girls n = 4,356, mean [SD] age 12.8 [2.3] years). Each participant performed 2 countermovement jumps; jump height was calculated using a Takei 5414 Jump-DF Digital Vertical (Takei Scientific Instruments Co., Ltd.). The highest jump was used for analysis and in the calculation of predicted Ppeak. Centile smoothed curves, percentiles, and tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using Cole's LMS (L [curve Box-Cox], M [curve median], and S [curve coefficient of variation]) method. The 2-way analysis of variance tests showed that maximum jump height (in centimeters) and predicted Ppeak (in watts) were higher in boys than in girls (p jump height and Ppeak in all ages. In boys, the maximum jump height and predicted Ppeak 50th percentile ranged from 24.0 to 38.0 cm and from 845.5 to 3061.6 W, respectively. In girls, the 50th percentile for jump height ranged from 22.3 to 27.0 cm, and the predicted Ppeak was 710.1-2036.4 W. For girls, jump height increased yearly from 9 to 17.9 years old. Our results provide, for the first time, sex- and age-specific vertical jump height and predicted Ppeak reference standards for Colombian schoolchildren aged 9-17.9 years.

Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

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Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

2011-03-15

Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

Multilevel Botulinum Toxin A (Abobotulinum Toxin A Injections in Spastic Forms of Cerebral Palsy: Retrospective Analysis of 8 Russian Centers Experience

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O. A. Klochkova

2016-01-01

Full Text Available Background: The contemporary application of Botulinum toxin A (BTA in cerebral palsy (CP implies multilevel injections both in on-label and off-label muscles. However, there is no single international opinion on the effective and safe dosages, target muscles, and intervals between the injections.Objective: Our aim was to analyze the Russian multicenter independent experience of single and repeated multilevel injections of Abobotulinum toxin А in patients with spastic forms of CP.Methods: 8 independent referral CP-centers (10 hospitals in different regions of Russia. Authors evaluated intervals between the injections, dosages of the BTA for the whole procedure, for the body mass, for the each muscle, and functional segment of the extremities.Results: 1872 protocols of effective BTA injections (1–14 repeated injections for 724 patients with spastic CP were included. The age of the patients was between 8 months to 17 years 4 months at the beginning of the treatment (with a mean of 3 years 10 months. Multilevel BTA injections were indicated for the majority (n = 634, 87.6% of the patients in all the centers. The medians of the dosages for the first BTA injection were between 30–31 U/kg (500 U, the repeated injections doses up to 45 U/kg (1000 U (in most centers. The median intervals between the repeated injections were 180–200 days in 484 (66.9% patients and 140–180 days in 157 (24.7% patients. In 2 centers, children with GMFCS IV–V were injected more often than others.Conclusion: Multilevel BTA injections were indicated for the most patients. The initial dose of Abobotulinum toxin A was 30–31 U/kg. The repeated injections dose could increase up to 40 U/kg. The repeated injections were done in 140–200 days after the previous injection.

[Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

Science.gov (United States)

Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

2015-01-01

In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Salient features and outcomes of Charcot foot – An often-overlooked diabetic complication: A 17-year-experience at a diabetic center in Bangkok

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Yotsapon Thewjitcharoen

2018-03-01

Full Text Available Background: Charcot foot is a rare but a serious diabetic condition. Recognition of this often overlooked condition to provide timely and proper management is important for a better prognosis. Limited data on Charcot foot was available in Asians. Aims: The aim of this study is to describe salient features and outcomes of Charcot foot in Thai patients. Method: We presented our experience of 40 cases of Charcot foot patients who were treated from 2000 to 2016 at Theptarin Hospital, Bangkok, Thailand. Results: A total of 40 Charcot foot patients were identified (13 acute, 27 chronic; mean age 58.7 ± 10.2 years; duration of diabetes 18.0 ± 8.8 years; T2DM 95%. The average serum HbA1c level was 9.2 ± 1.9%. While acute Charcot foot was frequently misdiagnosed as cellulitis in almost one-third of patients, osteomyelitis was a leading cause of misdiagnosis in 15% of chronic Charcot foot patients. Ulcer-free rate at 6 and 12 months were observed in 60% and 58% of patients, respectively. The mortality rate was 13% during a median follow-up period of 57 months. Only 61% of the patients resumed walking normally while almost one-fourth of them were wheelchair-bound. Conclusions: Charcot foot in Thai patients mainly developed in long-standing poorly controlled type 2 diabetes with neuropathy, and presented late in the course of the disease. It was often misdiagnosed resulting in improper management and poor outcome which included amputation. Keywords: Charcot foot, Outcomes, Thailand

Carbon Dioxide Analysis Center and World Data Center-A for Atmospheric Trace Gases fiscal year 1997 annual report

Energy Technology Data Exchange (ETDEWEB)

Burtis, M.D. [comp.; Cushman, R.M.; Boden, T.A.; Jones, S.B.; Kaiser, D.P.; Nelson, T.R.

1998-03-01

Fiscal year (FY) 1997 was another exciting and productive one for the Carbon Dioxide Information Analysis Center (CDIAC) at the Oak Ridge National Laboratory. During FY 1997, CDIAC launched the Quality Systems Science Center for the North American Research Strategy for Tropospheric Ozone (NARSTO). The purpose of NARSTO--a US-Canada-Mexico initiative of government agencies, industry, and the academic research community--is to improve the understanding of the formation and transport of tropospheric ozone.

A 2-year retrospective study of pediatric dental emergency visits at a hospital emergency center in Taiwan.

Science.gov (United States)

Jung, Chia-Pei; Tsai, Aileen I; Chen, Ching-Ming

2016-06-01

There is a paucity of information regarding pediatric dental emergencies in Taiwan. This study investigates the prevalence and characteristics of the pediatric dental emergency services provided at a medical center. This study included a retrospective chart review of patients under 18 years of age with dental complaints who visited the Emergency Department (ED) of Linkou Medical Center of Chang Gung Memorial Hospital from January 2012 to December 2013. Information regarding age, gender, time/day/month of presentation, diagnosis, treatment, and follow-up was collected and analyzed. Statistical analysis included descriptive statistics and Pearson's Chi-square test with the significance level set as p dental emergencies in the medical center ED were predominantly related to orodental trauma (47.1%) and pulpal pain (29.9%). Most patients were male (p management for dental emergencies was prescribing medication for pulp-related problems and orodental trauma. The follow-up rate of orodental trauma was the highest (p dental emergency visits at a hospital emergency center in Taiwan. While dental emergencies are sometimes unforeseeable or unavoidable, developing community awareness about proper at-home care as well as regular dental preventive measures can potentially reduce the number of emergency visits. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

[The AMY experiment

International Nuclear Information System (INIS)

1989-01-01

The AMY experiment is one of three major experiments at TRISTAN which is studying the states the matter produced in electron positron annihilations in the center of mass energy range of 50--65GeV. It provides information between the lower energy facilities such as PEP and PETRA and the new facilities SLC and LEP which are designed to operate in the region of the Z 0 mass near 90GeV. In the region of the AMY experiment, interaction cross sections are near their minimum of about 100pb, making it difficult to acquire large data samples during typical running cycles. This last year has seen an accumulation of about 10---12pb -1 of integrated luminosity in the energy range from 58 to 61.7GeV. Despite this limited data sample, the AMY experiment has been extremely active in attempting to extract the minimum amount of information from the data. Some of the most significant results are discussed in this paper. 9 refs

The Freedom Solo pericardial stentless valve: Single-center experience, outcomes, and long-term durability.

Science.gov (United States)

Stanger, Olaf; Bleuel, Irina; Gisler, Fabian; Göber, Volkhard; Reineke, Sylvia; Gahl, Brigitta; Aymard, Thierry; Englberger, Lars; Carrel, Thierry; Tevaearai, Hendrik

2015-07-01

To report our institutional experience and long-term results with the Freedom Solo bovine pericardial stentless bioprosthesis (Sorin Group, Saluggia, Italy). Between January 2005 and November 2009, 149 patients (mean age, 73.6 ± 8.7 years; 68 [45.6%] female) underwent isolated (n = 75) or combined (n = 74) aortic valve replacement (AVR) using the Solo in our institution. Follow-up was 100% complete with an average follow-up time of 5.9 ± 2.6 years (maximum, 9.6 years) and a total of 885.3 patient years. Operative (30-day) mortality was 2.7% (1.3% for isolated AVR [n = 1] and 4.0% for combined procedures [n = 3]). All causes of death were not valve-related. Preoperative peak (mean) gradients of 74.2 ± 23.0 mm Hg (48.6 ± 16.3 mm Hg) decreased to 15.6 ± 5.4 mm Hg (8.8 ± 3.0 mm Hg) after AVR, and remained low for up to 9 years. The postoperative effective orifice area was 1.6 ± 0.57 cm(2), 1.90 ± 0.45 cm(2), 2.12 ± 0.48 cm(2), and 2.20 ± 0.66 cm(2) for the valve sizes 21, 23, 25, and 27, respectively, with absence of severe prosthesis-patient mismatch and 0.7% (n = 1) experienced moderate prosthesis-patient mismatch. During follow-up, 26 patients experienced structural valve deterioration (SVD) and 14 patients underwent explantation. Kaplan-Meier estimates for freedom from death, explantation, and SVD at 9 years averaged 0.57 (range, 0.47-0.66), 0.82 (range, 0.69-0.90), and 0.70 (range, 0.57-0.79), respectively. The Freedom Solo stentless aortic valve is safe to implant and shows excellent early and midterm hemodynamic performance. However, SVD was observed in a substantial number of patients after only 5-6 years and the need for explantation increased markedly, suggesting low durability. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Perioperative management of patients with antiphospholipid syndrome: a single-center experience.

Science.gov (United States)

Atisha-Fregoso, Yemil; Espejo-Poox, Eric; Carrillo-Maravilla, Eduardo; Pulido-Ramírez, Alma Lilia; Lugo Baruqui, Diego; Hernández-Molina, Gabriela; Cabral, Antonio R

2017-07-01

The objective was to describe the management and risk factors for complications of antiphospholipid syndrome (APS) patients who underwent a surgical procedure in a single center. We reviewed medical records of all patients with primary or secondary APS who underwent an elective surgery during a 6-year period. Demographical data, management of anticoagulation and complications were recorded. We identified 43 patients, mean age 37.9 ± 8.9 years, who underwent a total of 48 elective surgeries. All patients had history of at least one thrombotic event and were under vitamin K antagonists. Before surgery, all patients received bridging therapy with intravenous infusion of heparin or low molecular weight heparin (LMWH). Among the LMWH group, 36 had a full anticoagulation regimen and nine prophylactic doses. In 62% of the surgeries, we identified an optimal management of periprocedural anticoagulation according to guidelines. Overall six patients had severe bleeding and three thrombotic complications (full anticoagulation regimen n = 2 and prophylactic dose group n = 1). Patients with optimal management of anticoagulation experienced less thrombotic and hemorrhagic complications (7 vs. 33%; OR 0.14, 95% CI 0.02-0.81; p = 0.040) and patients with INR ≤1.5 at surgery had fewer episodes of major bleeding (6 vs. 29%; OR 0.19, 95% CI 0.02-0.98; p = 0.050). All three thrombotic events occurred in patients with INR ≤1.5. Proper management of anticoagulation based on guidelines is associated with less complications in patients with APS. Notwithstanding the proper use of bridging therapy, some patients may develop thrombotic complications.

Development of a standard data base for FBR core nuclear design (XIII). Analysis of small sample reactivity experiments at ZPPR-9

International Nuclear Information System (INIS)

Sato, Wakaei; Fukushima, Manabu; Ishikawa, Makoto

2000-09-01

A comprehensive study to evaluate and accumulate the abundant results of fast reactor physics is now in progress at O-arai Engineering Center to improve analytical methods and prediction accuracy of nuclear design for large fast breeder cores such as future commercial FBRs. The present report summarizes the analytical results of sample reactivity experiments at ZPPR-9 core, which has not been evaluated by the latest analytical method yet. The intention of the work is to extend and further generalize the standard data base for FBR core nuclear design. The analytical results of the sample reactivity experiments (samples: PU-30, U-6, DU-6, SS-1 and B-1) at ZPPR-9 core in JUPITER series, with the latest nuclear data library JENDL-3.2 and the analytical method which was established by the JUPITER analysis, can be concluded as follows: The region-averaged final C/E values generally agreed with unity within 5% differences at the inner core region. However, the C/E values of every sample showed the radial space-dependency increasing from center to core edge, especially the discrepancy of B-1 was the largest by 10%. Next, the influence of the present analytical results for the ZPPR-9 sample reactivity to the cross-section adjustment was evaluated. The reference case was a unified cross-section set ADJ98 based on the recent JUPITER analysis. As a conclusion, the present analytical results have sufficient physical consistency with other JUPITER data, and possess qualification as a part of the standard data base for FBR nuclear design. (author)

Clinical spectrum of hypopituitarism in India: A single center experience

Science.gov (United States)

Gundgurthi, Abhay; Garg, M. K.; Bhardwaj, Reena; Brar, Karninder S.; Kharb, Sandeep; Pandit, Aditi

2012-01-01

Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 – 76 years). There were 78 (69%) males and 35 females (31%). There were 22 subjects aged ≤18 years (childhood and adolescence) and 91 adults (>18 years). Visual disturbances were the most common presenting complaint (33%), though headache was the most common symptom (81%). Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97%) was the most common abnormality seen followed by hypothyroidism (83.2%), hypoadrenalism (79.6%), growth hormone deficiency (88.1% of the 42 patients tested), and diabetes insipidus (13.3%). Panhypopituitarism was seen in 104 (92%) patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases. PMID:23087868

Clinical spectrum of hypopituitarism in India: A single center experience

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Abhay Gundgurthi

2012-01-01

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

Safety and effectiveness of the Genous™ endothelial progenitor cell-capture stent in the first year following ST-elevation acute myocardial infarction: A single center experience and review of the literature

Energy Technology Data Exchange (ETDEWEB)

Pereira-da-Silva, Tiago, E-mail: tiagopsilva@sapo.pt; Bernardes, Luís; Cacela, Duarte; Fiarresga, António; Sousa, Lídia; Patrício, Lino; Ferreira, Rui Cruz

2013-11-15

Purpose: The Genous™ stent (GS) is designed to accelerate endothelization, which is potentially useful in the pro-thrombotic environment of ST-elevation acute myocardial infarction (STEMI). We aimed to evaluate the safety and effectiveness of the GS in the first year following primary percutaneous coronary intervention (PCI) and to compare our results with the few previously published studies. Methods and Materials: All patients admitted to a single center due to STEMI that underwent primary PCI using exclusively GS, between May 2006 and January 2012, were enrolled. The primary study endpoints were major adverse cardiac events (MACEs), defined as the composite of cardiac death, acute myocardial infarction and target vessel revascularization, at one and 12 months. Results: In the cohort of 109 patients (73.4% male, 59 ± 12 years), 24.8% were diabetic. PCI was performed in 116 lesions with angiographic success in 99.1%, using 148 GS with median diameter of 3.00 mm (2.50–4.00) and median length of 15 mm (9–33). Cumulative MACEs were 2.8% at one month and 6.4% at 12 months. Three stent thromboses (2.8%), all subacute, and one stent restenosis (0.9%) occurred. These accounted for the four target vessel revascularizations (3.7%). At 12 months, 33.9% of patients were not on dual antiplatelet therapy. Conclusions: GS was safe and effective in the first year following primary PCI in STEMI, with an apparently safer profile comparing with the previously published data. Summary: We report the safety and effectiveness of the Genous™ stent (GS) in the first year following primary percutaneous coronary intervention in ST-elevation acute myocardial infarction. A comprehensive review of the few studies that have been published on this subject was included and some suggest a less safe profile of the GS. Our results and the critical review included may add information and reinforce the safety and effectiveness of the GS in ST-elevation in acute myocardial infarction.

Safety and effectiveness of the Genous™ endothelial progenitor cell-capture stent in the first year following ST-elevation acute myocardial infarction: A single center experience and review of the literature

International Nuclear Information System (INIS)

Pereira-da-Silva, Tiago; Bernardes, Luís; Cacela, Duarte; Fiarresga, António; Sousa, Lídia; Patrício, Lino; Ferreira, Rui Cruz

2013-01-01

Purpose: The Genous™ stent (GS) is designed to accelerate endothelization, which is potentially useful in the pro-thrombotic environment of ST-elevation acute myocardial infarction (STEMI). We aimed to evaluate the safety and effectiveness of the GS in the first year following primary percutaneous coronary intervention (PCI) and to compare our results with the few previously published studies. Methods and Materials: All patients admitted to a single center due to STEMI that underwent primary PCI using exclusively GS, between May 2006 and January 2012, were enrolled. The primary study endpoints were major adverse cardiac events (MACEs), defined as the composite of cardiac death, acute myocardial infarction and target vessel revascularization, at one and 12 months. Results: In the cohort of 109 patients (73.4% male, 59 ± 12 years), 24.8% were diabetic. PCI was performed in 116 lesions with angiographic success in 99.1%, using 148 GS with median diameter of 3.00 mm (2.50–4.00) and median length of 15 mm (9–33). Cumulative MACEs were 2.8% at one month and 6.4% at 12 months. Three stent thromboses (2.8%), all subacute, and one stent restenosis (0.9%) occurred. These accounted for the four target vessel revascularizations (3.7%). At 12 months, 33.9% of patients were not on dual antiplatelet therapy. Conclusions: GS was safe and effective in the first year following primary PCI in STEMI, with an apparently safer profile comparing with the previously published data. Summary: We report the safety and effectiveness of the Genous™ stent (GS) in the first year following primary percutaneous coronary intervention in ST-elevation acute myocardial infarction. A comprehensive review of the few studies that have been published on this subject was included and some suggest a less safe profile of the GS. Our results and the critical review included may add information and reinforce the safety and effectiveness of the GS in ST-elevation in acute myocardial infarction

46 CFR 280.9 - Special rules for last year of ODS agreement.

Science.gov (United States)

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Special rules for last year of ODS agreement. 280.9... LINER OPERATORS § 280.9 Special rules for last year of ODS agreement. (a) Reduction in payment of ODS. ODS payable during the last year of any ODS agreement shall be reduced, as provided in paragraph (b...

Clinical and demographic characteristics of patients with occupational contact dermatitis: A 3-year single center experience

Directory of Open Access Journals (Sweden)

Aslı Aytekin

2015-12-01

Full Text Available Background and Design: Occupational contact dermatitis (OCD is responsible for 80-90% of the occupational dermatoses. The aim of this work was to evaluate the clinical features of patients with OCD admitted to our hospital. Materials and Methods: The records of patients, who were admitted to our hospital with OCD between December 2009 and January 2013, were evaluated retrospectively. One hundred fifty-nine patients, who were diagnosed with OCD according to the Mathias criteria, were included in the study. Age, sex, location of the lesions, atopic status, glove use, occupational exposure time and total IgE levels of the patients were assessed. Patients with positive allergic reaction with "European Standard Series Skin Patch Test" were identified as allergic OCD and patients with negative test results as "irritant OCD". The clinical features and patch results of patients are evaluated. Results: One hundred fifty-nine patients with a mean age of 39±7.9 years consisted of 151 men and 8 women. The hands were the most common site of OCD; the palms were the most common affected areas of hand eczema. Eighty-one patients (50.1% were identified to have allergic OCD and 78 (49.9% as irritant OCD. Irritant OCD was most commonly seen in dental technicians, whereas allergic OCD was most commonly seen in tailors. The top 3 most frequent allergens were potassium dichromate (15.1%, nickel sulfate (9.11% and cobalt chloride (10.7%. Conclusion: In our country, there has been no comprehensive study presenting the clinical and descriptive characteristics of OCD. For preventing OCD and reducing sick leave we need to have data that belong to our country. Consequently, multicenter studies should be performed for establishing our own database on OCD.

The CMS experiment workflows on StoRM based storage at Tier-1 and Tier-2 centers

International Nuclear Information System (INIS)

Bonacorsi, D; Bartolome, I Cabrillo; Matorras, F; Gonzalez Caballero, I; Sartirana, A

2010-01-01

Approaching LHC data taking, the CMS experiment is deploying, commissioning and operating the building tools of its grid-based computing infrastructure. The commissioning program includes testing, deployment and operation of various storage solutions to support the computing workflows of the experiment. Recently, some of the Tier-1 and Tier-2 centers supporting the collaboration have started to deploy StoRM based storage systems. These are POSIX-based disk storage systems on top of which StoRM implements the Storage Resource Manager (SRM) version 2 interface allowing for a standard-based access from the Grid. In this notes we briefly describe the experience so far achieved at the CNAF Tier-1 center and at the IFCA Tier-2 center.

Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience.

Science.gov (United States)

Wiley, Marcel R; Riccio, Anthony I; Felton, Kevin; Rodgers, Jennifer A; Wimberly, Robert L; Johnston, Charles E

Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center's experience with this technique for the treatment of pediatric KFC. A retrospective review was conducted over a 26-year period. All patients with KFC treated with Quengel casting were included. Demographic data, associated medical conditions, adjunctive soft tissue releases, complications, and the need for late surgical intervention were recorded. Tibiofemoral angle measurements in maximal extension were recorded at initiation and termination of casting, 1-year follow-up, and final follow-up. Success was defined as no symptomatic recurrence of KFC or need for subsequent surgery. Eighteen patients (26 knees) were treated for KFC with Quengel casting. Average age at initiation of casting was 8.1 years with average follow-up of 59.9 months. Fifteen knees (58%) underwent soft tissue releases before casting. An average of 1.5 casts per knee were applied over an average of 23.9 days. Average KFC before casting was 50.6 degrees (range, 15 to 100 degrees) which improved to 5.96 degrees (0 to 40 degrees) at cast removal (Pcasting before 1 year. Of these, 11 knees (50%) had a successful outcome. Residual KFC of those treated successfully was 6.8 degrees (range, 0 to 30 degrees) at 1 year and 8.2 degrees (range, 0 to 30 degrees) at final follow-up, averaging 71.4 months (P=0.81). Of the 11 knees deemed failures, all had recurrence of deformity within an average of 1 year from cast removal. Surgical release before Quengel casting did not improve the chances for success (P=0.09). Quengel casting can improve pediatric KFC an average of 44.2 degrees with minimal complications. Although 50% of treated patients will demonstrate

Emergency Contraceptive Pills: A 10-Year Follow-up Survey of Use and Experiences at College Health Centers in the Mid-Atlantic United States

Science.gov (United States)

Miller, Laura McKeller; Sawyer, Robin G.

2006-01-01

The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved,…

Pattern of glomerular disease in the Saudi population: A single-center, five-year retrospective study

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Z Nawaz

2013-01-01

Full Text Available Glomerular diseases continue to be the leading cause of end-stage renal disease (ESRD globally. Hence, it is important to recognize the pattern of glomerular diseases in different geographical areas in order to understand the patho-biology, incidence and progression of the disorder. Published studies from different centers in Saudi Arabia have reported contradicting results. In this retrospective study, we report our experience at the Armed Forces Hospital, Riyadh, Saudi Arabia. A total of 348 native renal biopsies performed at our center on patients with proteinuria >1 g, hematuria and/or renal impairment during a period of 5 years (between January 2005 and December 2009 were studied by a histopathologist using light microscopy, immunofluorescence and electron microscopy, and were categorized. Results showed that primary glomerular disease accounted for 55.1% of all renal biopsies. The most common histological lesion was focal and segmental glomerulosclerosis (FSGS (27.6%, followed by minimal change disease (MCD (17.7% and membrano-proliferative glomerulonephritis (MPGN (13.0%. Secondary glomerular disease accounted for 37.9% of the glomerular diseases, with lupus nephritis (LN being the most common lesion (54.5%, followed by hypertensive nephrosclerosis (22%, post-infectious glomerulonephritis (7.5%, diabetic nephropathy (DN (6.8% and vasculitides (4.5%. Four percent of all biopsies turned out to be ESRD while biopsy was inadequate in 2.8% of the cases. In conclusion, our study showed that FSGS was the most common primary GN encountered, while LN was the most common secondary GN. We encountered 14 cases of crescentic glomerulonephritis. Also, the prevalence of MPGN, MCD, IgA nephropathy and membranous GN was many folds higher in males when compared with the Western data. We believe that it is mandatory to maintain a Saudi Arabian Renal Biopsy Registry to understand better the pattern of glomerular disease in the Saudi population and to follow

Patients' and procedural characteristics of AV-block during slow pathway modulation for AVNRT-single center 10year experience.

Science.gov (United States)

Wasmer, Kristina; Dechering, Dirk G; Köbe, Julia; Leitz, Patrick; Frommeyer, Gerrit; Lange, Phillip S; Kochhäuser, Simon; Reinke, Florian; Pott, Christian; Mönnig, Gerold; Breithardt, Günter; Eckardt, Lars

2017-10-01

Permanent AV-block is a recognized and feared complication of slow pathway modulation for AVNRT. We aimed to assess incidence of transient and permanent AV-block as well as consequences of transient AV-block in a large contemporary AVNRT ablation cohort. We searched our single center prospective ablation database for occurrence of transient and permanent AV-block during slow pathway modulation between January 2004 and October 2015. We analyzed patients' and procedural characteristics as well as outcome of patients in whom transient or permanent AV-block occurred. Of 9170 patients who underwent a catheter ablation at our institution between January 2004 and October 2015, 2101 patients (64% women, mean age 50±18years) underwent slow pathway modulation. In three patients, permanent AV-block occurred during RF application. Additional two patients had transient AV-block that recovered (after a few minutes and 25min), but recurred within two days of the procedure. All five patients underwent dual chamber pacemaker implantation (0.2%). Transient AV-block related to RF delivery occurred in 44 patients (2%). Transient mechanical AV-block occurred in additional 17 patients (0.8%). In 12 patients, ablation was continued despite transient AV-block. One of these patients developed permanent AV-block. Permanent AV-block following slow pathway modulation is a rare event, occurring in 0.2% of patients in a large contemporary single center cohort. Transient AV-block is more frequent (2%). Copyright © 2017 Elsevier B.V. All rights reserved.

Male victims of sexual assault; 10 years' experience from a Danish Assault Center

DEFF Research Database (Denmark)

Larsen, Mie-Louise; Hilden, Malene

2016-01-01

This study aims to provide descriptive data regarding male victims of sexual assault seen at the Centre for Victims of Sexual Assault in Copenhagen, Denmark. All 55 male victims attending the center in the time period of March 2001 until December 2010 underwent a standardized data collection. Data...... by another man is considered a taboo subject and it is likely that the dark figure of men exposed to sexual assault is much higher than it is for women. Strengthening our knowledge regarding male victims of sexual assault is necessary to improve both primary and secondary preventive measures in order to make...

Determinant factors of toothache in 8- and 9-year-old schoolchildren, Belo Horizonte, MG, Brazil

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Eliane Paula Reis Barrêtto

2009-06-01

Full Text Available A cross-sectional study was carried out to determine the prevalence, severity and impact of toothache among schoolchildren associated with socio-demographic variables (gender, degree of maternal schooling, economic group, and oral health status. Six hundred and one 8- and 9-year-old children were randomly selected from schools in Belo Horizonte, MG, Brazil. After formal authorization was obtained from their parents, the children were interviewed and clinically examined by a single examiner. The Chi squared test was applied and the odds ratio obtained. The prevalence of toothache was 45.9% (276/601, of which 15.6% (94/601 had occurred during the previous month. Among the children who had experienced pain, 39.4% (109/276 classified its severity as intense or very intense. Nearly 35% (96/276 were awoken by the pain, and 63.8% (176/276 were unable to carry out daily tasks as a result. The prevalence of pain was greater among children from less privileged economic groups, in which the mothers' level of schooling was lower (0-7 years of formal study and who showed poorer conditions of oral health, determined by the presence of dental and periodontal pathology (p<0.05. Gender did not influence either the experience of toothache or its severity and impact. The prevalence of toothache found in the age group between 8 and 9 years is very high and associated to social determinants and poorer conditions of oral health.

[A 6-year evaluation of dyslipidemia in a health center: Importance of improvement actions].

Science.gov (United States)

Antón-García, F; Correcher-Salvador, E; Rodríguez-Lagos, F A; González-Caminero, S

2014-01-01

Dyslipidemia, especially an increased LDL-cholesterol, has been shown to be one of the most important risk factors in the genesis of coronary involvement. The prevalence of dyslipidemias in Spain is high. The objective of this study is to assess the progress of dyslipidemic patients in our health center over a 6-year period, and see if there has been any improvement in its control after the presentation of the evaluation of the first 3 years, as well as an updated dyslipidemia protocol. Assessment Period 1 (2006-2008): 267 patients with dyslipidemia. Assessment Period 2 (2009-2011): 222 patients, excluding exitus and address changes. age, sex, personal history of CVD, vascular risk factors, lipids, drug treatment, risk levels, and percentages of CV control objectives. Mean age was 66.2 years (SD 13.4), 66.3% women. Period 1-Period 2: Total cholesterol: 221.9-196.6 mg/dl (P=.000); LDL-cholesterol: 147.9-115.8 mg/dl (P=.000). In high risk patients, therapeutic targets: 14-50.5% (P=.024); medium risk: 35-68.1% (P=.038); low risk: 44-68.2% (P=NS). Pharmacotherapy 68-77% (P=.000). Changing treatment: 30-43% (P=.001). Adherence: 75-86% (P=.003). Untreated high risk: 15.4-16.3% (P=NS). There was a significant improvement in Period 2, especially in high-risk patients, after presenting the results of the evaluation for Period 1 and with the updated dyslipidemia protocol. There are high risk patients without lipid-lowering treatment to be detected and reviewed. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Peritonitis in children with automated peritoneal dialysis: a single-center study of a 10-year experience.

Science.gov (United States)

Dotis, John; Myserlis, Pavlos; Printza, Nikoleta; Stabouli, Stella; Gkogka, Chrysa; Pavlaki, Antigoni; Papachristou, Fotios

2016-08-01

Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months. We found 23 episodes of PD-associated peritonitis occurred in 9 out of 27 patients (0.23 episodes/patient-year), with four patients experienced two or more peritonitis episodes. Gram-positive bacteria were responsible for 15 (65.2%) peritonitis episodes, with Staphylococcus aureus being the predominant specie isolated in 30.4% of cases. A total of seven episodes of exit-site infections (ESIs) were identified in five patients (0.069 episodes/patient-year) with the most common bacteria isolated being S. aureus (57.4%). Initial antibiotic treatment included intraperitoneal vancomycin plus ceftazidime in the majority of cases (82.6%). At the end of study, 12 (44.4%) patients remained on PD, 11 (41.8%) underwent renal transplantation, 2 (7.4%) shifted to hemodialysis and unfortunately, two patients (7.4%) died. Conclusively, our study revealed a noticeable low peritonitis and ESIs rate as compared to international data and represents the first evaluation of the characteristics and outcomes of peritonitis in the Greek pediatric PD population.

Carbon Dioxide Information Analysis Center and World Data Center - A for atmospheric trace gases. Fiscal year 1996, annual report

Energy Technology Data Exchange (ETDEWEB)

Cushman, R.M.; Boden, T.A.; Jones, S.B. [and others

1997-02-01

Fiscal year 1996 was especially productive for the Carbon Dioxide Information Analysis Center (CDIAC) at Oak Ridge National Laboratory (ORNL). This report describes publications and statistical data from the CDIAC.

Hypopharyngeal carcinoma: King Faisal Specialist Hospital and Research Center experience

International Nuclear Information System (INIS)

Mahasin, Z.; Khan, B.

1996-01-01

From 1975 to 1985, 202 patients with hypopharyngeal cancer were seen at King Faisal Specialist Hospital and Research Center (KFSHRC). The endoscopic investigation showed that 28.3% of these patients had postcricoid carcinoma; 19.85% had pyriform fossa carcinoma and 52.9% had involvement of both sites. The pathological diagnosis of all cases was squamous cell carcinoma type. The majority of the patients (62.98%) had T4 lesions, which showed a late presentation to KFSHRC. Information related to survival was available for a smaller number of patients to many lost-to-follow-up cases. The overall median survival time was 8.5 months (1-110 months). The survival rate for each site was calculated, as well as the staging of the disease and treatment modality used. It appeared that pyriform fossa (median 21 months) had the best survival rate. In addition the earlier the lesion was detected and the more aggressive the treatment applied, the better the survival rate. Fifty percent of the patients receiving radiation therapy and surgery had a five year survival arte. Factors other than smoking and/on drinking should be looked for in our community as predisposing to this disease in our population. (author)

Complications in paediatric craniofacial surgery: an initial four year experience.

Science.gov (United States)

Jones, B M; Jani, P; Bingham, R M; Mackersie, A M; Hayward, R

1992-04-01

107 children undergoing transcranial craniofacial surgery in a paediatric hospital have been reviewed to assess the incidence and type of complications which arose. This represents the first 4 years' experience of the craniofacial team. There were no deaths or permanent adverse sequelae of surgery. A total of 53 complications were seen in 42 patients. In 9.3% of patients they were potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The more serious complications were related either to haemorrhage and/or vasovagal shock at operation or to infection post-operatively. Infants undergoing monoblock frontofacial advancements and those with tracheostomies were at particular risk.

Effects of a Six-Session Introductory Psychology Programme on Year 9 Pupils' Interest in Psychology and Approaches to Learning

Science.gov (United States)

Norris, Emma; Chaves, Tahirah De Aguiar; Dunsmuir, Sandra

2015-01-01

Psychology is a popular UK A-level, despite many pupils having no previous taught experience of it. Prior introduction to psychology teaching could help pupils make more informed choices to study it. This study evaluates a six-session introduction to psychology programme for 20 Year 9 pupils called "Myth-Busting the Brain." A…

70 Years of Aeropropulsion Research at NASA Glenn Research Center

Science.gov (United States)

Reddy, Dhanireddy R.

2013-01-01

This paper presents a brief overview of air-breathing propulsion research conducted at the NASA Glenn Research Center (GRC) over the past 70 years. It includes a historical perspective of the center and its various stages of propulsion research in response to the countrys different periods of crises and growth opportunities. GRCs research and technology development covered a broad spectrum, from a short-term focus on improving the energy efficiency of aircraft engines to advancing the frontier technologies of high-speed aviation in the supersonic and hypersonic speed regimes. This paper highlights major research programs, showing their impact on industry and aircraft propulsion, and briefly discusses current research programs and future aeropropulsion technology trends in related areas

Short-term outcomes of transcatheter closure of secundum atrial septal defect in children and adolescents: An experience of two centers in Upper Egypt

Directory of Open Access Journals (Sweden)

Safaa H. Ali

2018-01-01

Conclusions: Transcatheter closure of ASDs in children and adolescents was feasible and safe in the first 4 years experience in our centers, with good short-term outcome. Balloon sizing is not necessary for transcatheter closure of secundum ASD. Multiple defects can be safety closed by a single device.

The EPRI NDE center after five years

International Nuclear Information System (INIS)

Dau, G.J.; Nemzek, T.A.

1985-01-01

In 1979, the Electric Power Research Institute (EPRI) established a Nondestructive Evaluation (NDE) Center. The purpose of the Center is to provide the electric utility industry with a dedicated NDE development and field-use-qualification capability. Later, the scope of activities at the NDE Center was expanded. Beginning in 1980, the BWR Owners Group (IGSCC) provided funding necessary to operate the BWR Pipe Remedy Demonstration and Training Facility. In 1984, the Maintenance Equipment Applications Center was established by EPRI. Both functions are co-located within the NDE Center. All three functions share common objectives of providing the electric utility industry with a capability dedicated to assuring reduction to practice of new or improved technology, proof testing, qualification for field use, and obtaining code and regulatory acceptance of qualified methods and training. The purpose of this paper is to describe typical activities of the Center and some of the benefits that have accrued. The next section describes the Center organization, operation, and facility, while the remaining sections discuss the technology transfer thrust and benefits

Long-term safety and outcome of a temporary self-expanding metallic stent for achalasia: a prospective study with a 13-year single-center experience

Energy Technology Data Exchange (ETDEWEB)

Zhao, Jun-Gong; Li, Yong-Dong; Li, Ming-Hua; Shang, Ke-Zhong [Shanghai Tong Ji University, Department of Radiology, Tenth Affiliated People' s Hospital, Shanghai (China); Cheng, Ying-Sheng [Shanghai Tong Ji University, Department of Radiology, Tenth Affiliated People' s Hospital, Shanghai (China); Shanghai Jiao Tong University, Department of Radiology, Sixth Affiliated People' s Hospital, Shanghai (China); Chen, Ni-Wei; Chen, Wei-Xiong [Shanghai Jiao Tong University, Department of Gastroenterology, Sixth Affiliated People' s Hospital, Shanghai (China)

2009-08-15

To prospectively evaluate the long-term clinical safety and efficacy of a newly designed self-expanding metallic stent (SEMS) in the treatment of patients with achalasia. Seventy-five patients with achalasia were treated with a temporary SEMS with a 30-mm diameter. The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4-5 days after stent placement. Follow-up data focused on dysphagia score, technique and clinical success, clinical remissions and failures, and complications and was performed at 6 months, 1 year, and within 3 to 5 years, 5 to 8 years, 8 to 10 years, and >10 years postoperatively. Stent placement was technically successful in all patients. Complications included stent migration (n=4, 5.33%), chest pain (n=28, 38.7%), reflux (n=15, 20%), and bleeding (n=9, 12%). No perforation or 30-day mortality occurred. Clinical success was achieved in all patients 1 month after stent removal. The overall remission rates at 6 months, 1, 1-3, 3-5, 5-8, 8-10, and >10 year follow-up periods were 100%, 96%, 93.9%, 90.9%, 100%, 100%, and 83.3%, respectively. Stent treatment failed in six patients, and the overall remission rate in our series was 92%. The median and mean primary patencies were 2.8 {+-} 0.28 years (95% CI: 2.25-3.35) and 4.28 {+-} 0.40 years (95% CI: 3.51-5.05), respectively. The use of temporary SEMSs with 30-mm diameter proved to be a safe and effective approach for managing achalasia with a long-term satisfactory clinical remission rate. (orig.)

[Experience feed back committee in radiotherapy (CREx): a compulsory tool for security management evaluation at two years].

Science.gov (United States)

Lartigau, E; Coche-Dequeant, B; Dumortier, V; Giscard, S; Lacornerie, T; Lasue, A; Cheval, V; Martel, V; Malfait, B; Fuchs, A; Pestel, M; Damman, M; Forrest, M

2008-11-01

After working on treatment organisation in radiotherapy (bonne pratiques organisationnelles en radiothérapie - action pilote MEAH 2003), the development of a security policy has become crucial. With the help of Air France Consulting and the MEAH, three cancer centers in Angers, Lille and Villejuif worked together on the implantation of experience feed back committees (CREx) dedicated to the registration, analysis and correction of precursor events. After two years, we report the centre Oscar-Lambret experience in Lille and try to get the recommendations for generalisation of the process. This seems now to be compulsory for security management in oncology.

Acute glomerulonephritis in children: A seven-year experience in a tertiary health center

Directory of Open Access Journals (Sweden)

Ali Güneş

2012-09-01

Full Text Available Objectives: The aim of this study was to examine clinicaland laboratory characteristics of children with AGN in atertiary university hospital.Materials and methods: Hospital records of childrenwhich hospitalized with AGN diagnosis in Pediatric NephrologyUnit, between 2004 and 2011, were retrospectivelyreviewed. Patients were divided into threesubgroups as age 10 years.Characteristics at hospital admission including, bloodpressure, diuresis state, serum urea, creatinine and electrolytelevels, complement factors C3 and C4, completeblood count and urine analysis results were recorded.Data about primary infection, treatments, disease courseand outcome were recorded and analyzed.Results: Totally 220 children (157 male, 71.2%; 63 female,28.8% were included. Probable etiological infectionswere tonsillopharyngitis in 133 (60.5%, pyodermain 12 (5.5%, other infections in 27 (12.2% children. In48 (21.8 children with AGN, no primary infection weredetected. Edema was found in 81.4% of patients, hypertensionin 73.6%, and pulmonary stasis in 22.6%. Low C3levels were found in 89.1%, azotemia in 45.9%, hematuriain 95.4%, nephritic proteinuria in 80.5%, and leukocyturiain 37.6% of patients. Diuresis was enabled withinone week in 82%. Additional vasodilators were given to45 (20.5% patients, and hemodialysis was performedto three. Except for frequency of low C3 (p=0.018 andanemia (p=0.006, no significant differences were foundin clinical and laboratory findings between age groups(p>0.05.Conclusions: No difference was found in clinical andlaboratory features of AGN based on age groups, excludinglow C3 and anemia frequency. J Clin Exp Invest 2012;3 (3: 357-362Key words: Acute glomerulonephritis, childhood, clinicalfindings, laboratory findings, age grops

Cavernous sinus hemangioma: a fourteen year single institution experience.

Science.gov (United States)

Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

2014-06-01

Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable. Copyright © 2013. Published by Elsevier Ltd.

SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

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S. V. Gautier

2011-01-01

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

NASA Glenn Research Center Solar Cell Experiment Onboard the International Space Station

Science.gov (United States)

Myers, Matthew G.; Wolford, David S.; Prokop, Norman F.; Krasowski, Michael J.; Parker, David S.; Cassidy, Justin C.; Davies , William E.; Vorreiter, Janelle O.; Piszczor, Michael F.; Mcnatt, Jeremiah S.;

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

Directory of Open Access Journals (Sweden)

Lan Zhu

2016-01-01

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

Etiology and Treatment of Childhood Peptic Ulcer Disease in Taiwan: A Single Center 9-Year Experience

Directory of Open Access Journals (Sweden)

Shu-Ching Huang

2010-01-01

Conclusion: In children, H. pylori-related PUD is associated with familial peptic ulcer and the presence of DU. However, short-term NSAID use is correlated highly with GU. The outcome of childhood PUD is good.

Airline experience with reliability-centered maintenance

International Nuclear Information System (INIS)

Matteson, T.D.

1985-01-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

Airline experience with reliability-centered maintenance

Energy Technology Data Exchange (ETDEWEB)

Matteson, T.D.

1985-11-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.).

Ten-Year Experience of Renal Transplantation at the Northwest National Medical Center, Sonora Mexico: A Survival Study.

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Ma, M A; Laguna-Teniente, I R

2016-03-01

To improve survival after kidney transplantation, it is important to identify the variables that affect it. The aim of this work was to determine the survival of renal grafts from living and cadaveric donors and the survival of patients with graft failure in a tertiary medical unit in northwest Mexico. We performed a retrospective cohort study of patients who received transplants since 2004 at the center. Database and medical records of patients were reviewed. The data were captured in a database previously designed in the SPSS v21.1 program for statistical processing. A descriptive analysis with frequencies and percentages and numeric variables measure of central tendency and dispersion was conducted. The survival analysis was made with the Kaplan-Meier method to estimate the graft survive. A total of 412 transplantations were performed during the 2004-2013 period. We analyzed 331 records, and the 10-year survival rates of donor allografts from living and cadaveric donors were 86.64% and 72.78%, respectively. Copyright © 2016 Elsevier Inc. All rights reserved.

Periosteal chondrosarcoma in a 9-year-old girl with osteochondromatosis

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Weinberg, Jacob [Schneider Children' s Hospital, Division of Pediatric Orthopaedic Surgery, New York (United States); New York University/Hospital for Joint Diseases, Division of Orthopaedic Oncology, New York, New York (United States); Miller, Theodore T. [North Shore University Hospital, Department of Radiology, Manhasset, New York (United States); Handelsman, John E.; Godfried, David H. [Schneider Children' s Hospital, Division of Pediatric Orthopaedic Surgery, New York (United States); Kahn, Leonard B. [Long Island Jewish Medical Center, Department of Pathology, New Hyde Park, New York (United States); Kenan, Samuel [Schneider Children' s Hospital, Division of Pediatric Orthopaedic Surgery, New York (United States); Children' s Hospital Boston, Department of Orthopaedic Surgery, Boston, Massachusetts (United States)

2005-09-01

A 9-year-old girl with multiple osteochondromatosis presented with a 1 year history of a gradually enlarging surface lesion originating from the midsection of the right humerus, distal to an osteochondroma. Radiographically and histologically this lesion proved to be a periosteal chondrosarcoma adjacent to an osteochondroma. (orig.)

Temporal bone paragangliomas: 15 years experience

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Mehmet Düzlü

Full Text Available Abstract Introduction Temporal bone paragangliomas (TBPs are benign tumors arising from neural crest cells located along the jugular bulbus and the tympanic plexus. In general surgical excision, radiotherapy and wait-and-scan protocols are the main management modalities for TBPs. Objective In this paper we aim to present our clinical experience with TBPs and to review literature data. Methods The patients who were operated for tympanomastoid paraganglioma (TMP or tympanojugular paraganglioma (TJP in our clinic in the last 15 years were enrolled in the study. A detailed patient's charts review was performed retrospectively. Results There were 18 (52.9% cases with TMPs and 16 (47.1% cases with TJPs, a total of 34 patients operated for TBPs in this time period. The mean age was 50.3 ± 11.7 (range 25-71 years. The most common presenting symptoms were tinnitus and hearing loss for both TMPs and TJPs. Gross total tumor resection was achieved in 17 (94.4% and 10 (62.5% cases for TMPs and TJPs, respectively. Five patients (31.2% with TJP experienced facial palsy following the operation. For all the patients the mean follow-up period was 25.8 months (range 4-108 months. Conclusion In conclusion, based on our findings and literature review, total surgical excision alone or with preoperative embolization is the main treatment modality for TBPs. However radiotherapy, observation protocol and subtotal resection must be considered in cases of preoperative functioning cranial nerves, large tumors and advanced age.

Temporal bone paragangliomas: 15 years experience.

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Düzlü, Mehmet; Tutar, Hakan; Karamert, Recep; Karaloğlu, Furkan; Şahin, Muammer Melih; Göcek, Mehmet; Uğur, Mehmet Birol; Göksu, Nebil

2016-12-08

Temporal bone paragangliomas (TBPs) are benign tumors arising from neural crest cells located along the jugular bulbus and the tympanic plexus. In general surgical excision, radiotherapy and wait-and-scan protocols are the main management modalities for TBPs. In this paper we aim to present our clinical experience with TBPs and to review literature data. The patients who were operated for tympanomastoid paraganglioma (TMP) or tympanojugular paraganglioma (TJP) in our clinic in the last 15 years were enrolled in the study. A detailed patient's charts review was performed retrospectively. There were 18 (52.9%) cases with TMPs and 16 (47.1%) cases with TJPs, a total of 34 patients operated for TBPs in this time period. The mean age was 50.3± 11.7 (range 25-71 years). The most common presenting symptoms were tinnitus and hearing loss for both TMPs and TJPs. Gross total tumor resection was achieved in 17 (94.4%) and 10 (62.5%) cases for TMPs and TJPs, respectively. Five patients (31.2%) with TJP experienced facial palsy following the operation. For all the patients the mean follow-up period was 25.8 months (range 4-108 months). In conclusion, based on our findings and literature review, total surgical excision alone or with preoperative embolization is the main treatment modality for TBPs. However radiotherapy, observation protocol and subtotal resection must be considered in cases of preoperative functioning cranial nerves, large tumors and advanced age. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Acute extradural haematomas in children: A single neurosurgery unit's 12-year experience.

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Enicker, B; Louw, H; Madiba, T

2016-11-01

Acute extradural haematomas (AEDHs) occur infrequently in children. This study was undertaken to review our experience with management and outcomes of this condition in children treated in the Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. A retrospective review of medical records of all children (age less than or equal to (≤) 12 years) with a diagnosis of AEDH admitted from January 2003 to December 2014 was performed. Records were analyzed for demographics, mechanisms of injury, clinical presentation, neuroradiology findings, management and outcomes at discharge. A total of 150 children with AEDHs were admitted during this period. The mean age was 6.6 ± 3.8 years with a peak incidence in the 7-9 year age group. There were 84 (56%) males, (M: F= 1.3:1). Sixty AEDHs resulted from road traffic crashes (40%). On admission 104 (69.3%) children were Glasgow coma scale (GCS) 13-15, 26 (17.3%) GCS 9-12 and 20 (13.4%) GCS 3-8. Haemoglobin was less than (children and the mean hospital stay was 6.9 ± 6.1 days. Four children (2.7%) died during in-hospital stay period. One hundred and forty one (94%) children had a favourable Glasgow outcome scale (GOS) at discharge. AEDHs in children carry a good prognosis, but can be potentially fatal. A vigilant approach is required when assessing these children, as early diagnosis and treatment yields gratifying results.

A ten-year experience with hemodialysis in burn patients at Los Angeles County + USC Medical Center.

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Soltani, Ali; Karsidag, Semra; Garner, Warren

2009-01-01

Acute renal failure (ARF) is a rare, but serious, complication after burn injury that is commonly thought to be fatal. Before the modern era, there were few survivors of burn injuries who required dialysis. We report our 10-year experience with ARF and dialysis at the Los Angeles County + USC burn unit. During the period of August 1994 to February 2004, 3356 patients were admitted. Furthermore, 1143 patients were admitted to the intensive care unit and 1125 had burns >10% TBSA. Thirty-three patients developed ARF necessitating dialysis, equaling 0.98% of all admitted patients, and 2.7% of patients with TBSA >10% burns, which is at the low end of published burn unit data. The average age of these patients requiring dialysis was 49 years, 91% were men, 24% were diabetic, and 39% were positive for substances of abuse at admission, and the average TBSA burned was 36%. This is compared with an average age of 31 years, 70% men, 7.3% diabetic, and 14.7% intoxicated in the general burned population at our burn unit. Furthermore, our overall mortality in the burn unit was 5% overall and 14% in patients with >10% TBSA burns during the study period. In patients requiring hemodialysis, the mortality rate was 69.7%. The average time to hemodialysis was 14 days in our series, and patients, on average, required 10.3 days of dialysis support. These mortality data are the lowest recorded for burned patients requiring dialysis and suggest that ARF is a survivable complication in some of these patients.

Sociodemographic parameters of Esophageal Cancer in northwest India: A regional cancer center experience of 10 years

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Akhil Kapoor

2015-01-01

Full Text Available Background: Despite various advances in the treatment of Esophageal Cancer (EC, being one of the least responsive tumors to cancer therapy, the overall prognosis remains poor. Therefore, it is significant to understand various sociodemographic factors associated with EC to find out various schemes for primary prevention of the disease. Materials and Methods: This is a retrospective analysis of medical records of the EC patients registered in the regional cancer center of northwest India from January 2003 to December 2012. The site of the disease and the histology were also recorded in addition to the various sociodemographic parameters. Results: Out of 55,742 patients registered in our hospital; 3,667 were diagnosed to have EC. Male:female ratio was 1.15:1. The mean age was 54.6 ± 11.74 years; 66.15% of the patients were illiterate and 48.6% belonged to the low socioeconomic status. Smoking and alcohol consumption were identified as risk factors in 48 and 25.6% of the patients, respectively. Conclusions: The etiology in majority of the patients is linked to tobacco and alcohol, thus, modification of life style with limiting the use of addictions may be an effective strategy in the prevention of this dreaded and mostly incurable disease.

Video-Teleconferencing in Pediatric Neuro-Oncology: Ten Years of Experience

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Nisreen Amayiri

2017-04-01

Full Text Available Purpose: The management of central nervous system tumors is challenging in low- and middle-income countries. Little is known about applicability of twinning initiatives with high-income countries in neuro-oncology. In 2004, a monthly neuro-oncology video-teleconference program was started between King Hussein Cancer Center (Amman, Jordan and the Hospital for Sick Children (Toronto, Ontario, Canada. More than 100 conferences were held and > 400 cases were discussed. The aim of this work was to assess the sustainability of such an initiative and the evolution of the impact over time. Methods: We divided the duration in to three eras according to the initial 2 to 3 years of work of three consecutive oncologists in charge of the neuro-oncology program at King Hussein Cancer Center. We retrospectively reviewed the written minutes and compared the preconference suggested plans with the postconference recommendations. Impact of changes on the patient care was recorded. Results: Thirty-three sets of written minutes (covering 161 cases in the middle era and 32 sets of written minutes (covering 122 cases in the last era were compared with the initial experience (20 meetings, 72 cases. Running costs of these conferences has dropped from $360/h to < $40/h. Important concepts were introduced, such as multidisciplinary teamwork, second-look surgery, and early referral. Suggestions for plan changes have decreased from 44% to 30% and 24% in the respective consecutive eras. Most recommendations involved alternative intervention modalities or pathology review. Most of these recommendations were followed. Conclusion: Video-teleconferencing in neuro-oncology is feasible and sustainable. With time, team experience is built while the percentage and the type of treatment modifications change. Commitment and motivation helped maintain this initiative rather than availability of financial resources. Improvement in patients’ care was achieved, in particular, with the

Strength, running speed, agility and balance profiles of 9- to 10-year ...

African Journals Online (AJOL)

The purpose of this study was to determine the strength, running speed and agility, and balance profiles of 9- to 10-year old learners and the relation between these skills of the learners. Using a stratified random selection from 20 schools with different socio-economic backgrounds, 862 9- to 10-year-old learners (457 boys; ...

Single-center experience using the Freedom SOLO aortic bioprosthesis.

Science.gov (United States)

Iliopoulos, Dimitrios C; Deveja, Aris Rezar; Androutsopoulou, Vasiliki; Filias, Vasilios; Kastelanos, Eleftherios; Satratzemis, Vasilios; Khalpey, Zain; Koudoumas, Dimitrios

2013-07-01

This study reviews a single institution experience with the Freedom SOLO (Sorin Group, Saluggia, Italy) aortic bioprosthesis. Between October 2006 and February 2010, 128 patients (64 men, 64 women; mean age, 75.8 ± 5.1 years) underwent aortic valve replacement using the Freedom SOLO stentless aortic valve. The follow-up time was 36.7 ± 1.2 months and 100% complete. Concomitant procedures were performed in 77 patients (60%). The mean standard European System for Cardiac Operative Risk Evaluation was 9 ± 2.7. Grade 3 aortic stenosis was present in 73% of patients, mixed aortic stenosis and regurgitation were present in 40% of patients, and mitral regurgitation was present in 46% of patients. The mean crossclamp time was 53 ± 12 minutes for isolated Freedom SOLO aortic valve implantation and 80 ± 28 minutes for concomitant procedures, and the mean cardiopulmonary bypass time was 103 ± 31 minutes. The mean implanted valve size was 22.6 ± 1.4 mm. The mean intensive care unit and hospital stays were 2.4 ± 1.1 days and 8.8 ± 2.6 days, respectively. Three patients underwent reoperation for bleeding. The 15-day, 30-day, and perioperative mortality were all 4.6%. The 36-month survival was 95.4% ± 1.6% for the cohort with a low European System for Cardiac Operative Risk Evaluation (9). Echocardiographic data preoperatively, immediately postoperatively, and at 3, 6, and 12 months postoperatively showed peak transvalvular gradients of 75 ± 23, 17 ± 6, 18 ± 6.5, 16 ± 6, and 16 ± 9 mm Hg, respectively (P SOLO stentless aortic valve has excellent early and intermediate-term results. Published by Mosby, Inc.

Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center.

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Tarchi, P; Cosola, D; Germani, P; Troian, M; De Manzini, N

2014-06-01

Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient

Long-term safety and outcome of a temporary self-expanding metallic stent for achalasia: a prospective study with a 13-year single-center experience

International Nuclear Information System (INIS)

Zhao, Jun-Gong; Li, Yong-Dong; Li, Ming-Hua; Shang, Ke-Zhong; Cheng, Ying-Sheng; Chen, Ni-Wei; Chen, Wei-Xiong

2009-01-01

To prospectively evaluate the long-term clinical safety and efficacy of a newly designed self-expanding metallic stent (SEMS) in the treatment of patients with achalasia. Seventy-five patients with achalasia were treated with a temporary SEMS with a 30-mm diameter. The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4-5 days after stent placement. Follow-up data focused on dysphagia score, technique and clinical success, clinical remissions and failures, and complications and was performed at 6 months, 1 year, and within 3 to 5 years, 5 to 8 years, 8 to 10 years, and >10 years postoperatively. Stent placement was technically successful in all patients. Complications included stent migration (n=4, 5.33%), chest pain (n=28, 38.7%), reflux (n=15, 20%), and bleeding (n=9, 12%). No perforation or 30-day mortality occurred. Clinical success was achieved in all patients 1 month after stent removal. The overall remission rates at 6 months, 1, 1-3, 3-5, 5-8, 8-10, and >10 year follow-up periods were 100%, 96%, 93.9%, 90.9%, 100%, 100%, and 83.3%, respectively. Stent treatment failed in six patients, and the overall remission rate in our series was 92%. The median and mean primary patencies were 2.8 ± 0.28 years (95% CI: 2.25-3.35) and 4.28 ± 0.40 years (95% CI: 3.51-5.05), respectively. The use of temporary SEMSs with 30-mm diameter proved to be a safe and effective approach for managing achalasia with a long-term satisfactory clinical remission rate. (orig.)

( Atp9) gene between cytoplasmic male sterile line and its ...

African Journals Online (AJOL)

Administrator

2011-09-07

Sep 7, 2011 ... Soybean Research Institute of Nanjing Agricultural University, National Center for Soybean .... All these transgenic experiments confirmed the correlation ... editing of ATP synthase subunit 9 mRNA using wheat mitochondrial.

Blunt pediatric anterior and posterior urethral trauma: 32-year experience and outcomes.

Science.gov (United States)

Voelzke, Bryan B; Breyer, Benjamin N; McAninch, Jack W

2012-06-01

To analyze our experience with delayed repair of pediatric urethral trauma. From 1978 to 2007, 26 boys posterior urethral injuries were separately stratified. There were 8 anterior and 18 posterior urethral strictures. All patients presented in a delayed fashion. Mean follow up of the anterior cohort was 2.9 years. All repairs were performed via a ventral onlay buccal graft or anastomotic approach. The mean follow up of the posterior cohort was 1.1 years, and all posterior urethral injuries were repaired via an anastomotic approach. Overall success for anterior stricture disease was 88.9% and for posterior stricture disease was 89.5%. All three urethroplasty failures responded favorably to internal urethrotomy; however, one failed anterior repair and one of the two failed posterior repairs required two internal urethrotomy operations for success. No secondary urethroplasty operations were required and ultimately all patients were voiding per urethra without need for urethral dilation. Delayed, definitive repair of pediatric urethral trauma via open urethroplasty has a high success rate. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

International Nuclear Information System (INIS)

Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Koutcher, Lawrence; Wolden, Suzanne L.; Zelefsky, Michael J.; Rowan, Nicholas; Sherman, Eric J.; Fury, Matthew G.; Pfister, David G.; Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H.; Shi Weiji; Zhang Zhigang; Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D.; Lee, Nancy Y.

2012-01-01

Purpose: To update the Memorial Sloan-Kettering Cancer Center’s experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27–91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3–135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia ≥Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

Neurofibromatosis 1 prevalence in children aged 9-11 years, Pinar del Río Province, Cuba.

Science.gov (United States)

Orraca, Miladys; Morejón, Griselda; Cabrera, Niurka; Menéndez, Reinaldo; Orraca, Odalys

2014-01-01

INTRODUCTION Neurofibromatosis 1 is one of the most common heritable genetic disorders in humans. It is characterized by formation of neurofibromas, with marked variability in expression. Half the cases are due to autosomal dominant inheritance; the rest arise from de novo mutations. Prevalence varies by population, and prevalence in Cuba is unknown. OBJECTIVE Determine the prevalence of neurofibromatosis 1 in a population of Cuban children aged 9-11 years old in Pinar del Río Province, Cuba. METHODS A descriptive cross-sectional study was carried out in Pinar del Río Province in 2004, in which 19,392 children were assessed for neurofibromatosis 1. The study was conducted in two phases: the first, a survey of the entire population aged 9-11 years by genetic counselors in the province's schools; the second, assessment by clinical geneticists of children who met criteria for referral to the Provincial Medical Genetics Center. Neurofibromatosis 1 cases and first-degree relatives were examined to identify the origin of the mutation (de novo or inherited). Neurofibromatosis 1 prevalence was calculated, as well as history of a first-degree relative with the disease and frequency of several principal clinical signs-café au lait spots, freckles in places unexposed to sunlight, presence of neurofibromas, Lisch nodules and characteristic bone lesions. RESULTS Of the eligible population, 99.3% was screened (10,034 boys and 9358 girls). Active case finding resulted in referral of 200 children to medical geneticists and the disease was confirmed in 17, for a prevalence of one case per 1141 children aged 9-11 years old. Café au lait spots were the most frequent sign (100%), followed by freckles in areas unexposed to sunlight (82.4%) and characteristic bone lesions (41.2%). Only 4 of the 17 cases were previously being treated for the disease. CONCLUSIONS Neurofibromatosis 1 has high prevalence in the group studied in Pinar del Rio Province and most cases are not detected in

Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

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İbrahim Kalelioğllu

2013-09-01

Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

Neutron capture therapy: Years of experimentation---Years of reflection

International Nuclear Information System (INIS)

Farr, L.E.

1991-01-01

This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven's Medical Research Center program

Acute Lymphoblastic Leukemia in Infants: 20 years of Experience

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Amanda Ibagy

2013-01-01

Full Text Available Objective: To analyze patients younger than 2 years with acute lymphoblastic leukemia, treated in the period between 1990 and 2010 in a state reference center. Methods: This was a clinical-epidemiological, cross-sectional, observational, and descriptive study. It included patients younger than 2 years with acute lymphoblastic leukemia, treated in the period of 1990 to 2010 in a pediatric oncology unit of a state reference center, totaling 41 cases. Results: All patients were white ethnicity, and 60.9% were females. Regarding age, 24.38% were younger than 6 months, 17.07% were between 6 months and 1 year, and 58.53% were older than 1 year. The age of 6 months was statistically significant for the outcome of death. Predominant signs and symptoms were fever, bruising, and petechiae. A leukocyte count > 100,000 was found in 34.14% of cases, hemoglobin count < 11 in 95.13%, and platelet count < 100,000 in 75.61. Infiltration of central nervous system was present in 12.91% of patients. According to the lineage, B-cell lineage predominated (73%, but the T-cell line was statistically significant for death. 39% of patients had disease recurrence. In relation to vital status, 70.73% of the patients died; septic shock was the main cause. Conclusions: Acute lymphoblastic leukemia in infants has a high mortality rate, especially in children under 1 year and those with T-cell derived lineage. Resumo: Objetivo: Analisar pacientes com menos de dois anos de idade com leucemia linfoblásti- ca aguda atendidos no período de 1990 a 2010, em um centro de referência estadual. Métodos: Estudo clínico, epidemiológico, transversal, descritivo e observacional. Pacientes incluídos tinham menos de dois anos de idade, com leucemia linfoblástica aguda, tratados no período de 1990 a 2010 na unidade de oncologia pediátrica de um centro de referência estadual, totalizando 41 casos. Resultados: Todos os pacientes eram Caucasianos e 60,9% eram do sexo feminino. Com rela

Update on excimer laser photorefractive keratectomy (PRK) at Cedars-Sinai Medical Center: two-year experience

Science.gov (United States)

Maguen, Ezra I.; Salz, James J.; Warren, Cathy; Papaioannou, Thanassis; Nesburn, Anthony B.; Macy, Jonathan I.; Hofbauer, John; Grundfest, Warren S.

1993-06-01

Our two year experience with excimer laser photorefractive keratectomy for the correction of myopia on 160 eyes of 128 patients is described. All eyes were treated with a VISX Twenty- Twenty excimer laser, with the following parameters: radiant exposure 160 mJ/cm2, frequency 5 Hz, ablation zone diameter 5.0 to 5.5 mm, and stromal ablation rate 0.18 to 0.33 (mu) /pulse. A suction fixation ring was used in all cases either with nitrogen flow (79 eyes) or without nitrogen flow (81 eyes) across the cornea. Follow-up ranged from one month (152 eyes) to 24 months (12 eyes). The results are stable between 3 and 24 months with less than 0.25 D change in the mean postoperative spherical equivalents. In eyes with a follow-up of 6 to 24 months, 77% to 100% were 20/40 or better uncorrected, and 84% to 92% were corrected to within +/- 1 D of emmetropia. Further follow-up is needed to assess the long term safety and efficacy of the procedure.

The Capillary Flow Experiments Aboard the International Space Station: Increments 9-15

Science.gov (United States)

Jenson, Ryan M.; Weislogel, Mark M.; Tavan, Noel T.; Chen, Yongkang; Semerjian, Ben; Bunnell, Charles T.; Collicott, Steven H.; Klatte, Jorg; dreyer, Michael E.

2009-01-01

This report provides a summary of the experimental, analytical, and numerical results of the Capillary Flow Experiment (CFE) performed aboard the International Space Station (ISS). The experiments were conducted in space beginning with Increment 9 through Increment 16, beginning August 2004 and ending December 2007. Both primary and extra science experiments were conducted during 19 operations performed by 7 astronauts including: M. Fincke, W. McArthur, J. Williams, S. Williams, M. Lopez-Alegria, C. Anderson, and P. Whitson. CFE consists of 6 approximately 1 to 2 kg handheld experiment units designed to investigate a selection of capillary phenomena of fundamental and applied importance, such as large length scale contact line dynamics (CFE-Contact Line), critical wetting in discontinuous structures (CFE-Vane Gap), and capillary flows and passive phase separations in complex containers (CFE-Interior Corner Flow). Highly quantitative video from the simply performed flight experiments provide data helpful in benchmarking numerical methods, confirming theoretical models, and guiding new model development. In an extensive executive summary, a brief history of the experiment is reviewed before introducing the science investigated. A selection of experimental results and comparisons with both analytic and numerical predictions is given. The subsequent chapters provide additional details of the experimental and analytical methods developed and employed. These include current presentations of the state of the data reduction which we anticipate will continue throughout the year and culminate in several more publications. An extensive appendix is used to provide support material such as an experiment history, dissemination items to date (CFE publication, etc.), detailed design drawings, and crew procedures. Despite the simple nature of the experiments and procedures, many of the experimental results may be practically employed to enhance the design of spacecraft engineering

Experience with Server Self Service Center (S3C)

International Nuclear Information System (INIS)

Sucik, Juraj; Bukowiec, Sebastian

2010-01-01

CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft (registered) Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

Experience with Server Self Service Center (S3C)

CERN Multimedia

Sucik, J

2009-01-01

CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

Prostate cancer in young adults-Seventeen-year clinical experience of a single center.

Science.gov (United States)

Huang, Tzu-Hao; Kuo, Junne-Yih; Huang, Yi-Hsiu; Chung, Hsiao-Jen; Huang, William J S; Wu, Howard H H; Chang, Yen-Hwa; Lin, Alex T L; Chen, Kuang-Kuo

2017-01-01

In the general population, prostate adenocarcinoma affects predominately older men. If fact, most current guidelines suggest that males over the age of 50 years should undergo prostate cancer screening. However, the clinical behavior and prognosis of prostate cancer in young adults is not well defined. The aim of this study was to evaluate the clinical behavior, pathological characteristics, and prognosis of prostate cancer in young adults. We retrospectively reviewed the records of young patients (age, ≤50 years) in our hospital with prostate adenocarcinoma between 1997 and 2013. We compared data including initial presentation, cancer cell type, Gleason score, disease stage, prostate-specific antigen (PSA) level, prostate volume, treatment, and survival between patients both younger and older than 50 years. Data were analyzed using the Kaplan-Meier method to assess survival. Twenty-six patients were enrolled in our study, accounting for 0.55% of all patients with a diagnosis of prostate cancer at our facility. All 26 patients had a pathology diagnosis of adenocarcinoma, with a mean age on diagnosis of 46.8±2.8 years (range, 39-50 years). On initial presentation, patients older than 50 years more frequently displayed lower urinary tract symptoms (LUTS) than younger patients (62.3% vs. 30.4%, p=0.008). There was no statistical difference in histological grade, disease stage, PSA level, overall survival, and biochemical-free survival between the two groups. The result of our investigation indicated that prostate adenocarcinoma patients younger than 50 years had similar histological grade, disease stage, PSA level, overall survival, and biochemical-free survival as the older population. However, patients younger than 50 years with prostate cancer less frequently showed initial symptoms of LUTS. Copyright © 2016. Published by Elsevier Taiwan LLC.

Sugar-sweetened beverages consumption in relation to changes in body fatness over 6 and 12 years among 9-year-old children

DEFF Research Database (Denmark)

Zheng, M; Rangan, A; Olsen, Lasse P.N.

2014-01-01

.Subjects/Methods:A longitudinal study of 9-year-old children (n=283) enrolled in the Danish part of the European Youth Heart Study with a 6-year and 12-year follow-up. Data were collected at ages 9, 15 and 21 years. Multivariate regression analyses with adjustment for potential confounders were used to evaluate the effect of SSB...

Reexposure Breeds Recall: Effects of Experience on 9-Month-Olds' Ordered Recall.

Science.gov (United States)

Bauer, Patricia J.; Wiebe, Sandra A.; Waters, Jennie M.; Bangston, Stephanie K.

2001-01-01

Two experiments using deferred imitation tested whether multiple experiences were necessary, or merely facilitative, of 9-month-olds' long-term recall. Found that infants did not demonstrate recall of a multi-step sequence experienced one, two, or three times a month earlier. However, when re-exposed to the experience 1 week after the initial…

The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

Energy Technology Data Exchange (ETDEWEB)

Farrer, R.; Longshore, A. [comps.

1995-06-01

This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation.

The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

International Nuclear Information System (INIS)

Farrer, R.; Longshore, A.

1995-06-01

This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation

Ten year experience with antiretroviral treatment in Cambodia: Trends in patient characteristics and treatment outcomes.

Directory of Open Access Journals (Sweden)

Phirum Lay

Full Text Available Although HIV disease stage at ART initiation critically determines ART outcomes, few reports have longitudinally monitored this within Asia. Using prospectively collected data from a large ART program at Sihanouk Hospital Center of Hope in Cambodia, we report on the change in patient characteristics and outcomes over a ten-year period.We conducted a retrospective analysis including all adults (≥ 18 years old starting ART from March 2003-March 2013 in a non-governmental hospital in Phnom Penh, Cambodia. The cumulative incidence of death, lost to follow-up (LTFU, attrition (death or LTFU and first line treatment failure were calculated using Kaplan-Meier methods. Independent risk factors for these outcomes were determined using Cox regression modeling.Over the ten-year period, 3581 patients initiated ART with a median follow-up time of 4.8 years (IQR 2.8-7.2. The median age was 35 years (IQR 30-41, 54% were female. The median CD4 count at ART initiation increased from 22 cells/μL (IQR 4-129 in 2003 to 218 (IQR 57-302 in 2013. Over the 10 year period, a total of 282 (7.9% individuals died and 433 (12.1% were defined LTFU. Program attrition (died or LTFU was 11.1% (95% CI: 10.1%- 12.4% at one year, 16.3% (95% CI: 15.1%-17.6% at three years, 19.8% (95% CI: 18.5%-21.2% at five years and 23.3% (95% CI: 21.6-25.1 at ten years. Male sex and low baseline body mass index (BMI were associated with increased attrition. Factors independently associated with mortality included a low baseline CD4 count, older age, male sex, low baseline BMI and hepatitis B co-infection. Individuals aged above 40 years old had an increased risk of mortality but were less likely to LTFU. There were a total of 137 individuals with first line ART failure starting second line treatment. The probability of first line failure was estimated at 2.8% (95% CI: 2.3%-3.4% at 3 years, 4.6% (95% CI: 3.9%-5.5% at 5 years and 7.8% (95% CI 4.8%-12.5% at ten years of ART. The probability was

International Perspectives on the First-Year Experience in Higher Education. The First-Year Experience Monograph Series No. 52

Science.gov (United States)

Nutt, Diane, Ed.; Calderon, Denis, Ed.

2009-01-01

Students around the globe have unique first-year experiences but struggle with many of the same challenges. This monograph focuses on their journeys and provides insights for educators interested in learning about how institutions across the globe provide supports to students dealing with first-year transition issues. Based on the successful…

The Elon Gap Experience: A Transformative First-Year Experience

Science.gov (United States)

Morrison, Stephen T.; Burr, Katherine H.; Waters, Rexford A.; Hall, Eric E.

2016-01-01

The Elon Gap Experience (EGE) was conceived out of Elon University's most recent strategic plan, the Elon Commitment (Elon University, 2009). One theme calls for "strategic and innovative pathways in undergraduate and graduate education," specifically "to launch a service program as part of a gap-year program" (Elon University,…

Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

Directory of Open Access Journals (Sweden)

Bjelović Miloš

2015-01-01

Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

GLOBE Observer and the Association of Science & Technology Centers: Leveraging Citizen Science and Partnerships for an International Science Experiment to Build Climate Literacy

Science.gov (United States)

Riebeek Kohl, H.; Chambers, L. H.; Murphy, T.

2016-12-01

For more that 20 years, the Global Learning and Observations to Benefit the Environment (GLOBE) Program has sought to increase environment literacy in students by involving them in the process of data collection and scientific research. In 2016, the program expanded to accept observations from citizen scientists of all ages through a relatively simple app. Called GLOBE Observer, the new program aims to help participants feel connected to a global community focused on advancing the scientific understanding of Earth system science while building climate literacy among participants and increasing valuable environmental data points to expand both student and scientific research. In October 2016, GLOBE Observer partnered with the Association of Science & Technology Centers (ASTC) in an international science experiment in which museums and patrons around the world collected cloud observations through GLOBE Observer to create a global cloud map in support of NASA satellite science. The experiment was an element of the International Science Center and Science Museum Day, an event planned in partnership with UNESCO and ASTC. Museums and science centers provided the climate context for the observations, while GLOBE Observer offered a uniform experience and a digital platform to build a connected global community. This talk will introduce GLOBE Observer and will present the results of the experiment, including evaluation feedback on gains in climate literacy through the event.

Liver transplantation in Greek children: 15 years experience

Directory of Open Access Journals (Sweden)

Dimitrios Takoudas

2010-09-01

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

Characteristics of medical teachers using student-centered teaching methods.

Science.gov (United States)

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Does EMS Perceived Anatomic Injury Predict Trauma Center Need?

Science.gov (United States)

Lerner, E. Brooke; Roberts, Jennifer; Guse, Clare E.; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Blatt, Alan; Jurkovich, Gregory J.; Brasel, Karen

2013-01-01

Objective Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods EMS providers caring for injured adults transported to regional trauma centers in 3 midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon ED arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as non-orthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics including positive likelihood ratios (+LR) with 95% confidence intervals. Results 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9 - 4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1 - 19.4), paralysis (6.8; CI: 4.2 - 11.2), two or more long bone fractures (6.3; CI: 4.5 - 8.9), and amputation (6.1; CI: 1.5 - 24.4). Criteria with a +LR >2 and <5 were penetrating injury (4.8; CI: 4.2 - 5.6), and skull fracture (4.8; CI: 3.0 - 7.7). Only pelvic fracture (1.9; CI: 1.3 - 2.9) had a +LR less than 2. Conclusions The anatomic step of the Field Triage Guidelines as determined by EMS providers is a reasonable tool for determining trauma center need. Use of EMS perceived pelvic fracture as an indicator for trauma center need should be re-evaluated. PMID:23627418

Indications and results of renal biopsy in children: a 36-year experience.

Science.gov (United States)

Santangelo, Luisa; Netti, Giuseppe Stefano; Giordano, Paolo; Carbone, Vincenza; Martino, Marida; Torres, Diletta Domenica; Rossini, Michele; Di Palma, Anna Maria; Gesualdo, Loreto; Giordano, Mario

2018-04-01

This study was conducted to investigate retrospectively the indications for renal biopsy (RB) in native kidneys and to analyze pathological findings in a single tertiary pediatric hospital in Southern Italy for the last 36 years. All patients who underwent RB at our hospital from 1979 to 2014 were included. All renal tissue specimens were studied under light and immunofluorescent microscopy, while electron microscopy was performed only for specific clinical indications. The study group included 213 patients (female 43.2%) who underwent 225 percutaneous native kidney biopsies. Median age was 10.4 years (range 0.6-24 years). The most frequent indication for RB was nephrotic syndrome (44.4%), followed by proteinuria (27.6%), asymptomatic hematuria (17.3%) and acute kidney injury (9.8%). Gross hematuria appeared after biopsy in less than 5% of the patients, but none of them needed blood transfusion. Adequate renal tissue sample was obtained in 95.5% of the renal biopsies. Primary glomerulonephritis (GN) was the most common finding (61.4%), followed by secondary GN (21.4%), tubulointerstitial diseases (3.7%) and hereditary nephropathy (2.8%), while in 10.7% of the cases, normal renal tissues were found. According to histopathological diagnosis, the most common causes of primary GN were IgA nephropathy (20.9%), followed by minimal change disease (18.1%) and focal segmental glomerulosclerosis (11.6%). The epidemiology of glomerular disease in our single-center cohort is similar to that shown in other national and international reports. Moreover, our study shows that percutaneous ultrasound-guided RB is a safe, reliable and effective technique in children.

Causes of amenorrhea in Korea: Experience of a single large center

OpenAIRE

Kwon, Su-Kyoung; Chae, Hee-Dong; Lee, Kyung-Hee; Kim, Sung-Hoon; Kim, Chung-Hoon; Kang, Byung-Moon

2014-01-01

Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea wer...

Effect of learner-centered teaching on motivation and learning strategies in a third-year pharmacotherapy course.

Science.gov (United States)

Cheang, Kai I

2009-05-27

To develop, implement, and assess a learner-centered approach to teaching a third-year pharmacotherapy course in a doctor of pharmacy (PharmD) program. The pharmacotherapy course was restructured according to the learner-centered approach. The Motivated Strategies for Learning Questionnaire (MSLQ) was administered to students before and after taking the course, and changes in MSLQ subscales from baseline were evaluated. Students' response to the learner-centered approach and characteristics associated with MSLQ scores were also evaluated. Compared to baseline, students' intrinsic goal orientation control of learning beliefs, self-efficacy, critical thinking, and metacognitive self-regulation improved after taking the course. Students responded positively to the learner-centered approach. Additionally, students with a clinical practice career orientation or who prepared frequently for classes scored higher on several MSLQ domains. The learner-centered approach was effective in promoting several domains of motivation and learning strategies in a third-year pharmacotherapy course.

Face Experience and the Attentional Bias for Fearful Expressions in 6- and 9-Month-Old Infants

Directory of Open Access Journals (Sweden)

Kristina Safar

2017-09-01

Full Text Available Infants demonstrate an attentional bias toward fearful facial expressions that emerges in the first year of life. The current study investigated whether this attentional bias is influenced by experience with particular face types. Six-month-old (n = 33 and 9-month-old (n = 31 Caucasian infants' spontaneous preference for fearful facial expressions when expressed by own-race (Caucasian or other-race (East Asian faces was examined. Six-month-old infants showed a preference for fearful expressions when expressed by own-race faces, but not when expressed by other-race faces. Nine-month-old infants showed a preference for fearful expressions when expressed by both own-race faces and other-race faces. These results suggest that how infants deploy their attention to different emotional expressions is shaped by experience: Attentional biases might initially be restricted to faces with which infants have the most experience, and later be extended to faces with which they have less experience.

Destructive operations--a vanishing art in modern obstetrics: 25 year experience at a tertiary care center in India.

Science.gov (United States)

Sikka, Pooja; Chopra, Seema; Kalpdev, Arun; Jain, Vanita; Dhaliwal, Lakhbir

2011-05-01

Destructive operations have a limited role in modern day obstetrics. In the developed countries, obstetrics has become so advanced that these instruments have actually been put away. However, in developing countries like India, these procedures have a limited role where obstructed labor still continues to plague thousands of women every year and accounts for 8% of maternal deaths. This study was planned to define the changing role of destructive operations in obstetrics over the years as more number of abdominal deliveries are conducted in modern day obstetrics than these procedures. A retrospective analysis of destructive operations performed at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, over a span of 25 years, between 1983 and 2007, was carried out. Of a total of 85,952 deliveries in PGIMER in these 25 years, there were 25,474 cesarean deliveries (29.63%), and 8,826 (10.26%) operative vaginal deliveries. The total number of destructive operations performed was 230 (0.26%). There were 202 craniotomies (87.8%), 13 decapitations (5.7%), 8 eviscerations (3.6%) and 7 cleidotomies (2.9%). There should be an individualized approach to each case of obstructed labor. The health care provider has to decide on the options available to him to deliver the mother by the safest route without causing morbidity and mortality. If the fetus is dead, a destructive procedure can be considered in place of abdominal-route delivery which carries considerable risk to the debilitated mother in neglected labor.

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus-group study

Science.gov (United States)

North, Carol S.; Pfefferbaum, Betty; Hong, Barry A.; Gordon, Mollie R.; Kim, You-Seung; Lind, Lisa; Pollio, David E.

2014-01-01

The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company’s workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees’ emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals. PMID:23066661

Level-2 perspectives computed quickly and spontaneously: Evidence from eight- to 9.5-year-old children.

Science.gov (United States)

Elekes, Fruzsina; Varga, Máté; Király, Ildikó

2017-11-01

It has been widely assumed that computing how a scene looks from another perspective (level-2 perspective taking, PT) is an effortful process, as opposed to the automatic capacity of tracking visual access to objects (level-1 PT). Recently, adults have been found to compute both forms of visual perspectives in a quick but context-sensitive way, indicating that the two functions share more features than previously assumed. However, the developmental literature still shows the dissociation between automatic level-1 and effortful level-2 PT. In the current paper, we report an experiment showing that in a minimally social situation, participating in a number verification task with an adult confederate, eight- to 9.5-year-old children demonstrate similar online level-2 PT capacities as adults. Future studies need to address whether online PT shows selectivity in children as well and develop paradigms that are adequate to test preschoolers' online level-2 PT abilities. Statement of Contribution What is already known on this subject? Adults can access how objects appear to others (level-2 perspective) spontaneously and online Online level-1, but not level-2 perspective taking (PT) has been documented in school-aged children What the present study adds? Eight- to 9.5-year-olds performed a number verification task with a confederate who had the same task Children showed similar perspective interference as adults, indicating spontaneous level-2 PT Not only agent-object relations but also object appearances are computed online by eight- to 9.5-year-olds. © 2017 The British Psychological Society.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

Science.gov (United States)

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

Annual report procurement and logistics management center Sandia National Laboratories fiscal year 2002.

Energy Technology Data Exchange (ETDEWEB)

Palmer, David L.

2003-05-01

This report summarizes the purchasing and transportation activities of the Procurement and Logistics Management Center for Fiscal Year 2002. Activities for both the New Mexico and California locations are included.

Cytomegalovirus disease in renal transplant recipients: a single-center experience.

Science.gov (United States)

Bhadauria, Dharmendra; Sharma, R K; Kaul, A; Prasad, Narayan; Gupta, Amit; Gupta, Anurag; Srivastava, Aneesh

2012-09-01

Cytomegalovirus (CMV) is the most common viral infection following kidney transplant, has been recognized as a major factor for graft loss and increased incidence of acute rejection. Different studies have reported a variable incidence of CMV disease with the use of Mycophenolate mofetil (MMF). We retrospectively analyzed our renal transplant recipients to review the results of CMV disease and to compare CMV disease in patient on Azathioprine and MMF for this purpose we retrospectively reviewed 521 live related kidney transplant recipients at our institute. 74 (14.2 %) live related allograft recipients developed CMV disease after a median interval of 7.18 ± 4.35 months from transplantation. The mean age was 36.15 ± 10.7 years. 63 of the patients were male. Malaise, fever and diarrhea were among most common symptoms. 20 (27.02 %) of the 74 recipients developed transaminitis, 13 (17.2 %) developed CMV gastritis, 5 (9.13 %) recipients developed pneumonia, and 3 (4.05 %) patient developed colitis. 59 (80 %) patients had leucopenia and 41 (56.5 %) developed thrombocytopenia. Mean serum creatinine level was 1.5 ± 0.4 (0.9-2.4) mg/dl before the disease, 1.9 ± 0.6 (1.3-3.6) mg/dl at the time of the diagnosis, and 1.7 ± 0.06 (0.8-4.2) mg/dl at the end of the treatment. CMV disease developed in 9 (36 %) of recipients who received basiliximab as induction therapy and 13 (30.24 %) of recipients who received ATG (p > 0.05). The incidence of CMV disease was similar in cyclosporine based regimen (13.2 %) and Tacrolimus based regimen 27 (16.16 %) (p = 0.137) and was also similar in Azathioprine 41 (9.5 %) and MMF group 33 (14.3 %) (p = 0.163). There was no significant difference in severity of CMV disease in both groups, except a higher incidence of leucopenia in Azathioprine group (86 vs. 74 %, p < 0.05) as compared to MMF group. 51 (68.91 %) patient developed graft dysfunction during CMV disease. In conclusion we report a low incidence

Firework injuries at a major trauma and burn center: A five-year prospective study.

Science.gov (United States)

Wang, Cheng; Zhao, Ran; Du, Wei-Li; Ning, Fang-Gang; Zhang, Guo-An

2014-03-01

In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007-2011. Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition. From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136-150). The mean age of the patients was 26±15.3 years (range, 1-95 years). Of the 734 patients, the highest proportion of injuries were the 5-14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment. The private use of fireworks during the Spring Festival Holidays is associated

Combined immunodeficiencies: twenty years experience from a single center in Turkey

OpenAIRE

Akar, H. Haluk; Patiroglu, Turkan; Hershfield, Michael; van der Burg, Mirjam

2016-01-01

Combined immunodeficiencies (CIDs) include a group of inherited monogenic disorders. CIDs are characterized by defective cellular and humoral immunities that lead to severe infections. CIDs can be classified according to immunologic phenotypes as T?B?NK? CID, T?B?NK+ CID, T?B+NK? CID and T?B+NK+ CID. In a 20-year period, from 1994 to 2014, a total of 40 CID patients were diagnosed at the Pediatric Immunology of Erciyes University Medical Faculty in Kayseri, Turkey. The gender ratio (F/M) was ...

Experiments with Analytic Centers: A confluence of data, tools and help in using them.

Science.gov (United States)

Little, M. M.; Crichton, D. J.; Hines, K.; Cole, M.; Quam, B. M.

2017-12-01

Traditional repositories have been primarily focused on data stewardship. Over the past two decades, data scientists have attempted to overlay a superstructure to make these repositories more amenable to analysis tasks, with limited success. This poster will summarize lessons learned and some realizations regarding what it takes to create an analytic center. As the volume of Earth Science data grows and the sophistication of analytic tools improves, a pattern has emerged that indicates different science communities uniquely apply a selection of tools to the data to produce scientific results. Infrequently do the experiences of one group help steer other groups. How can the information technology community seed these domains with tools that conform to the thought processes and experiences of that particular science group? What types of succcessful technology infusions have occured and how does technology get adopted. AIST has been experimenting with the management of this analytic center process; this paper will summarize the results and indicate a direction for future infusion attempts.

Evaluation of long term health-related quality of life in extensive burns: a 12-year experience in a burn center.

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Xie, Bing; Xiao, Shi-chu; Zhu, Shi-hui; Xia, Zhao-fan

2012-05-01

We sought to evaluate the long term health-related quality of life (HRQOL) in patients survived severely extensive burn and identify their clinical predicting factors correlated with HRQOL. A cross-sectional study was conducted in 20 patients survived more than 2 years with extensive burn involving ≥70% total body surface area (TBSA) between 1997 and 2009 in a burn center in Shanghai. Short Form-36 Medical Outcomes Survey (SF-36), Brief Version of Burn Specific Health Scale (BSHS-B) and Michigan Hand Outcome Questionnaire (MHQ) were used for the present evaluation. SF-36 scores were compared with a healthy Chinese population, and linear correlation analysis was performed to screen the clinical relating factors predicting physical and mental component summary (PCS and MCS) scores from SF-36. HRQOL scores from SF-36 were significantly lower in the domains of physical functioning, role limitations due to physical problems, pain, social functioning and role limitations due to emotional problems compared with population norms. Multiple linear regression analysis demonstrated that only return to work (RTW) predicted improved PCS. While age at injury, facial burns, skin grafting and length of hospital stay were correlated with MCS. Work, body image and heat sensitivity obtained the lowest BSHS-B scores in all 9 domains. Improvements of HRQOL could still be seen in BSHS-B scores in domains of simple abilities, hand function, work and affect even after a quite long interval between burns and testing. Hand function of extensive burn patients obtained relatively poor MHQ scores, especially in those without RTW. Patients with extensive burns have a poorer quality of life compared with that of general population. Relatively poor physical and psychological problems still exist even after a long period. Meanwhile, a trend of gradual improvements was noted. This information will aid clinicians in decision-making of comprehensive systematic regimens for long term rehabilitation

The LHC cryogenic system and operational experience from the first three years run

International Nuclear Information System (INIS)

Delikaris, Dimitri; Tavian, Laurent

2014-01-01

The LHC (Large Hadron Collider) accelerator helium cryogenic system consists of eight cryogenically independent sectors, each 3.3 km long, all cooled and operated at 1.9 K. The overall, entropy equivalent, installed cryogenic capacity totalizes 144 kW (a) 4.5 K including 19.2 kW (a) 1.8 K with an associated helium inventory of 130 ton. The LHC cryogenic system is considered among the most complex and powerful in the world allowing the cooling down to superfluid helium temperature of 1.9 K. of the accelerators' high field superconducting magnets distributed over the 26.7 km underground ring. The present article describes the LHC cryogenic system and its associated cryogen infrastructure. Operational experience, including cryogen management, acquired from the first three years of LHC operation is finally presented. (author)

Frequency of daily tooth brushing: predictors of change in 9- to 11-year old US children.

Science.gov (United States)

Polk, D E; Geng, M; Levy, S; Koerber, A; Flay, B R

2014-09-01

To investigate whether an increase in daily tooth brushing frequency in children was predicted by either a) having a strong intention to brush twice a day or b) their parents receiving information about their new caries experience. Secondary data analyses were conducted on two waves of data from the Aban Aya Youth Project and the Iowa Fluoride Study. The Aban Aya study included 576 10- and 11-year olds from Chicago, Illinois. The Iowa Fluoride Study included a convenience sample of 709 babies born in Iowa. The present study includes those children at age 9. In both studies, reported daily tooth brushing frequency was assessed twice six months apart. In the Aban Aya data, compared with children with a weak intention at wave 1 to brush twice a day, children with a strong intention to brush twice a day were more likely to increase their brushing frequency by wave 2, OR 7.0, 95%CI 1.5,32.9. In the Iowa Fluoride Study, compared with children who did not have new caries at wave 1, children who had new caries experience were less likely to increase their brushing frequency by wave 2, OR 0.4, 95%CI 0.2,0.9. Strengthening intention to brush twice a day might increase children's brushing frequency. However, simply providing parents with information about new caries probably will not. Future studies should assess tooth brushing frequency, habit strength, intention, and situational cues at closely-spaced waves.

Job embeddedness factors and retention of nurses with 1 to 3 years of experience.

Science.gov (United States)

Halfer, Diana

2011-10-01

An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention. Recent literature reports an increased focus on understanding the work experience and career support needed for new graduate nurses. Several studies report improvements in job satisfaction and retention after implementation of structured mentoring programs for new graduate nurses. However, despite successful transition programs, turnover for these same nurses after 1 to 3 years of organizational tenure remains high. Studying factors that contribute to retention and supporting careers beyond the first year of practice may have a significant effect on improving retention and will contribute new knowledge to the nursing literature. This study, undertaken at a Midwestern pediatric academic medical center, examined job factors and career development support that lead to retention of nurses with 1 to 3 years of experience. Understanding these issues may guide nursing leaders and staff development educators in investing in focused retention and career development plans during an economic recession. Copyright 2011, SLACK Incorporated.

Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

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Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

2014-12-01

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands.

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Rijnders, Marlies; Baston, Helen; Schönbeck, Yvonne; van der Pal, Karin; Prins, Marianne; Green, Josephine; Buitendijk, Simone

2008-06-01

Little research has been conducted to date on women's postnatal emotional well-being and satisfaction with the care received in the Netherlands. The aim of this study was to investigate Dutch women's views of their birth experience 3 years after the event. A questionnaire was mailed to all women who had given birth in 2001 and who had at least one prenatal, perinatal, or postnatal visit to the participating midwifery practice. Women who had a subsequent birth after the index birth in 2001 were not excluded. We specifically asked respondents to reflect on the birth that occurred in 2001. Women were asked to say how they felt now looking back on their labor and birth, with five response options from "very happy" to "very unhappy." We received 1,309 postnatal questionnaires (response rate 44%). The sample was fairly representative with respect to the mode of delivery, place of birth, and obstetric interventions compared with the total Dutch population of pregnant women; however, the sample was not representative for ethnicity and initial caregiver. Three years after delivery, most women looked back positively on their birth experience, but more than 16 percent looked back negatively. More than 1 in 5 primiparas looked back negatively compared with 1 in 9 multiparas. Adjusted odds ratios (OR) for looking back negatively 3 years later included having had an assisted vaginal delivery or unplanned cesarean delivery (OR 2.6, 95% CI 1.59-4.14), no home birth (OR 1.4, 95% CI 1.04-1.93), referral during labor (OR 2.4, 95% CI 1.48-3.77), not having had a choice in pain relief (OR 2.9, 95% CI 1.91-4.45), not being satisfied in coping with pain (OR 4.9, 95% CI 2.55-9.40), a negative description of the caregivers (OR 2.9, 95% CI 1.85-4.40), or having had fear for the baby's life or her own life (OR 2.3, 95% CI 1.47-3.48). A substantial proportion of Dutch women looked back negatively on their birth experience 3 years postpartum. Further research needs to be undertaken to

[Pheochromocytoma in 8-year observation at a single endocrinological center in Wroclaw].

Science.gov (United States)

Bednarek-Tupikowska, Grazyna; Bucyk, Barbara; Daroszewski, Jacek; Bidzińska-Speichert, Bozena; Bohdanowicz-Pawlak, Anna; Szymczak, Jadwiga; Bednorz, Włodzimierz; Podgórski, Franciszek; Zareba-Bogdał, Elzbieta; Kuliczkowska-Płaksej, Justyna; Lenarcik, Agnieszka; Filus, Alicja; Kałuzny, Marcin; Kubicka, Eliza; Syrycka, Joanna; Tupikowska, Małgorzata; Lizurej, Oskar; Bolanowski, Marek; Milewicz, Andrzej

2009-01-01

Pheochromocytoma is rare tumor with a highly variable clinical presentation. This report provides clinical picture, efficiency of diagnostics and treatment of pheochromocytoma in 8-years in the endocrinological center in Wroclaw. The records of 37 patients with pheochromocytoma were identified, who were treated in 2000-2007 in the Department of Endocrinology, Diabetology and Isotope Treatment in Wroclaw. There were 23 women (age 23-75 year) and 14 men (age 17-74). We studied frequency of clinical signs, usefulness of diagnostic methods and efficacy of treatment. The duration of the clinical history ranged from 2 months to 16 years. The most frequent symptoms were: hypertension paroxysmal and constant, palpitations, headache, sweating and anxiety. The most sensitive diagnostic method was increased concentration of urinary metanephrine in 24-hour urine. Computed tomography was the most widely used method for tumor localization. Adrenal pheochromocytoma was detecting by CT in all patients, predominated in right adrenal, in 1 case in urinary bladder. Surgery caused remission of hypertension in 59%, improvement in 26.8%, and no changes in 13.9% of patients. Malignancy was reported in 2 cases, 1 woman died after surgery. MEN 2A occur in 21.6%. The diagnosis of pheochromocytma is usually made after long duration of the disease. The study confirms that clinical presentation of pheochromocytoma is variable and nonspecific, this finding makes the diagnosis very difficult. The most typical symptom is paroxysmal hypertension, which is present only in 40%, other symptoms are nonspecific. The measurement of 24-hour urinary metanephrines was the best indicator. CT was almost always successful in localizing the tumor. Patients with pheochromocytoma should be consider for other endocrine diseases especially medullary carcinoma, primary hyperparathyroidism and other component of MEN 2A.

Occupational accidents in dental school: a 10-year retrospective

Directory of Open Access Journals (Sweden)

Viviane Maia Araújo

2009-12-01

Full Text Available Objective: To investigate occupational accidents that occurred during the first 10 years of Fortaleza University (UNIFOR Dental School. Methods: A documental study based on secondary data from the Notification Center of Occupational Accidents of UNIFOR Dental School, reported in the last 10 years. The variables included characteristics of the accidents and of the injured, besides the type of instrument and the resulting injury. Results: Were recorded 160 occupational accidents divided by location, function of the injured and type of accident. It was observed that 63.1% of cases occurred in the Multidisciplinary Clinic, 23.1% in the Integrated Clinic, 8.8% in the laboratories, 1.9% at home, 1.25% in the Surgical Center, 1.25% in the Material Sterilization Central and 0.6% during the training outside university. Concerning the injured, 90.6% of the victims were undergraduates, 5.0% staff, 3.8% teachers and 0.6% patients. Regarding the injury, 40.6% were penetrating bloody injuries, 11.9% cutting bloody injuries, 2.5% cutting non-bloody injuries, 5% burns, 5% penetrating bloody injuries/cutting bloody injuries, 2.5% were injuries with maceration, 1.9% injuries causing ocular trauma and 0.6% of an incident of dog bite. Conclusion: It was concluded that penetrating injuries were prevalent and these occurred mostly in the multidisciplinary clinic, where students of earlier periods of dental course work, indicating that the experience in dental practice generates more care with safety.

[Differences in practice among physicians staffing an emergency department in relation to years of experience].

Science.gov (United States)

Busca, Pablo; Inchaurza, Estibaliz; Illarramendi, Aiora; Urbina, Ohiana; González, Laura; Miró, Òscar

2015-06-01

To determine differences in certain variables reflecting clinical practice in a group of emergency physicians with varying levels of experience and to explore whether differences are associated with experience. Retrospective observational study of differences in variables reflecting emergency physicians' practice between 2005 and 2012. We studied work variables (months worked, patients treated, caseload distribution according to triage levels), patient management variables (consultation with other specialists, admissions, ambulance requests), diagnostic procedures ordered (simple radiographs, laboratory tests, ultrasound or computed tomography imaging), and time patients discharged home spent in the department (arrival to discharge). We explored relationships between these variables and the emergency physician's experience using linear regression analysis, followed by the construction of multivariable models to adjust for physician characteristics. Data for 50 emergency medicine physicians, in 291 years of work, were analyzed. The specialists' experience ranged from 1 to 22 years (mean [SD], 9.5 [5.8] years). They attended between 47 and 158 patients monthly (mean, 86 [19] patients). The physicians' experience was inversely and independently related to the mean number of patients attended monthly and the percentage of patients assigned a triage level of 1 or 2. Experience was directly and independently related to discharged patients' time spent in the emergency department and number of simple radiographs ordered. All associations were small (R2<0.010), however. Those variables continued to show statistically significant associations after increasingly complex modeling to adjust for the following physician variables: physician, age, sex, specialty, residency training in the same hospital). The practice of emergency physicians with more accumulated experience shows slight but significant differences from the practice of less experienced physicians.

Influences on patient satisfaction in healthcare centers: a semi-quantitative study over 5 years.

Science.gov (United States)

Thornton, Ruth D; Nurse, Nicole; Snavely, Laura; Hackett-Zahler, Stacey; Frank, Kenice; DiTomasso, Robert A

2017-05-19

Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years. Patients' responses to 21 questions were analyzed by principal components varimax rotated factor analysis. Three classifiable components emerged: Satisfaction with Physician, Availability/Convenience, and Orderly/Time. To study the effects of several independent variables (location of clinics, patients' and physicians' age, education level and duration at the clinic), data were subjected to multivariate analysis of variance (MANOVA).. Changes in the healthcare centers over time were not significantly related to patient satisfaction. However, location of the center did affect satisfaction. Urban patients were more satisfied with their physicians than rural, and inner city patients were less satisfied than urban or rural on Availability/Convenience and less satisfied than urban patients on Orderly/Time. How long a patient attended a center most affected satisfaction, with patients attending >10 years more satisfied in all three components than those attending 60 years old. Patients were significantly more satisfied with their 30-40 year-old physicians compared with those over 60. On Orderly/Time, patients were more satisfied with physicians who were in their 50's than physicians >60. Improvement in patient satisfaction includes a need for immediate, specific feedback. Although Medical Directors received feedback yearly, we found no significant changes in patient satisfaction over time. Our results

Vision screening in children: Is 7-9 years of age a threshold for visual impairment?

Science.gov (United States)

Ertekin, Yusuf Haydar; Tekin, Murat; Uludag, Aysegul; Arikan, Sedat; Sahin, Erkan Melih

2016-01-01

The present study aimed to assess the prevalence of decreased visual acuity, strabismus, and spectacle wear in children aged 5 to 13 years. A cross-sectional study was performed in primary education schools. A total of 1938 participants, including 940 females (48.5%) and 998 males (51.5%) with a mean age 8.96 ± 2.31 (5-13 years old), were screened. The comparisons were performed with gender, age, and age groups. The children attended to vision screening were assigned to three age groups as 5-6 years, 7-9 years, and 10-13 years. The prevalence of the parameters was detected as decreased visual acuity 12.4%, strabismus 2.2%, and spectacle wear 6.9%. The prevalence of decreased visual acuity was significantly higher in girls and in children aged 7-9 years old (p = 0.013, p children aged 7-9 years old (p = 0.019, p visual acuity decrease in 33 of 106 (31.1%) children despite wearing own spectacle. There was no significant difference among three age groups for strabismus. Increased prevalence of decreased visual acuity, as well as the higher frequency of spectacle wear in children at ages of 7-9 years old may point out a threshold for visual impairment.

A control center design revisited: learning from users’ appropriation

DEFF Research Database (Denmark)

Souza da Conceição, Carolina; Cordeiro, Cláudia

2014-01-01

This paper aims to present the lessons learned during a control center design project by revisiting another control center from the same company designed two and a half years before by the same project team. In light of the experience with the first project and its analysis, the designers and res...

Quality of working life of nurses in a tertiary cancer center in Qatar

Directory of Open Access Journals (Sweden)

Santhirani Nagammal

2017-01-01

Full Text Available Background Nurses are the largest segment of professionals working in the healthcare industry, and a satisfactory quality of working life will empower them to provide the highest quality care to their patients. Aim To assess the quality of working life among nurses in a tertiary cancer care center in Qatar concerning the following variables; control at work, employee engagement, general well-being, home-work interface, job/career satisfaction, stress at work, and working conditions. Methods A cross-sectional, descriptive study was conducted to assess the QoWL among 146 Staff Nurses working in different units of a tertiary cancer center in Qatar. A Quality of Work life Scale, a seven-point Likert’s scale was used, were nurses self-reported their QoWL. Results The mean age of the study participants were 36.48 years ± 6.74, and mean total years of clinical experience in nursing and clinical experience at the center was 14.16 years and 7.65 years respectively. The majority (69.9% of the nurses who participated in the study were working in inpatient units. Around fifty-four percentage were graduate nurses. A vast majority (89.7% of the respondents were married and among them, 84.2% of nurses lived with their family. Nurses’ perception of the factors associated with QoWL including control and stress at work were found average, and others such as employee engagement, general well-being, homework interface, job/career satisfaction, working condition, and overall quality of work life were considered good. There was no statistically significant difference in the QoWL scores and participants’ characteristics (P>0.05. Conclusion The overall QoWL was found to be good for the Oncology Nurses working at a cancer center in Qatar. However, Nurses reported having varying degrees of stress at work. Nurses require highly specialized clinical competencies to accurately determine patients' states and predict and cope with difficulties that may occur during

Neuro-Oncology Branch patient experience and expertise | Center for Cancer Research

Science.gov (United States)

Experience and Expertise We have more than 20 years of experience working with patients and their physicians to offer a comprehensive approach to patient care. Patients travel from all over the world to be evaluated and treated by our clinical team. The Brain Tumor Clinic sees hundreds of new patients and 2,000–3,000 follow-up patients each year. 

Effects of a six-session introductory psychology programme on Year 9 pupils' interest in psychology and approaches to learning

OpenAIRE

Norris, E.; De Aguiar Chaves, T.; Dunsmuir, S.

2015-01-01

Psychology is a popular UK A-level, despite many pupils having no previous taught experience of it. Prior introduction to psychology teaching could help pupils make more informed choices to study it. This study evaluates a six-session introduction to psychology programme for 20 Year 9 pupils called ‘Myth-Busting the Brain’. A pre-/post-programme questionnaire investigated pupil interest towards future psychology study, interest in the programme and approaches to learning. There wa...

Children's sleep patterns from 0 to 9 years: Australian population longitudinal study.

Science.gov (United States)

Price, Anna M H; Brown, Judith E; Bittman, Michael; Wake, Melissa; Quach, Jon; Hiscock, Harriet

2014-02-01

To provide accurate population normative data documenting cross-sectional, age-specific sleep patterns in Australian children aged 0-9 years. The first three waves of the nationally representative Longitudinal Study of Australian Children, comprising two cohorts recruited in 2004 at ages 0-1 years (n=5107) and 4-5 years (n=4983), and assessed biennially. Children with analysable sleep data for at least one wave. At every wave, parents prospectively completed 24-h time-use diaries for a randomly selected week or weekend day. 'Sleeping, napping' was one of the 26 precoded activities recorded in 15-min time intervals. From 0 to 9 years of age, 24-h sleep duration fell from a mean peak of 14 (SD 2.2) h at 4-6 months to 10 (SD 1.9) h at 9 years, mainly due to progressively later mean sleep onset time from 20:00 (SD 75 min) to 21:00 (SD 60 min) and declining length of day sleep from 3.0 (SD 1.7) h to 0.03 (SD 0.2) h. Number and duration of night wakings also fell. By primary school, wake and sleep onset times were markedly later on weekend days. The most striking feature of the centile charts is the huge variation at all ages in sleep duration, sleep onset time and, especially, wake time in this normal population. Parents and professionals can use these new centile charts to judge normalcy of children's sleep. In future research, these population parameters will now be used to empirically determine optimal child sleep patterns for child and parent outcomes like mental and physical health.

Mortality in Children Aged 0-9 Years: A Nationwide Cohort Study from Three Nordic Countries

DEFF Research Database (Denmark)

Yu, Yongfu; Qin, Guoyou; Cnattingius, Sven

2016-01-01

boys and girls decreased from 1.25 to 1.21 with the most prominent reduction in children aged 5–9 years (from 1.59 to 1.19). Neoplasms, diseases of the nervous system and transport accidents were the most frequent cause of death after the first year of life. These three leading causes of death declined...... comparing cause-specific mortality, and half of deaths from diseases of the nervous system occurred in infancy. Mortality rate due to transport accidents increased with age and was highest in boys aged 5–9 years. Conclusions Mortality rate in children aged 0–9 years has been decreasing with diminished...... difference between genders over the past decades. Our results suggest the importance of further research on mortality by causes of neoplasms, and causes of transport accidents—especially in children aged 5–9 years...

Cyberattack analysis through Malaysian Nuclear Agency experience as nuclear research center

International Nuclear Information System (INIS)

Mohd Dzul Aiman Aslan; Mohd Fauzi Haris; Saaidi Ismail; Nurbahyah Hamdan

2011-01-01

As a nuclear research center, Nuclear Malaysia is one of the Critical National Information Infrastructure (CNII) in the country. One of the easiest way to launch a malicious attack is through the online system, whether main web site or online services. Recently, we also under port scanning and hack attempts from various sources. This paper will discuss on analysis based on Nuclear Malaysia experience regarding these attempts which keep arising nowadays. (author)

A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

Science.gov (United States)

Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

2015-01-01

Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

A Look at Person- and Family-Centered Care Among Older Adults: Results from a National Survey [corrected].

Science.gov (United States)

Wolff, Jennifer L; Boyd, Cynthia M

2015-10-01

Person-centered and family-centered care represents the pinnacle of health care quality, but delivering it is challenging, as is assessing whether it has occurred. Prior studies portray older adults as passive in health decisions and burdened by care-but emphasize age-based differences or focus on vulnerable subgroups. We aimed to examine domains of person-centered and family-centered care among older adults and whether the social context in which older adults manage their health relates to preferences for participating in health decisions and experiences with care. This was an observational study of a nationally representative survey of adults aged 65+ years, conducted in concert with the 2012 National Health and Aging Trends Study (n = 2040). Approach to managing health (self-manage, co-manage, delegate); preferences for making health care decisions with: (1) doctors, (2) family/close friends; and experiences with care pertaining to treatment burden were measured. Approximately two-thirds of older adults self-manage (69.4 %) and one-third co-manage (19.6 %) or delegate (11.0 %) health care activities. The majority prefer an independent or shared role when making health decisions with doctors (84.7 %) and family/close friends (95.9 %). Nearly four in ten older adults (37.9 %) experience treatment burden-that managing health care activities are sometimes or often hard for either them or their family/close friends, that health care activities get delayed or don't get done, or that they are cumulatively too much to do. Relative to older adults who self-manage, those who delegate health care activities are more likely to prefer to share or leave health decisions to doctors (aOR = 1.79 (95 % CI, 1.37-2.33) and family/close friends (aOR = 3.12 (95 % CI, 2.23-4.36), and are more likely to experience treatment burden (aOR = 2.37 (95 % CI, 1.61-3.47). Attaining person-centered and family-centered care will require strategies that respect diverse decision

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

Science.gov (United States)

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

2015-05-01

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

Vector Graphics for Web Lectures: Experiences with Adobe Flash 9 and SVG

Science.gov (United States)

Ketterl, Markus; Mertens, Robert; Vornberger, Oliver

2007-01-01

Purpose: The purpose of this paper is to describe vector graphics for web lectures, focusing on the experiences with Adobe Flash 9 and SVG. Design/methodology/approach: The paper presents experiences made during the development and everyday use of two versions of the lecture-recording system virtPresenter. The first of these versions is based on…

An application framework and data model prototype for the BaBar experiment

CERN Document Server

Quarrie, D

2003-01-01

The BaBar experiment is a high energy physics experiment to do physics with e sup + e sup - colliding beams in the 10 GeV center-of-mass energy at the PEP-II accelerator at the Stanford Linear Accelerator Center. The principal objectives are to study CP violation and rare processes in decays of B mesons. The experiment is under construction, with first data anticipated in 1999. The BaBar experiment is expected to accumulate of order 10 sup 9 events per calendar year, with over 10 sup 8 interesting hadronic events. The data must be stored efficiently, but must be easily accessible in order for multiple and frequent physics analyses to be carried out. The analysis framework must be flexible enough to accommodate a variety of analysis modules and multiple input/output streams. The BaBar collaboration has developed a prototype for the analysis framework and data access, written in C++ using an object-oriented design philosophy. The data access is based on the Farfalla package. The base class is a ''node''. Variou...

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

Directory of Open Access Journals (Sweden)

Priscila Menezes Ferri

2012-03-01

Full Text Available CONTEXT: Portal vein thrombosis refers to a total or partial obstruction of the blood flow in this vein due to a thrombus formation. It is an important cause of portal hypertension in the pediatric age group with high morbidity rates due to its main complication - the upper gastrointestinal bleeding. OBJECTIVE: To describe a group of patients with portal vein thrombosis without associated hepatic disease of the Pediatric Hepatology Clinic of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil with emphasis on diagnosis, presentation form and clinical complications, and the treatment of portal hypertension. METHODS: This is a descriptive study of a series of children and adolescents cases assisted from January 1990 to December 2010. The portal vein thrombosis diagnosis was established by ultrasound. RESULTS: Of the 55 studied patients, 30 (54.5% were male. In 29 patients (52.7%, none of the risk factors for portal vein thrombosis was observed. The predominant form of presentation was the upper gastrointestinal bleeding (52.7%. In 20 patients (36.4%, the initial manifestation was splenomegaly. During the whole following period of the study, 39 patients (70.9% showed at least one episode of upper gastrointestinal bleeding. The mean age of patients in the first episode was 4.6 ± 3.4 years old. The endoscopic procedure carried out in the urgency or electively for search of esophageal varices showed its presence in 84.9% of the evaluated patients. The prophylactic endoscopic treatment was performed with endoscopic band ligation of varices in 31.3% of patients. Only one died due to refractory bleeding. CONCLUSIONS: The portal vein thrombosis is one of the most important causes of upper gastrointestinal bleeding in children. In all non febrile children with splenomegaly and/or hematemesis and without hepatomegaly and with normal hepatic function tests, it should be suspect of portal vein thrombosis. Thus, an

Cardiorespiratory fitness and body mass index values in 9-year-old rural Norwegian children

DEFF Research Database (Denmark)

Resaland, G K; Mamen, A; Anderssen, S A

2009-01-01

AIM: To describe cardiorespiratory fitness and body mass index (BMI) values in a representative population of 9-year-old Norwegian children in two rural communities and compare present values with previous findings. METHODS: Two hundred and fifty-nine 9-year-old children were invited, and 256......, children's BMI values seem to have increased substantially. This increase is most pronounced in girls. When assessing these differences using the PI, this increase is less marked. Comparing maximal oxygen uptake data with that in earlier Nordic studies, there is no evidence that fitness has declined among...... 9-year olds. However, the limitations of the few earlier studies make reliable comparisons difficult....

Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience.

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Qiuming Chen

Full Text Available This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus.From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years.Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years. Thirty patients (60% were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9 units.m2 and 64.3±17.9 (range, 38 to 101 mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28% patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335-43.092; p = 0.022. Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II.Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up.

Pesticide-related poison center exposures in children and adolescents aged ≤19 years in Texas, 2000-2013.

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Trueblood, Amber B; Forrester, Mathias B; Han, Daikwon; Shipp, Eva M; Cizmas, Leslie H

2016-11-01

Although national poison center data show that pesticides were the 8th most commonly reported substance category (3.27%) for children aged ≤5 years in 2014, there is limited information on childhood and adolescent pesticide exposures. This study assessed pesticide-related poison center exposures in children and adolescents aged ≤19 years from 2000-2013 in Texas to characterize the potential burden of pesticides. Pesticide-related poison center exposures among children and adolescents aged ≤19 years reported to Texas poison centers were identified. The distribution of exposures was estimated by gender, age category, medical outcome, management site, exposure route, and pesticide category. From 2000 to 2013, there were 61,147 pesticide-related poison center exposures in children and adolescents aged ≤19 years. The prevalence was highest among males at 864.24 per 100,000 population. The prevalence of unintentional exposures was highest among children aged ≤5 years at 2310.69 per 100,000 population, whereas the prevalence of intentional exposures was highest among adolescents aged 13-19 years at 13.82 per 100,000 population. A majority of medical outcomes reported were classified as having no effect (30.24%) and not followed, but minimal clinical effects possible (42.74%). Of all the exposures, 81.24% were managed on site. However, 57% of intentional exposures were referred to or treated at a health-care facility. The most common routes of exposure were ingestion (80.83%) and dermal (17.21%). The most common pesticide categories included rodenticides (30.02%), pyrethrins/pyrethroids (20.69%), and other and unspecified insecticides (18.14%). The study found differences in the frequency of exposures by intent for sex and age categories, and identified the most common medical outcomes, management site, exposure route, and pesticide category. Through characterizing pesticide-related poison center exposures, future interventions can be designed to address groups

Congenital megaprepuce: a 12-year experience (52 cases) of this specific form of buried penis.

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Rod, Julien; Desmonts, Alexis; Petit, Thierry; Ravasse, Philippe

2013-12-01

Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of megaprepuce in children, describing the surgical procedure we used to treat it and the results. We retrospectively reviewed the charts of all children who underwent congenital megaprepuce repair between January 1999 and August 2011 in our institution. Fifty-two children were operated during the study period. Our single surgical technique, not an original one, consists of fixing the penile shaft at the base of the penis, and widely reducing the inner prepuce. Four children (8%) underwent revision surgery but according to our criteria a very good result was observed in only 23 patients, and a less good but still acceptable result in 25 patients. Our 12-year experience in the surgical treatment of congenital megaprepuce demonstrated satisfying results from a safe and simple surgical technique, but to achieve the optimum result remains difficult. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Primary Budd-Chiari syndrome - a single center experience.

Science.gov (United States)

Raszeja-Wyszomirska, Joanna; Mieżyńska-Kurtycz, Joanna; Marlicz, Wojciech; Lawniczak, Małgorzata; Wójcicki, Maciej

2012-09-01

Budd-Chiari syndrome (BCS) is recognized as a clinical manifestation of various prothrombotic conditions which may be lethal within 3 years of the onset of symptoms if untreated. This study is a retrospective analysis of patients with BCS managed between 2004 and 2011. The diagnosis was confirmed with contrast CT-angiography and/or Doppler ultrasound. BCS was diagnosed in 20 patients (11 females and 9 males), median age 38 years (ranging from 18 to 56). Twelve patients were referred as acute BCS for the liver transplant (LTx) assessment. Thrombosis of the hepatic veins was caused by myeloproliferative disorders (n=8), end-stage liver disease (n=4), protein C deficiency (n=3), paroxysmal nocturnal hemoglobinuria (PNH) (n=1), antiphospholipid syndrome (n=1) and secondary poliglobulia (n=1). In two patients the origin of BCS could not be established despite appropriate screening. Median follow-up was 29 months. Low molecular heparin with subsequent conversion to vitamin K antagonists was routinely applied in all patients. Two patients underwent TIPS procedure with good long term outcome and 10 subjects received LTx; 1 patient was lost to follow-up and 1 died of chest infection 9 years since the diagnosis of BCS was made; 14 patients, including those who received LTx, were alive and well at least one year after BCS diagnosis. All survivors remain stable and are followed-up on a regular basis. Strict adherence to the diagnostic and therapeutic guidelines plays a crucial role in the management of BCS patients. Our results confirm the efficacy of anticoagulation as well as TIPS and/or OLT in treatment of this rare condition.

Management of autoimmune hemolytic anemia in children and adolescents: A single center experience

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Nazan Sarper

2011-09-01

Full Text Available Objective: To present and discuss the treatment of autoimmune hemolytic anemia (AIHA. Materials and Methods: The medical records of all patients (n=19 diagnosed in a tertiary hematology center between 1999 and 2010 were retrospectively reviewed.Results: Median age at diagnosis of AIHA was 5 years (range: 4 months-17 years. In all, 13 patients had primary (idiopathic AIHA, whereas 2 had primary Evans Syndrome (ES, 2 had autoimmune lymphoproliferative syndrome (ALPS+ES, and 1 had Wiskott-Aldrich syndrome (WAS+AIHA. Among the 13 primary idiopathic AIHA patients, 9 recovered following a 4-8-week course of prednisolone treatment without relapses, whereas 3 patients required a longer course of prednisolone. One AIHA patient that was very resistant to prednisolone recovered after cyclosporine A was added to the treatment. All patients with primary idiopathic AIHA were in remission for a median of 3 years (range: 4 months-10 years at the time this manuscript was written. Among the patients with primary ES, 2 had relapses similar to the ALPS patients. Splenectomy was performed in 1 primary ES patient, who at the time this report was written was also in remission. One ALPS patient required the addition of mycophenolate mofetil due to prednisolone resistance. The WAS patient was treatment resistant and died due to septicemia.Conclusions: Primary AIHA in pediatric patients generally has an acute onset and good response to corticosteroids. Primary or secondary ES has a chronic or relapsing course, and treatment may require other immunosuppressive agents in addition to corticosteroids. Complications of splenectomy must not be underestimated in patients with underlying immunodeficiency. AIHA often causes considerable morbidity and mortality in WAS.

Effects of Patient-centered Medical Home Transformation on Child Patient Experience.

Science.gov (United States)

Harder, Valerie S; Krulewitz, Julianne; Jones, Craig; Wasserman, Richard C; Shaw, Judith S

2016-01-01

Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation. This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013. Patient experiences related to child development and prevention were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS). A 10-point increase in NCQA score at PCMH practices is associated with a 3.1% higher CAHPS child prevention score (P = .004). Among pediatric practices, PCMH recognition is associated with 7.7% (P child development and prevention composite scores, respectively. Among family medicine practices, PCMH recognition is associated with 7.4% (P = .001) and 11.0% (P child development and prevention composite scores, respectively. Our results suggest that PCMH recognition may improve child patient experience at pediatric practices and worsen experience at family medicine practices. These findings warrant further investigation into the differential influence of NCQA PCMH transformation on family medicine and pediatric practices. © Copyright 2016 by the American Board of Family Medicine.

From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience

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Giovanni Monni

2018-02-01

Full Text Available The incidence of β-thalassemia in Sardinia is high and β-39 is the most common mutation. The prevention campaign started in 1977 and was performed in a single center (Microcitemico Hospital, Cagliari, Sardinia, Italy. It was based on educational programs, population screening by hematological and molecular identification of the carriers. Prenatal and pre-implantation diagnosis was offered to couples at risk. 8564 fetal diagnosis procedures using different invasive approaches and analysis techniques were performed in the last 40 years. Trans-abdominal chorionic villous sampling was preferred due to lower complication risks and early diagnosis. Chorionic villous DNA was analyzed by PCR technique. 2138 fetuses affected by β-thalassemia were diagnosed. Women opted for termination of the pregnancy (TOP in 98.2% of these cases. Pre-implantation genetic diagnosis (PGD was proposed to couples at risk to avoid TOP. A total of 184 PGD were performed. Initially, the procedure was exclusively offered to infertile couples, according to the law in force. The success rate of pregnancies increased from 11.1% to 30.8% when, crucial law changes were enacted, and PGD was offered to fertile women as well. Forty years of β-thalassemia prevention programs in Sardinia have demonstrated the important decrease of this severe genetic disorder.

From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience.

Science.gov (United States)

Monni, Giovanni; Peddes, Cristina; Iuculano, Ambra; Ibba, Rosa Maria

2018-02-20

The incidence of β-thalassemia in Sardinia is high and β-39 is the most common mutation. The prevention campaign started in 1977 and was performed in a single center (Microcitemico Hospital, Cagliari, Sardinia, Italy). It was based on educational programs, population screening by hematological and molecular identification of the carriers. Prenatal and pre-implantation diagnosis was offered to couples at risk. 8564 fetal diagnosis procedures using different invasive approaches and analysis techniques were performed in the last 40 years. Trans-abdominal chorionic villous sampling was preferred due to lower complication risks and early diagnosis. Chorionic villous DNA was analyzed by PCR technique. 2138 fetuses affected by β-thalassemia were diagnosed. Women opted for termination of the pregnancy (TOP) in 98.2% of these cases. Pre-implantation genetic diagnosis (PGD) was proposed to couples at risk to avoid TOP. A total of 184 PGD were performed. Initially, the procedure was exclusively offered to infertile couples, according to the law in force. The success rate of pregnancies increased from 11.1% to 30.8% when, crucial law changes were enacted, and PGD was offered to fertile women as well. Forty years of β-thalassemia prevention programs in Sardinia have demonstrated the important decrease of this severe genetic disorder.

BN-600 power unit 15-year operating experience

International Nuclear Information System (INIS)

Saraev, O.M.; Oshkanov, N.N.; Vylomov, V.V.

1996-01-01

Comprehensive experience has been gained with the operating fast reactor BN-600 with a power out of 600 MWe. This paper includes important performance results and gives also an overview of the experience gained from BN-600 NPP commercial operation during 15 years. (author). 2 figs, 1 tab

Barrett's esophagus: Ten years of experience at a tertiary care hospital center in Mexico

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F. Valdovinos-Andraca

2018-01-01

Conclusions: The frequency of Barrett's esophagus was 9.6 cases for every 1,000 upper gastrointestinal endoscopies performed. Dysplasia was not documented in the majority of the patients with Barrett's esophagus and they had no histopathologic changes during follow-up. A total of 19.3% of the patients presented with dysplasia or cancer.

A Child-centered Method of Interviewing Children with Movement Impairments.

Science.gov (United States)

Kanagasabai, Parimala S; Mirfin-Veitch, Brigit; Hale, Leigh A; Mulligan, Hilda

2018-08-01

Children are increasingly included in qualitative research and new methods for interviewing children are emerging. The aim of this article is to describe and discuss the strategies of a child-centered method of data collection for interviewing children with movement impairments to explore their leisure participation experiences. A study was conducted using an Interpretative Phenomenological Approach (IPA) to explore leisure participation experiences of children with movement impairments aged 6 to 12 years. Various strategies, guided by children, were used to facilitate children's active involvement in the interview process. Twenty-two children (mean age 8.7 years) participated in the interview study, most of them in the presence of their parents or guardian (18 children) and some of them (9 children) with their siblings present. Children enjoyed and were actively engaged in the interview process. Along with talking, 19 children did drawings, 5 children used stickers, 4 children played quiet games, six children shared pictures of their leisure activities, and 16 children physically demonstrated some of their leisure activities, environment, and equipment. A wide range of data collection strategies facilitated children to communicate their leisure participation experiences and to represent children's views without being overly influenced by parental views.

Percutaneous liver biopsy and revised coagulation guidelines: a 9-year experience.

Science.gov (United States)

Kitchin, Douglas R; Del Rio, Alejandro Munoz; Woods, Michael; Ludeman, Lucas; Hinshaw, J Louis

2017-09-19

To retrospectively review revised pre-procedural coagulation guidelines for percutaneous liver biopsy to determine whether their implementation is associated with increased hemorrhagic complications on a departmental scale. Secondary endpoints were to determine the effect of this change on pre-procedural blood product (FFP and platelet) utilization, to evaluate the impact of administered blood products on hemorrhagic complications, and to determine whether bleeding complications were related to INR and platelet levels. This IRB-approved, HIPAA-compliant, retrospective study reviewed 1846 percutaneous liver biopsies in 1740 patients, comparing biopsies performed, while SIR consensus pre-procedural coagulation guidelines were in place (INR ≤ 1.5, platelets ≥50,000 µL) to those performed after departmental implementation of revised, less stringent guidelines (INR ≤ 2.0, platelets ≥25,000 µL). On a departmental scale, there were significantly fewer hemorrhagic complications in the population of patients treated after adoption of less stringent guidelines as compared to those treated under the SIR guidelines (1.6% vs. 3.4%, p = 0.0192) despite a significant decrease in pre-procedural FFP (0.8% vs. 3.9%, p guidelines for percutaneous liver biopsy (INR ≤ 2.0, platelets ≥25,000 µL) did not result in an increase in departmental hemorrhagic complication rates but did significantly decrease pre-procedural FFP/platelet administration. An individual patient's bleeding risk does increase as INR increases and platelets decrease, but pre-procedural FFP and/or platelet transfusion did not mitigate that increased risk.

Organizational Processes and Patient Experiences in the Patient-centered Medical Home.

Science.gov (United States)

Aysola, Jaya; Schapira, Marilyn M; Huo, Hairong; Werner, Rachel M

2018-06-01

There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES:: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); P=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. Although some organizational processes relate to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.

The Research Results of Radioactive Waste Management Technology Center Year 1997/1998

International Nuclear Information System (INIS)

1998-12-01

The research results of Radioactive Waste Management Technology Center, National Atomic Energy Agency of Indonesia year 1997/1998 contain paper as form of research results on radioactive waste management related fields. There were included many aspects such as radioactive waste processing, storage, decontamination, decommissioning, safety and environmental aspects. There are 26 papers indexed individually (ID)

Outcome of liver transplantation for hepatocellular carcinoma -- a single center experience.

Science.gov (United States)

Iacob, R; Iacob, S; Gheorghe, L; Gheorghe, C; Hrehoreţ, D; Brașoveanu, V; Croitoru, A; Herlea, V; Popescu, I

2013-01-01

Liver transplantation (LT) is a promising treatment for patients with liver cirrhosis associated with hepatocellular carcinoma (HCC). The aim of our study was to evaluate our experience regarding the clinical and pathological staging of HCC in patients who underwent LT, as well as recurrence free and overall survival. From January 2006 to December 2011, 38 patients with diagnosis of HCC, underwent LT in our Center. Demographic, clinical, imaging and pathologic information were recorded. A Cox proportional hazards survival analysis was performed in order to identify significant predictors of tumor recurrence and patient's death after LT. Eighteen patients (47.4%) in our study group were within Milan criteria. The mean follow-up was 22 months and the recurrence rate of HCC after LT was 13.2%. The 1, 3- year recurrence free survival rates were 85%, 74.3% respectively. The 1 and 3-year overall survival rates were 83.5% and 63.6% respectively. No significant predictor for HCC recurrence was identified in our study group by survival analysis, taking into account 13 different variables. As independent predictors of patient'ss death after LT for HCC however, the presence of diabetes mellitus (p=0.001), presence of more than 3 HCC nodules (p=0.03) and tumor recurrence after LT (p=0.03) were identified by multivariate Cox proportional hazards survival analysis. In our cohort HCC recurrence rate after LT was 13.2%. Diabetes mellitus, presence of more than 3 HCC nodules and HCC recurrence were significant predictors of poor overall survival after LT. Celsius.

Race and association with disease manifestations and mortality in scleroderma: a 20-year experience at the Johns Hopkins Scleroderma Center and review of the literature.

Science.gov (United States)

Gelber, Allan C; Manno, Rebecca L; Shah, Ami A; Woods, Adrianne; Le, Elizabeth N; Boin, Francesco; Hummers, Laura K; Wigley, Fredrick M

2013-07-01

Experience suggests that African Americans may express autoimmune disease differently than other racial groups. In the context of systemic sclerosis (scleroderma), we sought to determine whether race was related to a more adverse expression of disease. Between January 1, 1990, and December 31, 2009, a total of 409 African American and 1808 white patients with scleroderma were evaluated at a single university medical center. While the distribution by sex was virtually identical in both groups, at 82% female, African American patients presented to the center at a younger mean age than white patients (47 vs. 53 yr; p scleroderma-specific autoantibody status, and for the socioeconomic measures of educational attainment and health insurance status, diminished these risk estimates (RR, 1.3; 95% CI, 1.0-1.6). The heightened risk of mortality persisted in strata defined by age at disease onset, diffuse cutaneous disease, anticentromere seropositivity, decade of care at the center, and among women. These findings support the notion that race is related to a distinct phenotypic profile in scleroderma, and a more unfavorable prognosis among African Americans, warranting heightened diagnostic evaluation and vigilant care of these patients. Further, we provide a chronologic review of the literature regarding race, organ system involvement, and mortality in scleroderma; we furnish synopses of relevant reports, and summarize findings.

Early experiences with big data at an academic medical center.

Science.gov (United States)

Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

Gaps-in-Noise test: gap detection thresholds in 9-year-old normal-hearing children.

Science.gov (United States)

Marculino, Carolina Finetti; Rabelo, Camila Maia; Schochat, Eliane

2011-12-01

To establish the standard criteria for the Gaps-in-Noise (GIN) test in 9-year-old normal-hearing children; to obtain the mean gap detection thresholds; and to verify the influence of the variables gender and ear on the gap detection thresholds. Forty normal-hearing individuals, 20 male and 20 female, with ages ranging from 9 years to 9 years and 11 months, were evaluated. The procedures performed were: anamnesis, audiological evaluation, acoustic immittance measures (tympanometry and acoustic reflex), Dichotic Digits Test, and GIN test. The results obtained were statistically analyzed. The results revealed similar performance of right and left ears in the population studied. There was also no difference regarding the variable gender. In the subjects evaluated, the mean gap detection thresholds were 4.4 ms for the right ear, and 4.2 ms for the left ear. The values obtained for right and left ear, as well as their standard deviations, can be used as standard criteria for 9-year-old children, regardless of ear or gender.

EBR-II: twenty years of operating experience

International Nuclear Information System (INIS)

Lentz, G.L.; Buschman, H.W.; Smith, R.N.

1985-01-01

Experimental Breeder Reactor No. 2 (EBR-II) is an unmoderated, sodium-cooled reactor with a design power of 62.5 MWt. For the last 20 years EBR-II has operated safely, has demonstrated stable operating characteristics, has shown excellent performance of its sodium components, and has had an excellent plant factor. These years of operating experience provide a valuable resource to the nuclear community for the development and design of future liquid metal fast reactors. This report provides a brief description of the EBR-II plant and its early operating experience, describes some recent problems of interest to the nuclear community, and also mentions some of the significant operating achievements of EBR-II. Finally, a few words and speculations on EBR-II's future are offered. 4 figs., 1 tab

[Achilles tendon ruptures: 25 year's experience in sport-orthopedic treatment].

Science.gov (United States)

Majewski, M; Widmer, K H; Steinbrück, K

2002-12-01

From 1972 - 1996 570 Achilles tendon ruptures in 565 patients were treated in the Sportklinik Stuttgart. The 499 men and 66 women had an average age of 38 years. For the diagnosis of a Achilles tendon rupture Ultrasound and MRI are important procedures, but clinical history and examination are still the best methods to find an Achilles tendon rupture (100%). However,the Actiology of the Achilles tendon rupture is still controversial and cannot be answered by these methods. Opposed to the degenerative theory, biomechanical experiments show that any Achilles tendon can tear when the calf muscle is tensed before the tendon is quickly stretched. We found that 69.8% of the patients with Achilles tendon rupture had a real trauma. Regardless of that, the treatment of the ruptured Achilles tendon has considerably changed over the last ten years. Responsible for this development are the positive experiences at the field of sports medicine with minimally invasive methods and the early functional treatment after knee surgery. Since we use an early functional rehabilitation concept instead of plaster immobilisation, all methods to treat a ruptured Achilles tendon have been improved. 43.5% of the patients after plaster immobilisation and 28.8% of the patients after early functional rehabilitation had a subjectively felt force reduction. Other important selecting criteria are the risk factors related to treatment method. Minimal invasive percutaneous Achilles tendon repair is considerably better than conservative therapy with a high rate of re-rupture (9.8%) and better than the open surgical repair, which carries a higher risk of infection (2.2%)

Extracorporeal life support as a bridge to lung transplantation-experience of a high-volume transplant center.

Science.gov (United States)

Hoetzenecker, Konrad; Donahoe, Laura; Yeung, Jonathan C; Azad, Sassan; Fan, Eddy; Ferguson, Niall D; Del Sorbo, Lorenzo; de Perrot, Marc; Pierre, Andrew; Yasufuku, Kazuhiro; Singer, Lianne; Waddell, Thomas K; Keshavjee, Shaf; Cypel, Marcelo

2018-03-01

Extracorporeal life support (ECLS) is increasingly used to bridge deteriorating patients awaiting lung transplantation (LTx), however, few systematic descriptions of this practice exist. We therefore aimed to review our institutional experience over the past 10 years. In this case series, we included all adults who received ECLS with the intent to bridge to LTx. Data were retrieved from patient charts and our institutional ECLS and transplant databases. Between January 2006 and September 2016, 1111 LTx were performed in our institution. ECLS was used in 71 adults with the intention to bridge to LTx; of these, 11 (16%) were bridged to retransplantation. The median duration of ECLS before LTx was 10 days (range, 0-95). We used a single dual-lumen venous cannula in 23 patients (32%). Nine of 13 patients (69%) with pulmonary hypertension were bridged by central pulmonary artery to left atrium Novalung. Twenty-five patients (35%) were extubated while on ECLS and 26 patients (37%) were mobilized. Sixty-three patients (89%) survived to LTx. Survival by intention to treat was 66% (1 year), 58% (3 years) and 48% (5 years). Survival was significantly shorter in patients undergoing ECLS bridge to retransplantation compared with first LTx (median survival, 15 months (95% CI, 0-31) versus 60 months (95% CI, 37-83); P = .041). In our center experience, ECLS bridge to first lung transplant leads to good short-term and long-term outcomes in carefully selected patients. In contrast, our data suggest that ECLS as a bridge to retransplantation should be used with caution. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

Surgical management of gynecomastia: 20 years' experience.

Science.gov (United States)

Lapid, O; Jolink, F

2014-03-01

Gynecomastia, breast hypertrophy in men, is a common finding. The diagnosis is clinical, and ancillary tests may be performed; however, there is no unanimity in the literature about their use or utility. The mainstay of management is conservative, with a minority of patients being operated on. The surgical treatment of gynecomastia is not restricted to one discipline and is performed by plastic, general, and pediatric surgeons. The aim of this study was to assess the experience treating gynecomastia in a university hospital and the practices of the different surgical disciplines in the diagnosis and surgical treatment of gynecomastia; this knowledge could be used for the formulation of guidelines and the allocation of health-care resources. a university medical center. A retrospective cohort study in which all records of patients operated on for gynecomastia over a 20-year period were retrieved. Data were obtained concerning patient demographics, responsible surgical discipline, the workup and etiology found, the surgical technique used, the occurrence of reoperations and revisions, and the use of pathological examination and its results. A total of 179 patients were treated. There was a difference between the patient groups operated on by the different disciplines regarding the indication, the workup, as well as in the operative techniques used. Plastic surgeons performed more bilateral operations than the other disciplines. Surgeons used more radiology and cytology testing. These results most probably represent differences in the population and pathologies treated. This is possibly due to a bias in the referrals by primary care physicians.

The Research Results of Radioactive Waste Management Technology Center Year 1996/1997

International Nuclear Information System (INIS)

Budiman, P.; Martono, H.; Las, T.; Lubis, E.; Mulyanto; Wisnubroto, D. S.; Sucipta

1997-12-01

The research results of Radioactive Waste Management Technology Center, National Atomic Energy Agency of Indonesia year 1996/1997 contain paper as form of research results on radioactive waste management related fields. There were included many aspects such as radioactive waste processing, storage, decontamination, decommissioning, safety and environmental aspects. There are 24 papers and 12 short communications indexed individually(ID)

Volpe Center Office of Research and Technology Applications (ORTA) : fiscal year 2014 annual report

Science.gov (United States)

2014-12-01

Technology transfer activities performed by the Volpe National Transportation Systems Center during fiscal year 2014 in fulfillment of statutory Office of Research and Technology Applications (ORTA) responsibilities are summarized in this report.

Software quality assurance - seven years experience

International Nuclear Information System (INIS)

Malsbury, J.A.

1987-01-01

This paper describes seven years experience with software quality assurance at PPPL. It covers the early attempts of 1980 and 1981 to establish software quality assurance; the first attempt of 1982 to develop a complete software quality assurance plan; the significant modifications of this plan in 1985; and the future. In addition, the paper describes the role of the Quality Assurance organization within each plan. The scope of this paper is limited to discussions of the software development procedures used in the seven year period. Other software quality topics, such as configuration control or problem identification and resolution, are not discussed

Fort Collins Science Center fiscal year 2010 science accomplishments

Science.gov (United States)

Wilson, Juliette T.

2011-01-01

The scientists and technical professionals at the U.S. Geological Survey (USGS), Fort Collins Science Center (FORT), apply their diverse ecological, socioeconomic, and technological expertise to investigate complicated ecological problems confronting managers of the Nation's biological resources. FORT works closely with U.S. Department of the Interior (DOI) agency scientists, the academic community, other USGS science centers, and many other partners to provide critical information needed to help answer complex natural-resource management questions. In Fiscal Year 2010 (FY10), FORT's scientific and technical professionals conducted ongoing, expanded, and new research vital to the science needs and management goals of DOI, other Federal and State agencies, and nongovernmental organizations in the areas of aquatic systems and fisheries, climate change, data and information integration and management, invasive species, science support, security and technology, status and trends of biological resources (including the socioeconomic aspects), terrestrial and freshwater ecosystems, and wildlife resources, including threatened and endangered species. This report presents selected FORT science accomplishments for FY10 by the specific USGS mission area or science program with which each task is most closely associated, though there is considerable overlap. The report also includes all FORT publications and other products published in FY10, as well as staff accomplishments, appointments, committee assignments, and invited presentations.

Gregory Merkel Tours Marshall Space Flight Center (MSFC)

Science.gov (United States)

1972-01-01

Gregory A. Merkel (left), high school student from Springfield, Massachusetts, is pictured here with Harry Coons of the Marshall Space Flight Center (MSFC) during a visit to the center. Merkel was among 25 winners of a contest in which some 3,500 high school students proposed experiments for the following year's Skylab mission. The nationwide scientific competition was sponsored by the National Science Teachers Association and the National Aeronautics and Space Administration (NASA). The winning students, along with their parents and sponsor teachers, visited MSFC where they met with scientists and engineers, participated in design reviews for their experiments, and toured MSFC facilities. Of the 25 students, 6 did not see their experiments conducted on Skylab because the experiments were not compatible with Skylab hardware and timelines. Of the 19 remaining, 11 experiments required the manufacture of additional equipment.

Radiation protection training: twenty year experience in Hungary

International Nuclear Information System (INIS)

Pellet, Sandor; Kanyar, Bela; Zagyvay, Peter; Solymosi, Jozsef; Bujtas, Tibor; Feher, Istvan; Giczi, Ferenc; Deme, Sandor; Uray, Istvan

2008-01-01

In Hungary, radiation protection training for radiation workers has been introduced in very early, just following the publication of the ICRP recommendation No. 26. Before that, in some of the institutions, radiation protection training was recommended for technicians and medical doctors working in nuclear medicine, X-ray diagnostic radiology and radiation therapy, as well as in some of industrial applications, but not on regular way. Since 1988, radiation protection training regulated by the Ministry of Health and required for all of the workers in radiation workplaces licensed by the authority the State Public Health and Medical Officers Service (SPHAMOS). Decree No. 16/2000. (VI. 8.) EuM of the Minister of Health on the enforcement of Clauses of the Nuclear Law 116/1996 regulates the radiation protection training of Radiation Workers (RW). Annex 4 of Decree sees radiation protection training and in-service training: Persons performing conducted work in the field of the use of the nuclear energy and any other work within legal relationship shall be educated in training and in-service training at an interval of 5 years. Three levels of the training introduced; basic, extended and comprehensive, based on radiation risk related to the given job. Several institutions are involved in performing radiation protection training, such universities, scientific institutions, Regional Radiological Health Centers (RRHC) of SPHAMOS, private enterprises etc. All training course material is subject to accreditation. Most of the faculties of the universities involved in training of natural sciences and engineering provide subjects on the fundamentals of dosimetry, radiobiology and radiation protection within the courses of physics, biophysics, chemistry, biology, ecology etc. These courses take 5-10 contact hours per week on average. The members of the Hungarian Committee of EUTERP Platform summarize their broad experience collected in the past 20 year. (author)

HANARO operation experience in the year 2004

International Nuclear Information System (INIS)

Oh, Soo-Youl; Kim, Heonil; Cho, Yeong-Garp; Jun, Byung-Jin

2006-01-01

The experiences of the HANARO operation and maintenance in the year 2004 are presented in this article. The operation of HANARO, a 30 MW research reactor operated by the Korea Atomic Energy Research Institute (KAERI), aims at a safe and effective operation to enhance its utilization in various fields of scientific research and industry. Regardless of its importance of the routine operation, this article is devoted to rather unusual matters such as irregular maintenance events and incidents. Since the first criticality in 1995, it has been a long-cherished task to reach the designed power level of 30 MW from the temporarily approved 24 MW. By resolving the concern on the fuel integrity, the designed level could be licensed and, eventually, it was achieved last November. On the other hand, after its 9 years of operation, the mechanical integrity of the heavy water reflector tank was checked. The measurement of the vertical straightness of the tank inner shell indicated its integrity. Meanwhile, the HANARO fuel production facility was completed at the KAERI site, and it will begin to supply centrifugally atomized fuels, instead of conventional comminuted fuels, to HANARO shortly. There were several incidents in 2004, which have all been cleared, including a leak of heavy water, melting of a sample in an irradiation hole for the neutron activation analysis, and a condensation problem in a horizontal beam tube. The progress of and lessons from each incident are presented. The utilization of HANARO is expanding every year and the trend will also continue in 2005. The operation mode has been changed from an 18-day continuous operation and 10-day shutdown (18-10 mode) to the 23-12 mode since the end of 2004, and a further extension is planned to the 30-12 mode. Thanks to this extended operation term, an increased power level and, most importantly, a reliable operation, the HANARO is gaining more and more credit from the end users. (author)

The experiments of high power electron beam emission by the K-9M-57 and K-9M-58 rockets

International Nuclear Information System (INIS)

Kaneko, Osamu; Sasaki, Susumu; Yamori, Akira; Hagiwara, Michinobu; Kawashima, Nobuki

1977-01-01

Active experiments have been conducted to obtain the precise picture of the ionosphere and magnetosphere. As the turbulence source of the active experiment by the authors, electron beam was employed, and the variation of the rocket potential, wave excitation and turbulence of peripheral plasma were investigated. The rated voltage and current of the present electron gun were 6 kV and 500 mA, respectively. The Langmuir probe, floating probe, optical detector and wave receiver were used for the measurement of various phenomena associated with electron beam emission. The experimental data on the voltage-current characteristics of the electron gun, the rocket potential, total light emission and plasma density and temperature were obtained by the K-9M-57 and K-9M-58 rockets. (Yoshimori, M.)

Surgical management for active infective endocarditis: a single hospital 10 years experience

International Nuclear Information System (INIS)

Parvizi, R.; Varshouchi, M.; Alizadeh, R.

2007-01-01

To examine the outcome of surgery for active infective endocarditis (IE) in a cohort of patients. One hundred sixty-four consecutive patients who underwent valve surgery for active IE (diagnosis according to Duke criteria) in Madani Heart Center, Tabriz, Iran from 1996 to 2006 were studied. The mean age of patients was 36.3+-16 years overall: 34.6+-17.5 years for native valve endocarditis and 38.6+-15.2 yrs for prosthetic valve endocarditis (p=0.169). Ninety one (55.5%) patients were men. The infected valve was native in 112 (68.7%) of patients and prosthetic in 52(31.3%). In 61 (37%) patients, no predisposing heart disease was found. The aortic valve was infected in 78 (47.6%), mitral valve in 69 (42.1%), and multiple valves in 17 (10.3%) of patients. Active culture positive endocarditis was present in 81 (49.4%) whereas 83 (50.6%) patients had culture-negative endocarditis. Staphylococcus aureus was the most common isolated microorganism. Ninety patients (54.8%) were in NYHA classes III and IV. Mechanical valves were implanted in 69 patients (42.1%) and bioprostheses in 95 (57.9%), including a homograft in 19 (11.5%). There were 16 (9%) operative deaths, but there was only 1 death in patients that underwent aortic homograft replacement. Reoperation was required in 18 (10.9%) of cases. On multivariate logistic regression analysis, Staphylococcus aureus infection (p=0.008), prosthetic valve endocarditis (p=0.01), paravalvular abscess (p=0.001) and left ventricular ejection fraction less than 40% (p=0.04) were independent predictors of in-hospital mortality. Surgery for infective endocarditis continues to be challenging and associated with high operative mortality and morbidity. Prosthetic valve endocarditis, impaired ventricular function, paravalvular abscess and Staphylococcus aureus infection adversely affect in-hospital mortality. Also we found that aortic valve replacement with an aortic homograft can be performed with acceptable in hospital mortality and

Advanced Life Support Project: Crop Experiments at Kennedy Space Center

Science.gov (United States)

Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

2004-01-01

Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

[Ovarian tissue cryopreservation in cancer patients--six years of clinical experience].

Science.gov (United States)

Huser, M; Záková, J; Crha, I; Smardová, L; Král, Z; Revel, A; Ventruba, P

2012-04-01

Presentation of clinical results and experience with this technique during past six years. Original paper. Gynekologicko-porodnická klinika LF MU a FN Brno, Interní hemato-onkologická klinika LF MU a FN Brno, Department of Obstetrics and Gynecology. Hadassah University Hospital Ein-Karem, Jerusalem, Izrael. Ovarian tissue cryopreservation (OTC) and its future auto-transplantation becomes an alternative for patients to prevent serious damage of ovarian function by oncology treatment. Patient is indicated to OTC in case of high risk of ovarian failure due to planned chemotherapy and impossibility to use other oncofertility techniques. Ovarian tissue harvesting is done by laparoscopy in short-term general anesthesia. After tissue processing the samples are cryopreserved in programmable automatic freezer or by vitrification. The auto-transplantation of ovarian tissue is planned after the complete cure of patient's malignancy. Our workplace doesn't have own experience with tissue transplantation - until now cryopreserved tissue has not yet been utilized by the patients. Clinical experience with this technique gained by our team during academic stay in abroad Israeli clinic is presented. During the years of 2005-2011 the OTC was performed in 19 cancer patients before chemotherapy. In majority of cases, patients suffered from blood or lymph node systemic malignancy (84%). Average age of women was 26 years. The patient set consisted of mostly nulliparous women (88%). Patient's average body mass index was 23,9 kg/m2. The length of systemic chemotherapy averaged 7.1 months. Time from fertility preservation counseling to chemotherapy was not exceeding one week (7.2 days on average). Ovarian tissue harvesting was conducted by laparoscopic surgery in all cases. The length of surgery did not exceed 60 minutes and no surgical complications were observed. The case of ovarian tissue transplantation performed on abroad university settings is discussed. In the consensus of with

Ethics in psychosocial and biomedical research – A training experience at the Interdisciplinary Center for Bioethics (CIEB) of the University of Chile1

Science.gov (United States)

Lolas, Fernando; Rodriguez, Eduardo

2012-01-01

This paper reviews the experience in training Latin American professionals and scientists in the ethics of biomedical and psychosocial research at the Interdisciplinary Center for Studies in Bioethics (CIEB) of the University of Chile, aided by a grant from Fogarty International Center (FIC) – National Institutes of Health from 2002 to 2011. In these 10 years of experience, 50 trainees have completed a 12-month training combining on-line and in-person teaching and learning activities, with further support for maintaining contact via webmail and personal meetings. The network formed by faculty and former trainees has published extensively on issues relevant in the continent and has been instrumental in promoting new master level courses at different universities, drafting regulations and norms, and promoting the use of bioethical discourse in health care and research. Evaluation meetings have shown that while most trainees did benefit from the experience and contributed highly to developments at their home institutions and countries, some degree of structuring of demand for qualified personnel is needed in order to better utilize the human resources created by the program. Publications and other deliverables of trainees and faculty are presented. PMID:22754084

International radiation protection recommendations. Five years experience of ICRP Publication 26

International Nuclear Information System (INIS)

Lindell, B.; Beninson, D.; Sowby, F.D.

1983-01-01

The International Commission on Radiological Protection has issued radiation protection recommendations since 1928. The latest set of basic recommendations was adopted by the Commission on 17 January 1977, and subsequently published as ICRP Publication 26. This document has met with a wider interest than any of the previous ICRP recommendations. It has been considered to mark a radical change in the protection policy advocated by ICRP. It is not often appreciated that recommendations which are believed to be 'new' in ICRP Publication 26 had already been made in ICRP Publication 9 more than ten years earlier. In any event, ICRP Publication 26 has had a substantial impact on regulatory work in countries all over the world. It forms the basis for the Basic Safety Standards of the international organizations IAEA, ILO, OECD/NEA and WHO. The paper refers to the experience gained in using the new ICRP recommendations over the five years that have passed since ICRP Publication 26 was adopted and discusses some of the problems that have arisen in the practical application of the new recommendations in various countries. (author)

Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

Science.gov (United States)

Story, Julie A.

2014-01-01

The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

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

Directory of Open Access Journals (Sweden)

Himanshu V Patel

2013-01-01

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

Heart valve replacement with the Sorin tilting-disc prosthesis. A 10-year experience.

Science.gov (United States)

Milano, A; Bortolotti, U; Mazzucco, A; Mossuto, E; Testolin, L; Thiene, G; Gallucci, V

1992-02-01

From 1978 to 1988, 697 patients with a mean age of 48 +/- 11 years (range 5 to 75 years) received a Sorin tilting-disc prosthesis; 358 had had aortic valve replacement, 247 mitral valve replacement, and 92 mitral and aortic valve replacement. Operative mortality rates were 7.8%, 11.3%, and 10.8%, respectively, in the three groups. Cumulative duration of follow-up is 1650 patient-years for aortic valve replacement (maximum follow-up 11.4 years), 963 patient-years for mitral valve replacement (maximum follow-up 9.9 years) and 328 patient-years for mitral and aortic valve replacement (maximum follow-up 9.4 years). Actuarial survival at 9 years is 72% +/- 4% after mitral valve replacement, 70% +/- 3% after aortic valve replacement, and 50% +/- 12% after mitral and aortic valve replacement, and actuarial freedom from valve-related deaths is 97% +/- 2% after mitral valve replacement, 92% +/- 2% after aortic valve replacement, and 62% +/- 15% after mitral and aortic valve replacement. Thromboembolic events occurred in 21 patients with aortic valve replacement (1.3% +/- 0.2%/pt-yr), in 12 with mitral valve replacement (1.2% +/- 0.3% pt-yr), and in seven with mitral and aortic valve replacement (2.1% +/- 0.8%), with one case of prosthetic thrombosis in each group; actuarial freedom from thromboembolism at 9 years is 92% +/- 3% after mitral valve replacement, 91% +/- 3% after aortic valve replacement, and 74% +/- 16% after mitral and aortic valve replacement. Anticoagulant-related hemorrhage was observed in 15 patients after aortic valve replacement (0.9% +/- 0.2%/pt-yr), in 9 after mitral valve replacement (0.9% +/- 0.3%/pt-yr), and in 6 with mitral and aortic valve replacement (0.9% +/- 0.5%/pt-yr); actuarial freedom from this complication at 9 years is 94% +/- 2% after aortic valve replacement, 91% +/- 4% after mitral valve replacement, and 68% +/- 16% after mitral and aortic valve replacement. Actuarial freedom from reoperation at 9 years is 97% +/- 2% after mitral and

Frequency of fall-related injuries of female patients referred to the trauma center in the city of Kashan from years 2005 to 2008

Directory of Open Access Journals (Sweden)

Sayyah Mansour

2013-02-01

Full Text Available 【Abstract】 Objective: Falls are one of the life events leading to injury and in serious cases cause high morbidity and mortality. This research was conducted to determine the fall incidence among female population of Kashan city from the years 2005 to 2008. Methods: This was a retrospective research using existing data from the data bank of trauma center of Kashan University of Medical Sciences. Records of all the female patients treated at local hospitals with complete hospitalisation kept at the center were examined for 4 con-secutive years from 2005 to 2008. Results: A total of 2 094 female patients’ records were examined. A significantly higher incidence of injuy occurred in 2008 compared to 2005 (P<0.0001. In addition, the highest frequency of injury occurred in age group above 65 years (31.9% and in group with elementary education level (42.8%. Conclusion: The results showed that fall incidences occurred in the old age group above 65 years. Fall injuries at this age may cause disability. Therefore, preventive mea-sures should be taken, such as increasing the awareness of the aging population about the seriousness of fall incidence and encouraging the aged individuals to get involved in fitness program to remain physical fit and healthy. Key words: Accidental falls; Wounds and injuries; Female

High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

Science.gov (United States)

Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

2017-09-01

High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012.

Science.gov (United States)

Spiller, H A; Strauch, J; Essing-Spiller, S J; Burns, G

2016-10-01

Oxcarbazepine (OXC) is a 10-keto analogue of carbamazepine used in patients with partial and secondary generalized seizures. We evaluated ingestions of OXC reported to US poison centers for adverse effects from supratherapeutic doses and/or overdose. Retrospective analysis of data reported to National Poison Data System from single-substance OXC ingestions between January 2000 and December 2012. There were 18,867cases with a mean of 1451 exposures/year. The patients were predominantly adults with 5464 exposures in children effects were drowsiness (n = 4703, 25%), vomiting (n = 1559, 8%), tachycardia (n = 590, 3%), agitated (n = 342, 1.8%), hypotension (n = 178, 0.9%), electrolyte disturbance (n = 153, 0.8%), coma (n = 156, 0.8%), and seizures (n = 121, 0.6%). There were 176 patients with a major effect of which 31 involved were children and 1728 (9%) patients with moderate effects of which 300 involved were children. Five deaths were reported in adults. Intentional exposure (e.g. suicide) was the reason for exposure in 68% of patients with major effects and in all fatalities. Fifty-three percent of adults and 38% of children were managed in a health-care facility (HCF). HCF utilization levels remained consistent. Severe outcomes appear to be infrequent (<1%). Unlike other anticonvulsants OXC does not appear to be proconvulsant in overdose. Serious outcomes for OXC overdoses are unlikely in the pediatric patient. With only mild symptoms likely, observation at home may be appropriate for the majority of cases. In the adult population there appears to be few neurologic and cardiovascular complications even in the intentional exposure. © The Author(s) 2015.

Kennedy Space Center Five Year Sustainability Plan

Science.gov (United States)

Williams, Ann T.

2016-01-01

The Federal Government is committed to following sustainable principles. At its heart, sustainability integrates environmental, societal and economic solutions for present needs without compromising the ability of future generations to meet their needs. Building upon its pledge towards environmental stewardship, the Administration generated a vision of sustainability spanning ten goals mandated within Executive Order (EO) 13693, Planning for Federal Sustainability in the Next Decade. In November 2015, the National Aeronautics and Space Administration (NASA) responded to this EO by incorporating it into a new release of the NASA Strategic Sustainability Performance Plan (SSPP). The SSPP recognizes the importance of aligning environmental practices in a manner that preserves, enhances and strengthens NASA's ability to perform its mission indefinitely. The Kennedy Space Center (KSC) is following suit with KSC's Sustainability Plan (SP) by promoting, maintaining and pioneering green practices in all aspects of our mission. KSC's SP recognizes that the best sustainable solutions use an interdisciplinary, collaborative approach spanning civil servant and contractor personnel from across the Center. This approach relies on the participation of all employees to develop and implement sustainability endeavors connected with the following ten goals: Reduce greenhouse gas (GHG) emissions. Design, build and maintain sustainable buildings, facilities and infrastructure. Leverage clean and renewable energy. Increase water conservation. Improve fleet and vehicle efficiency and management. Purchase sustainable products and services. Minimize waste and prevent pollution. Implement performance contracts for Federal buildings. Manage electronic equipment and data centers responsibly. Pursue climate change resilience. The KSC SP details the strategies and actions that address the following objectives: Reduce Center costs. center dot Increase energy and water efficiencies. Promote smart

Role of surgical treatment in breast cancer liver metastases: a single center experience.

Science.gov (United States)

Bacalbasa, Nicolae; Dima, Simona Olimpia; Purtan-Purnichescu, Raluca; Herlea, Vlad; Popescu, Irinel

2014-10-01

The aim of the present study was to review a single hepatobiliary center experience, the benefit of hepatic metastasectomy in breast cancer liver metastases (BCLM) patients and to identify predictors of survival. Fifty-two female patients underwent surgery for BCLM between 2002 and 2013. Only patients with liver resections (n=43) were included in the analysis. The median survival of the 43 patients with liver resection was 32.2 months. The factors significantly associated with overall post-hepatectomy survival were estrogen/progesteron receptor (ER/PR) status (p=0.002), node involvement of the primary tumor (p=0.049), size (p=0.005) and number (p=0.006) of the metastatic lesions. The 1-, 3- and 5-year survival rates after curative liver resection were 93.02%, 74.42%, 58.14%, respectively. BCLM resection is a safe procedure and offers survival benefit, especially in patients with reduced liver metastatic burden (solitary metastases, diameter of the metastases <5 cm) and positive ER/PR status. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Meckel's diverticulum in children: Our 12-year experience

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Kamal Nain Rattan

2016-01-01

Full Text Available Background: Meckel's diverticulum (MD is the one of the most common congenital malformation of gastrointestinal tract and has varied clinical presentations. We are presenting here our 12-year experiences with MD in children at tertiary care hospital in North India. It highlights the fact that isolated gangrene of MD can occur, and it is associated with increased morbidity. Materials and Methods: This retrospective study is conducted by analysing the medical records of the patients who were operated for MD in the last 12 years in paediatric surgery department at our hospital. Results: Sixty-five patients were operated for MD in study period; in this 52 were males and 13 were females with mean age of presentation 3.2 years. The most common presentation was intestinal obstruction seen in 86.1% (56 cases. Intestinal haemorrhage was seen in 4.6% (3 cases and diverticulitis in 3% (2 cases. Perforation of the gut with peritonitis was present in 6.1% (four cases. Cause of obstruction was intussusception in 21.4% (12 cases, fibrous band connected to umbilicus in 17.8% (10 cases, volvulus in 17.8% (10 cases, kinking in 16.0% (9 cases, knotting in 14.2% (8 cases and herniation of gut below in 12.5% (7 cases. Isolated gangrene of MD was present in ten cases with intestinal obstruction. The ectopic gastric mucosa was seen in three and pancreatic mucosa in two cases. Mortality and morbidity during the study were one and three cases, respectively. Conclusion: MD may remain clinically silent for lifetime, or it may have life-threatening complications. In our series, intestinal obstruction and not the haemorrhage was the most common presentation. Isolated gangrene of MD with obstruction was present in significant numbers, which we failed to find in literature.

Genetic basis of cystinosis in Turkish patients: a single-center experience.

NARCIS (Netherlands)

Topaloglu, R.; Vilboux, T.; Coskun, T.; Ozaltin, F.; Tinloy, B.; Gunay-Aygun, M.; Bakkaloglu, A.; Besbas, N.; Heuvel, L.P. van den; Kleta, R.; Gahl, W.A.

2012-01-01

We report the molecular findings for the CTNS gene in 12 Turkish cystinosis patients aged 7-29 years. All presented initially with severe failure to thrive, polyuria, and polydipsia. Cystinosis was diagnosed at age 1 month to 9 years. Seven patients reached end-stage renal failure at ages ranging

Salomon: '97 E and P looking strongest in 9 years

International Nuclear Information System (INIS)

Anon.

1997-01-01

Based on companies' disclosed spending plans, 1997 is shaping up to be the strongest year-ahead outlook in 9 years, according to Salomon Bros. Inc. Salomon Bros.' conclusion stems from its 15th annual survey of worldwide oil and gas exploration and production spending. The survey, released last month, included 125 US independents, 97 Canadian companies, 103 companies outside the US and Canada, and 15 majors. Significantly, when the 15% growth experienced in 1996 is combined with the 1997 outlook, it represents the strongest indicator of 2-year activity in the past 15 years, said Salomon Bros. Double-digit spending growth is projected in all regions for 1997, the analyst said. Salomon Bros. said a higher percentage of companies' E and P budgets are being allocated to offshore projects, driven in part by attractive prospects, 3D seismic technology, and increased operational efficiencies

Health professionals’ experiences of person-centered collaboration in mental health care

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Rita Sommerseth

2008-10-01

Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

Effects of Game Pitch Count and Body Mass Index on Pitching Biomechanics in 9- to 10-Year-Old Baseball Athletes.

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Darke, Jim D; Dandekar, Eshan M; Aguinaldo, Arnel L; Hazelwood, Scott J; Klisch, Stephen M

2018-04-01

Pitching while fatigued and body composition may increase the injury risk in youth and adult pitchers. However, the relationships between game pitch count, biomechanics, and body composition have not been reported for a study group restricted to 9- to 10-year-old athletes. During a simulated game with 9- to 10-year-old athletes, (1) participants will experience biomechanical signs of fatigue, and (2) shoulder and elbow kinetics will correlate with body mass index (BMI). Descriptive laboratory study. Thirteen 9- to 10-year-old youth baseball players pitched a simulated game (75 pitches). Range of motion and muscular output tests were conducted before and after the simulated game to quantify fatigue. Kinematic parameters at foot contact, maximum external rotation, and maximum internal rotation velocity (MIRV), as well as maximum shoulder and elbow kinetics between foot contact and MIRV were compared at pitches 1-5, 34-38, and 71-75. Multivariate analyses of variance were used to test the first hypothesis, and linear regressions were used to test the second hypothesis. MIRV increased from pitches 1-5 to 71-75 ( P = .007), and head flexion at MIRV decreased from pitches 1-5 to 34-38 ( P = .022). Maximum shoulder horizontal adduction, external rotation, and internal rotation torques increased from pitches 34-38 to 71-75 ( P = .031, .023, and .021, respectively). Shoulder compression force increased from pitches 1-5 to 71-75 ( P = .011). Correlations of joint torque/force with BMI were found at every pitch period: for example, shoulder internal rotation ( R 2 = 0.93, P biomechanics for 9- to 10-year-old baseball pitchers and may be used in future studies to improve evidence-based injury prevention guidelines.

Dietary supplement adverse events: report of a one-year poison center surveillance project.

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Haller, Christine; Kearney, Tom; Bent, Stephen; Ko, Richard; Benowitz, Neal; Olson, Kent

2008-06-01

The safety and efficacy of dietary supplements is of growing concern to regulators, health-care providers and consumers. Few scientific data exist on clinical effects and potential toxicities of marketed products. Harmful supplements may not be identified for months or years with existing adverse event monitoring mechanisms. Retrospective review of poison center statistics to capture supplement-associated toxicity also has limitations. We collaborated with the FDA Center for Food Safety and Nutrition (CFSAN) to conduct a 1-year prospective surveillance study of dietary supplement-related poison control center calls in 2006. Prompt follow-up of symptomatic cases, laboratory analysis of implicated dietary supplements, and causality assessment by a case review expert panel were performed. Of 275 dietary supplements calls, 41% involved symptomatic exposures; and two-thirds were rated as probably or possibly related to supplement use. Eight adverse events required hospital admission. Sympathomimetic toxicity was most common, with caffeine products accounting for 47%, and yohimbe products accounting for 18% of supplement-related symptomatic cases. Suspected drug-herb interactions occurred in 6 cases, including yohimbe co-ingested with buproprion (1) and methamphetamine (3), and additive anticoagulant/antiplatelet effects of NSAIDs taken with fish oils (1) and ginkgo (1). Laboratory analysis identified a pharmacologically active substance in 4 cases; supplement toxicity was ruled unlikely when analytical testing was negative in 5 cases. Most supplement-related adverse events were minor. Clinically significant toxic effects were most frequently reported with caffeine and yohimbe-containing products. Active surveillance of poison control center reports of dietary supplement adverse events enables rapid detection of potentially harmful products, which may facilitate regulatory oversight.

Celebrating 25 Years. National Dropout Prevention Center/Network Newsletter. Volume 22, Number 3

Science.gov (United States)

Duckenfield, Marty, Ed.

2011-01-01

The "National Dropout Prevention Newsletter" is published quarterly by the National Dropout Prevention Center/Network. This issue contains the following articles: (1) Leading the Way in Dropout Prevention; (2) The 15 Effective Strategies in Action; (3) Technology Changes 1986-2011 (Marty Duckenfield); (4) 25 Years of Research and Support…

12 years' experience with intraoperative radiotherapy (IORT) of malignant gliomas

International Nuclear Information System (INIS)

Schueller, P.; Micke, O.; Moustakis, C.; Bruns, F.; Schuck, A.; Willich, N.; Palkovic, S.; Schroeder, J.; Wassmann, H.

2005-01-01

Background: Even after surgery and radiotherapy, malignant gliomas still have a poor prognosis. The authors report on their experience with IORT in 71 patients. Patients and methods: From May 1992 to February 2004, 71 patients with malignant gliomas were treated with IORT. 26 patients suffered from grade III gliomas, 45 patients from glioblastomas (GBM). IORT was carried out using a standard electron tube and 9- to 18-MeV electrons. 52/71 patients who were primarily treated received 20 Gy IORT + 60 Gy postoperative radiotherapy, 19/71 patients with recurrences only received IORT (20-25 Gy). Results: The complication rates were 1.4% for wound infections and 5.6% for hemorrhage. Median disease-specific survival amounted to 14.9 months (gliomass III) and 14.2 months (GBM). The 2-year survival rates amounted to 26.9% (gliomas III) and 6.8% (GBM; p=0.0296). Total versus subtotal resection had no significant influence on survival (p=0.0741), nor had age, sex, tumor site, performance status, size, primary versus recurrence, and radiation dose. A comparison to a conventionally treated patient group did not show a significant survival improvement. 3 months after treatment, initial symptoms had improved in 59% (hemiparesis), 50% (aphasia), 50% (hemianopsia), and 60% (convulsions). Conclusion: IORT has been shown to be feasible; perioperative complication rates were not increased. Survival was generally not improved compared to a historical control group. Recurrences achieved the same survival as primary tumors, and GBM also had a slightly increased survival, thus being possible indications for IORT. (orig.)

Experience gained during 10 years transmutation experiments in Dubna

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Zamani, M.; Fragopoulou, M.; Manolopoulou, M.; Stoulos, S.; Brandt, R.; Westmeier, W.; Krivopustov, M.; Sosnin, A.; Golovatyuk, S.

2006-05-01

Transmutation, the procedure of transforming long-lived radioactive isotopes into stable or short-lived, was proposed for reducing the amount of radioactive waste resulting from technological applications of nuclear fission. The Accelerator Driven Systems (ADS) provide the possibility to generate intense neutron spectrum yielding in an effective transmutation of unwanted isotopes. Such experiments are being carried out for the last 10 years in Synchrophasotron / Nuclotron accelerators at the Veksler-Baldin Laboratory of High Energies of the Joint Institute for Nuclear Research in Dubna, Russia. Thick Pb and Pb-U targets, surrounded by moderators, have been irradiated by protons in the energy range of 0.5-7.4 GeV. Neutron fluence measurements have been performed by different techniques of passive detectors (neutron activation detectors, solid state nuclear track detectors). Transmutation of 129I, 237Np, 239Pu was studied. The results of these experiments are presented and discussed.

Texas pavement preservation center four-year summary report.

Science.gov (United States)

2009-07-04

The Texas Pavement Preservation Center (TPPC), in joint collaboration with the Center for Transportation Research (CTR) of the University of Texas at Austin and the Texas Transportation Institute (TTI) of Texas A&M University, promotes the use of pav...

Electronic medical record in cardiology: a 10-year Italian experience.

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Carpeggiani, Clara; Macerata, Alberto; Morales, Maria Aurora

2015-08-01

the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based. an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined. the final EMR product integrated multimedia document (text, images, signals). EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology. the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

Electronic medical record in cardiology: a 10-year Italian experience

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Clara Carpeggiani

2015-08-01

Full Text Available SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals. EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

Transplante hepático pediátrico: experiência de 10 anos em um único centro no Brasil Pediatric liver transplantation: 10 years of experience at a single center in Brazil

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Marta Celeste de Oliveira Mesquita

2008-10-01

Full Text Available OBJETIVOS: Avaliar a experiência dos primeiros 10 anos de transplante hepático em crianças e adolescentes do Serviço de Transplante Hepático do Instituto Alfa de Gastroenterologia do Hospital das Clínicas da Universidade Federal de Minas Gerais. MÉTODOS: Estudo descritivo de 84 pacientes menores de 18 anos inscritos em lista para transplante, no período de março de 1995 a janeiro de 2006, quanto às seguintes variáveis: idade, indicação do transplante, escores de gravidade (Child-Pugh, Malatack, PELD/MELD, tempo de espera em lista, complicações pós-operatórias e sobrevida. RESULTADOS: De 84 pacientes inscritos, 40 foram submetidos ao transplante, ocorrendo dois retransplantes. Vinte e seis faleceram na lista de espera. A atresia biliar foi a indicação mais freqüente. A mediana da idade no momento do transplante foi de 6,6 anos (variou de 1,9 a 16,8 anos. A mortalidade no pós-transplante foi de 32,5% (13 de 40 crianças. O tempo de espera em lista dos 40 pacientes transplantados apresentou mediana de 291 dias. As complicações relacionadas ao enxerto ocorreram em 24 dos 42 transplantes (57,1%, sendo que as vasculares representaram 30,8%, prevalecendo a trombose da artéria hepática (16,6%; episódio de rejeição aguda ocorreu em 16,6% dos casos. CONCLUSÃO: Os resultados encontrados são semelhantes ao que é observado na literatura em relação às indicações e sobrevida no pós-transplante. No entanto, houve elevada taxa de complicações não relacionadas ao enxerto e daquelas relacionadas à artéria hepática.OBJECTIVES: To evaluate the first 10 years' experience of the liver transplantation department at the Alfa Institute, Hospital das Clínicas da Universidade Federal de Minas Gerais, Brazil. METHODS: A descriptive study, based on a retrospective analysis of 84 children and adolescents enrolled on a liver transplantation waiting list, from March 1995 to January 2006, based on the following variables: age, etiology

Quantitative Interpretation of X-ray Absorption Near Structure Continuation Progress Report for 1st year 9/15/98-9/14/99

International Nuclear Information System (INIS)

Rehr, John J.; Bare, Simon; Stocht, Joachim

1999-01-01

OAK-B135 Quantitative Interpretation of X-ray Absorption Near Structure Continuation Progress Report for 1st year 9/15/98-9/14/99. This paper proposes to develop two industrial research collaborations to further develop the FEFF8 x-ray spectroscopy code to achieve a quantitative interpretation of x-ray absorption near edge structure (XANES) in materials of interest in energy research: (a) Quantitative interpretation of XANES for heterogeneous catalysts and disordered materials; and (b) quantitative interpretation of white-lines in XANES. The paper also outlines significant results achieved during the first Grant year

Simultaneous Kidney-Pancreas Transplantation With an Original "Transverse Pancreas" Technique: Initial 9 Years' Experience With 56 Cases.

Science.gov (United States)

Paulino, J; Martins, A; Vigia, E; Marcelino, P; Nobre, A M; Bicho, L; Filipe, E; Barroso, E

2017-10-01

An innovative technique for pancreas transplantation is described. The main aspect consists of the horizontal positioning of the pancreas, which allows a better venous outflow, thus preventing thrombosis and graft loss. The program of pancreas transplantation in this national reference center for pancreatic and liver surgery was started in 2007; the initial results were considered poor, resulting in the loss of half of the grafts due to venous thrombosis. After analyzing the possible causes, this technique was proposed and successfully implemented, reducing the postoperative complications, particularly the problem of venous thrombosis. A detailed description of the new surgical technique is provided. The main clinical and demographic characteristics of the 56 patients who underwent the surgery are analyzed. The incidence of venous thrombosis was 5.3% (3 patients) and graft loss was 3.5% (2 patients). Due to the good results, this technique became the standard surgery for transplantation of the pancreas in our center. The technique proved to be safe and successful. Due to the unique pancreas graft implantation, we called it "transverse pancreas surgery." Copyright © 2017 Elsevier Inc. All rights reserved.

Virtual Knowledge Center Five Year Vision

International Nuclear Information System (INIS)

KENNY, N.E.

2003-01-01

The vision for Virtual Knowledge Center (VKC) is to make information accessible from one verifiable source, provide an environment for knowledge capture and sharing, and provide for automated business process management. VKC will be the foundation for management and integration of information activities at the Hanford Site for the next 5 years. It provides a distinctive solution that can increase return on investment, increase a facility's efficiency, and reduce a project's cost and schedule. This Five-Year Vision presents a clear path forward to support the U.S. Department of Energy and its contractors in their goals of achieving the Site's missions of preparing for the future, restoring the river corridor, and transitioning the central plateau. Diminishing funds and reduced availability of resources has created a direct obligation for the Hanford Site to be more innovative and resourceful in the use of its current information assets. The difficulty and, in some instances, the inability of current systems to effectively and efficiently meet evolving standards and directions, coupled with Hanford's geographical size, pose challenges to information acquisition, sharing, and use. An imbalance exists in the lifecycle process of information between locating information and executing work. The need to capture and retain workers' knowledge for future use was evaluated to identify cost effective alternatives. The VKC is comprised of a suite of technologies that enables seamless access to the information available through integration of databases and systems. The VKC uses web technology to provide the environment for gathering information from disparate data sources. The VKC makes information available to users; allowing them to search, access documents, retain enterprise knowledge, or interact with other users. The VKC provides a single path to electronic information; allows capture of knowledge at its source and makes data and information available for informed decision

Influence of Institutional Experience and Technological Advances on Outcome of Stereotactic Body Radiation Therapy for Oligometastatic Lung Disease.

Science.gov (United States)

Rieber, Juliane; Abbassi-Senger, Nasrin; Adebahr, Sonja; Andratschke, Nicolaus; Blanck, Oliver; Duma, Marciana; Eble, Michael J; Ernst, Iris; Flentje, Michael; Gerum, Sabine; Hass, Peter; Henkenberens, Christoph; Hildebrandt, Guido; Imhoff, Detlef; Kahl, Henning; Klass, Nathalie Desirée; Krempien, Robert; Lohaus, Fabian; Lohr, Frank; Petersen, Cordula; Schrade, Elsge; Streblow, Jan; Uhlmann, Lorenz; Wittig, Andrea; Sterzing, Florian; Guckenberger, Matthias

2017-07-01

Many technological and methodical advances have made stereotactic body radiotherapy (SBRT) more accurate and more efficient during the last years. This study aims to investigate whether experience in SBRT and technological innovations also translated into improved local control (LC) and overall survival (OS). A database of 700 patients treated with SBRT for lung metastases in 20 German centers between 1997 and 2014 was used for analysis. It was the aim of this study to investigate the impact of fluorodeoxyglucose positron-emission tomography (FDG-PET) staging, biopsy confirmation, image guidance, immobilization, and dose calculation algorithm, as well as the influence of SBRT experience, on LC and OS. Median follow-up time was 14.3 months (range, 0-131.9 months), with 2-year LC and OS of 81.2% (95% confidence interval [CI] 75.8%-85.7%) and 54.4% (95% CI 50.2%-59.0%), respectively. In multivariate analysis, all treatment technologies except FDG-PET staging did not significantly influence outcome. Patients who received pre-SBRT FDG-PET staging showed superior 1- and 2-year OS of 82.7% (95% CI 77.4%-88.6%) and 64.8% (95% CI 57.5%-73.3%), compared with patients without FDG-PET staging resulting in 1- and 2-year OS rates of 72.8% (95% CI 67.4%-78.8%) and 52.6% (95% CI 46.0%-60.4%), respectively (P=.012). Experience with SBRT was identified as the main prognostic factor for LC: institutions with higher SBRT experience (patients treated with SBRT within the last 2 years of the inclusion period) showed superior LC compared with less-experienced centers (P≤.001). Experience with SBRT within the last 2 years was independent from known prognostic factors for LC. Investigated technological and methodical advancements other than FDG-PET staging before SBRT did not significantly improve outcome in SBRT for pulmonary metastases. In contrast, LC was superior with increasing SBRT experience of the individual center. Copyright © 2016 Elsevier Inc. All rights reserved.

Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil,

OpenAIRE

Schweiger, Cláudia; Manica, Denise; Becker, Carolina Fischer; Abreu, Larissa Santos Perez; Manzini, Michelle; Sekine, Leo; Kuhl, Gabriel

2017-01-01

Abstract Introduction: Children may require tracheostomy due to many different health conditions. Over the last 40 years, indications of tracheostomy have endorsed substantial modifications. Objective: To evaluate pediatric patients warranted tracheostomy at our Hospital, in regard to their indications, associated comorbidities, complications and decannulation rates. Methods: Retrospective study concerning patients under 18 years of age undergoing tracheostomy in a tertiary health care cen...

MRI-guided stereotactic amygdalohippocampectomy: a single center experience

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Vojtěch Z

2015-02-01

Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

Streptococcus pneumoniae(Spn) Nasopharyngeal Carriage in Children Under 3 Years Old, Attending Day Care Centers in Argentina

Science.gov (United States)

Gentile, Angela; Rearte, Analía; Von Spetch, Martha; Laban, Celia; Papucci, Santiago Lopez; Badano, Andrea; Ferrario, Claudia; Pereda, Rosana; Flores, Devora; Berry, Diana; Aguilera, Alejandra; Sponton, Norma; Sorhouet, Cecilia; Napoli, Daniela; Devoto, Susana; Vizzotti, Carla

2017-01-01

Abstract Background In 2012 the 13-valent conjugated pneumococcal vaccine (PCV-13) was introduced in the National Immunization Program. We performed an epidemiological study to describe SPN nasopharyngeal carriage prevalence. Methods Between June to September 2015 it was performed a cross-sectional study among children Salta (North West), Trelew (South), Rosario (Centre), Buenos Aires (Capital city) and Posadas (North East)). Samples were analyzed at references hospitals of each city and isolates were submitted to the INEI “Dr. Carlos G. Malbrán “, for confirming and serotyping. We considered completed schedule 3 doses of PCV13, administrated14 days prior to enrollment. Results We included 359 toddlers, 61,6% (IC95% 56,3–66,6) were SPN carriers. Median age was 24 months, without significative difference in carriage status. Multivariate analysis showed that independently of age, sex and socioeconomic level, variables associated with carriage were: · City: Taking Salta as reference (less carriage prevalence), Rosario and Posadas were statistically associated with higher prevalence rates: OR: 3,1 (IC95% 1,3–7,1) y OR: 2,8 (IC96% 1,2–6,3) respectively · Children attending to public day care centers had higher carriage rates than those attending private ones: OR: 1,9 (IC95% 1,06–3,4) · Children sharing bedroom with 3 or more persons, were associated to mayor risk or carriage: OR: 1,7 (IC95% 1,03–2,7) We found 46 serotypes in the 221 isolates. (2 couldn’t be serotyped), 90,9% (IC95% 86,3–94,3) were non PCV 13 serotypes (most frequent were 15B, 23B and 11A). Only 7 of 46 were PCV13 serotypes. (Graphic 1) Of the 20 toddlers with PCV13 serotypes, 16 were completely vaccinated Graphic 1: S pneumoniae serotype distribution. N = 221 Conclusion Nasopharyngeal carriage of SPN was high in children < 3 years old attending day care centers. Most isolates were Non PCV13 serotypes. The independent predictors for higher prevalence rates were: 1- Children living

Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

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Amandeep S. Kalra

2015-01-01

Full Text Available Background. There has been a growing use of both capsule endoscopy (CE and double balloon enteroscopy (DBE to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P<0.001. Also contingency coefficient was calculated and was found to be 0.732 (P<0.001. Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%.

Factor VII deficiency: a single-center experience.

Science.gov (United States)

Salcioglu, Zafer; Akcay, Arzu; Sen, Hulya Sayilan; Aydogan, Gonul; Akici, Ferhan; Tugcu, Deniz; Ayaz, Nuray Aktay; Baslar, Zafer

2012-11-01

Congenital factor VII deficiency is the most common form of rare coagulation factor deficiencies. This article presents a retrospective evaluation of 73 factor VII deficiency cases that had been followed at our center. The study consisted of 48 males and 25 females (2 months-19 years). Thirty-one (42.5%) of them were asymptomatic. Out of symptomatic patients, 17 had severe clinical symptoms, whereas 8 presented with moderate and 17 with mild symptoms. The symptoms listed in order of frequency were as follows: epistaxis, petechia or ecchymose, easy bruising, and oral cavity bleeding. The genotype was determined in 8 patients. Recombinant activated factor VII (rFVIIa) was used to treat 49 bleeding episodes in 8 patients after 2002. In 2 patients with repeated central nervous system bleeding prophylaxis with rFVIIa was administered. No allergic and thrombotic events were observed during both treatment and prophylaxis courses. Antibody occurrence was not detected in the patients during treatment.

Recent trends in television tip over-related injuries among children aged 0-9 years.

Science.gov (United States)

Murray, K J; Griffin, R; Rue, L W; McGwin, G

2009-08-01

To describe recent trends in television tip over-related injuries among children aged 0-9 years, and to compare injury rates with sales of newer digital televisions. Digital television sales data were obtained from marketing data provided by the Television Bureau of Advertising. Data regarding television tip over-related injuries among children aged 0-9 years were obtained from the 1998-2007 National Electronic Injury Surveillance System. A Wald chi(2) test, estimated from logistic analysis, was used to determine whether the distribution of injury types differed by age group. Pearson's correlation was used to estimate the association between digital television sales and television tip over-related injuries. An estimated 42 122 (95% CI 35 199 to 49 122) injuries from television tip-overs were treated in US emergency departments from 1998 to 2007. The injury rate was highest for children aged 1-4 years (18.6/100 000). A majority of injuries (63.9%) involved the head and neck for children under 1 year of age, while a higher proportion of injuries among children aged 1-4 involved the hip and lower extremity (42.9% and 31.0%, respectively), and shoulder and upper extremity (16.8%) for children aged 5-9. A strong, positive correlation was observed between television sales and annual injury rates (r = 0.89, pdigital television sales were strongly correlated with increased injury rates, the lack of information regarding the type of television involved prevents inference regarding causation.

Use of electroroentgenography in a traumatology center

International Nuclear Information System (INIS)

Mil'ko, V.I.; Kostyuchenko, A.N.; Litvinenko, V.P.

1986-01-01

5-year experience of the use of electroroentgenography in a traumatology center for the diagnosis of bone traumatic injuries had been described. Some proposals to decrease radiation exposure and to create optimum working conditions for the medical personnel of an X-ray unit had been made

Integrating qualified nurses and non-nurses in midwifery education: the two-year experience of an ACNM DOA Accredited Program.

Science.gov (United States)

Fullerton, J T; Shah, M A; Schechter, S; Muller, J H

2000-01-01

In 1996, the Division of Accreditation (DOA) of the American College of Nurse-Midwives (ACNM) preaccredited the first direct entry program of midwifery education for candidates who already possess undergraduate degrees in non-nursing disciplines. Inaugurated through the partnership of the State University of New York Health Science Center at Brooklyn and the North Central Bronx Hospital, this 1-year, postbaccalaureate, certificate program of studies graduated two integrated classes of 22 registered nurse (RN) and nine direct entry (DE) students between 1997 and 1998. This article presents the experience of the first 2 years of this innovative program, focusing on the profiles of the DE students, their achievements, and their experiences entering the workforce. All of the data comparing nurse and non-nurse student progress through the program of studies strongly support the conclusion that, within an ACNM DOA preaccredited/accredited midwifery education program, DE students can achieve standards of academic excellence and clinical competency that are at least equivalent to those demonstrated by their RN peers.

Comparative Evaluation of Auditory Attention in 7 to 9 Year Old Learning Disabled Students

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Fereshteh Amiriani

2011-06-01

Full Text Available Background and Aim: Learning disability is a term referes to a group of disorders manifesting listening, reading, writing, or mathematical problems. These children mostly have attention difficulties in classroom that leads to many learning problems. In this study we aimed to compare the auditory attention of 7 to 9 year old children with learning disability to non- learning disability age matched normal group.Methods: Twenty seven male 7 to 9 year old students with learning disability and 27 age and sex matched normal conrols were selected with unprobable simple sampling. 27 In order to evaluate auditory selective and divided attention, Farsi versions of speech in noise and dichotic digit test were used respectively.Results: Comparison of mean scores of Farsi versions of speech in noise in both ears of 7 and 8 year-old students in two groups indicated no significant difference (p>0.05 Mean scores of 9 year old controls was significant more than those of the cases only in the right ear (p=0.033. However, no significant difference was observed between mean scores of dichotic digit test assessing the right ear of 9 year-old learning disability and non learning disability students (p>0.05. Moreover, mean scores of 7 and 8 year- old students with learning disability was less than those of their normal peers in the left ear (p>0.05.Conclusion: Selective auditory attention is not affected in the optimal signal to noise ratio, while divided attention seems to be affected by maturity delay of auditory system or central auditory system disorders.

Pediatric Lower Extremity Lawn Mower Injuries and Reconstruction: Retrospective 10-Year Review at a Level 1 Trauma Center.

Science.gov (United States)

Branch, Leslie G; Crantford, John C; Thompson, James T; Tannan, Shruti C

2017-11-01

From 2004 to 2013, there were 9341 lawn mower injuries in children under 20 years old. The incidence of lawn mower injuries in children has not decreased since 1990 despite implementation of various different prevention strategies. In this report, the authors review the results of pediatric lawn mower-related lower-extremity injuries treated at a tertiary care referral center as well as review the overall literature. A retrospective review was performed at a level 1 trauma center over a 10-year period (2005-2015). Patients younger than 18 years who presented to the emergency room with lower extremity lawn mower injuries were included. Of the 27 patients with lower-extremity lawn mower injuries during this period, the mean age at injury was 5.5 years and Injury Severity Score was 7.2. Most (85%) patients were boys and the predominant type of mower causing injury was a riding lawn mower (96%). Injury occurred in patients who were bystanders in 78%, passengers in 11%, and operators in 11%. Mean length of stay was 12.2 days, and mean time to reconstruction was 7.9 days. Mean number of surgical procedures per patient was 4.1. Amputations occurred in 15 (56%) cases with the most common level of amputation being distal to the metatarsophalangeal joint (67%). Reconstructive procedures ranged from direct closure (41%) to free tissue transfer (7%). Major complications included infection (7%), wound dehiscence (11%), and delayed wound healing (15%). Mean follow up was 23.6 months and 100% of the patients were ambulatory after injury. The subgroup of patients with the most severe injuries, highest number of amputations, and need for overall surgical procedures were patients aged 2 to 5 years. A review of the literature also showed consistent findings. This study demonstrates the danger and morbidity that lawn mowers present to the pediatric population, particularly children aged 2 to 5 years. Every rung of the so-called reconstructive ladder is used in caring for these

A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

Science.gov (United States)

Reid, Eric Justin

2015-01-01

This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

Fifteen years experience: Egyptian metabolic lab

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Ekram M. Fateen

2014-10-01

Conclusion: This study illustrates the experience of the reference metabolic lab in Egypt over 15 years. The lab began metabolic disorder screening by using simple diagnostic techniques like thin layer chromatography and colored tests in urine which by time updated and upgraded the methods to diagnose a wide range of disorders. This study shows the most common diagnosed inherited inborn errors of metabolism among the Egyptian population.

O- centers in LuAG:Ce,Mg ceramics

Czech Academy of Sciences Publication Activity Database

Hu, C.; Liu, S.; Fasoli, M.; Vedda, A.; Nikl, Martin; Feng, X. Q.; Pan, Y.B.

2015-01-01

Roč. 9, č. 4 (2015), s. 245-249 ISSN 1862-6254 R&D Projects: GA ČR GAP204/12/0805 Institutional support: RVO:68378271 Keywords : scintillator * hole center * EPR * LuAG * Ce 3+ Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.578, year: 2015

Occupational toxicant inhalation injury: the World Trade Center (WTC) experience.

Science.gov (United States)

de la Hoz, Rafael E; Shohet, Michael R; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Levin, Stephen M; Herbert, Robin

2008-02-01

Clinical descriptive data is presented on a group of 554 former workers and volunteers (with more than 90 different occupations) at the World Trade Center (WTC) disaster site. A subsample of 168 workers (30% of the group) was selected to examine lower airway disease risk in relation to smoking and WTC exposure variables. Five diagnostic categories clearly predominate: upper airway disease (78.5%), gastroesophageal reflux disease (57.6%), lower airway disease (48.9%), psychological (41.9%) and chronic musculoskeletal illnesses (17.8%). The most frequent pattern of presentation was a combination of the first three of those categories (29.8%). Associations were found between arrival at the WTC site within the first 48 h of the terrorist attack and lower airway and gastroesophageal reflux disease, and between past or present cigarette smoking and lower airway disease. Occupational exposures at the WTC remain consistently associated with a disease profile, which includes five major diagnostic categories. These conditions often coexist in different combinations, which (as expected) mutually enhances their clinical expression, complicates medical management, and slows recovery. Cigarette smoking and early arrival at the WTC site appear to be risk factors for lower airway disease diagnosis.

Lifetime and past-year prevalence of children's exposure to violence in 9 Balkan countries: the BECAN study.

Science.gov (United States)

Nikolaidis, George; Petroulaki, Kiki; Zarokosta, Foteini; Tsirigoti, Antonia; Hazizaj, Altin; Cenko, Enila; Brkic-Smigoc, Jelena; Vajzovic, Emir; Stancheva, Vaska; Chincheva, Stefka; Ajdukovic, Marina; Rajter, Miro; Raleva, Marija; Trpcevska, Liljana; Roth, Maria; Antal, Imola; Ispanovic, Veronika; Hanak, Natasha; Olmezoglu-Sofuoglu, Zeynep; Umit-Bal, Ismail; Bianchi, Donata; Meinck, Franziska; Browne, Kevin

2018-01-01

Children's exposure to violence is a major public health issue. The Balkan epidemiological study on Child Abuse and Neglect project aimed to collect internationally comparable data on violence exposures in childhood. A three stage stratified random sample of 42,194 school-attending children (response rate: 66.7%) in three grades (aged 11, 13 and 16 years) was drawn from schools in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslavian Republic of Macedonia (FYROM), Greece, Romania, Serbia and Turkey. Children completed the ICAST-C questionnaire, which measures children's exposure to violence by any perpetrator. Exposure rates for psychological violence were between 64.6% (FYROM) and 83.2% (Greece) for lifetime and 59.62% (Serbia) and 70.0% (Greece) for past-year prevalence. Physical violence exposure varied between 50.6% (FYROM) and 76.3% (Greece) for lifetime and 42.5% (FYROM) and 51.0% (Bosnia) for past-year prevalence. Sexual violence figures were highest for lifetime prevalence in Bosnia (18.6%) and lowest in FYROM (7.6%). Lifetime contact sexual violence was highest in Bosnia (9.8%) and lowest in Romania (3.6%). Past-year sexual violence and contact sexual violence prevalence was lowest in Romania (5.0 and 2.1%) and highest in Bosnia (13.6 and 7.7% respectively). Self-reported neglect was highest for both past-year and lifetime prevalence in Bosnia (48.0 and 20.3%) and lowest in Romania (22.6 and 16.7%). Experiences of positive parental practices were reported by most participating children in all countries. Where significant differences in violence exposure by sex were observed, males reported higher exposure to past-year and lifetime sexual violence and females higher exposure to neglect. Children in Balkan countries experience a high burden of violence victimization and national-level programming and child protection policy making is urgently needed to address this.

STS-29 crewmembers receive briefing on Student Experiment (SE) 83-9

Science.gov (United States)

1988-01-01

STS-29 Discovery, Orbiter Vehicle (OV) 103, crewmembers receive briefing on Student Experiment (SE) 83-9 Chicken Embryo Development in Space or 'Chix in Space' from student experimenter John C. Vellinger and sponsor Mark S. Deusser. Vellinger (right) explains operation of an incubator used in his experiment to crewmembers, seated around table, and other support personnel in audience. Clockwise from Mission Specialist (MS) Robert C. Springer (hands together at left) are MS James F. Buchli (glasses), Commander Michael L. Coats, Pilot John E. Blaha, MS James P. Bagian, Vellinger, and Deusser. The student's sponsor is Kentucky Fried Chicken (KFC).

New Mexico center for particle physics: Studies of fundmental interactions

International Nuclear Information System (INIS)

1997-01-01

This report summarizes the results of the research program in the New Mexico Center during the last year and presents our program of proposed research for the next year. The majority of the New Mexico Center group's research involves the CDF experiment at the Tevatron pp collider at Fermilab. Our group is a leader in all of the SVX vertex detector upgrades for CDF. These vertex detectors are of critical importance to the pursuit of our physics interests at the Tevatron; they are also an imposing instrumentation challenge. Our group is also deeply involved in several CDF B-physics analyses and in an exotics search. Our research also includes important contributions to R ampersand D for the ATLAS experiment at the LHC

Affiliations of community health centers with the accredited schools and colleges of optometry in the states and territories of the United States.

Science.gov (United States)

2008-10-01

In 2006, the American Optometric Association Community Health Center Committee surveyed schools/colleges of optometry in the United States and its territories to assess collaborations between community health centers and optometric institutions. The survey investigated the number and structure of affiliations that existed between Federally Qualified Health Centers and schools/colleges of optometry in the United States. The survey reached the schools through the American Optometric Association Faculty Relations Committee or personal contact (Inter-American University of Puerto Rico). The survey showed wide variation in affiliations of community health centers with optometry programs. Six schools had no affiliations, whereas the remaining 11 ranged from 1 to 14. Information relating to 37 community health centers was reported. Results showed that schools utilized community health centers for fourth-year students in 5 schools, and both third- and fourth-year students in the remaining 6 schools. Schools vary regarding how precepting is managed with either full-time faculty (64.9%) or adjunct faculty. Business models also vary between schools. Affiliations between school/colleges of optometry and community health centers differ considerably. Optometric affiliations with community health centers can result in increased access to eye care for underserved populations and increased clinical experience for optometry students and residents. Opportunities exist to establish additional affiliations. Educational benefits and costs associated with affiliations should be explored before entering into a collaborative model of eye care delivery.

47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

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I. Suliman

2016-07-01

Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

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M. Doknić

2017-01-01

Full Text Available There are only a few published studies related to the population-based etiology of hypopituitarism. New risks for developing hypopituitarism have been recognized in the last 10 years. Aim. To present data regarding the etiology of hypopituitarism collected in a tertiary center over the last decade. This is a cross-sectional database study. Patients and Methods. We included 512 patients (pts with hypopituitarism, with a mean age of 45.9 ± 1.7 yrs (range: 18–82; male: 57.9%. Results. Nonfunctional pituitary adenomas were presented in 205 pts (40.5%, congenital causes in 74 pts (14.6%, while acromegaly and prolactinomas were presented in 37 (7.2% and 36 (7.0% patients, respectively. Craniopharyngiomas were detected in 30 pts (5.9%, and head trauma due to trauma brain injury-TBI and subarachnoid hemorrhage-SAH in 27 pts (5.4%. Survivors of hemorrhagic fever with renal syndrome (HFRS and those with previous cranial irradiation were presented in the same frequency (18 pts, 3.5% each. Conclusion. The most common causes of hypopituitarism in our database are pituitary adenomas. Increased awareness of the other causes of pituitary dysfunction, such as congenital, head trauma, extrapituitary cranial irradiation, and infections, is the reason for a higher frequency of these etiologies of hypopituitarism in the presented database.

Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

Science.gov (United States)

Pekić, S.; Miljić, D.; Popović, V.; Stojanović, M.; Petakov, M.

2017-01-01

There are only a few published studies related to the population-based etiology of hypopituitarism. New risks for developing hypopituitarism have been recognized in the last 10 years. Aim. To present data regarding the etiology of hypopituitarism collected in a tertiary center over the last decade. This is a cross-sectional database study. Patients and Methods. We included 512 patients (pts) with hypopituitarism, with a mean age of 45.9 ± 1.7 yrs (range: 18–82; male: 57.9%). Results. Nonfunctional pituitary adenomas were presented in 205 pts (40.5%), congenital causes in 74 pts (14.6%), while acromegaly and prolactinomas were presented in 37 (7.2%) and 36 (7.0%) patients, respectively. Craniopharyngiomas were detected in 30 pts (5.9%), and head trauma due to trauma brain injury-TBI and subarachnoid hemorrhage-SAH in 27 pts (5.4%). Survivors of hemorrhagic fever with renal syndrome (HFRS) and those with previous cranial irradiation were presented in the same frequency (18 pts, 3.5% each). Conclusion. The most common causes of hypopituitarism in our database are pituitary adenomas. Increased awareness of the other causes of pituitary dysfunction, such as congenital, head trauma, extrapituitary cranial irradiation, and infections, is the reason for a higher frequency of these etiologies of hypopituitarism in the presented database. PMID:28702053

Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.

Science.gov (United States)

Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan

2017-02-01

The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.

The normal development of proximal humeral epiphyseal ossification center in the first 2 years of life

International Nuclear Information System (INIS)

Kim, Seung Cheol

1998-01-01

The purpose of this study is to ascertain the normal maturation of proximal epiphyseal ossification centers by monthly age during the first years of life. The distribution of age was 0 to 24 months. Six hundred and seventy-five infants were male and 436 were female; their ages were measured in months, and there was no evidence of developmental problems. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs ; if not visualized, they were graded as 0, and otherwise, as follows : grade 1 : visualized with poor margin or a diameter of less than 1/4 of metaphyseal width; grade 2: visualized with good margin or a diameter of more than 1/4 of metaphyseal width; in grade 3 and 4, two ossification centers were visualized. Grade 3 indicated that one ossification center had the morphology of grade 2. Grade 5 indicated that two ossification centers were fused. We then assessed the relationship between the development of an ossification center and monthly age. A proximal humeral epiphyseal ossification center shows regular maturational features according to monthly age. 6 refs., 2 tabs., 5 figs

The Risk of Radiation-Induced Tumors or Malignant Transformation After Single-Fraction Intracranial Radiosurgery: Results Based on a 25-Year Experience

Energy Technology Data Exchange (ETDEWEB)

Pollock, Bruce E., E-mail: pollock.bruce@mayo.edu [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Link, Michael J. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Department of Otorhinolaryngology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Stafford, Scott L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Parney, Ian F. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Garces, Yolanda I.; Foote, Robert L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States)

2017-04-01

Purpose: To determine the risk of radiation-induced tumors or malignant transformation after single-fraction intracranial stereotactic radiosurgery (SRS). Methods and Materials: We performed a retrospective review of 1837 patients who received single-fraction SRS for arteriovenous malformation or benign tumor (meningioma, vestibular schwannoma, pituitary adenoma, glomus tumor) at a single center between 1990 and 2009. Patients were excluded if they refused research authorization (n=31), had a genetic predisposition to tumor development (n=84), received prior or concurrent radiation therapy (n=79), or had less than 5 years of imaging follow-up after SRS (n=501). The median imaging follow-up period for the remaining 1142 patients was 9.0 years (range, 5-24.9 years). Results: No radiation-induced tumors were identified in 11,264 patient-years of follow-up after SRS. The risk of a radiation-induced tumor developing after SRS was 0.0% at 5 years (95% confidence interval [CI], 0.0%-0.4%), 0.0% at 10 years (95% CI, 0.0%-0.9%), and 0.0% at 15 years (95% CI, 0.0%-2.8%). Malignant transformation occurred in 7 of 316 meningioma patients (2.2%) and 1 of 358 vestibular schwannoma patients (0.3%) at a median of 4.9 years (range, 2.8-13.8 years) after SRS. No cases of malignant transformation were noted in patients with pituitary adenomas (n=188) or glomus tumors (n=47). The 5-, 10-, and 15-year risk of malignant transformation was 0.5% (95% CI, 0.0%-0.9%), 0.8% (95% CI, 0.0%-1.8%), and 2.4% (95% CI, 0.0%-5.5%), respectively. Patients who underwent prior resection (hazard ratio, 14.56; 95% CI, 1.79-118.33; P=.01) and who had meningioma pathology (hazard ratio, 11.72; 95% CI, 1.44-96.15; P=.02) were at increased risk of malignant transformation. Conclusions: The risk of radiation-induced tumors or malignant transformation after SRS is very low and should not be used as a justification for choosing alternative treatment approaches (surgical resection, observation) over SRS

The Risk of Radiation-Induced Tumors or Malignant Transformation After Single-Fraction Intracranial Radiosurgery: Results Based on a 25-Year Experience

International Nuclear Information System (INIS)

Pollock, Bruce E.; Link, Michael J.; Stafford, Scott L.; Parney, Ian F.; Garces, Yolanda I.; Foote, Robert L.

2017-01-01

Purpose: To determine the risk of radiation-induced tumors or malignant transformation after single-fraction intracranial stereotactic radiosurgery (SRS). Methods and Materials: We performed a retrospective review of 1837 patients who received single-fraction SRS for arteriovenous malformation or benign tumor (meningioma, vestibular schwannoma, pituitary adenoma, glomus tumor) at a single center between 1990 and 2009. Patients were excluded if they refused research authorization (n=31), had a genetic predisposition to tumor development (n=84), received prior or concurrent radiation therapy (n=79), or had less than 5 years of imaging follow-up after SRS (n=501). The median imaging follow-up period for the remaining 1142 patients was 9.0 years (range, 5-24.9 years). Results: No radiation-induced tumors were identified in 11,264 patient-years of follow-up after SRS. The risk of a radiation-induced tumor developing after SRS was 0.0% at 5 years (95% confidence interval [CI], 0.0%-0.4%), 0.0% at 10 years (95% CI, 0.0%-0.9%), and 0.0% at 15 years (95% CI, 0.0%-2.8%). Malignant transformation occurred in 7 of 316 meningioma patients (2.2%) and 1 of 358 vestibular schwannoma patients (0.3%) at a median of 4.9 years (range, 2.8-13.8 years) after SRS. No cases of malignant transformation were noted in patients with pituitary adenomas (n=188) or glomus tumors (n=47). The 5-, 10-, and 15-year risk of malignant transformation was 0.5% (95% CI, 0.0%-0.9%), 0.8% (95% CI, 0.0%-1.8%), and 2.4% (95% CI, 0.0%-5.5%), respectively. Patients who underwent prior resection (hazard ratio, 14.56; 95% CI, 1.79-118.33; P=.01) and who had meningioma pathology (hazard ratio, 11.72; 95% CI, 1.44-96.15; P=.02) were at increased risk of malignant transformation. Conclusions: The risk of radiation-induced tumors or malignant transformation after SRS is very low and should not be used as a justification for choosing alternative treatment approaches (surgical resection, observation) over SRS

Surgical Management of Renal Cell Carcinoma Extending Into Venous System: A 20-Year Experience.

Science.gov (United States)

Xiao, X; Zhang, L; Chen, X; Cui, L; Zhu, H; Pang, D; Yang, Y; Wang, Q; Wang, M; Gao, C

2017-11-01

The purpose of this study is to report our 20-year experience with the surgical management of renal cell carcinoma extending into the inferior vena cava using a novel classification system. We retrospectively reviewed the data of 103 patients (69 males, 34 females, mean age: 52.9 ± 12.6 years) with renal cell carcinoma involving the venous system treated between 1993 and 2014. The inferior vena cava tumor thrombus was classified into five levels: 0 (renal vein, n = 12), 1 (infrahepatic, n = 33), 2a (low retrohepatic, n = 26), 2b (high retrohepatic, n = 19), and 3 (supradiaphragmatic, n = 13). Clinical data were summarized, and overall survival, cancer-specific survival, and disease-free survival were examined by Cox regression analysis. All patients underwent radical surgery. Complete resections of the renal tumor and thrombus were achieved in 101 patients (98.1%). Two intraoperative and one postoperative in-hospital deaths (2.9%) occurred. In total, 19 patients (18.8%) had a total of 29 postoperative complications. Mean follow-up time was 46 months (range, 1-239 months). The 5- and 10-year overall survival rates were 62.9% and 56.0%, respectively. Metastasis, rather than thrombus level, was a significant risk factor associated with overall survival (hazard ratio = 4.89, 95% confidence interval: 2.24-10.67, p system can be used to select the optimal surgical approach and method for patients with renal cell carcinoma and venous thrombus. Its use is associated with prolonged survival and relatively few complications. Metastasis is an independent risk factor of overall survival.

The Centre de l'Aube repository. The Public Information Center

International Nuclear Information System (INIS)

Fernique, J.C.

1993-01-01

The Centre de l'Aube repository, second French final disposal site for low activity short lived wastes, started operating in january 1992. Since the beginning of the Project public reception and information were among ANDRA's main concern. Open to public one year before disposal operations, the Public Information Center received many visitors coming as well from the regional as from national and international origin. The two years experience will be presented as well as the modifications of the information center taking into account ANDRA's evolution. (author)

Identifying Attrition Risk Based on the First Year Experience

Science.gov (United States)

Naylor, Ryan; Baik, Chi; Arkoudis, Sophia

2018-01-01

Using data collected from a recent national survey of Australian first-year students, this paper defines and validates four scales--belonging, feeling supported, intellectual engagement and workload stress--to measure the student experience of university. These scales provide insights into the university experience for both groups and individual…

Diaphragm and lung-preserving surgery with hyperthermic chemotherapy for malignant pleural mesothelioma: A 10-year experience.

Science.gov (United States)

Ambrogi, Marcello Carlo; Bertoglio, Pietro; Aprile, Vittorio; Chella, Antonio; Korasidis, Stylianos; Fontanini, Gabriella; Fanucchi, Olivia; Lucchi, Marco; Mussi, Alfredo

2018-04-01

The best surgical treatment for malignant pleural mesothelioma is still under a debate, but recent evidence points toward a less-invasive approach to reduce morbidity and mortality. We reported our 10-year experience of a limited surgical approach associated with hyperthermic intrathoracic chemotherapy (HITHOC). Between 2005 and 2014, patients with epithelioid or biphasic malignant pleural mesothelioma were treated with lung-diaphragm-pericardium-sparing pleurectomy associated with double-drug HITHOC; at least 3 cycles of adjuvant chemotherapy were then administered. The primary outcome examined was the feasibility of the procedure, whereas secondary outcomes were overall survival and disease-free interval. Among 49 patients, 41 were male. Median age was 68 years (35-76 years). Histology was epithelioid in 43 cases. Pathologic stage I, II, III, and IV occurred in 12, 14, 20, and 3 cases, respectively. No intraoperative complications or postoperative mortality occurred, whereas morbidity rate was 46.9%. Median hospital stay was 8 days (5-45 days). Actuarial median overall survival was 22 months and a 1-, 2-, and 5-year survival accounted for 79.6%, 45.7%, and 9.9%, respectively. Disease-free survival after surgery was 62%, 37.5%, and 18.5% at 1, 2, and 5 years, respectively. Risk factors analysis for overall survival confirmed a significant role for early stages, epithelioid histology, and fibrinogen serum levels. Cytoreductive surgery associated with HITHOC and adjuvant chemotherapy appears feasible and safe, with no mortality and low morbidity. Preserving lung and diaphragmatic function might warrant an acceptable long-term outcome. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

[Cocaine base paste: experience from the Montevideo Poison Control Center].

Science.gov (United States)

Pascale, Antonio; Negrin, Alba; Laborde, Amalia

2010-01-01

In Uruguay, cocaine base paste (CBP, pasta base) is a widely used form of cocaine. The aim of our study is to determine the main clinical characteristics of CBP abusers. Retrospective, single-center study of consultations at the Montevideo Poison Control Center between January 1, 2004 and December 31, 2005. One hundred and thirteen consultations were included, with an average age of 22 years (+ - 0.5 years) and a female-male sex ratio of 1:4.3. The consultations were related to drug overdose (77%), suicide attempt (16.8%), and wanting to give up CBP use (6.2%). In 48.1% the time elapsed since inhalation of CBP was less than 6 hours. Doses varied between 0.5 gr. and 25 gr. Use of other drugs at the same time, such as alcohol, marijuana or benzodiazepines, was common (51 cases). The symptoms most frequently observed were neuropsychiatric and cardiovascular, followed by respiratory symptoms. In 16.8% of patients, reason for the consultation was intentional acute ingestion of drugs, considered as a suicide attempt, occurring within a few hours of drug consumption. CBP users are mostly young males. Although clinical findings are compatible with those for cocaine abuse, euphoria is a major clinical feature in CBP abusers. The presence of respiratory symptoms reflects the complications associated with the ingestion route. Suicide attempts occurring within a few hours of CBP confirm the high prevalence of suicidal ideation reported by other authors. cocaine base paste, clinical features, suicide attempts.

Development of 9Al2O3{center_dot}2B2O3 whiskers reinforced piston by squeeze casting. Manufacturing process and characteristics of whiskers preform; Squeeze cast ho ni yoru 9Al2O3{center_dot}2B2O3 whisker kyoka piston no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Yamauchi, T; Suzuki, M; Takahashi, M; Takada, I; Toda, M [Suzuki Motor Co. Ltd., Shizuoka (Japan)

1997-10-01

The properties of 9Al2O3 {center_dot} 2B2O3 whisker reinforced aluminum alloy is excellent compared with conventional material at elevated temperatures. 9Al2O3 {center_dot} 2B2O3 whisker reinforced aluminum alloy was applied to the piston head of two cycle engines. This piston was produced by a squeeze casting process with the granulated whiskers preform which was infiltrated by a molten aluminum alloy under high pressure. Since the permeability of the granulated whiskers preform is larger than that of the uniform preform in which whiskers are distributed randomly and uniformly, it became possible to suppress the preform deformation using the developed preform. 7 refs., 8 figs., 2 tabs.

Preimplantation genetic diagnosis for aneuploidy testing in women older than 44 years: a multicenter experience.

Science.gov (United States)

Ubaldi, Filippo Maria; Cimadomo, Danilo; Capalbo, Antonio; Vaiarelli, Alberto; Buffo, Laura; Trabucco, Elisabetta; Ferrero, Susanna; Albani, Elena; Rienzi, Laura; Levi Setti, Paolo E

2017-05-01

To report laboratory and clinical outcomes in preimplantation genetic diagnosis for aneuploidies (PGD-A) cycles for women 44 to 47 years old. Multicenter, longitudinal, observational study. In vitro fertilization (IVF) centers. One hundred and thirty-seven women aged 44.7 ± 0.7 years (range: 44.0-46.7) undergoing 150 PGD-A cycles during April 2013 to January 2016. Quantitative polymerase chain reaction-based PGD-A on trophectoderm biopsies and cryopreserved euploid single-embryo transfer (SET). Primary outcome measure: delivery rate per cycle; secondary outcome measures: miscarriage rate, and the rate and reasons for cycle cancelation with subanalyses for female age and number of metaphase 2 oocytes retrieved. In 102 (68.0%) of 150 cycles blastocyst development was obtained, but only 21 (14.0%) were euploid blastocysts. The overall euploidy rate was 11.8% (22 of 187). Twenty-one SET procedures were performed, resulting in 13 clinical pregnancies, of which 1 miscarried and 12 delivered. The delivery rate was 57.1% per transfer, 8.0% per cycle, and 8.8% per patient. The logistic regression analysis found that only female age (odds ratio 0.78) and number of metaphase 2 oocytes retrieved (odds ratio 1.25) statistically significantly correlated with the likelihood of delivery. The delivery rate per cycle was 10.6% (11 of 104) in patients aged 44.0 to 44.9 years and 2.6% in patients aged 45.0 to 45.9 years (n = 1 of 38). No euploid blastocysts were found for patients older than 45.0 years. Extensive counseling based on biological and clinical data should be provided to women older than 43 years who are requesting IVF because of their very low odds of success and high risk for embryonic aneuploidies. Nevertheless, the low miscarriage and good delivery rates reported in this study in women with good ovarian reserve aged 44 should encourage the use of PGD-A in this population. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc

A Balancing Act: Interpreting Tragedy at the 9/11 Memorial Museum

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Rauch, Noah

2018-01-01

The 9/11 Memorial Museum's docent program offers visitors artifact-based entry-points into a difficult, emotional history. The program's launch raised a host of questions, many centered on how to balance and convey strongly held, often traumatic, and sometimes conflicting experiences with a newly constructed institutional narrative. This article…

Connecticut Children's Medical Center multi-year branding campaign.

Science.gov (United States)

Botvin, J

2000-01-01

As the only children's hospital in the state, Connecticut Children's Medical Center was challenged by the inherent complacency of parents. It met the challenge through a multi-level marketing effort which included television and radio, community outreach and strong media relations. By emphasizing the unique nature of children, the campaign affirms the need for a specialized children's health center.

The Comparison between Teacher Centered and Student Centered Educational Methods

Directory of Open Access Journals (Sweden)

M Anvar

2009-02-01

Full Text Available Background and Purpose: Various approaches to learning are suggested & practiced. The traditional medical education were more teacher centered oriented . In this method the students’ involvement in the process of learning is not remarkable, but the new approach to medical education supports the students involvement. This study evaluated the various method of lecturing considering students involvements.Methods: One hundred two first year medical and nursing students involved in this study and their opinion about these two methods of learning were obtained by filling of a questionnaire. The subject of the lectures was “general psychology” which was carried out 50% by the students and 50% by the teacher. The statistical analysis was carried out by SPSS program.Results: Considering students opinion in student-centered method the various aspect of learning such as mutual understanding, use of textbooks and references were significantly increased , whereasother aspects of learning such as self esteem, study time, innovation, and study attitude though were improved, but were not significant as compared with teacher centered method. In teacher-centeredmethod the understanding of the subjects was significantly increased .Other aspects of learning such as motivation and concentration were improved but not significantly as compared with studentcentered method.Conclusion: As the result showed student centered method was favored in several aspects of learning while in teacher centered method only understanding of the subject was better . Careful choice of teaching method to provide a comprehensive learning experience should take into account these differences.Key words: TEACHER CENTERED, STUDENT CENTERED, LEARNING

PREVALENCE OF PAEDIATRIC DERMATOSES IN THE AGE GROUP OF 5-14 YEARS AT A TERTIARY CARE CENTER IN SALEM

Directory of Open Access Journals (Sweden)

Prasanna Kanniah Baskara

2017-01-01

Full Text Available BACKGROUND Skin diseases in pediatric age group are common all over the world. Pediatric dermatoses require separate view from adult dermatoses as there are differences in their clinical presentation and treatment. OBJECTIVE The aim of our study was to determine the prevalence of pediatric dermatoses attending our tertiary care center. MATERIALS AND METHODS This was a cross-sectional study conducted in 100 consecutive children with dermatoses between 5-14 years of age attending dermatology outpatient department at Vinayaka Missions Kirupananda Variyar medical college, Salem. The study was conducted over a period of 6 months from February 2016 to August 2016. Demographic parameters, detailed history, clinical features and diagnosis were recorded and analyzed. RESULTS In our short term study, we examined 100 pediatric cases with 106 dermatoses. The incidence of infections and infestations (43.39% was more prevalent in our study. The most common non-infectious dermatoses in our study was insect bite reactions (17.9%. Dermatitis and eczema (9.39%, disorders of sweat and sebaceous glands (6.6%, pigmentary disorders (5.66%, disorders of hair and nails (3.77%, genetic disorders (2.88%, immune and allergic disorders (2.8%, psoriasis (2.8%, nutritional disorders (0.9%, Polymorphic light eruption (0.9%, pearly penile papule (0.9%, aphthous ulcer (0.9% and pityriasis rosea (0.9% were the other dermatoses seen in the study.CONCLUSION Fungal infections (tinea versicolor and tinea corporis, scabies and insect bite reactions were the common dermatoses observed in our study. Most of the pediatric patients attending our hospital came from rural areas belonging to low socioeconomic strata. Health education, proper sanitation and improved nutrition will help to reduce the incidence of pediatric dermatoses.

Experience in procurement and processing of heart valves at the Northwest Tissue Center

International Nuclear Information System (INIS)

Strong, M.; O'Neal, P.D.; Gage, H.N.; Moogk, M.

1999-01-01

The Northwest Tissue Center established a human heart valve program in 199 1. It is one of four non-profit tissue banks and one for-profit program that recover and process heart valves in the United States. During the eight years in which the Northwest Tissue Center has been involved in heart valve banking, there have been a total of 673 hearts procured for processing. The age of the donors ranged from <1 to 44 years with a mean of 26.2 years, 66% werw male,and 6.5% of the hearts procered were discarded due to a variety of medical and criteria reason. The primary reasons for differal were questions of possible cancer and questions of high risk behavior/social history. Of the 1,264 cardiovascular tissues processed, 6% were lost because of donor history, 17% were lost because of microbiology results, and 5% were lost because of donor serology . There were total a total of 190 aortic valves and 48 pulmonic conduits transplanted over this time period. The mean age of the recipients was 23.4 with a median or 23 years; 102 of the recipients were less than one year of age. Males comprised 62% of the recipients. Since 1993, there has been a clear shift towards more use of pulmonic valves over aortic valves as a results of the acceptance of the Ross procedure. Early in the program, reports were received from surgeons that some heart valves appeared to have cracks in the conduits. Experimentations in the laboratory led to the discovery that thawing too rapidly would result in cracking of these materials. Packaging was designed to reduce the rate of thawing and this has resolved the problem with cracking. The heart valve program at the Northwest Tissue Center has been very successful in providing the necessary valves for patients in the Northwest Region of the United States

Lessons Learned (3 Years of H2O2 Propulsion System Testing Efforts at NASA's John C. Stennis Space Center)

Science.gov (United States)

Taylor, Gary O.

2001-01-01

John C. Stennis Space Center continues to support the Propulsion community in an effort to validate High-Test Peroxide as an alternative to existing/future oxidizers. This continued volume of peroxide test/handling activity at Stennis Space Center (SSC) provides numerous opportunities for the SSC team to build upon previously documented 'lessons learned'. SSC shall continue to strive to document their experience and findings as H2O2 issues surface. This paper is intended to capture all significant peroxide issues that we have learned over the last three years. This data (lessons learned) has been formulated from practical handling, usage, storage, operations, and initial development/design of our systems/facility viewpoint. The paper is intended to be an information type tool and limited in technical rational; therefore, presenting the peroxide community with some issues to think about as the continued interest in peroxide evolves and more facilities/hardware are built. These lessons learned are intended to assist industry in mitigating problems and identifying potential pitfalls when dealing with the requirements for handling high-test peroxide.

Large block migration experiments: INTRAVAL phase 1, Test Case 9

Energy Technology Data Exchange (ETDEWEB)

Gureghian, A.B.; Noronha, C.J. (Battelle, Willowbrook, IL (USA). Office of Waste Technology Development); Vandergraaf, T.T. (Atomic Energy of Canada Ltd., Ottawa, ON (Canada))

1990-08-01

The development of INTRAVAL Test Case 9, as presented in this report, was made possible by a past subsidiary agreement to the bilateral cooperative agreement between the US Department of Energy (DOE) and Atomic Energy of Canada Limited (AECL) encompassing various aspects of nuclear waste disposal research. The experimental aspect of this test case, which included a series of laboratory experiments designed to quantify the migration of tracers in a single, natural fracture, was undertaken by AECL. The numerical simulation of the results of these experiments was performed by the Battelle Office of Waste Technology Development (OWTD) by calibrating an in-house analytical code, FRACFLO, which is capable of predicting radionuclide transport in an idealized fractured rock. Three tracer migration experiments were performed, using nonsorbing uranine dye for two of them and sorbing Cs-137 for the third. In addition, separate batch experiments were performed to determine the fracture surface and rock matrix sorption coefficients for Cs-137. The two uranine tracer migration experiment were used to calculate the average fracture aperture and to calibrate the model for the fracture dispersivity and matrix diffusion coefficient. The predictive capability of the model was then tested by simulating the third, Cs-137, tracer test without changing the parameter values determined from the other experiments. Breakthrough curves of both the experimental and numerical results obtained at the outlet face of the fracture are presented for each experiment. The reported spatial concentration profiles for the rock matrix are based solely on numerical predictions. 22 refs., 12 figs., 8 tabs.

Interior renovation of a general practitioner office leads to a perceptual bias on patient experience for over one year.

Science.gov (United States)

Gauthey, Jérôme; Tièche, Raphaël; Streit, Sven

2018-01-01

Measuring patient experience is key when assessing quality of care but can be biased: A perceptual bias occurs when renovations of the interior design of a general practitioner (GP) office improves how patients assessed quality of care. The aim was to assess the length of perceptual bias and if it could be reproduced after a second renovation. A GP office with 2 GPs in Switzerland was renovated twice within 3 years. We assessed patient experience at baseline, 2 months and 14 months after the first and 3 months after the second renovation. Each time, we invited a sample of 180 consecutive patients that anonymously graded patient experience in 4 domains: appearance of the office; qualities of medical assistants and GPs; and general satisfaction. We compared crude mean scores per domain from baseline until follow-up. In a multivariate model, we adjusted for patient's age, gender and for how long patients had been their GP. At baseline, patients aged 60.9 (17.7) years, 52% females. After the first renovation, we found a regression to the baseline level of patient experience after 14 months except for appearance of the office (pInterior renovation of a GP office probably causes a perceptual bias for >1 year that improves how patients rate quality of care. This bias could be reproduced after a second renovation strengthening a possible causal relationship. These findings imply to appropriately time measurement of patient experience to at least one year after interior renovation of GP practices to avoid environmental changes influences the estimates when measuring patient experience.

Macronutrients Association with Change in Waist and Hip Circumference Over 9 Years.

Science.gov (United States)

Lofley, Amy C; Root, Martin M

2017-01-01

The calorie distribution of macronutrients affects individuals' health. Quantity and source of macronutrients may play major roles in waist circumference (WC) and hip circumference (HC). This study's purpose is to investigate the association between the quantity and source of macronutrients and the change in WC and HC over 9 years. Participants (N = 11,343) were from the Atherosclerosis Risk in Community Study. Those diagnosed with cancer or a decrease in WC or HC of 15 cm or more over 9 years were excluded. Change scores were created for anthropometrics between clinic visits over 9 years. Macronutrient intakes were assessed by a food frequency questionnaire at visit 1 and presented as a percentage of energy intake. Linear regressions were performed with quartiles of dietary components on change scores for WC and HC with controlling cofactors. Gender subgroup analysis was performed. A larger increase in WC was associated with higher intakes of total carbohydrates, dietary fiber, and fructose (p for trend Macronutrient source and quantity play a significant role in individuals' adiposity and effects on WC and HC. Overall, an increase in WC and HC was seen over the 11 years. The source and quantity of the macronutrients play a significant role in WC and HC. Further research needs to be conducted to see the exact effect that macronutrients play on WC and HC.

Single center experience with percutaneous and laparoscopic cryoablation of small renal masses.

Science.gov (United States)

Malcolm, John B; Berry, Tristan T; Williams, Michael B; Logan, Joshua E; Given, Robert W; Lance, Raymond S; Barone, Bethany; Shaves, Sarah; Vingan, Harlan; Fabrizio, Michael D

2009-06-01

While partial nephrectomy remains the gold standard for the management of most small renal masses, increasing experience with renal cryoablation has suggested a viable alternative with a favorable morbidity profile and good efficacy. We report intermediate-term oncologic outcomes from a single-center experience with laparoscopic and percutaneous renal cryoablation. We performed a retrospective review of our laparoscopic renal cryoablation (LRC) and percutaneous renal cryoablation (PRC) experience between January 2003 and April 2007. Patients with at least 12 months of follow-up were included in the analysis. Follow-up consisted of imaging and laboratory studies at regular intervals. Persistent mass enhancement or interval tumor growth was considered a treatment failure. Sixty-six patients (44% women/56% men; 42% African-American/58% Caucasian/other; mean body mass index, 29.7) with 72 tumors underwent either LRC (n = 52) or PRC (n = 20) with a mean follow-up of 30 months (median 25.1 mos; range 13-63 mos). Average patient age was 66.5 years (range 34-82 yrs). Mean tumor size was 2.33 cm (range 1-4.6 cm). Comorbid conditions were prevalent: 76% hypertension, 36% hyperlipidemia, 24% chronic kidney disease, 29% diabetes mellitus, 36% tobacco use, and 32% heart disease. RESULTS of pretreatment biopsy were 62% renal-cell carcinoma and 38% benign or nondiagnostic. Overall cancer-specific and cancer-free survival were 100% and 97%, respectively. There were two treatment failures (3.8%) in the LRC group and five primary failures in the PRC group (25%) (P = 0.015), four of which were salvaged with repeated PRC with no evidence of recurrence at 6 to 36 months of follow-up. There has been no significant local or metastatic progression. LRC and PRC achieved good oncologic control with minimal morbidity at a mean follow-up of 30 months in a patient cohort characterized by numerous comorbid conditions. PRC had a significantly higher primary treatment failure rate than LRC, but

Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience

International Nuclear Information System (INIS)

Cutuli, Bruno; Cohen-Solal-le Nir, Christine; Lafontan, Brigitte de; Mignotte, Herve; Fichet, Virginie; Fay, Renaud; Servent, Veronique; Giard, Sylvia; Charra-Brunaud, Claire; Lemanski, Claire; Auvray, Hugues; Jacquot, Stephane; Charpentier, Jean-Christophe

2002-01-01

Purpose: To assess the long-term outcome for women with ductal carcinoma in situ of the breast treated in current clinical practice by conservative surgery with or without definitive breast irradiation. Methods and Materials: We analyzed 705 cases of ductal carcinoma in situ treated between 1985 and 1995 in nine French regional cancer centers; 515 underwent conservative surgery and radiotherapy (CS+RT) and 190 CS alone. The median follow-up was 7 years. Results: The 7-year crude local recurrence (LR) rate was 12.6% (95% confidence interval [CI] 9.4-15.8) and 32.4% (95% CI 25-39.7) for the CS+RT and CS groups, respectively (p<0.0001). The respective 10-year results were 18.2% (95% CI 13.3-23) and 43.8% (95% CI 30-57.7). A total of 125 LRs occurred, 66 and 59 in the CS+RT and CS groups, respectively. Invasive or microinvasive LRs occurred in 60.6% and 52% of the cases in the same respective groups. The median time to LR development was 55 and 41 months. Nine (1.7%) and 6 (3.1%) nodal recurrences occurred in the CS+RT and CS groups, respectively. Distant metastases occurred in 1.4% and 3% of the respective groups. Patient age and excision quality (final margin status) were both significantly associated with LR risk in the CS+RT group: the LR rate was 29%, 13%, and 8% among women aged ≤40, 41-60, and ≥61 years (p<0.001). Even in the case of complete excision, we observed a 24% rate of LR (6 of 25) in women <40 years. Patients with negative, positive, or uncertain margins had a 7-year crude LR rate of 9.7%, 25.2%, and 12.2%, respectively (p=0.008). RT reduced the LR rate in all subgroups, especially in those with comedocarcinoma (17% vs. 59% in the CS+RT and CS groups, respectively, p<0.0001) and mixed cribriform/papillary tumors (9% vs. 31%, p<0.0001). In the multivariate Cox regression model, young age and positive margins remained significant in the CS+RT group (p=0.00012 and p=0.016). Finally, the relative LR risk in the CS+RT group compared with the CS group

Scientific and technical information output of the Langley Research Center for calendar year 1984

Science.gov (United States)

1985-01-01

The scientific and technical information that the Langley Research Center produced during the calendar year 1984 is compiled. Approximately 1650 citations are included comprising formal reports, quick-release technical memorandums, contractor reports, journal articles and other publications, meeting presentations, technical talks, computer programs, tech briefs, and patents.

Rumination, Age, and Years of Experience: A Predictive Study of Burnout

Science.gov (United States)

McDuffy, Moriel S.

2016-01-01

This study used a non-experimental design to examine whether job satisfaction, rumination, age and years of experience predict burnout among human service workers serving high-risk populations. The study also used a stepwise regression to assess whether job satisfaction, rumination, age, or years of experience predict burnout equally. Burnout was…

Books, Read-Alouds, and Voluntary Book Interactions: What Do We Know about Centers Serving Three-Year-Olds?

Science.gov (United States)

Mesmer, Heidi Anne

2018-01-01

This study examined the quality of books, the quality of read-alouds, and children's voluntary interactions with books in childcare centers serving low-income 3-year-olds (N = 30). Although a large percentage of centers had book areas, the features of book areas differed. The highest percentage of books was highly recommended and appropriate (39%)…

A 9-year follow-up of a self-management group intervention for persistent neck pain in primary health care: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Gustavsson C

2016-12-01

Full Text Available Catharina Gustavsson,1,2 Lena von Koch1,3,4 1Center for Clinical Research Dalarna, Department of Public Health and Caring Science, Uppsala University, Uppsala, 2School of Education, Health and Social Studies, Dalarna University, Falun, 3Department of Neurobiology, Care Science and Society, Karolinska Institutet, 4Department of Neurology, Karolinska University Hospital, Stockholm, Sweden Background and objective: In previous short-term and 2-year follow-ups, a pain and stress self-management group intervention (PASS had better effect on pain-related disability, self-efficacy, catastrophizing, and perceived pain control than individually administered physiotherapy (IAPT for patients with persistent tension-type neck pain. Studies that have evaluated long-term effects of self-management approaches toward persistent neck pain are sparse. The objective of this study was to compare pain-related disability, self-efficacy for activities of daily living (ADL, catastrophizing, pain, pain control, use of analgesics, and health care utilization in people with persistent tension-type neck pain 9 years after they received the PASS or IAPT. Materials and methods: Of 156 people (PASS, n = 77; IAPT, n = 79 originally included in a randomized controlled trial, 129 people (PASS, n = 63; IAPT, n = 66 were eligible and were approached for the 9-year follow-up. They were sent a self-assessment questionnaire, comprising the Neck Disability Index, the Self-Efficacy Scale, the Coping Strategies Questionnaire, and questions regarding pain, analgesics, and health care utilization. Mixed linear models for repeated measures analysis or generalized estimating equations were used to evaluate the differences between groups and within groups over time (baseline, previous follow-ups, and 9-year follow-up and the interaction effect of “time by group”. Results: Ninety-four participants (73% responded (PASS, n = 48; IAPT, n = 46. At 9 years, PASS participants reported less

Annual report of Tokyo Metropolitan Isotope Research Center, fiscal year 1994

International Nuclear Information System (INIS)

1995-01-01

This Research Center was founded in 1959, and has carried out the research, test and guidance regarding industry, agriculture and fishry, medical treatment, environment preservation and radiation protection by utilizing the merits of radiation and based on the needs of the age, thus obtained good results. Recently, by the adoption of an ion accelerator, the application to advanced technology such as ion implantation has been tried, and the development of advanced measurement technology using PIXE and RBS has been carried out. In fiscal year 1994, the results have been obtained in the research 'Development of the method of evaluating the nobility of noble metal products by nondestructive inspection'. Also the research on the development of the technology for utilizing the ion accelerator was started. The researches on making radiation breeding of Chinese cabbage efficient and the business of technically supporting the activation of medium and small enterprises were advanced. The history, organization and budget of this Research Center, the reports of research and investigation, safety control, the publication of research, events and others are reported. (K.I.)

Geriatric Trauma Patients With Cervical Spine Fractures due to Ground Level Fall: Five Years Experience in a Level One Trauma Center.

Science.gov (United States)

Wang, Hao; Coppola, Marco; Robinson, Richard D; Scribner, James T; Vithalani, Veer; de Moor, Carrie E; Gandhi, Raj R; Burton, Mandy; Delaney, Kathleen A

2013-04-01

It has been found that significantly different clinical outcomes occur in trauma patients with different mechanisms of injury. Ground level falls (GLF) are usually considered "minor trauma" with less injury occurred in general. However, it is not uncommon that geriatric trauma patients sustain cervical spine (C-spine) fractures with other associated injuries due to GLF or less. The aim of this study is to determine the injury patterns and the roles of clinical risk factors in these geriatric trauma patients. Data were reviewed from the institutional trauma registry of our local level 1 trauma center. All patients had sustained C-spine fracture(s). Basic clinical characteristics, the distribution of C-spine fracture(s), and mechanism of injury in geriatric patients (65 years or older) were compared with those less than 65 years old. Furthermore, different clinical variables including age, gender, Glasgow coma scale (GCS), blood alcohol level, and co-existing injuries were analyzed by multivariate logistic regression in geriatric trauma patients due to GLF and internally validated by random bootstrapping technique. From 2006 - 2010, a total of 12,805 trauma patients were included in trauma registry, of which 726 (5.67%) had sustained C-spine fracture(s). Among all C-spine fracture patients, 19.15% (139/726) were geriatric patients. Of these geriatric patients 27.34% (38/139) and 53.96% (75/139) had C1 and C2 fractures compared with 13.63% (80/587) and 21.98% (129/587) in young trauma patients (P geriatric trauma patients 13.67% (19/139) and 18.71% (26/139) had C6 and C7 fractures compared with 32.03% (188/587) and 41.40% (243/587) in younger ones separately (P geriatric patients had sustained C-spine fractures due to GLF with more upper C-spine fractures (C1 and C2). Only 3.2% of those had positive blood alcohol levels compared with 52.9% of younger patients (P geriatric patients due to GLF had intracranial pathology (ICP) which was one of the most common co

Outcomes of Solo Smart valve in a single-center experience of 270 patients.

Science.gov (United States)

Liu, Hao; Khani-Hanjani, Abbas; Yang, Siyuan; Wang, Wei; Sidhu, Surita; Mullen, John; Modry, Dennis; Wang, Shaohua

2018-04-03

The Solo Smart pericardial aortic valve has been widely used in Europe as an option for aortic valve replacement (AVR). We are reporting early and midterm clinical outcomes of AVR with the Solo Smart valve in a single North America center. This is a retrospective study of 270 consecutive patients who had AVR at Mazankowski Alberta Heart Institute from February 2011 to March 2015. Follow-up and echocardiographic data were collected retrospectively from electronic and paper charts. Univariate and multivariate analysis were performed to evaluate the results. The mean age was 71.2±10.0 years, 67.4% were male, and 79.3% had combined procedures. Mean STS Score was 4.18±3.91. Early mortality was 3.7% for the entire group and 0% for isolated aortic valve replacement group. Mean cross-clamp time for isolated AVR and AVR with concomitant procedure was 70.8±12.7min and 117.0±45.0min, respectively. Permanent pacemaker implantation was necessary in 2.2% of patients. Echocardiography demonstrated a reduction in mean gradients from 40.8±17.4mmHg to 7.6±3.7 mmHg and peak gradient from 72.5 ± 48.8 mmHg to 15.5±7.5 mmHg. The 1-, 3-, and 5- year overall survival was 93.0%, 86.5% and 75.9%, respectively. At 5 years, freedom from valve-related death was 92.4%, freedom from structural valve deterioration and freedom from aortic valve reoperation were 96.4% and 98%, respectively. The Solo Smart valve is safe and has excellent hemodynamic performance. Aortic valve reoperation and rates of valve-related adverse events during midterm follow-up were low.

The International Science and Technology Center (ISTC) - Fifteen-Year Experience in Management of Innovative Nuclear and Other Programs (Information Review)

Energy Technology Data Exchange (ETDEWEB)

Gudowski, W.; Tocheny, L.V. [ISTC - International Science and Technology Center, Krasnoproletarskaya 32-34, PO Box 20, 127473 Moscow (Russian Federation)

2009-06-15

projects: - Are managing internationally; - Have plans and results, available for international collaborators; - Results may be passed to international centers (OECD/NEA and/or others) for further international benchmarking. As for today - a set of demonstration and basic-type experiments, which fit closely with IAEA/ INPRO and GIF program, with EU Frame-Work programs, - had been done or under development now in the frame of ISTC projects and programs with active international collaboration. The ISTC - as a unique international tool - is ready to take part and manage further this activity. Among five thousand project proposals submitted to ISTC, there are about five hundred related to different aspects of nuclear technologies and Nuclear Fuel Cycle (NFC). Survey of the ISTC project results: The following information will be included in the review, with special attention on details of corresponding experimental programs: - Novel reactor concepts, corresponding to GIF: - Fast reactors (Sodium-, Lead-and Lead-Bismuth-cooled); - Supercritical Pressure Water aspects; - HTGR - critical modeling, engineering. - Molten salts. - Nuclear Fuel Cycle options (including Partitioning and Transmutation). - Reactor data benchmarking and verification, critical experiments. - Nuclear Power Plant life management (Reactor pressure vessel and internals control, etc.). - Nuclear data measurements. - Severe accident study (Corium modelling, Quench-effect, Chernobyl). - Sky-shine experiments. - Depleted Uranium for RAW storage. - Technical and economical analysis of NFC, including non-proliferation issues. - Novel reactor engineering systems - experimental and computer modelling (steam-generators, etc.). - Accelerator Driven Systems (experimental modeling). References: The ISTC Annual Reports - ISTC, Moscow, 1996 - 2007. Web-site: www.istcinfo.ru. (authors)

Center for Coastline Security Technology, Year-2

National Research Council Canada - National Science Library

Glegg, Stewart; Glenn, William; Furht, Borko; Beaujean, P. P; Frisk, G; Schock, S; VonEllenrieder, K; Ananthakrishnan, P; An, E; Granata, R

2007-01-01

...), the Imaging Technology Center, the Department of Computer Science and Engineering, and the University Consortium for Intermodal Transportation Safety and Security at Florida Atlantic University...

Dangers faced by emergency staff: experience in urban centers in southern Turkey.

Science.gov (United States)

Gülalp, Betül; Karcioğlu, Ozgür; Köseoğlu, Zikret; Sari, Azade

2009-05-01

The aim of this study was to investigate the incidence and characteristics of aggression, threat and physical violence directed towards the staff in emergency departments. A questionnaire was completed by the emergency staff. The individualized data collected included the pattern and incidence of violence, sex, age, profession, and years of experience of the emergency staff, and the behavioral characteristics of the assailants, together with outcome of incidents. Data regarding incidences occurring between May 1-31, 2006 were abstracted. A total of 109 staff were evaluated. There was a statistically significant relationship between aggression and profession (p=0.000), but no relation was determined with sex, age or years of experience (p values 0.464, 0.692, and 0.298, respectively). The relationship of incidences of threat with sex, age, profession, and experience was insignificant (p values 0.311, 0.278, 0.326, 0.994, respectively). On the other hand, significant relationships were identified between physical assault and sex, age, profession, and experience (p values 0.042, 0.000, 0.000, 0.011). Violence directed towards the emergency staff is common. Aggression occurs towards the emergency physician distinctively. Otherwise, there is no significant relationship between aggression or threat and personal characteristics. However, male sex, > or =31 years of age, being an emergency physician, and having worked for longer than five years in the emergency department are the risk factors for physical violence.

Center for Momentum Transport and Flow Organization (CMTFO). Final technical report

International Nuclear Information System (INIS)

Tynan, George R.; Diamond, P. H.; Ji, H.; Forest, C. B.; Terry, P. W.; Munsat, T.; Brummell, N.

2013-01-01

The Center for Momentum Transport and Flow Organization (CMTFO) is a DOE Plasma Science Center formed in late 2009 to focus on the general principles underlying momentum transport in magnetic fusion and astrophysical systems. It is composed of funded researchers from UCSD, UW Madison, U. Colorado, PPPL. As of 2011, UCSD supported postdocs are collaborating at MIT/Columbia and UC Santa Cruz and beginning in 2012, will also be based at PPPL. In the initial startup period, the Center supported the construction of two basic experiments at PPPL and UW Madison to focus on accretion disk hydrodynamic instabilities and solar physics issues. We now have computational efforts underway focused on understanding recent experimental tests of dynamos, solar tachocline physics, intrinsic rotation in tokamak plasmas and L-H transition physics in tokamak devices. In addition, we have the basic experiments discussed above complemented by work on a basic linear plasma device at UCSD and a collaboration at the LAPD located at UCLA. We are also performing experiments on intrinsic rotation and L-H transition physics in the DIII-D, NSTX, C-Mod, HBT EP, HL-2A, and EAST tokamaks in the US and China, and expect to begin collaborations on K-STAR in the coming year. Center funds provide support to over 10 postdocs and graduate students each year, who work with 8 senior faculty and researchers at their respective institutions. The Center has sponsored a mini-conference at the APS DPP 2010 meeting, and co-sponsored the recent Festival de Theorie (2011) with the CEA in Cadarache, and will co-sponsor a Winter School in January 2012 in collaboration with the CMSO-UW Madison. Center researchers have published over 50 papers in the peer reviewed literature, and given over 10 talks at major international meetings. In addition, the Center co-PI, Professor Patrick Diamond, shared the 2011 Alfven Prize at the EPS meeting. Key scientific results from this startup period include initial simulations of the

Center for Momentum Transport and Flow Organization (CMTFO). Final technical report

Energy Technology Data Exchange (ETDEWEB)

Tynan, George R. [University of California, San Diego, CA (United States); Diamond, P. H. [University of California, San Diego, CA (United States); Ji, H. [Princeton Plasma Physics Lab., NJ (United States); Forest, C. B. [Univ. of Wisconsin, Madison, WI (United States); Terry, P. W. [Univ. of Wisconsin, Madison, WI (United States); Munsat, T. [Univ. of Colorado, Boulder, CO (United States); Brummell, N. [Univ. of California, Santa Cruz (United States)

2013-07-29

The Center for Momentum Transport and Flow Organization (CMTFO) is a DOE Plasma Science Center formed in late 2009 to focus on the general principles underlying momentum transport in magnetic fusion and astrophysical systems. It is composed of funded researchers from UCSD, UW Madison, U. Colorado, PPPL. As of 2011, UCSD supported postdocs are collaborating at MIT/Columbia and UC Santa Cruz and beginning in 2012, will also be based at PPPL. In the initial startup period, the Center supported the construction of two basic experiments at PPPL and UW Madison to focus on accretion disk hydrodynamic instabilities and solar physics issues. We now have computational efforts underway focused on understanding recent experimental tests of dynamos, solar tachocline physics, intrinsic rotation in tokamak plasmas and L-H transition physics in tokamak devices. In addition, we have the basic experiments discussed above complemented by work on a basic linear plasma device at UCSD and a collaboration at the LAPD located at UCLA. We are also performing experiments on intrinsic rotation and L-H transition physics in the DIII-D, NSTX, C-Mod, HBT EP, HL-2A, and EAST tokamaks in the US and China, and expect to begin collaborations on K-STAR in the coming year. Center funds provide support to over 10 postdocs and graduate students each year, who work with 8 senior faculty and researchers at their respective institutions. The Center has sponsored a mini-conference at the APS DPP 2010 meeting, and co-sponsored the recent Festival de Theorie (2011) with the CEA in Cadarache, and will co-sponsor a Winter School in January 2012 in collaboration with the CMSO-UW Madison. Center researchers have published over 50 papers in the peer reviewed literature, and given over 10 talks at major international meetings. In addition, the Center co-PI, Professor Patrick Diamond, shared the 2011 Alfven Prize at the EPS meeting. Key scientific results from this startup period include initial simulations of the

The Great Recession and Behavior Problems in 9-Year Old Children

Science.gov (United States)

Schneider, William; Waldfogel, Jane; Brooks-Gunn, Jeanne

2015-01-01

This article examines associations between the Great Recession and 4 aspects of 9-year olds' behavior--aggression (externalizing), anxiety/depression (internalizing), alcohol and drug use, and vandalism-using the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort drawn from 20 U.S. cities (21% White, 50% Black, 26% Hispanic,…

Unusual bilaterally fused teeth in permanent dentition of a 9 -year ...

African Journals Online (AJOL)

The presence of bilateral fusion of teeth in permanent dentition is an unusual and rare condition. It is a developmental anomaly characterized by the union of two separate tooth germs during formation. The case of a 9 year old boy with fusion of permanent maxillary central incisors with associated bilateral disto-palatal ...

Scientific and technical information output of the Langley Research Center for Calendar Year 1985

Science.gov (United States)

1986-01-01

A compilation of the scientific and technical information that the Langley Research Center has produced during the calendar year 1985 is presented. Included are citations for Formal Reports, Quick-Release Technical Memorandums, Contractor Reports, Journal Articles and Other Publications, Meeting Presentations, Technical Talks, Computer Programs, Tech Briefs, and Patents.

Center for Applied Linguistics, Washington DC, USA

Science.gov (United States)

Sugarman, Julie; Fee, Molly; Donovan, Anne

2015-01-01

The Center for Applied Linguistics (CAL) is a private, nonprofit organization with over 50 years' experience in the application of research on language and culture to educational and societal concerns. CAL carries out its mission to improve communication through better understanding of language and culture by engaging in a variety of projects in…

NOAA-9 Earth Radiation Budget Experiment (ERBE) scanner offsets determination

Science.gov (United States)

Avis, Lee M.; Paden, Jack; Lee, Robert B., III; Pandey, Dhirendra K.; Stassi, Joseph C.; Wilson, Robert S.; Tolson, Carol J.; Bolden, William C.

1994-01-01

The Earth Radiation Budget Experiment (ERBE) instruments are designed to measure the components of the radiative exchange between the Sun, Earth and space. ERBE is comprised of three spacecraft, each carrying a nearly identical set of radiometers: a three-channel narrow-field-of-view scanner, a two-channel wide-field-of-view (limb-to-limb) non-scanning radiometer, a two-channel medium field-of view (1000 km) non-scanning radiometer, and a solar monitor. Ground testing showed the scanners to be susceptible to self-generated and externally generated electromagnetic noise. This paper describes the pre-launch corrective measures taken and the post-launch corrections to the NOAA-9 scanner data. The NOAA-9 scanner has met the mission objectives in accuracy and precision, in part because of the pre-launch reductions of and post-launch data corrections for the electromagnetic noise.

Epidemiology of chronic renal failure in Iran: A four year single center experience

International Nuclear Information System (INIS)

Afshar, R.; Sanavi, S.; Salimi, J.

2007-01-01

Chronic renal failure (CRF) is a major public health problem. Early diagnosis and proper management have important roles in prevention of CRF progression to end-stage renal disease (ESRD). For this purpose, determining the etiology of CRF may be helpful. This study was conducted in the nephrology department at the Mostafa Khomeini Hospital in Tehran, Iran from March 2001 to March 2005, to determine the etiology of CRF in adult Iranian patients. A total of 1200 patients with a diagnosis of CRF were involved in the study. Relevant data were collected using a reliable questionnaire. All data analyses were carried out using SPSS and the x2 test. Of the 1200 patients, 61% were males and 39% females. The most frequent age group was 61-75 years (38.3%) and the mean age of study patients was 51.6 +- 17 years. The etiology of CRF in our series included diabetes mellitus in 26.8%, hypertension in 13.5%, obstructive uropathy in 12%, cystic and congenital disorders in 10.3%, glomerulonephritis in 6.5%, urinary tract infections in 4%, vasculitis in 2%, tubulo-interstitial nephritis and pregnancy related in 0.8% each and unknown causes in 29.5% of the patients. Laboratory and ultrasonographic assessment at initiation of the study revealed blood urea nitrogen >100 mg/dl in 57.8% of the patients, serum creatinine >10mg/dl in 40.3%, glomerular filtration rate (GFR) < 10ml/min in 61.3%, hemoglobin < 10 g/dl in 65.8% and kidney size lesser than 8 cm in 46% of the cases. There was a significant statistical relationship between kidney size and duration of hypertension greater than five years (P=0.017). The high frequency of CRF of unknown etiology in this study may be attributed to diagnostic limitations prevailing in our country. A GFR of < 10 ml/min in 61.3% of these cases at presentation suggests late diagnosis/ and/or referral. Aggressive screening and treatment strategies to prevent ESRD are recommended. (author)

Outcomes of kidney transplant tourism in children: a single center experience.

Science.gov (United States)

Majid, Abdul; Al Khalidi, Lina; Ahmed, Bushra Q; Opelz, Gerhard; Schaefer, Franz

2010-01-01

Transplant tourism is a necessity for children with end-stage renal disease living in regions without established local transplantation programs. The use of kidneys from living unrelated donors (LURDs) was common practice in Asia prior to the recent global condemnation of commercial organ transplantation. Objective information on the outcomes of pediatric transplant tourism is scarce. Here, we report the Dubai experience with 45 renal allograft transplantations performed outside the United Arab Emirates (UAE) between 1993 and 2009. Transplantation from 33 LURDs, ten living related donors (LRDs) and two deceased donors was performed in 14 different countries. The mean number of human leukocyte antigen (HLA) A/B/DR allele matches was 1.4 +/- 0.8 in the LURD graft recipients and 3.9 +/- 0.7 in the LRD recipients. Outcomes were compared with those of a matched group of 3,150 pediatric LRD transplantations from the Collaborative Transplant Study (CTS). Ten-year patient survival was 100% in the LRD patients, 91.2% in the LURD patients, and 92% in the CTS patients. The three deaths in the LURD group occurred within the first 4 months after transplantation and were related to acute rejection. One-year and 10-year graft survival was 100% in the LRD group and 94.8% and 66.7% in the CTS-LRD groups, vs 87.8% and 43.4% in the LURD group. Major viral infections [Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella zoster (VZV)] were four-times more common in patients that had received LURD grafts than in those that had received LRD grafts. In conclusion, whereas LRD kidney transplantation performed abroad yields excellent long-term results, transplantation of LURD kidneys is fraught with a high complication rate affecting graft and even early patient survival.

Stent-assisted coil embolization of intracranial aneurysms: a single center experience.

Science.gov (United States)

Luo, Chao-Bao; Teng, Michael Mu-Huo; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo; Chang, Cheng-Yen

2012-07-01

Endovascular detachable coil embolization has become an important method in the management of intracranial aneurysms. However, coil embolization alone may fail to treat some wide-neck aneurysms. Herein, we report our experience with and outcome of stent-assisted coil embolization (SACE) of intracranial aneurysms. Over a 5-year period, a total of 59 patients diagnosed with 63 intracranial aneurysms underwent SACE. Of the total 63 aneurysms, 6 aneurysms were treated by SACE as a salvageable procedure because of coil instability after detachment. There were 17 men and 42 women enrolled in the study, with ages ranging from 24 to 86 years (mean: 60 years). We retrospectively assessed the clinical data, aneurysm characteristics, and angiographic and clinical outcomes of all patient cases. The mean aneurysm size was 9.4 mm, and the mean neck size was 5.5 mm. Clinical and angiographic follow-up exceeding 6 months were available in 51 and 40 patients, respectively. The mean clinical follow-up time was 28 months (range: 6-49 months). Successful stent deployment was found in 60 aneurysms (95%). Midterm total or subtotal angiographic aneurismal occlusion was obtained in 56 aneurysms (89%), with further thrombosis of the aneurismal sac occurring in 4 (10%). Stable coiling aneurysm was found in 24 (78%), aneurysm recurrence was observed in 5 (13%), and permanent procedural morbidity was observed in two patients (3.4%). During the follow-up period, there were no hemorrhagic events and no stent displacement. Despite a modest procedural complication rate, and some evidence of aneurismal recurrence, SACE was proved to be both effective and safe in managing wide-neck intracranial aneurysms. Our results also demonstrated the midterm durability and stability of aneurysm treated by SACE. Furthermore, SACE can be a salvageable procedure in cases with coil instability after detachment. Copyright © 2012. Published by Elsevier B.V.

RCM [reliability-centered maintenance] at Ginna: Preventive maintenance program optimization at year 20

International Nuclear Information System (INIS)

Edgar, E.C.

1989-01-01

The reliability-centered maintenance (RCM) program at Rochester Gas ampersand Electric Company's Ginna station is entering its second year. Of the 20 systems originally selected for evaluation, 10 are in various stages of completion, and recommendations resulting from the earliest systems studied are now being implemented. As expected, few major discoveries have been made in terms of preventive maintenance program failings or excesses. The performance of the now 20-yr-old plant has been excellent in recent years, and objectives focus more on ensuring continued high standards of safety, reliability, and economy than on maintenance program cost reduction

Office for Analysis and Evaluation of Operational Data 1994-FY 95 annual report. Volume 9, Number 2

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-09-01

This annual report of the US Nuclear Regulatory Commission`s Office for Analysis and Evaluation of Operational Data (AEOD) describes activities conducted during CY 1994 and FY 1995. The report is published in three parts. NUREG-1272, Vol. 9, No. 1, covers power reactors and presents an overview of the operating experience of the nuclear power industry from the NRC perspective, including comments about the trends of some key performance measures. The report also includes the principal findings and issues identified in AEOD studies over the past year and summarizes information from such sources as licensee event reports, diagnostic evaluations, and reports to the NRC`s Operations Center. NUREG-1272, Vol. 9, No. 2, covers nuclear materials and presents a review of the events and concerns associated with the use of licensed material in nonreactor applications, such as personnel overexposures and medical misadministrations. Both reports also contain a discussion of the Incident Investigation Team program and summarize both the Incident Investigation Team and Augmented Inspection Team reports. Each volume contains a list of the AEOD reports issued from 1980 through FY 1995. NUREG-1272, Vol. 9, No. 3, covers technical training and presents the activities of the Technical Training Center in support of the NRC`s mission.

Office for Analysis and Evaluation of Operational Data 1994-FY 95 annual report. Volume 9, Number 2

International Nuclear Information System (INIS)

1996-09-01

This annual report of the US Nuclear Regulatory Commission's Office for Analysis and Evaluation of Operational Data (AEOD) describes activities conducted during CY 1994 and FY 1995. The report is published in three parts. NUREG-1272, Vol. 9, No. 1, covers power reactors and presents an overview of the operating experience of the nuclear power industry from the NRC perspective, including comments about the trends of some key performance measures. The report also includes the principal findings and issues identified in AEOD studies over the past year and summarizes information from such sources as licensee event reports, diagnostic evaluations, and reports to the NRC's Operations Center. NUREG-1272, Vol. 9, No. 2, covers nuclear materials and presents a review of the events and concerns associated with the use of licensed material in nonreactor applications, such as personnel overexposures and medical misadministrations. Both reports also contain a discussion of the Incident Investigation Team program and summarize both the Incident Investigation Team and Augmented Inspection Team reports. Each volume contains a list of the AEOD reports issued from 1980 through FY 1995. NUREG-1272, Vol. 9, No. 3, covers technical training and presents the activities of the Technical Training Center in support of the NRC's mission

12 years' experience with intraoperative radiotherapy (IORT) of malignant gliomas

Energy Technology Data Exchange (ETDEWEB)

Schueller, P.; Micke, O.; Moustakis, C.; Bruns, F.; Schuck, A.; Willich, N. [University Hospital Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Palkovic, S.; Schroeder, J.; Wassmann, H. [University Hospital Muenster (Germany). Dept. of Neurosurgery

2005-08-01

Background: Even after surgery and radiotherapy, malignant gliomas still have a poor prognosis. The authors report on their experience with IORT in 71 patients. Patients and methods: From May 1992 to February 2004, 71 patients with malignant gliomas were treated with IORT. 26 patients suffered from grade III gliomas, 45 patients from glioblastomas (GBM). IORT was carried out using a standard electron tube and 9- to 18-MeV electrons. 52/71 patients who were primarily treated received 20 Gy IORT + 60 Gy postoperative radiotherapy, 19/71 patients with recurrences only received IORT (20-25 Gy). Results: The complication rates were 1.4% for wound infections and 5.6% for hemorrhage. Median disease-specific survival amounted to 14.9 months (gliomass III) and 14.2 months (GBM). The 2-year survival rates amounted to 26.9% (gliomas III) and 6.8% (GBM; p=0.0296). Total versus subtotal resection had no significant influence on survival (p=0.0741), nor had age, sex, tumor site, performance status, size, primary versus recurrence, and radiation dose. A comparison to a conventionally treated patient group did not show a significant survival improvement. 3 months after treatment, initial symptoms had improved in 59% (hemiparesis), 50% (aphasia), 50% (hemianopsia), and 60% (convulsions). Conclusion: IORT has been shown to be feasible; perioperative complication rates were not increased. Survival was generally not improved compared to a historical control group. Recurrences achieved the same survival as primary tumors, and GBM also had a slightly increased survival, thus being possible indications for IORT. (orig.)

Bleeding Peptic Ulcer - Tertiary Center Experience: Epidemiology, Treatment and Prognosis.

Science.gov (United States)

Budimir, Ivan; Stojsavljević, Sanja; Hrabar, Davor; Kralj, Dominik; Bišćanin, Alen; Kirigin, Lora Stanka; Zovak, Mario; Babić, Žarko; Bohnec, Sven; Budimir, Ivan

2017-12-01

The aim of this study was to demonstrate epidemiological, clinical and endoscopic characteristics of acute upper gastrointestinal bleeding (UGIB) with special reference to peptic ulcer bleeding (PUB). The study included 2198 consecutive patients referred to our emergency department due to acute UGIB from January 2008 to December 2012. All patients underwent urgent upper GI endoscopy within 24 hours of admission, and 842 patients diagnosed with PUB were enrolled and prospectively followed-up. The cumulative incidence of UGIB was 126/100,000 in the 5-year period. Two out of five patients had a bleeding peptic ulcer; in total, 440 (52.3%) had bleeding gastric ulcer, 356 (42.3%) had bleeding duodenal ulcer, 17 (2%) had both bleeding gastric and duodenal ulcers, and 29 (3.5%) patients had bleeding ulcers on gastroenteric anastomoses. PUB was more common in men. The mean patient age was 65.9 years. The majority of patients (57%) with PUB were taking agents that attenuate the cytoprotective function of gastric and duodenal mucosa. Rebleeding occurred in 77 (9.7%) patients and 47 (5.9%) patients required surgical intervention. The 30-day morality was 5.2% and 10% of patients died from uncontrolled bleeding and concomitant diseases. In conclusion, PUB is the main cause of UGIB, characterized by a significant rebleeding rate and mortality.

Long term sequelae of pediatric craniopharyngioma - literature review and 20 years of experience

Directory of Open Access Journals (Sweden)

Michal eCohen

2011-11-01

Full Text Available Craniopharyngioma are rare histologically benign brain tumors that develop in the pituitary- hypothalamic area. They may invade nearby anatomical structures causing significant rates of neurological, neurocognitive and endocrinological complications including remarkable hypothalamic damage. Information regarding long term implications of the tumors and treatment in the pediatric population is accumulating, and treatment goals appear to be changing accordingly. In this review we aim to present data regarding long term complications of craniopharyngioma in children and adolescents and our experience from a large tertiary center. Hypothalamic dysfunction was noted to be the most significant complication, adversely affecting quality of life in survivors. Obesity, fatigue and sleep disorders are the most notable manifestations of this dysfunction, and treatment is extremely difficult. Changes in management in recent years show a potential for improved long term outcomes; we found a trend towards less aggressive surgical management and increasing use of adjuvant treatment, accompanied by a decrease in complication rates.

Emotional Experience Improves With Age: Evidence Based on Over 10 Years of Experience Sampling

Science.gov (United States)

Carstensen, Laura L.; Turan, Bulent; Scheibe, Susanne; Ram, Nilam; Ersner-Hershfield, Hal; Samanez-Larkin, Gregory R.; Brooks, Kathryn P.; Nesselroade, John R.

2012-01-01

Recent evidence suggests that emotional well-being improves from early adulthood to old age. This study used experience-sampling to examine the developmental course of emotional experience in a representative sample of adults spanning early to very late adulthood. Participants (N = 184, Wave 1; N = 191, Wave 2; N = 178, Wave 3) reported their emotional states at five randomly selected times each day for a one week period. Using a measurement burst design, the one-week sampling procedure was repeated five and then ten years later. Cross-sectional and growth curve analyses indicate that aging is associated with more positive overall emotional well-being, with greater emotional stability and with more complexity (as evidenced by greater co-occurrence of positive and negative emotions). These findings remained robust after accounting for other variables that may be related to emotional experience (personality, verbal fluency, physical health, and demographic variables). Finally, emotional experience predicted mortality; controlling for age, sex, and ethnicity, individuals who experienced relatively more positive than negative emotions in everyday life were more likely to have survived over a 13 year period. Findings are discussed in the theoretical context of socioemotional selectivity theory. PMID:20973600

Scientific and technical information output of the Langley Research Center for calendar year 1980

Science.gov (United States)

1981-01-01

This document is a compilation of the scientific and technical information that the Langley Research Center has produced during the calendar year 1980. Approximately 1400 citations are given. Formal reports, quick-release technical memorandums, contractor reports, journal articles, meeting/conference papers, computer programs, tech briefs, patents, and unpublished research are included.

Scientific and technical information output of the Langley Research Center for calendar year 1986

Science.gov (United States)

1987-01-01

This document is a compilation of the scientific and technical information that the Langley Research Center has produced during the calendar year 1986. Included are citations for Formal Reports, Quick-Release Technical Memorandums, Contractor Reports, Journal Articles and Other Publications, Meeting Presentations, Techncial Talks, Computer Programs, Tech Briefs, and Patents.

Implementation of a new CT colonography service: 5 Year experience

International Nuclear Information System (INIS)

Lung, P.F.C.; Burling, D.; Kallarackel, L.; Muckian, J.; Ilangovan, R.; Gupta, A.; Marshall, M.; Shorvon, P.; Halligan, S.; Bhatnagar, G.; Bassett, P.; Taylor, S.A.

2014-01-01

Aim: To describe our experience using a 5 year audit of computed tomography colonography (CTC) practice and identify factors that influence diagnostic performance to guide implementation in other centres. Material and methods: Consecutive patients referred for CTC at a single institution over a 5 year period were identified, and reporting rates and positive predictive value (PPV) calculated for small polyps, large polyps, and colorectal cancer. Diagnostic performance was compared using the Chi-squared test, and trends over time were examined with logistic regression. The effect of faecal tagging and an intravenous spasmolytic were investigated using Fisher's exact test. Results: In total, 4355 CTC examinations were performed. Overall reporting rates and PPV were 17% and 92%, respectively. Negative predictive value (NPV) for cancer was 99.9%. A significant decrease in reporting rate (p < 0.001) was accompanied by an increase in PPV for small polyps (p = 0.02) following the introduction of faecal tagging. Adequacy rates for CTC improved over time (96% to 99%), with improved adequacy rates when using a spasmolytic, 98% versus 96% without. A significant difference in reporting rates, but not PPV, was found between radiologists. Conclusion: Accurate colonic investigation using CTC can be delivered safely to a high-risk patient population at a single centre. Faecal tagging and an intravenous spasmolytic improve diagnostic performance

IS RESECTION OF HEPATOCELLULAR CARCINOMA IN THE ERA OF LIVER TRANSPLANTATION WORTHWILE? A single center experience

Directory of Open Access Journals (Sweden)

Paulo HERMAN

Full Text Available ABSTRACT Background - Liver resection for hepatocellular carcinoma is a potentially curative therapeutic procedure that can be performed readily after its indication, without the need of a long waiting time and lower costs when compared to liver transplantation, being a good alternative in patients with preserved/good liver function. Objective - Evaluate long-term results of liver resection from a high volume single center for selected patients with hepatocellular carcinoma in a context of a long waiting list for liver transplant. Methods - One hundred and one patients with hepatocellular carcinoma, with a mean age of 63.1 years, and preserved liver function were submitted to liver resection. Clinical and pathological data were evaluated as prognostic factors. Mean follow-up was 39.3 months. Results - All patients had a single nodule and 57 (58.2% patients were within the Milan criteria. The size of the nodule ranged from 1 to 24 cm in diameter. In 74 patients, liver resection was performed with the open approach and in 27 (26.7% was done laparoscopically. Postoperative morbidity was 55.3% being 75.5% of the complications classified as Dindo-Clavien I and II and operative mortality was 6.9%. Five-year overall and disease free survival rates were 49.9% and 40.7%, respectively.After a log-rank univariate analysis, the levels of preoperative alpha-fetoprotein (P=0.043, CA19-9 (P=0.028, capsule invasion (P=0.03, positive margin (R1-R2 (P=0.004 and Dindo-Claviens' morbidity classification IV (P=0.001 were the only parameters that had a significant negative impact on overall survival. On the odds-ratio evaluation, the only significant factors for survival were high levels of alpha-fetoprotein (P=0.037, and absence of free margins (P=0.008. Conclusion - Resection, for selected cases, is a potentially curative treatment with acceptable morbidity and mortality and, in a context of a long waiting list for transplant, plays an important role for the

Center Variation and the Effect of Center and Provider Characteristics on Clinical Outcomes in Kidney Transplantation: A Systematic Review of the Evidence

Directory of Open Access Journals (Sweden)

Anne Tsampalieros

2017-10-01

Full Text Available Background: Kidney transplantation is the best treatment option for patients with end-stage renal disease. While patient-level factors affecting survival are established, the presence of variation in the management of transplant recipients remains unknown. Objective: The objective of this study was to examine center variation in kidney transplantation and identify center and provider characteristics that may be associated with clinical outcomes. Design: This is a systematic review. Data sources: Ovid Medline, Embase, and Cochrane library from inception to June 2016 were used. Study eligibility: Any study examining the association between center or provider characteristics and graft or patient survival, quality of life, or functional status were included. Results: We identified 6327 records and 24 studies met eligibility. Most studies used data registries. Characteristics evaluated include center volume (n = 17, provider volume (n = 2, provider experience (n = 1, center type (n = 2, and location of follow-up (n = 1. Outcomes assessed included graft survival (n = 24 and patient survival (n = 9. Significant center variation was described in 12 of 15 and 5 of 7 studies for graft and patient survival. There was a significant and positive association between center volume and graft and patient survival in 8 and 2 studies, respectively. Provider experience and volume were significantly associated with less allograft loss and provider volume with lower risk of death. There was no association between graft survival and location of follow-up or center type. Limitations: There was substantial heterogeneity in the variables assessed and methodology used to analyze associations. Conclusion: This systematic review found center variation in kidney transplantation. Future studies in the current era are necessary to better evaluate this important topic.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-07-15

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

Relationship between caries experience and demarcated hypomineralised lesions (including MIH) in the permanent dentition of 15-year-olds.

Science.gov (United States)

Kühnisch, Jan; Kabary, Lamiaa; Malyk, Yuri; Rothmaier, Katrin; Metz, Isabel; Hickel, Reinhard; Heinrich, Joachim; Manton, David; Standl, Marie

2018-06-01

This cross-sectional study compared the caries experience in 15-year-olds with and without demarcated hypomineralised lesions (DHL) in permanent teeth. One thousand three hundred and two 15-year-old adolescents from two ongoing birth cohorts (GINIplus15 and LISAplus15) were examined to determine non-cavitated carious lesions (NCCL) and the DMF index. Furthermore, DHL was scored on all permanent teeth/surfaces according to the molar-incisor hypomineralisation criteria of the European Academy of Paediatric Dentistry (MIH/EAPD). Adolescents with DHL were categorised into those with a minimum of one DHL in the permanent dentition (DHL ≥ 1), with DHL on at least one first permanent molar (MIH/EAPD) and with DHL on at least one first permanent molar and permanent incisor (MIH/Severe). The study was conducted in the metropolitan area of Munich. The proportion of children without caries amounted to 63.7% (DMF > 0) and 26.0% (D 1-4 MF > 0); the caries experience was mean = 4.0(SD = 5.2) NCCL/T and 0.9(1.7) DMF/T. Existence of DHL ≥ 1, MIH/EAPD and MIH/Severe was detected in 40.2, 17.2 and 9.8% of all adolescents, respectively. The corresponding DMF/T values were: no DHL 0.9(1.7); DHL ≥ 1 1.0(1.7); MIH/EAPD 1.1(1.6); MIH/Severe 1.1(1.7). The group of adolescents with MIH/EAPD and MIH/Severe were found to have statistically higher caries rates in comparison to those with no DHL. Caries and DHL are prevalent and influenced the dental health of 15-year-old adolescents. A significant positive association existed between the presence of caries and DHL. Children with MIH/EAPD or MIH/Severe had a higher probability to develop carious lesions in the permanent dentition.

Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population--a 20-year experience over three time periods.

Science.gov (United States)

Leow, A H-R; Lim, Y-Y; Liew, W-C; Goh, K-L

2016-04-01

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting. A time trend study of upper gastrointestinal disease and H. pylori infection in three time periods: 1989-1990, 1999-2000 and 2009-2010 spanning a period of 20 years was carried out. Consecutive first time gastroscopies carried out on patients attending the University of Malaya Medical Center were studied. Diagnoses and H. pylori infection status were carefully recorded. A steady decline in prevalence of duodenal ulcer (DU) and gastric ulcer (GU) from 21.1% to 9.5% to 5.0% and from 11.9% to 9.4% to 9.9% while an increase in erosive oesophagitis (EO) from 2.0% to 8.4% to 9.5% (chi-square for trend; P Chinese and Indians but the difference over time was most marked in Malays. There was a steady decline in the proportion of patients with gastric and oesophageal cancers. Peptic ulcers have declined significantly over a 20-year period together with a decline in H. pylori infection. In contrast, a steady increase in erosive oesophagitis was observed. Gastric and oesophageal squamous cell cancers have declined to low levels. © 2016 John Wiley & Sons Ltd.

STAR: Preparing future science and math teachers through authentic research experiences at national laboratories

Science.gov (United States)

Keller, John; Rebar, Bryan

2012-11-01

The STEM Teacher and Researcher (STAR) Program provides 9-week paid summer research experiences at national research laboratories for future science and math teachers. The program, run by the Cal Poly Center for Excellence in Science and Mathematics Education (CESaME) on behalf of the entire California State University (CSU) System, has arranged 290 research internships for 230 STEM undergraduates and credential candidates from 43 campuses over the past 6 years. The program has partnered with seven Department of Energy labs, four NASA centers, three NOAA facilities, and the National Optical Astronomy Observatory (NOAO). Primary components of the summer experience include a) conducting research with a mentor or mentor team, b) participating in weekly 2-3 hour workshops focused on translating lessons learned from summer research into classroom practice, and c) presenting a research poster or oral presentation and providing a lesson plan linked to the summer research experience. The central premise behind the STAR Program is that future science and math teachers can more effectively prepare the next generation of science, math, and engineering students if they themselves have authentic experiences as researchers.

Objectively assessed physical activity and aerobic fitness in a population-based sample of Norwegian 9- and 15-year-olds

DEFF Research Database (Denmark)

Kolle, E; Steene-Johannessen, J; Andersen, Lars Bo

2010-01-01

The present study described current physical activity, determined compliance with physical activity guidelines and assessed aerobic fitness in a nationally representative sample of 9- and 15-year-olds in Norway. In 2005-2006, 2299 children and adolescents were randomly recruited. The participation...... rate was 89% and 74% among the 9- and 15-year-olds, respectively. Physical activity was assessed objectively by accelerometry, and aerobic fitness was measured directly as peak oxygen uptake during a cycle ergometry test. Boys were more physically active than girls, and 9-year-olds were substantially......, 48.2 (7.1) mL/min/kg; 9-year-old girls, 42.9 (6.7) mL/min/kg; and 15-year-old girls 41.1 (6.0) mL/min/kg and 15-year-old boys 51.9 (8.0) mL/min/kg. Because of the high participation rate, this study provides a good description of the physical activity and aerobic fitness in the young population...

The first year experience of occupational therapy students at an Australian regional university: Promoting student retention and developing a regional and remote workforce.

Science.gov (United States)

Boehm, Jackie; Cordier, Reinie; Thomas, Yvonne; Tanner, Bronwyn; Salata, Karen

2017-02-01

Student retention at regional universities is important in addressing regional and remote workforce shortages. Students attending regional universities are more likely to work in regional areas. First year experience at university plays a key role in student retention. This study aimed to explore factors influencing the first year experience of occupational therapy students at a regional Australian university. Surveys were administered to 58 second year occupational therapy students in the first week of second year. Data were analysed using descriptive statistics, inferential statistics (Pearson χ 2 ; Spearman rho) and summarising descriptive responses. An Australian regional university. Second year undergraduate occupational therapy students. Factors influencing students' decisions to study and continue studying occupational therapy; factors enhancing first year experience of university. Fifty-four students completed the survey (93.1%). A quarter (25.9%) of students considered leaving the course during the first year. The primary influence for continuing was the teaching and learning experience. Most valued supports were orientation week (36.7%) and the first year coordinator (36.7%). The importance of the first year experience in retaining occupational therapy students is highlighted. Engagement with other students and staff and academic support are important factors in facilitating student retention. It is important to understand the unique factors influencing students' decisions, particularly those from regional and remote areas, to enter and continue in tertiary education to assist in implementing supports and strategies to improve student retention. © 2015 National Rural Health Alliance Inc.

[Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

Science.gov (United States)

Coulet, O; Kraemer, P; Leyral, G; Cloatre, G

2004-01-01

Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

[Merkel cell carcinoma experience in a reference medical center.

Science.gov (United States)

Roesch-Dietlen, Federico; Devezé-Bocardi, Raúl; Ruiz-Juárez, Isabel; Grube-Pagola, Peter; Romero-Sierra, Graciela; Remes-Troche, José María; Silva-Cañetas, Carmen Sofía; Lozoya-López Escalera, Hilda

2013-01-01

Background: Merkel cell carcinoma is a rare tumor that occurs on areas exposed to ultraviolet light. It is usually asymptomatic and it is diagnosed late often. The treatment is surgical, associated with adjuvant radiotherapy. The objective was to present the experience in the management of Merkel cell carcinoma in a reference medical center. Methods: all patients with Merkel cell carcinoma treated at the Instituto de Investigaciones Médico-Biológicas of the Universidad Veracruzana during the period 2008 to 2011 were studied. Sex, age, evolution time, tumor localization, size, metastases and treatment were analyzed. Results: of 3217 patients treated, three cases were Merkel cell carcinoma (0.09 %), their age was 52.1 ± 14.17, male predominance of 66.67 %; the evolution time was of 29.66 ± 35.36 months; the tumour localization was on inguinal region, anterior chest and left arm; the noodle size was of 6.0 ± 5.19 cm; two patients had lymph node metastases. In two cases, resection and lymphadenectomy were performed. They all received radiation therapy and chemotherapy in one case. Histologically the medium variant predominated; immunohistochemistry was positive in the three cases. One patient died ten months after the study was done. Conclusions: our experience is similar with others authors, Merkel cell carcinoma is a rare tumor, usually diagnosed late, and it has poor survival.

Magnetic resonance imaging appearance of soft-tissue metastases: our experience at an orthopedic oncology center

International Nuclear Information System (INIS)

Sammon, Jennifer; Jain, Abhishek; Bleakney, Robert; Mohankumar, Rakesh

2017-01-01

To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass. A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed. Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old. Most (80%) of the masses were located deep to the deep fascia. In our cohort of patients, melanoma was the most common primary malignancy contributing to soft-tissue metastasis (21.8%). Among soft-tissue metastasis from solid organs, breast and lung were the most frequent (9.1% each). Five patients had soft-tissue metastases from an unknown primary. Imaging diagnosis of soft-tissue metastases is challenging as it can demonstrate imaging appearances similar to primary soft-tissue sarcoma. The presence of a known malignancy may not be evident in everyone, and even if available, histopathology will be necessary for diagnosis if this is the only site of recurrence/metastasis to differentiate from a primary soft-tissue sarcoma. Moreover, soft-tissue metastasis may be the initial presentation of a malignancy. Primary malignancies with soft-tissue metastasis carry a poor prognosis; hence, prompt diagnosis and management in essential. (orig.)

Magnetic resonance imaging appearance of soft-tissue metastases: our experience at an orthopedic oncology center

Energy Technology Data Exchange (ETDEWEB)

Sammon, Jennifer; Jain, Abhishek; Bleakney, Robert; Mohankumar, Rakesh [Mount Sinai Hospital and University of Toronto, Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Toronto, Ontario (Canada)

2017-04-15

To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass. A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed. Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old. Most (80%) of the masses were located deep to the deep fascia. In our cohort of patients, melanoma was the most common primary malignancy contributing to soft-tissue metastasis (21.8%). Among soft-tissue metastasis from solid organs, breast and lung were the most frequent (9.1% each). Five patients had soft-tissue metastases from an unknown primary. Imaging diagnosis of soft-tissue metastases is challenging as it can demonstrate imaging appearances similar to primary soft-tissue sarcoma. The presence of a known malignancy may not be evident in everyone, and even if available, histopathology will be necessary for diagnosis if this is the only site of recurrence/metastasis to differentiate from a primary soft-tissue sarcoma. Moreover, soft-tissue metastasis may be the initial presentation of a malignancy. Primary malignancies with soft-tissue metastasis carry a poor prognosis; hence, prompt diagnosis and management in essential. (orig.)

Some Aspects of Crystal Centering During X-ray High-throughput Protein Crystallography Experiment

Science.gov (United States)

Gaponov, Yu. A.; Matsugaki, N.; Sasajima, K.; Igarashi, N.; Wakatsuki, S.

A set of algorithms and procedures of a crystal loop centering during X-ray high-throughput protein crystallography experiment has been designed and developed. A simple algorithm of the crystal loop detection and preliminary recognition has been designed and developed. The crystal loop detection algorithm is based on finding out the crystal loop ending point (opposite to the crystal loop pin) using image cross section (digital image column) profile analysis. The crystal loop preliminary recognition procedure is based on finding out the crystal loop sizes and position using image cross section profile analysis. The crystal loop fine recognition procedure based on Hooke-Jeeves pattern search method with an ellipse as a fitting pattern has been designed and developed. The procedure of restoring missing coordinate of the crystal loop is described. Based on developed algorithms and procedures the optimal auto-centering procedure has been designed and developed. A procedure of optimal manual crystal centering (Two Clicks Procedure) has been designed and developed. Developed procedures have been integrated into control software system PCCS installed at crystallography beamlines Photon Factory BL5A and PF-AR NW12, KEK.