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Sample records for early biochemical failure

  1. Aspirin and Statin Nonuse Associated With Early Biochemical Failure After Prostate Radiation Therapy

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    Zaorsky, Nicholas G. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Buyyounouski, Mark K., E-mail: mark.buyyounouski@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Li, Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Horwitz, Eric M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2012-09-01

    Purpose: To present the largest retrospective series investigating the effect of aspirin and statins, which are hypothesized to have antineoplastic properties, on biochemical failure (nadir plus 2 ng/mL) after prostate radiation therapy (RT). Methods and Materials: Between 1989 and 2006, 2051 men with clinically localized prostate cancer received definitive RT alone (median dose, 76 Gy). The rates of aspirin use and statin use (defined as any use at the time of RT or during follow-up) were 36% and 34%, respectively. The primary endpoint of the study was an interval to biochemical failure (IBF) of less than 18 months, which has been shown to be the single strongest predictor of distant metastasis, prostate cancer survival, and overall survival after RT. Patient demographic characteristics and tumor staging factors were assessed with regard to associations with the endpoint. Univariate analysis was performed with the {chi}{sup 2} test for categorical variables and the Wilcoxon test for continuous variables. Multivariable analysis was performed with a multiple logistic regression. Results: The median follow-up was 75 months. Univariate analysis showed that an IBF of less than 18 months was associated with aspirin nonuse (P<.0001), statin nonuse (P<.0001), anticoagulant nonuse (P=.0006), cardiovascular disease (P=.0008), and prostate-specific antigen (continuous) (P=.008) but not with Gleason score, age, RT dose, or T stage. On multivariate analysis, only aspirin nonuse (P=.0012; odds ratio, 2.052 [95% confidence interval, 1.328-3.172]) and statin nonuse (P=.0002; odds ratio, 2.465 [95% confidence interval, 1.529-3.974]) were associated with an IBF of less than 18 months. Conclusions: In patients who received RT for prostate cancer, aspirin or statin nonuse was associated with early biochemical failure, a harbinger of distant metastasis and death. Further study is needed to confirm these findings and to determine the optimal dosing and schedule, as well as the relative

  2. Aspirin and Statin Nonuse Associated With Early Biochemical Failure After Prostate Radiation Therapy

    International Nuclear Information System (INIS)

    Zaorsky, Nicholas G.; Buyyounouski, Mark K.; Li, Tianyu; Horwitz, Eric M.

    2012-01-01

    Purpose: To present the largest retrospective series investigating the effect of aspirin and statins, which are hypothesized to have antineoplastic properties, on biochemical failure (nadir plus 2 ng/mL) after prostate radiation therapy (RT). Methods and Materials: Between 1989 and 2006, 2051 men with clinically localized prostate cancer received definitive RT alone (median dose, 76 Gy). The rates of aspirin use and statin use (defined as any use at the time of RT or during follow-up) were 36% and 34%, respectively. The primary endpoint of the study was an interval to biochemical failure (IBF) of less than 18 months, which has been shown to be the single strongest predictor of distant metastasis, prostate cancer survival, and overall survival after RT. Patient demographic characteristics and tumor staging factors were assessed with regard to associations with the endpoint. Univariate analysis was performed with the χ 2 test for categorical variables and the Wilcoxon test for continuous variables. Multivariable analysis was performed with a multiple logistic regression. Results: The median follow-up was 75 months. Univariate analysis showed that an IBF of less than 18 months was associated with aspirin nonuse (P<.0001), statin nonuse (P<.0001), anticoagulant nonuse (P=.0006), cardiovascular disease (P=.0008), and prostate-specific antigen (continuous) (P=.008) but not with Gleason score, age, RT dose, or T stage. On multivariate analysis, only aspirin nonuse (P=.0012; odds ratio, 2.052 [95% confidence interval, 1.328-3.172]) and statin nonuse (P=.0002; odds ratio, 2.465 [95% confidence interval, 1.529-3.974]) were associated with an IBF of less than 18 months. Conclusions: In patients who received RT for prostate cancer, aspirin or statin nonuse was associated with early biochemical failure, a harbinger of distant metastasis and death. Further study is needed to confirm these findings and to determine the optimal dosing and schedule, as well as the relative

  3. Does the Presence of Primary Circulating Prostate Cells Imply the Presence of Agressive Prostate Cancer with Early Biochemical Failure: a Comparison with the Walz Nomogram.

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    Murray, Nigel P; Reyes, Eduardo; Orellana, Nelson; Fuentealba, Cynthia; Orellana, Sebastian; Jacob, Omar

    2016-01-01

    To determine the utility of primary circulating prostate cells (CPC) for predicting early biochemical failure after radical prostatectomy for prostate cancer and compare the results with the Walz nomogram. A single centre prospective study of men with prostate cancer treated with radical prostatectomy was conducted between 2004 and 2014. Clinicalpathological details were registered, along with total serum PSA presurgery, Gleason score, extracapsular extension, positive surgical margins, infiltration of lymph nodes, seminal vesicles and pathological stage. Primary circulating prostate cells were obtained using differential gel centrifugation and detected using standard immunocytochemistry with antiPSA. Biochemical failure was defined as a PSA >0.2ng/ml, predictive values were calculated using the Walz nomagram and CPC detection. A total of 285 men participated, of whom 103/285 (36.1%) suffered biochemcial failure; 32/103 (31.1%) within two years of radical prostatectomy. Men with higher Gleason scores, higher pathological stage, infiltration of the surgical margin or prostate capsule and infiltration of seminal vesicles were more likely to undergo biochemical failure. There was a significant increase in the frequency of biochemical failure with increasing number of CPCs detected (p<0.0004 Chi squared for trend) and increasing percent prediction for the Walz nomogram (p<0.0001 Chi squared for trends). The positive predictive value of primary CPC detection, even using a cutoff point of ≥ 4 cells/sample was very low. The detection of primary CPCs in men as a prognostic factor pretreatment fails to identify those at high risk of biochemical failure within two years of curative therapy. This is in keeping with their biological significance, that the majority of them will be eliminated by the primary therapy and thus have no influence on the subsequent clinical history of the patient.

  4. Biochemical parameters in chronic renal failure.

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    Hakim, R M; Lazarus, J M

    1988-03-01

    We analyzed biochemical data derived from 911 patients with renal insufficiency observed at our institution for periods up to 7 years. During early renal failure (RF) (creatinine less than 5 mg/dL), the rate of change of hematocrit, total CO2 (tCO2) and urea per unit change of creatinine was significantly higher than during moderate (creatinine between 5 and 10 mg/dL) or advanced (creatinine greater than 10 mg/dL) RF. For example, the rate of change of hematocrit (%, volume/volume [v/v]) was (mean +/- SEM) -2.15 +/- 0.15% for each 1 mg/dL increase in creatinine in the range of creatinine less than 5 mg/dL, whereas for the range of creatinine greater than 10 mg/dL, the rate of change was only -0.48 +/- 0.06% (P less than 0.001). Similarly, the rate of change of tCO2 was -1.68 +/- 0.09 mEq/L for each 1 mg/dL increment in creatinine concentration during early RF, and -0.19 +/- 0.09 mEq/L per unit increase in creatinine during advanced RF (P less than 0.001). Chloride concentration initially increased as a function of creatinine in early RF, but decreased in advanced RF, whereas the anion gap increased throughout the course of RF. Mean serum phosphate concentration also increased steadily, but remained below the upper range of normal (4.7 mg/dL) during early RF without the use of phosphate binders. These data suggest that different biochemical parameters change at different rates as a function of the severity of renal dysfunction, and that although phosphate retention may occur, hyperphosphatemia is not a hallmark of early RF.

  5. Prostate cancer volume adds significantly to prostate-specific antigen in the prediction of early biochemical failure after external beam radiation therapy

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Propert, Kathleen J.

    1996-01-01

    Purpose: A new clinical pretreatment quantity that closely approximates the true prostate cancer volume is defined. Methods and Materials: The cancer-specific prostate-specific antigen (PSA), PSA density, prostate cancer volume (V Ca ), and the volume fraction of the gland involved with carcinoma (V Ca fx) were calculated for 227 prostate cancer patients managed definitively with external beam radiation therapy. 1. PSA density PSA/ultrasound prostate gland volume 2. Cancer-specific PSA = PSA - [PSA from benign epithelial tissue] 3. V Ca = Cancer-specific PSA/[PSA in serum per cm 3 of cancer] 4. V Ca fx = V Ca /ultrasound prostate gland volume A Cox multiple regression analysis was used to test whether any of these-clinical pretreatment parameters added significantly to PSA in predicting early postradiation PSA failure. Results: The prostate cancer volume (p = 0.039) and the volume fraction of the gland involved by carcinoma (p = 0.035) significantly added to the PSA in predicting postradiation PSA failure. Conversely, the PSA density and the cancer-specific PSA did not add significantly (p > 0.05) to PSA in predicting postradiation PSA failure. The 20-month actuarial PSA failure-free rates for patients with calculated tumor volumes of ≤0.5 cm 3 , 0.5-4.0 cm 3 , and >4.0 cm 3 were 92, 80, and 47%, respectively (p = 0.00004). Conclusion: The volume of prostate cancer (V Ca ) and the resulting volume fraction of cancer both added significantly to PSA in their ability to predict for early postradiation PSA failure. These new parameters may be used to select patients in prospective randomized trials that examine the efficacy of combining radiation and androgen ablative therapy in patients with clinically localized disease, who are at high risk for early postradiation PSA failure

  6. Definitions of biochemical failure in prostate cancer following radiation therapy

    International Nuclear Information System (INIS)

    Taylor, Jeremy M.G.; Griffith, Kent A.; Sandler, Howard M.

    2001-01-01

    Purpose: The American Society for Therapeutic Radiology and Oncology (ASTRO) published a consensus panel definition of biochemical failure following radiation therapy for prostate cancer. In this paper, we develop a series of alternative definitions of biochemical failure. Using data from 688 patients, we evaluated the sensitivity and specificity of the various definitions, with respect to a defined 'clinically meaningful' outcome. Methods and Materials: The ASTRO definition of biochemical failure requires 3 consecutive rises in prostate-specific antigen (PSA). We considered several modifications to the standard definition: to require PSA rises of a certain magnitude, to consider 2 instead of 3 rises, to require the final PSA value to be greater than a fixed cutoff level, and to define biochemical failure based on the slope of PSA over 1, 1.5, or 2 years. A clinically meaningful failure is defined as local recurrence, distant metastases, initiation of unplanned hormonal therapy, unplanned radical prostatectomy, or a PSA>25 later than 6 months after radiation. Results: Requiring the final PSA in a series of consecutive rises to be larger than 1.5 ng/mL increased the specificity of biochemical failure. For a fixed specificity, defining biochemical failure based on 2 consecutive rises, or the slope over the last year, could increase the sensitivity by up to approximately 20%, compared to the ASTRO definition. Using a rule based on the slope over the previous year or 2 rises leads to a slightly earlier detection of biochemical failure than does the ASTRO definition. Even with the best rule, only approximately 20% of true failures are biochemically detected more than 1 year before the clinically meaningful event time. Conclusion: There is potential for improvement in the ASTRO consensus definition of biochemical failure. Further research is needed, in studies with long follow-up times, to evaluate the relationship between various definitions of biochemical failure and

  7. Biochemical failure after radical external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Nomoto, Satoshi; Imada, Hajime; Kato, Fumio; Yahara, Katsuya; Morioka, Tomoaki; Ohguri, Takayuki; Nakano, Keita; Korogi, Yukunori

    2005-01-01

    The purpose of this study was to evaluate biochemical failures after radical external beam radiotherapy for prostate cancer. A total of 143 patients with prostate cancer (5 cases in stage A2, 95 in stage B and 43 in stage C; 18 in low risk group, 37 in intermediate risk group, 67 in high risk group and 21 in unknown group) were included in this study. Patients of stage A2 and B underwent external irradiation of 46 Gy to the prostate gland and seminal vesicle and additional 20 Gy to the prostate gland, while patients of stage C underwent external irradiation of 66 Gy to the prostate gland and seminal vesicle including 46 Gy to the pelvis. Neoadjuvant hormonal therapy was done in 66 cases, and long-term hormonal therapy in 75 cases; two cases were treated with radiation therapy alone. The 3-year relapse free survival rates by stage A2, B and C were 100%, 96.7% and 88.1%, respectively. The 3-year relapse free survival rates by low, intermediate and high risk groups were 100%, 92.3% and 89.7%, respectively. Biochemical failure was noted in nine cases during the average observation term of 32.2 months; in this group the median of prostate specific antigen (PSA) value was 2.6 ng/ml, the doubling time was 8.6 months, and the term of biochemical failure was 33.2 months. Six of eight cases with biochemical failure were the neoadjuvant hormonal therapy group, but biochemical no evidence of disease (bNED) curve showed no significant difference between neoadjuvant and long-term hormonal groups. It is supposed that unnecessary hormonal therapies were performed based on the nonspecific diagnosis of biochemical failure after radical radiotherapy in our group of patients. A precise criterion of biochemical failure after radical radiotherapy for prostate cancer is necessary. (author)

  8. [Biochemical principles of early saturnism recognition].

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    Tsimakuridze, M P; Mansuradze, E A; Zurashvili, D G; Tsimakuridze, M P

    2009-03-01

    The aim of the work is to determine the major sensitive criteria of biochemical indicators that allow timely discovery of negative influence of lead on organism and assist in early diagnosis of primary stages of saturnism. The workers of Georgian typographies, performing technological processes of letterpress printing were observed. Professional groups having contact with lead aerosols (main group of 66 people) and the workers of the same typography not being in touch with the poison (control group of 24 people) were studied. It was distinguished that, protracted professional contact with lead causes moderate increase of lead, coproporphyrin and DALA in daily urine in most cases; it is more clearly evidenced in the professional groups of lead smelters and lino operators and less clearly among typesetter and printers. Upon the checkup of people, having a direct contact with lead, biochemical analysis of urine should be given a preference, especially the determination of quantitative content of lead and coproporphyrin in urine with the aim of revealing the lead carrier, which is one of the first signals for occupational lookout and medical monitoring of the similar contingent.

  9. Prostate-specific antigen nadir within 12 months as an early surrogate marker of biochemical failure and distant metastasis after low-dose-rate brachytherapy or external beam radiotherapy for localized prostate cancer.

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    Nishimura, Shuichi; Ohashi, Toshio; Momma, Tetsuo; Sakayori, Masanori; Eriguchi, Takahisa; Tanaka, Tomoki; Yamashita, Shoji; Kosaka, Takeo; Oya, Mototsugu; Shigematsu, Naoyuki

    2018-05-01

    Prostate-specific antigen nadir (nPSA) after radiotherapy for localized prostate cancer has been investigated as a predictor. However, nPSA usually requires several years, limiting its clinical utility. We investigated the significance of nPSA within 12 months (nPSA12) after low-dose-rate prostate brachytherapy (LDR-PB) or external beam radiotherapy (EBRT) on treatment outcomes. Between 2006 and 2014, 663 patients with prostate cancer were treated with LDR-PB or EBRT at two institutions. Four hundred and seventy-four men received LDR-PB and 189 men received EBRT, without androgen deprivation therapy. The Kaplan-Meier method was used for biochemical failure (BF)-free survival (BFFS) and distant metastasis (DM)-free survival (DMFS) analyses, and multivariable Cox regression analysis was performed. The median follow-up was 61.3 months. The median nPSA12 in the LDR-PB and EBRT cohorts was 0.7 and 1.0 ng/mL, respectively. The 7-year BFFS and DMFS rates in LDR-PB patients with nPSA12 ≤ 0.7 ng/mL were 99.1% and 99.5%, respectively; when nPSA12 was >0.7 ng/mL, they were 90.2% and 94.8%, respectively. In EBRT patients with nPSA12 ≤ 1.0 ng/mL, BFFS and DMFS rates were 85.4% and 98.5%, respectively; when nPSA12 was >1.0 ng/mL, they were 67.1% and 87.2%, respectively. nPSA12 was an independent predictor of BF and DM in both cohorts (LDR-PB, P = 0.004 and 0.020, respectively; EBRT, P = 0.005 and 0.041, respectively). The nPSA12 after LDR-PB or EBRT is significantly associated with treatment outcomes of prostate cancer. Higher nPSA12 may identify patients at high risk of relapse who might benefit from salvage treatment. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  10. Comparison of biochemical failure definitions for permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Kuban, Deborah A.; Levy, Larry B.; Potters, Louis; Beyer, David C.; Blasko, John C.; Moran, Brian J.; Ciezki, Jay P.; Zietman, Anthony L.; Zelefsky, Michael J.; Pisansky, Thomas M.; Elshaikh, Mohamed; Horwitz, Eric M.

    2006-01-01

    Purpose: To assess prostate-specific antigen (PSA) failure definitions for patients with Stage T1-T2 prostate cancer treated by permanent prostate brachytherapy. Methods and Materials: A total of 2,693 patients treated with radioisotopic implant as solitary treatment for T1-T2 prostatic adenocarcinoma were studied. All patients had a pretreatment PSA, were treated at least 5 years before analysis, 1988 to 1998, and did not receive hormonal therapy before recurrence. Multiple PSA failure definitions were tested for their ability to predict clinical failure. Results: Definitions which determined failure by a certain increment of PSA rise above the lowest PSA level to date (nadir + x ng/mL) were more sensitive and specific than failure definitions based on PSA doubling time or a certain number of PSA rises. The sensitivity and specificity for the nadir + 2 definition were 72% and 83%, vs. 51% and 81% for 3 PSA rises. The surgical type definitions (PSA exceeding an absolute value) could match this sensitivity and specificity but only when failure was defined as exceeding a PSA level in the 1-3 ng/mL range and only when patients were allowed adequate time to nadir. When failure definitions were compared by time varying covariate regression analysis, nadir + 2 ng/mL retained the best fit. Conclusions: For patients treated by permanent radioisotopic implant for prostate cancer, the definition nadir + 2 ng/mL provides the best surrogate for failure throughout the entire follow-up period, similar to patients treated by external beam radiotherapy. Therefore, the same PSA failure definition could be used for both modalities. For brachytherapy patients with long-term follow-up, at least 6 years, defining failure as exceeding an absolute PSA level in the 0.5 ng/mL range may be reasonable

  11. Knowledge representation methods for early failure detection

    International Nuclear Information System (INIS)

    Scherer, K.P.; Stiller, P.

    1990-01-01

    To supervise technical processes like nuclear power plants, it is very important to detect failure modes in an early stage. In the nuclear research center at Karlsruhe an expert system is developed, embedded in a computer network of autonomous computers, which are used for intelligent prepocessing. Events, process data and actual parameter values are stored in slots of special frames in the knowledge base of the expert system. Both rule based and fact based knowledge representations are employed to generate cause consequence chains of failure states. By on-line surveillance of the reactor process, the slots of the frames are dynamically actualized. Immediately after the evaluation, the inference engine starts in the special domain experts (triggered by metarules from a manager) and detects the correspondend failures or anomaly state. Matching the members of the chain and regarding a catalogue of instructions and messages, what is to do by the operator, future failure states can be estimated and propagation can be prohibited. That means qualitative failure prediction based on cause consequence in the static part of the knowledge base. Also, a time series of physical data can be used to predict on analytical way future process state and to continue such a theoretical propagation with matching the cause consuquence chain

  12. Early failure analysis of machining centers: a case study

    International Nuclear Information System (INIS)

    Wang Yiqiang; Jia Yazhou; Jiang Weiwei

    2001-01-01

    To eliminate the early failures and improve the reliability, nine ex-factory machining centers are traced under field conditions in workshops. Their early failure information throughout the ex-factory run-in test is collected. The field early failure database is constructed based on the collection of field early failure data and the codification of data. Early failure mode and effects analysis is performed to indicate the weak subsystem of a machining center or the troublemaker. The distribution of the time between early failures is analyzed and the optimal ex-factory run-in test time for machining center that may expose sufficiently the early failures and cost minimum is discussed. Suggestions how to arrange ex-factory run-in test and how to take actions to reduce early failures for machining center is proposed

  13. The definition of biochemical failure in patients treated with definitive radiotherapy

    International Nuclear Information System (INIS)

    Kattan, Michael W.; Fearn, Paul A.; Leibel, Steven; Potters, Louis

    2000-01-01

    Purpose: The American Society for Therapeutic Radiology and Oncology (ASTRO) published a definition for biochemical failure following treatment of prostate cancer. Others have noted difficulties with interpreting this definition and recommended modifications to accommodate special recurrence patterns. We have compared various modifications to the original ASTRO definition on our series of 1213 patients treated with transperineal permanent prostate brachytherapy. Methods and Materials: The ASTRO modifications we considered adjusted for (1) early censoring of nonrecurrent patients with rising prostate-specific antigen levels (PSA), (2) cumulative rather than consecutive rises (without a decrease) as evidence of recurrence, (3) both of the above, and (4) waiting 2 years before data analysis. The Kaplan-Meier method was used to compute the effects on recurrence rate for patients treated with and without neoadjuvant hormones. Results: With the original ASTRO definition, freedom from recurrence in our series of men who did not receive neoadjuvant hormones was 83% at 4 years. All of the modifications considered had statistically insignificant effects on freedom from recurrence rates, varying from 80% to 83% at 4 years. Patients treated with neoadjuvant hormones also showed very little sensitivity to the recurrence definition employed. Conclusion: Early censoring of equivocal patients and counting cumulative rather than consecutive rises in PSA (without a decrease) had little empiric effect on the ASTRO recurrence rates. However, we favor the addition of both these modifications to the ASTRO definition on conceptual grounds for evaluating patients following any modality (radiation or surgery), whereby a trend over multiple PSA values is used to judge failure.

  14. Perineural invasion on prostate needle biopsy does not predict biochemical failure following brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Weight, Christopher J.; Ciezki, Jay P.; Reddy, Chandana A.; Zhou Ming; Klein, Eric A.

    2006-01-01

    Purpose: To determine if the presence of perineural invasion (PNI) predicts biochemical recurrence in patients who underwent low-dose-rate brachytherapy for the treatment of localized prostate cancer. Methods and Materials: A retrospective case control matching study was performed. The records of 651 patients treated with brachytherapy between 1996 and 2003 were reviewed. Sixty-three of these patients developed biochemical failure. These sixty-three patients were then matched in a one-to-one ratio to patients without biochemical failure, controlling for biopsy Gleason score, clinical stage, initial prostate-specific antigen, age, and the use of androgen deprivation. The pathology of the entire cohort was then reviewed for evidence of perineural invasion on initial prostate biopsy specimens. The biochemical relapse free survival rates for these two groups were compared. Results: Cases and controls were well matched, and there were no significant differences between the two groups in age, Gleason grade, clinical stage, initial prostate-specific antigen, and the use of androgen deprivation. PNI was found in 19 (17%) patients. There was no significant difference in the rates of PNI between cases and controls, 19.6% and 14.3% respectively (p 0.45). PNI did not correlate with biochemical relapse free survival (p 0.40). Conclusion: Perineural invasion is not a significant predictor of biochemical recurrence in patients undergoing brachytherapy for prostate cancer

  15. Outcome of salvage radiotherapy for biochemical failure after radical prostatectomy with or without hormonal therapy

    International Nuclear Information System (INIS)

    Cheung, Rex; Kamat, Ashish M.; Crevoisier, Renaud de; Allen, Pamela K.; Lee, Andrew K.; Tucker, Susan L.; Pisters, Louis; Babaian, Richard J.; Kuban, Deborah

    2005-01-01

    Background: This study analyzed the outcome of salvage radiotherapy for biochemical failure after radical prostatectomy (RP). By comparing the outcomes for patients who received RT alone and for those who received combined RT and hormonal therapy, we assessed the potential benefits of hormonal therapy. Patients and Methods: This cohort was comprised of 101 patients who received salvage RT between 1990 and 2001 for biochemical failure after RP. Fifty-nine of these patients also received hormone. Margin status (positive vs. negative), extracapsular extension (yes vs. no), seminal vesicle involvement (yes vs. no), pathologic stage, Gleason score, pre-RP PSA, post-RP PSA, pre-RT PSA, hormonal use, radiotherapy dose and technique, RP at M. D. Anderson Cancer Center, and time from RP to salvage RT were analyzed. Statistically significant variables were used to construct prognostic groups. Results: Independent prognostic factors for the RT-alone group were margin status and pre-RT PSA. RP at M. D. Anderson Cancer Center was marginally significant (p = 0.06) in multivariate analysis. Pre-RT PSA was the only significant prognostic factor for the combined-therapy group. We used a combination of margin status and pre-RT PSA to construct a prognostic model for response to the salvage treatment based on the RT group. We identified the favorable group as those patients with positive margin and pre-RT PSA ≤0.5 ng/mL vs. the unfavorable group as otherwise. This stratification separates patients into clinically meaningful groups. The 5-year PSA control probabilities for the favorable vs. the unfavorable group were 83.7% vs. 61.7% with radiotherapy alone (p = 0.03). Androgen ablation seemed to be most beneficial in the unfavorable group. Conclusion: After prostatectomy, favorable-group patients may fare well with salvage radiotherapy alone. These patients may be spared the toxicity of androgen ablation. The other patients may benefit most from a combined approach with hormonal

  16. Forensic Study of Early Failures with Unbonded Concrete Overlays

    Science.gov (United States)

    2017-11-01

    A forensic investigation was conducted to identify failure mechanisms responsible for early failures of unbonded concrete overlays on selected projects in Ohio, including I-70 in Madison County, I-77 in Washington and Noble Counties, and I-90 in Lake...

  17. Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy

    International Nuclear Information System (INIS)

    Buyyounouski, Mark K.; Hanlon, Alexandra L.; Horwitz, Eric M.; Pollack, Alan

    2008-01-01

    Purpose: Few biochemical parameters have been related to mortality. The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials: The study group consisted of 211 T1c-T3Nx-N0M0 patients who had experienced BF among 1,174 men treated with three-dimensional conformal radiotherapy alone. Biochemical failure was defined as a post-treatment prostate-specific antigen (PSA) level of at, or greater than, the PSA nadir plus 2 ng/mL. Cox proportional hazards modeling was used to identify independent predictors of DM and PCSM on multivariate analysis. Results: An IBF of <18 months was independently predictive for DM (p = 0.008), as was a Gleason score of 7-10 (p = 0.0005), PSA nadir ≥2 ng/mL (p = 0.04), and decreasing radiation dose (p = 0.02) on multivariate analysis, including increasing pretreatment PSA level, PSA nadir ≥2.5 ng/mL, PSA doubling time of <3 months, and Stage T3 disease. An IBF of <18 months was the only predictor of PCSM (p = 0.0003) in the same model. The actuarial 5-year DM rate for an IBF of <18 vs. ≥18 months was 52% vs. 20% (p < 0.0001), and the actuarial PCSM rate was 36% vs. 6%, respectively (p = 0.0001). Conclusions: The IBF is an important descriptor of the PSA kinetics after radiotherapy to identify men at high risk of clinical failure and death. A IBF of <18 months could aid in selecting men for early, aggressive salvage therapy or participation in a clinical trial

  18. Optimal timing of salvage radiotherapy for biochemical recurrence after radical prostatectomy: is ultra-early salvage radiotherapy beneficial?

    International Nuclear Information System (INIS)

    Taguchi, Satoru; Shiraishi, Kenshiro; Fukuhara, Hiroshi; Nakagawa, Keiichi; Morikawa, Teppei; Naito, Akihiro; Kakutani, Shigenori; Takeshima, Yuta; Miyazaki, Hideyo; Nakagawa, Tohru; Fujimura, Tetsuya; Kume, Haruki; Homma, Yukio

    2016-01-01

    The optimal timing of salvage radiotherapy for biochemical recurrence after radical prostatectomy is controversial. In particular, the prognostic significance of salvage radiotherapy delivered before a current definition of biochemical recurrence, i.e. ultra-early salvage radiotherapy, is unclear. We reviewed 76 patients with pT2-3N0M0 prostate cancer who underwent salvage radiotherapy for post-prostatectomy biochemical recurrence at the following three timings: ultra-early salvage radiotherapy (n = 20) delivered before meeting a current definition of biochemical recurrence (two consecutive prostate-specific antigen [PSA] values ≥0.2 ng/mL); early salvage radiotherapy (n = 40) delivered after meeting the definition but before PSA reached 0.5 ng/mL; and delayed salvage radiotherapy (n = 16) delivered after PSA reached 0.5 ng/mL. The primary endpoint was failure of salvage radiotherapy, defined as a PSA value ≥0.2 ng/mL. The log-rank test and Cox proportional hazards model were used for univariate and multivariate analyses, respectively. During the follow-up period (median: 70 months), four of 20 (20 %), nine of 40 (23 %) and seven of 16 (44 %) patients failed biochemically in the ultra-early, early and delayed salvage radiotherapy groups, respectively. On univariate analyses, the outcome of delayed salvage radiotherapy was worse than the others, while there was no significant difference between ultra-early and early groups. Multivariate analysis demonstrated the presence of Gleason pattern 5, perineural invasion and delayed salvage radiotherapy as independent predictors of poorer survival. No survival benefit of ultra-early salvage radiotherapy was demonstrated, whereas delayed salvage radiotherapy was associated with worse outcome as reported in previous studies. Our results may support the current recommendations that salvage radiotherapy should be undertaken after two consecutive PSA values ≥0.2 ng/mL and before reaching 0.5 ng/mL

  19. Scrutiny of the ASTRO consensus definition of biochemical failure in irradiated prostate cancer patients demonstrates its usefulness and robustness

    International Nuclear Information System (INIS)

    Hanlon, Alexandra L.; Hanks, Gerald E.

    2000-01-01

    Purpose: The goals of this study are: (1) to establish the robustness of the Fox Chase Cancer Center (FCCC) and the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definitions of failure by comparing biochemical estimates under various modifications of the censoring and failure time components to their respective unaltered definitions; (2) to isolate the source of variation between the two definitions of failure; and (3) to describe the hazard of failure over time for each definition. Methods: Between May 1989 and May 1997, 670 men were treated at Fox Chase Cancer Center for localized prostate cancer using three-dimensional conformal radiation therapy (3DCRT). These men were stratified into three groups for analysis: 111 men treated with adjuvant hormones; 204 men treated with radiation therapy alone and presenting with more favorable prognosis tumor characteristics; 255 men treated with radiation therapy alone and presenting with less favorable prognosis tumor characteristics. For each group, biochemical failure was estimated and compared using the FCCC and ASTRO definitions of failure. The robustness of each definition was evaluated by comparing estimates under the definition as stated to those under various modifications of the censoring and failure components. Analyses were also performed while excluding slow-progressing patients. To isolate the source of variation between the two failure definitions, estimates were compared for patients with agreement in failure status. Estimates of biochemical failure, and thus hazard rates, were made using Kaplan-Meier methodology. Results: ASTRO biochemical failure estimates were higher than the FCCC failure estimates in the first 5 years post-treatment. Beyond 5 years, ASTRO estimates level off, while the FCCC failure estimates continued to increase. These failure patterns were similar in all patient groups; however, patients treated with adjuvant hormones had a much higher risk of failure

  20. Early pregnancy failure management among family physicians.

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    Wallace, Robin; Dehlendorf, Christine; Vittinghoff, Eric; Gold, Katherine J; Dalton, Vanessa K

    2013-03-01

    Family physicians, as primary care providers for reproductive-aged women, frequently initiate or refer patients for management of early pregnancy failure (EPF). Safe and effective options for EPF treatment include expectant management, medical management with misoprostol, and aspiration in the office or operating room. Current practice does not appear to reflect patient preferences or to utilize the most cost-effective treatments. We compared characteristics and practice patterns among family physicians who do and do not provide multiple options for EPF care. We performed a secondary analysis of a national survey of women's health providers to describe demographic and practice characteristics among family physicians who care for women with EPF. We used multivariate logistic regression to identify correlates of providing more than one option for EPF management. The majority of family physicians provide only one option for EPF; expectant management was most frequently used among our survey respondents. Misoprostol and office-based aspiration were rarely used. Providing more than one option for EPF management was associated with more years in practice, smaller county population, larger proportions of Medicaid patients, intrauterine contraception provision, and prior training in office-based aspiration. Family physicians are capable of providing a comprehensive range of options for EPF management in the outpatient setting but few providers currently do so. To create a more patient-centered and cost-effective model of care for EPF, additional resources should be directed at education, skills training, and system change initiatives to prepare family physicians to offer misoprostol and office-based aspiration to women with EPF.

  1. Proteins Annexin A2 and PSA in Prostate Cancer Biopsies Do Not Predict Biochemical Failure.

    Science.gov (United States)

    Lamb, David S; Sondhauss, Sven; Dunne, Jonathan C; Woods, Lisa; Delahunt, Brett; Ferguson, Peter; Murray, Judith; Nacey, John N; Denham, James W; Jordan, T William

    2017-12-01

    We previously reported the use of mass spectrometry and western blotting to identify proteins from tumour regions of formalin-fixed paraffin-embedded biopsies from 16 men who presented with apparently localized prostate cancer, and found that annexin A2 (ANXA2) appeared to be a better predictor of subsequent biochemical failure than prostate-specific antigen (PSA). In this follow-up study, ANXA2 and PSA were measured using western blotting of proteins extracted from biopsies from 37 men from a subsequent prostate cancer trial. No significant differences in ANXA2 and PSA levels were observed between men with and without biochemical failure. The statistical effect sizes were small, d=0.116 for ANXA2, and 0.266 for PSA. ANXA2 and PSA proteins measured from biopsy tumour regions are unlikely to be good biomarkers for prediction of the clinical outcome of prostate cancer presenting with apparently localized disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  2. Wrong to be Right: Margin Laterality is an Independent Predictor of Biochemical Failure After Radical Prostatectomy.

    Science.gov (United States)

    Kang, Jung J; Reiter, Robert E; Kummer, Nicolas; DeKernion, Jean; Steinberg, Michael L; King, Christopher R

    2018-01-01

    To examine the impact of positive surgical margin (PSM) laterality on failure after radical prostatectomy (RP). A PSM can influence local recurrence and outcomes after salvage radiation. Unlike intrinsic risk factors, a PSM is caused by intervention and thus iatrogenic failures may be elucidated by analyzing margin laterality as surgical approach is itself lateralized. We reviewed 226 RP patients between 1991 and 2013 with PSM. Data includes operation type, pre/postoperative PSA, surgical pathology, and margin type (location, focality, laterality). The median follow-up was 47 months. Biochemical recurrence after RP was defined as PSA≥0.1 ng/mL or 2 consecutive rises above nadir. Ninety-two patients received salvage radiation therapy (SRT). Failure after SRT was defined as any PSA≥0.2 ng/mL or greater than presalvage. Kaplan-Meier and Cox multivariate analyses compared relapse rates. The majority of PSM were iatrogenic (58%). Laterality was associated with differences in median relapse: right 20 versus left 51 versus bilateral 14 months (PRight-sided margins were more likely to progress than left (hazard ratio, 1.67; P=0.04). More right-sided margins were referred for SRT (55% right vs. 23% left vs. 22% bilateral), but were equally salvaged. Only T-stage and pre-SRT PSA independently influenced SRT success. Most PSM are iatrogenic, with right-sided more likely to progress (and sooner) than left sided. Margin laterality is a heretofore unrecognized independent predictor of biochemical relapse and hints at the need to modify the traditional unilateral surgical technique.

  3. Smoking increases the risk of early meniscus repair failure.

    Science.gov (United States)

    Blackwell, Ryan; Schmitt, Laura C; Flanigan, David C; Magnussen, Robert A

    2016-05-01

    The goal of this study is to determine whether patients who smoke cigarettes at the time of surgery are at significantly increased risk of early meniscus repair failure relative to non-smokers. Retrospective chart review identified 64 current smokers within a series of 444 consecutive patients who underwent meniscus repair during a 7 years period. Fifty-two of these 64 smokers were available for follow-up and were matched by age, sex, and ACL status with non-smokers from the same cohort. Records of these 104 patients with a total of 120 meniscus repairs were reviewed to identify meniscus repair failure (defined as repeat surgery on the index meniscus) during the median 13-month (range: 3-79 months) follow-up period. The smoking and non-smoking groups were similar in age, sex, ACL status, BMI, meniscus repair technique, and meniscus involved. Meniscus repair failure occurred in 19 of the 112 menisci in 104 patients, for an overall failure risk of 17 %. Of the 19 failures, 14 occurred in 79 repaired medial menisci (18 % failure risk) and 5 occurred in 33 repaired lateral menisci (15 % failure risk). Meniscus repair failure occurred in significantly more smokers (15 failures in 56 menisci in 52 patients -27 % failure risk) than non-smokers (4 failures in 56 menisci in 52 patients -7 % failure risk) (p = 0.0076). Smoking is associated with significantly increased risk of early meniscus repair failure as defined by the incidence of repeat surgery on the index meniscus. III.

  4. A neurological and biochemical study of early lead poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Ashby, J A.S.

    1980-05-01

    Motor nerve conduction velocities in 194 workers exposed to lead in a battery factory were compared with those of 94 age-matched controls. Changes in nerve conduction velocities of the 94 lead workers were found to have occurred. All mean maximum motor nerve conducting velocities measured were significantly lower in the lead-exposed group than in the control group. There was no statistically significant correlation to indicate that progressive slowing of nerve conduction was associated with increasing exposure to lead or with the commonly measured biochemical changes associated with disturbed haemopoiesis in lead exposure. Results suggest that the onset of nerve conduction changes occurs within two years.

  5. Biochemical failure as single abnormality in patients with prostate cancer following radical treatment with external radiotherapy: follow-up without immediate treatment

    Directory of Open Access Journals (Sweden)

    Sergio L. Faria

    2004-08-01

    Full Text Available INTRODUCTION: Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatment of prostate cancer. The appropriate management in such cases is controversial. The most usual treatment has been early introduction of hormones. Such patients will live for many years and hormone therapy causes important secondary effects and increases costs. The guideline in our Department of Radiotherapy has been to follow up, with no initial therapy, cases with low PSA and short PSA doubling time. The present study reports this experience. MATERIALS AND METHODS: 528 patients with localized prostate cancer were treated by radical approach between 1992 and 1999, with external radiotherapy, with or without adjuvant hormone therapy. After a median follow-up of 77 months, there were 207 (39% cases with biochemical failure, 78 of which were followed without therapy after the identification of biochemical failure. All of them were asymptomatic patients and had negative radiographic examinations or did not have imaging exams requested since they presented a favorable outcome. The follow-up included at least 2 annual visits with physical examination and PSA. RESULTS: Of the 78 patients with biochemical failure followed without initial therapy, 7 died from other causes than prostate cancer and the remaining 71 cases were alive and asymptomatic in the last follow-up. Prognostic factors previous to radiotherapy such as stage and Gleason score were not considered when deciding for follow-up without initial therapy in these cases. The most significant aspects considered for this decision were low PSA value (median PSA on the last visit for the 78 cases was only 3.9 ng/mL and a slow PSA doubling time (in the present experience the median PSA doubling time was 22.5 months. CONCLUSION: There seems to be space for expectant management, without initial hormone therapy, in patients with prostate cancer who present biochemical failure and are

  6. Serum PSA Evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes

    International Nuclear Information System (INIS)

    Do, Tri; Dave, Giatri; Parker, Robert; Kagan, A. Robert

    2001-01-01

    Introduction: Serum prostate specific antigen (PSA) levels have proved to be sensitive markers for the diagnosis of prostate cancer. In addition, PSA levels are useful for detecting and monitoring prostate cancer progression after radiotherapy. Serum PSA evaluations during radiotherapy, however, have not been well documented. In this study, we investigate the prognostic value of PSA evaluations during salvage radiotherapy for prostatectomy failures. Methods: Forty-one patients with biochemical failures after prostatectomy treated with salvage radiotherapy consented to have their serum PSA levels evaluated at 30 Gy and 45 Gy of irradiation. All 41 patients had negative metastatic workup and pathologically uninvolved pelvic lymph nodes at the time of referral for salvage radiotherapy. Radiation therapy was delivered with 10-25 MV photons, with doses of 59.4-66.6 Gy. No patients received hormonal ablation therapy before irradiation. Results: The mean follow-up for all patients was 30.9 months. At last follow-up, 28/41 patients (68.3%) were free from biochemical failure, with 20 of 41 patients (48.8%) expressing undetectable PSA levels. Serum PSA evaluations at 30 Gy did not significantly predict for either biochemical (p=0.0917) or clinical (p=0.106) disease-free outcome. However, serum PSA evaluations at 45 Gy significantly predicted for both biochemical (p=0.0043) and clinical (p=0.0244) disease-free outcomes, with PSA elevations at 45 Gy significantly associated with poor outcomes. On univariate analysis of prognosticators for biochemical failures, the following were significant: an elevation in serum PSA levels at 45 Gy, detectable serum PSA immediately after prostatectomy, Gleason score 7-10, and serum PSA level >1 ng/ml before salvage radiotherapy. Conclusion: Evaluation of serum PSA level at 45 Gy of salvage radiotherapy for biochemical relapses after prostatectomy may serve as a significant prognosticator for both biochemical and clinical disease-free outcomes

  7. Practical application of biochemical failure definitions: what to do and when to do it

    International Nuclear Information System (INIS)

    Kestin, Larry L.; Vicini, Frank A.; Martinez, Alvaro A.

    2002-01-01

    Purpose: The posttreatment prostate-specific antigen (PSA) profile can often be difficult to interpret after external beam radiotherapy for prostate cancer. We performed an extensive analysis of post-radiotherapy PSA measurements to determine the clinical significance of biochemical failure (BF) and the correlation of BF with clinical failure (CF) and cause-specific death (CSD). Materials and Methods: Between 1987 and 1997, 727 patients with clinical stage T1-T3 N0 M0 prostate cancer were treated with definitive external beam radiotherapy at William Beaumont Hospital and had at least five post-radiotherapy PSA levels and did not receive hormonal therapy for post-radiotherapy PSA elevations only (before evidence of CF). All patients received external beam radiotherapy alone (no adjuvant hormonal therapy) to a median total prostate dose of 66.6 Gy. More than 20 BF definitions were tested for their correlation with CF (any local failure or distant metastasis) and CSD. All BF definitions were tested for sensitivity, specificity, accuracy, and positive and negative value of predicting subsequent CF and CSD. The median follow-up was 5.0 years. Results: Three consecutive PSA rises yielded a 73% sensitivity, 76% specificity, and 75% overall accuracy for predicting CF. The 10-year CF rate (from the completion of radiotherapy) for those 251 patients demonstrating three consecutive rises (BF) was 64% vs. 14% for those patients who did not have three rises (biochemically controlled). Defining BF as a post-nadir increase to ≥3 ng/ml above the nadir yielded the highest accuracy of 87%. In addition, this definition also seemed to provide the greatest separation in CF rates: 82% for BF vs. 5% for biochemically controlled at 10 years after radiotherapy. CF rates were also calculated from the date of BF (e.g., date of third rise). The CF rates at 6 months and 2 years after the third PSA rise were 9% and 27%, respectively. The CF rates at 6 months and 2 years after an increase to

  8. [Circulating miR-152 helps early prediction of postoperative biochemical recurrence of prostate cancer].

    Science.gov (United States)

    Chen, Jun-Feng; Liao, Yu-Feng; Ma, Jian-Bo; Mao, Qi-Feng; Jia, Guang-Cheng; Dong, Xue-Jun

    2017-07-01

    To investigate the value of circulating miR-152 in the early prediction of postoperative biochemical recurrence of prostate cancer. Sixty-six cases of prostate cancer were included in this study, 35 with and 31 without biochemical recurrence within two years postoperatively, and another 31 healthy individuals were enrolled as normal controls. The relative expression levels of circulating miR-152 in the serum of the subjects were detected by qRT-PCR, its value in the early diagnosis of postoperative biochemical recurrence of prostate cancer was assessed by ROC curve analysis, and the correlation of its expression level with the clinicopathological parameters of the patients were analyzed. The expression of circulating miR-152 was significantly lower in the serum of the prostate cancer patients than in the normal controls (t = -5.212, P = 0.001), and so was it in the patients with than in those without postoperative biochemical recurrence (t = -5.727, P = 0.001). The ROC curve for the value of miR-152 in the early prediction of postoperative biochemical recurrence of prostate cancer showed the area under the curve (AUC) to be 0.906 (95% CI: 0.809-0.964), with a sensitivity of 91.4% and a specificity of 80.6%. The expression level of miR-152 was correlated with the Gleason score, clinical stage of prostate cancer, biochemical recurrence, and bone metastasis (P 0.05). The expression level of circulating miR-152 is significantly reduced in prostate cancer patients with biochemical recurrence after prostatectomy and could be a biomarker in the early prediction of postoperative biochemical recurrence of the malignancy.

  9. Defining biochemical failure after radiotherapy with and without androgen deprivation for prostate cancer

    International Nuclear Information System (INIS)

    Buyyounouski, Mark K.; Hanlon, Alexandra L.; Eisenberg, Debra F.; Horwitz, Eric M.; Feigenberg, Steven J.; Uzzo, Robert G.; Pollack, Alan

    2005-01-01

    Purpose: To compare several characteristics of alternative definitions of biochemical failure (BF) in men with extended follow-up after radiotherapy (RT) with or with androgen deprivation therapy (ADT) for prostate cancer. Methods and Materials: From December 1, 1991, to April 30, 1998, 688 men with Stage T1c-T3NX-N0M0 prostate cancer received RT alone (n = 586) or RT plus ADT (n = 102) with a minimal follow-up of 4 years and five or more 'ADT-free' posttreatment prostate-specific antigen levels. BF was defined by three methods: (1) the ASTRO definition (three consecutive rises in prostate-specific antigen level); (2) a modified American Society for Therapeutic Radiology Oncology (ASTRO) definition requiring two additional consecutive rises when a decline immediately subsequent to three consecutive rises occurred; and (3) the 'Houston' or nadir plus 2-ng/mL definition (a rise of at least 2 ng/mL greater than the nadir). The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were determined for each using clinical progression as the endpoint. Furthermore, the misclassification rates for a steadily rising prostate-specific antigen level, ability to satisfy the proportional hazards (RT with or without ADT), effects of short follow-up, and intervals to the diagnosis of BF were compared. Results: The misclassification rate for BF using the nadir plus 2-ng/mL definition was 2% for RT alone and 0% for RT plus ADT compared with 0% and 0% for the modified ASTRO definition, and 5% and 23% for the ASTRO definition, respectively. The hazard rates for RT alone and RT plus ADT were proportional only for the nadir plus 2 ng/mL definition and seemingly unaffected by the length of follow-up. For RT with or without ADT, the nadir plus 2 ng/mL definition was the most specific (RT, 80% vs. RT plus ADT, 75%) with the greatest positive predictive value (RT, 36% vs. RT plus ADT, 25%) and overall accuracy (RT, 81% vs. RT plus ADT, 77%). A

  10. Salvage Radiation Therapy Dose Response for Biochemical Failure of Prostate Cancer After Prostatectomy—A Multi-Institutional Observational Study

    Energy Technology Data Exchange (ETDEWEB)

    Pisansky, Thomas M., E-mail: pisansky.thomas@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Agrawal, Shree [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Hamstra, Daniel A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Koontz, Bridget F. [Department of Radiation Oncology, Duke Cancer Institute, Durham, North Carolina (United States); Liauw, Stanley L. [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois (United States); Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Michalski, Jeff M. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Abramowitz, Matthew C.; Pollack, Alan [Department of Radiation Oncology, University of Miami, Miami, Florida (United States); Anscher, Mitchell S. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Moghanaki, Drew [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Virginia (United States); Den, Robert B. [Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Stephans, Kevin L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Lee, W. Robert [Department of Radiation Oncology, Duke Cancer Institute, Durham, North Carolina (United States); Kattan, Michael W. [Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (United States); and others

    2016-12-01

    Purpose: To determine whether a dose-response relationship exists for salvage radiation therapy (RT) of biochemical failure after prostatectomy for prostate cancer. Methods and Materials: Individual data from 1108 patients who underwent salvage RT at 10 academic centers were pooled. The cohort was enriched for selection criteria more likely associated with tumor recurrence in the prostate bed (margin positive and pre-RT prostate-specific antigen [PSA] level of ≤2.0 ng/mL) and without the confounding of planned androgen suppression. The cumulative incidence of biochemical failure and distant metastasis over time was computed, and competing risks hazard regression models were used to investigate the association between potential predictors and these outcomes. The association of radiation dose with outcomes was the primary focus. Results: With a 65.2-month follow-up duration, the 5- and 10-year estimates of freedom from post-RT biochemical failure (PSA level >0.2 ng/mL and rising) was 63.5% and 49.8%, respectively, and the cumulative incidence of distant metastasis was 12.4% by 10 years. A Gleason score of ≥7, higher pre-RT PSA level, extraprostatic tumor extension, and seminal vesicle invasion were associated with worse biochemical failure and distant metastasis outcomes. A salvage radiation dose of ≥66.0 Gy was associated with a reduced cumulative incidence of biochemical failure, but not of distant metastasis. Conclusions: The use of salvage radiation doses of ≥66.0 Gy are supported by evidence presented in the present multicenter pooled analysis of individual patient data. The observational reporting method, limited sample size, few distant metastasis events, modest follow-up duration, and elective use of salvage therapy might have diminished the opportunity to identify an association between the radiation dose and this endpoint.

  11. Secondary Circulating Prostate Cells Predict Biochemical Failure in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Although 90% of prostate cancer is considered to be localized, 20%–30% of patients will experience biochemical failure (BF, defined as serum PSA >0.2 ng/mL, after radical prostatectomy (RP. The presence of circulating prostate cells (CPCs in men without evidence of BF may be useful to predict patients at risk for BF. We describe the frequency of CPCs detected after RP, relation with clinicopathological parameters, and association with biochemical failure. Methods and Patients. Serial blood samples were taken during followup after RP, mononuclear cells were obtained by differential gel centrifugation, and CPCs identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, nonorgan confined, pathological grade, margin status (positive, negative, extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative were compared with the presence/absence of CPCs and with and without biochemical failure. Kaplan Meier methods were used to compare the unadjusted biochemical failure free survival of patients with and without CPCs. Results. 114 men participated, and secondary CPCs were detected more frequently in patients with positive margins, extracapsular extension, and vascular and lymphatic infiltration and were associated with biochemical failure independent of these clinicopathological variables, and with a shorter time to BF. Conclusions. Secondary CPCs are an independent risk factor associated with increased BF in men with a PSA <0.2 ng/mL after radical prostatectomy, but do not determine if the recurrence is due to local or systemic disease. These results warrant larger studies to confirm the findings.

  12. Salvage Radiation Therapy Dose Response for Biochemical Failure of Prostate Cancer After Prostatectomy—A Multi-Institutional Observational Study

    International Nuclear Information System (INIS)

    Pisansky, Thomas M.; Agrawal, Shree; Hamstra, Daniel A.; Koontz, Bridget F.; Liauw, Stanley L.; Efstathiou, Jason A.; Michalski, Jeff M.; Feng, Felix Y.; Abramowitz, Matthew C.; Pollack, Alan; Anscher, Mitchell S.; Moghanaki, Drew; Den, Robert B.; Stephans, Kevin L.; Zietman, Anthony L.; Lee, W. Robert; Kattan, Michael W.

    2016-01-01

    Purpose: To determine whether a dose-response relationship exists for salvage radiation therapy (RT) of biochemical failure after prostatectomy for prostate cancer. Methods and Materials: Individual data from 1108 patients who underwent salvage RT at 10 academic centers were pooled. The cohort was enriched for selection criteria more likely associated with tumor recurrence in the prostate bed (margin positive and pre-RT prostate-specific antigen [PSA] level of ≤2.0 ng/mL) and without the confounding of planned androgen suppression. The cumulative incidence of biochemical failure and distant metastasis over time was computed, and competing risks hazard regression models were used to investigate the association between potential predictors and these outcomes. The association of radiation dose with outcomes was the primary focus. Results: With a 65.2-month follow-up duration, the 5- and 10-year estimates of freedom from post-RT biochemical failure (PSA level >0.2 ng/mL and rising) was 63.5% and 49.8%, respectively, and the cumulative incidence of distant metastasis was 12.4% by 10 years. A Gleason score of ≥7, higher pre-RT PSA level, extraprostatic tumor extension, and seminal vesicle invasion were associated with worse biochemical failure and distant metastasis outcomes. A salvage radiation dose of ≥66.0 Gy was associated with a reduced cumulative incidence of biochemical failure, but not of distant metastasis. Conclusions: The use of salvage radiation doses of ≥66.0 Gy are supported by evidence presented in the present multicenter pooled analysis of individual patient data. The observational reporting method, limited sample size, few distant metastasis events, modest follow-up duration, and elective use of salvage therapy might have diminished the opportunity to identify an association between the radiation dose and this endpoint.

  13. A Statistical Evaluation of Rules for Biochemical Failure After Radiotherapy in Men Treated for Prostate Cancer

    International Nuclear Information System (INIS)

    Bellera, Carine A.; Hanley, James A.; Joseph, Lawrence; Albertsen, Peter C.

    2009-01-01

    Purpose: The 'PSA nadir + 2 rule,' defined as any rise of 2 ng/ml above the current prostate-specific antigen (PSA) nadir, has replaced the American Society for Therapeutic Radiology and Oncology (ASTRO) rule, defined as three consecutive PSA rises, to indicate biochemical failure (BF) after radiotherapy in patients treated for prostate cancer. We propose an original approach to evaluate BF rules based on the PSAdt as the gold standard rule and on a simulation process allowing us to evaluate the BF rules under multiple settings (different frequency, duration of follow-up, PSA doubling time [PSAdt]). Methods and Materials: We relied on a retrospective, population-based cohort of individuals identified by the Connecticut Tumor Registry and treated for localized prostate cancer with radiotherapy. We estimated the 470 underlying true PSA trajectories, including the PSAdt, using a Bayesian hierarchical changepoint model. Next, we simulated realistic, sophisticated data sets that accurately reflect the systematic and random variations observed in PSA series. We estimated the sensitivity and specificity by comparing the simulated PSA series to the underlying true PSAdt. Results: For follow-up of more than 3 years, the specificity of the PSA nadir + 2 rule was systematically greater than that of the ASTRO criterion. In few settings, the nadir + 2 rule had a lower sensitivity than the ASTRO. The PSA nadir + 2 rule appeared less dependent on the frequency and duration of follow-up than the ASTRO. Conclusions: Our results provide some refinements to earlier findings as the BF rules were evaluated according to various parameters. In most settings, the PSA nadir + 2 rule outperforms the ASTRO criterion.

  14. Primary Gleason pattern in biopsy Gleason score 7 is predictive of adverse histopathological features and biochemical failure following radical prostatectomy

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Røder, Martin Andreas; Brasso, Klaus

    2014-01-01

    +3. No difference in age, PSA, percentage of biopsies with cancer, clinical tumour stage or volume on transrectal ultrasonography was found. Primary Gleason pattern 4 was associated with worse pathological stage (p = 0.049). On multivariate analysis, primary Gleason pattern 4 (p ... (p analysis, Gleason score 3+4 had a significantly lower biochemical failure rate compared with Gleason score 4+3 (p = 0.0035). PSA (p 4 (p = 0.001) and percentage of biopsies...

  15. A multicenter study demonstrating discordant results from electronic prostate-specific antigen biochemical failure calculation systems

    International Nuclear Information System (INIS)

    Williams, Scott G.; Pickles, Tom; Kestin, Larry; Potters, Louis; Fearn, Paul; Smith, Ryan; Pratt, Gary

    2006-01-01

    Purpose: To evaluate the interobserver variation of four electronic biochemical failure (bF) calculators using three bF definitions. Methods and Materials: The data of 1200 men were analyzed using the electronic bF calculators of four institutions. Three bF definitions were examined for their concordance of bF identification across the centers: the American Society for Therapeutic Radiology and Oncology consensus definition (ACD), the lowest prostate-specific antigen (PSA) level to date plus 2 ng/mL (L2), and a threshold of 3 ng/mL (T3). Results: Unanimous agreement regarding bF status using the ACD, L2, and T3 definitions occurred in 87.3%, 96.4%, and 92.7% of cases, respectively. Using the ACD, 63% of the variation was from one institution, which allowed the bF status to be reversed if a PSA decline was seen after bF (PSA 'bounce'). A total of 270 men had an ACD bF time variation of >2 months across the calculators, and the 5-year freedom from bF rate was 49.8-60.9%. The L2 definition had a 20.5% rate of calculated bF times; which varied by >2 months (median, 6.4; range, 2.1-75.6) and a corresponding 5-year freedom from bF rate of 55.9-61.0%. The T3 definition had a 2.0% range in the 5-year freedom from bF. Fifteen definition interpretation variations were identified. Conclusion: Reported bF results vary not only because of bF definition differences, but because of variations in how those definitions are written into computer-based calculators, with multiple interpretations most prevalent for the ACD. An algorithm to avoid misinterpretations is proposed for the L2 definition. A verification system to guarantee consistent electronic bF results requires development

  16. Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Crevoisier, Renaud de; Tucker, Susan L.; Dong Lei; Mohan, Radhe; Cheung, Rex; Cox, James D.; Kuban, Deborah A.

    2005-01-01

    Purpose: To retrospectively test the hypothesis that rectal distension on the planning computed tomography (CT) scan is associated with an increased risk of biochemical and local failure among patients irradiated for prostate carcinoma when a daily repositioning technique based on direct prostate-organ localization is not used. Methods and Materials: This study included 127 patients who received definitive three-dimensional conformal radiotherapy for prostate cancer to a total dose of 78 Gy at University of Texas M.D. Anderson Cancer Center. Rectal distension was assessed by calculation of the average cross-sectional rectal area (CSA; defined as the rectal volume divided by length) and measuring three rectal diameters on the planning CT. The impact of rectal distension on biochemical control, 2-year prostate biopsy results, and incidence of Grade 2 or greater late rectal bleeding was assessed. Results: The incidence of biochemical failure was significantly higher among patients with distended rectums (CSA >11.2 cm 2 ) on the planning CT scan (p 0.0009, log-rank test). Multivariate analysis indicates that rectal distension and high-risk disease are independent risk factors for biochemical failure, with hazard ratios of 3.89 (95% C.I. 1.58 to 9.56, p = 0.003) and 2.45 (95% C.I. 1.18 to 5.08, p = 0.016), respectively. The probability of residual tumor without evidence of radiation treatment (as scored by the pathologist) increased significantly with rectal distension (p = 0.010, logistic analysis), and a lower incidence of Grade 2 or greater late rectal bleeding within 2 years was simultaneously observed with higher CSA values (p = 0.031, logistic analysis). Conclusions: We found strong evidence that rectal distension on the treatment-planning CT scan decreased the probability of biochemical control, local control, and rectal toxicity in patients who were treated without daily image-guided prostate localization, presumably because of geographic misses. Therefore, an

  17. Biochemical and neurophysiological parameters in hemodialyzed patients with chronic renal failure

    NARCIS (Netherlands)

    Schoots, A.C.; Vries, de P.M.J.M.; Thiemann, R.C.J.; Hazejager, W.A.; Visser, S.L.; Oe, P.L.

    1989-01-01

    Serum concentrations of accumulated solutes, standard clinical biochemistry, and parameters of clinical neuropathy, were determined in hemodialyzed patients with chronic renal failure. Analyses by high-performance liquid chromatography included creatinine, pseudouridine, urate, p-hydroxyhippuric

  18. The role of androgen deprivation therapy on biochemical failure and distant metastasis in intermediate-risk prostate cancer: effects of radiation dose escalation

    International Nuclear Information System (INIS)

    Ludwig, Michelle S; Kuban, Deborah A; Du, Xianglin L; Lopez, David S; Yamal, Jose-Miguel; Strom, Sara S

    2015-01-01

    To determine whether the effect of androgen deprivation therapy (ADT) on the risk of biochemical failure varies at different doses of radiation in patients treated with definitive external beam radiation for intermediate risk prostate cancer (IRPC). This study included 1218 IRPC patients treated with definitive external beam radiation therapy to the prostate and seminal vesicles from June 1987 to January 2009 at our institution. Patient, treatment, and tumor information was collected, including age, race, Gleason score, radiation dose, PSA, T-stage, and months on ADT. The median follow-up was 6 years. A total of 421(34.6%) patients received ADT, 211 (17.3%) patients experienced a biochemical failure, and 38 (3.1%) developed distant metastasis. On univariable analyses, higher PSA, earlier year of diagnosis, higher T-stage, lower doses of radiation, and the lack of ADT were associated with an increased risk of biochemical failure. No difference in biochemical failure was seen among different racial groups or with the use of greater than 6 months of ADT compared with less than 6 months. On multivariate analysis, the use of ADT was associated with a lower risk of biochemical failure than no ADT (HR, 0.599; 95% CI, 0.367-0.978; P < 0.04) and lower risk of distant metastasis (HR, 0.114; 95% CI, 0.014-0.905; P = 0.04). ADT reduced the risk of biochemical failure and distant metastasis in both low- and high dose radiation groups among men with intermediate-risk PCa. Increasing the duration of ADT beyond 6 months did not reduce the risk of biochemical failures. Better understanding the benefit of ADT in the era of dose escalation will require a randomized clinical trial

  19. Evaluating the Phoenix definition of biochemical failure after (125)I prostate brachytherapy: Can PSA kinetics distinguish PSA failures from PSA bounces?

    Science.gov (United States)

    Thompson, Anna; Keyes, Mira; Pickles, Tom; Palma, David; Moravan, Veronika; Spadinger, Ingrid; Lapointe, Vincent; Morris, W James

    2010-10-01

    To evaluate the prostate-specific antigen (PSA) kinetics of PSA failure (PSAf) and PSA bounce (PSAb) after permanent (125)I prostate brachytherapy (PB). The study included 1,006 consecutive low and "low tier" intermediate-risk patients treated with (125)I PB, with a potential minimum follow-up of 4 years. Patients who met the Phoenix definition of biochemical failure (nadir + 2 ng/mL(-1)) were identified. If the PSA subsequently fell to ≤0.5 ng/mL(-1)without intervention, this was considered a PSAb. All others were scored as true PSAf. Patient, tumor and dosimetric characteristics were compared between groups using the chi-square test and analysis of variance to evaluate factors associated with PSAf or PSAb. Median follow-up was 54 months. Of the 1,006 men, 57 patients triggered the Phoenix definition of PSA failure, 32 (56%) were true PSAf, and 25 PSAb (44%). The median time to trigger nadir + 2 was 20.6 months (range, 6-36) vs. 49 mo (range, 12-83) for PSAb vs. PSAf groups (p < 0.001). The PSAb patients were significantly younger (p < 0.0001), had shorter time to reach the nadir (median 6 vs. 11.5 months, p = 0.001) and had a shorter PSA doubling time (p = 0.05). Men younger than age 70 who trigger nadir +2 PSA failure within 38 months of implant have an 80% likelihood of having PSAb and 20% chance of PSAf. With adequate follow-up, 44% of PSA failures by the Phoenix definition in our cohort were found to be benign PSA bounces. Our study reinforces the need for adequate follow-up when reporting PB PSA outcomes, to ensure accurate estimates of treatment efficacy and to avoid unnecessary secondary interventions. 2010. Published by Elsevier Inc. All rights reserved.

  20. Evaluating the Phoenix Definition of Biochemical Failure After 125I Prostate Brachytherapy: Can PSA Kinetics Distinguish PSA Failures From PSA Bounces?

    International Nuclear Information System (INIS)

    Thompson, Anna; Keyes, Mira; Pickles, Tom

    2010-01-01

    Purpose: To evaluate the prostate-specific antigen (PSA) kinetics of PSA failure (PSAf) and PSA bounce (PSAb) after permanent 125 I prostate brachytherapy (PB). Methods and Materials: The study included 1,006 consecutive low and 'low tier' intermediate-risk patients treated with 125 I PB, with a potential minimum follow-up of 4 years. Patients who met the Phoenix definition of biochemical failure (nadir + 2 ng/mL -1 ) were identified. If the PSA subsequently fell to ≤0.5 ng/mL -1 without intervention, this was considered a PSAb. All others were scored as true PSAf. Patient, tumor and dosimetric characteristics were compared between groups using the chi-square test and analysis of variance to evaluate factors associated with PSAf or PSAb. Results: Median follow-up was 54 months. Of the 1,006 men, 57 patients triggered the Phoenix definition of PSA failure, 32 (56%) were true PSAf, and 25 PSAb (44%). The median time to trigger nadir + 2 was 20.6 months (range, 6-36) vs. 49 mo (range, 12-83) for PSAb vs. PSAf groups (p < 0.001). The PSAb patients were significantly younger (p < 0.0001), had shorter time to reach the nadir (median 6 vs. 11.5 months, p = 0.001) and had a shorter PSA doubling time (p = 0.05). Men younger than age 70 who trigger nadir +2 PSA failure within 38 months of implant have an 80% likelihood of having PSAb and 20% chance of PSAf. Conclusions: With adequate follow-up, 44% of PSA failures by the Phoenix definition in our cohort were found to be benign PSA bounces. Our study reinforces the need for adequate follow-up when reporting PB PSA outcomes, to ensure accurate estimates of treatment efficacy and to avoid unnecessary secondary interventions.

  1. [Heart failure as early manifestation of neonatal hyperthyroidism. Case report].

    Science.gov (United States)

    Alvarado S, Jorge Luis; Fernández V, Zhirly Andrea

    2014-04-01

    Neonatal hyperthyroidism is usually a self-limited condition frequently associated with transplacental passage of thyroid stimulating antibodies secondary to maternal autoimmune disorders. To timely detect mothers with this medical antecedents decreases the risk for fetal adverse events. To report a case of neonatal hyperthyroidism associated with intrauterine growth restriction and heart failure. A 36 week-old newborn with birth weight of 1,240 g. Symptoms were tachycardia, distal coldness, exophthalmos, hepatomegaly and tremors. Echocardiogram ruled out structural heart disorders. Due to maternal symptoms suggestive of hyperthyroidism, TSH tests were performed showing 0.01 ulU/ml, free T4 7.7 ng/dl, so the diagnosis of neonatal hyperthyroidism was confirmed. It was treated with methimazole and propanol, alleviating the symptoms and decreasing the levels of free T4. To know the maternal history helps identify and manage neonatal complications of hyperthyroidism. Heart failure and other cardiopulmonary disorders are determinants of mortality during early neonatal period. High-risk newborns should receive follow up assessments.

  2. The Interval to Biochemical Failure Is Prognostic for Metastasis, Prostate Cancer-Specific Mortality, and Overall Mortality After Salvage Radiation Therapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Johnson, Skyler; Jackson, William; Li, Darren; Song, Yeohan; Foster, Corey; Foster, Ben; Zhou, Jessica; Vainshtein, Jeffrey; Feng, Felix; Hamstra, Daniel

    2013-01-01

    Purpose: To investigate the utility of the interval to biochemical failure (IBF) after salvage radiation therapy (SRT) after radical prostatectomy (RP) for prostate cancer as a surrogate endpoint for distant metastasis (DM), prostate cancer-specific mortality (PCSM), and overall mortality (OM). Methods and Materials: A retrospective analysis of 575 patients treated with SRT after RP from a single institution. Of those, 250 patients experienced biochemical failure (BF), with the IBF defined as the time from commencement of SRT to BF. The IBF was evaluated by Kaplan-Meier and Cox proportional hazards models for its association with DM, PCSM, and OM. Results: The median follow-up time was 85 (interquartile range [IQR] 49.8-121.1) months, with a median IBF of 16.8 (IQR, 8.5-37.1) months. With a cutoff time of 18 months, as previously used, 129 (52%) of patients had IBF ≤18 months. There were no differences among any clinical or pathologic features between those with IBF ≤ and those with IBF >18 months. On log–rank analysis, IBF ≤18 months was prognostic for increased DM (P<.0001, HR 4.9, 95% CI 3.2-7.4), PCSM (P<.0001, HR 4.1, 95% CI 2.4-7.1), and OM (P<.0001, HR 2.7, 95% CI 1.7-4.1). Cox proportional hazards models with adjustment for other clinical variables demonstrated that IBF was independently prognostic for DM (P<.001, HR 4.9), PCSM (P<.0001, HR 4.0), and OM (P<.0001, HR 2.7). IBF showed minimal change in performance regardless of androgen deprivation therapy (ADT) use. Conclusion: After SRT, a short IBF can be used for early identification of patients who are most likely to experience progression to DM, PCSM, and OM. IBF ≤18 months may be useful in clinical practice or as an endpoint for clinical trials

  3. Impact of biochemical failure on overall survival after radiation therapy for localized prostate cancer in the PSA era

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Buchsbaum, Jeffrey C.; Patel, Chandrika; Elshaikh, Mohamed; Reddy, Chandana A.; Zippe, Craig; Klein, Eric A.

    2002-01-01

    Purpose: To study the impact of biochemical failure on overall survival rates during the first 10 years after definitive radiotherapy for localized prostate cancer. Methods and Materials: The analysis was performed on 936 cases treated at a single institution between 1986 and 1998 with definitive radiotherapy. The median age of treatment was 69 years (range: 46-86 years). Pretreatment PSA levels (iPSA) and biopsy Gleason scores (bGS) were available for all cases. The clinical stage was T1/T2A in 63%, T2B/C in 27%, and T3 in 10%. The median iPSA level was 9.6 ng/mL (range: 0.4-692.9 ng/mL). The iPSA was ≤10 in 53% and >10 in 47%. The bGS was ≤6 in 59% and ≥7 in 41%. Androgen deprivation (AD) was administered in 181 cases (19%) for a median duration of 6 months (range: 1-6 months). All 181 cases received AD neoadjuvantly, i.e., before and/or during the radiotherapy. No AD was delivered after the completion of radiation. The median radiation dose was 70 Gy (range: 60-78 Gy). The radiotherapy technique was conformal in 376 (40%) cases. The American Society of Therapeutic Radiology and Oncology definition of biochemical failure (bF) was used; 316 cases (34%) had failed biochemically, and 620 (66%) had not. The end point was overall survival (OS). Time to death was determined from the time of definitive radiotherapy. The median PSA follow-up was 58 months. The median follow-up times for bF vs. no-bF cases were 77 and 49 months, respectively. A multivariate analysis of factors affecting OS using the proportional hazards model was performed for all cases using the following variables: age (>65 vs. ≤65 years), race (African-American vs. Caucasian), clinical T stage (T1-2A vs. T2B-C vs. T3), bGS (≤6 vs. 7 vs. ≥8), iPSA (continuous variable), use of AD (yes vs. no), year of therapy (continuous variable), radiation dose (continuous variable), radiation technique (conformal vs. standard), and biochemical failure (yes vs. no). Results: The 5-year OS rate for the

  4. Recognizing False Biochemical Failure Calls After Radiation With or Without Neo-Adjuvant Androgen Deprivation for Prostate Cancer

    International Nuclear Information System (INIS)

    Denham, James W.; Kumar, Mahesh; Gleeson, Paul S.; Lamb, David S.; Joseph, David FRANZCR.; Atkinson, Chris FRANZCR.; Matthews, John FRANZCR.; Tai, K.-H.; Spry, Nigel A.; Christie, David; Turner, Sandra FRANZCR.; Greer, Peter B.; D'Este, Catherine; Steigler, Allison

    2009-01-01

    Purpose: We studied prostate-specific antigen (PSA) changes after radiation with or without neoadjuvant androgen deprivation to determine posttreatment PSA scenarios in which false-positive biochemical failures (FPBF) are most likely to occur. Methods and Materials: In the Trans-Tasman Radiation Oncology 96.01 Group trial, patients with T2b, 2c, 3, 4 N0 prostate cancer were randomized to 3 or 6 months goserelin and flutamide (STAD) before and during 66 Gy to the prostate and seminal vesicles (XRT) or to XRT alone. Piecewise longitudinal changes in PSA before relapse were characterized and quantified to determine which might cause FPBF calls. Results: Between 1996 and 2000, 802 eligible patients were randomized. Of these, 492 met the criteria for American Society for Therapeutic Radiology and Oncology (ASTRO) failure and 467 for Phoenix failure. Seventy-seven ASTRO fails and 39 Phoenix fails were deemed false positives (FPs). The majority of FPBFs were associated with the 'plateauing' in PSA values that follow posttreatment nadir. FPBFs were particularly common in men treated with STAD, in whom small, consecutive PSA rises before or during this phenomenon triggered 56 FP ASTRO fail calls. In these men, the Phoenix fail criteria triggered only 15 FPBF calls. However, the Phoenix criteria were more vulnerable than ASTRO to short-term isolated PSA rises during plateau, which resulted in 15 Phoenix fail calls but only 3 FP ASTRO fails. Conclusions: The Phoenix definition avoided 50% of FPBF calls that occurred with the ASTRO definition. Failures should be confirmed by further PSA rises before investigation and treatment is considered.

  5. The public health challenge of early growth failure in India.

    Science.gov (United States)

    Young, M F; Martorell, R

    2013-05-01

    Recent recognition of the early onset and high prevalence of wasting (30%) and stunting (20%) among infants 0-5 months in India draws attention to the need to understand the causes and develop prevention strategies. Such growth failure has dire consequences in the short (increased mortality) and long-term (loss of human capital and increased risk of chronic diseases). Food interventions before 6 months will increase morbidity/mortality through contamination in settings of poor sanitation and hygiene. Waiting to improve nutrition only after the initiation of complementary feeding at 6 months is a missed opportunity and may permanently alter life trajectory and potential. This underscores the importance of maternal nutrition. Iron and folic acid and protein energy supplementation during pregnancy are interventions that can improve maternal nutrition and birth outcomes. Maternal supplementation during lactation should be considered as a means to improve maternal and child outcomes, although the evidence needs strengthening. Support and counseling are also required to improve maternal diets and promote exclusive breastfeeding. Programs focused on improving maternal nutrition across the continuum of preconception, pregnancy and lactation are likely to have the greatest impact as mothers are central gatekeepers to the health and future of their children.

  6. Measuring Time to Biochemical Failure in the TROG 96.01 Trial: When Should the Clock Start Ticking?

    International Nuclear Information System (INIS)

    Denham, James W.; Steigler, Allison; Kumar, Mahesh; Lamb, David S.; Joseph, David; Spry, Nigel A.; Tai, Keen-Hun; Atkinson, Chris; Turner, Sandra FRANZCR; Greer, Peter B.; Gleeson, Paul S.; D'Este, Catherine

    2009-01-01

    Purpose: We sought to determine whether short-term neoadjuvant androgen deprivation (STAD) duration influences the optimal time point from which Phoenix fail (time to biochemical failure; TTBF) should be measured. Methods and Materials: In the Trans-Tasman Radiation Oncology Group 96.01 trial, men with locally advanced prostate cancer were randomized to 3 or 6 months STAD before and during prostatic irradiation (XRT) or to XRT alone. The prognostic value of TTBF measured from the end of radiation (ERT) and randomization were compared using Cox models. Results: Between 1996 and 2000, 802 eligible patients were randomized. In 436 men with Phoenix failure, TTBF measured from randomization was a powerful predictor of prostate cancer-specific survival and marginally more accurate than TTBF measured from ERT in Cox models. Insufficient data were available to confirm that TTBF measured from testosterone recovery may also be a suitable option. Conclusions: TTBF measured from randomization (commencement of therapy) performed well in this trial dataset and will be a convenient option if this finding holds in other datasets that include long-term androgen deprivation data.

  7. Biochemical Analysis of Synovial Fluid, Cerebrospinal Fluid and Vitreous Humor at Early Postmortem Intervals in Donkeys

    Directory of Open Access Journals (Sweden)

    Doha Yahia

    2014-01-01

    Full Text Available Biochemical analysis of body fluids after death is a helpful tool in veterinary forensic medicine. Synovial fluid, cerebrospinal fluid (CSF and vitreous humor are easily accessible and well preserved from contamination. Five donkeys (Equus africanus asinus aged 1 - 2 years old were subjected to the study. Samples (Synovial fluid, CSF and vitreous humor were collected before death (antimortem and then at 2, 4, 6, 8, 10 and 12 hours postmortem. Samples were analyzed for glucose, chloride, sodium, magnesium, potassium, enzymes and total protein. Synovial fluid analysis showed that glucose concentration started to decrease at 6 hours postmortem, while magnesium level increased with time. Other parameters were more stable. CSF analysis showed several changes related to time after death as the decrease in glucose and sodium levels, and the increased levels of potassium, magnesium, calcium and total protein. Vitreous analysis revealed a reduction in glucose level and increased potassium and magnesium concentrations. The present study concluded that biochemical analysis of synovial fluid, vitreous humor and CSF can help in determination of time since death in donkeys. This study recommend using CSF for determination of early post-mortem intervals.

  8. Biochemical failure and the temporal kinetics of prostate-specific antigen after radiation therapy with androgen deprivation

    International Nuclear Information System (INIS)

    Buyyounouski, Mark K.; Hanlon, Alexandra L.; Horwitz, Eric M.; Uzzo, Robert G.; Pollack, Alan

    2005-01-01

    Purpose: The accuracy of the American Society of Therapeutic Radiation Oncology consensus definition of biochemical failure (BF) after radiation therapy (RT) and androgen deprivation (AD) has been questioned, because posttreatment prostate-specific antigen (PSA) levels typically rise after release from AD, and misclassification of BF may be made. The temporal kinetics of posttreatment PSA levels was examined to define the error in the classification of BF. Methods and Materials: Between December 1, 1991 and April 30, 1998, 688 men with T1c-T3 NX/0 M0 prostate cancer received three-dimensional conformal RT alone (n = 586) or in combination with either short-term (STAD: 3 to 12 months, n = 82) or long-term (LTAD: 12 to 36 months, n = 20) AD. Follow-up, calculated from the end of all treatment, was ≥48 months. The mean posttreatment PSA was calculated in 3-month intervals. Results: The median posttreatment clinical follow-up period was 76 months (range, 48-152 months). The posttreatment PSA values from the end of all treatment for the RT+STAD-BF group showed an initial period of rise followed by a period of decline at 30 months and then a continued rise again. The decline in the mean posttreatment PSA is explained in part by stabilization in PSA level after 3 consecutive rises. Nonbiochemical failures (NBF) after RT+STAD had a relatively constant mean PSA over time of approximately 0.5 ng/mL. Unlike the RT+STAD-NBF profile, the RT+LTAD-NBF profile rose continuously and steadily to a level approaching 1 ng/mL. The RT+LTAD-BF profile rose continuously but at a slower rate over time. Nine RT+STAD-NBF patients (22%) and 2 RT+LTAD-BF (29%) patients experienced 3 consecutive rises followed by a subsequent decline and stabilization of PSA compared to 10 RT-BF patients (5%). Redistributing these misclassified patients to their respective NBF groups changed the mean posttreatment PSA profiles as follows: The RT+LTAD-BF profile rose constantly and steadily with a doubling

  9. Biochemical, histopathological and morphological profiling of a rat model of early immune stimulation: relation to psychopathology.

    Directory of Open Access Journals (Sweden)

    Anna Kubesova

    Full Text Available Perinatal immune challenge leads to neurodevelopmental dysfunction, permanent immune dysregulation and abnormal behaviour, which have been shown to have translational validity to findings in human neuropsychiatric disorders (e.g. schizophrenia, mood and anxiety disorders, autism, Parkinson's disease and Alzheimer's disease. The aim of this animal study was to elucidate the influence of early immune stimulation triggered by systemic postnatal lipopolysaccharide administration on biochemical, histopathological and morphological measures, which may be relevant to the neurobiology of human psychopathology. In the present study of adult male Wistar rats we examined the brain and plasma levels of monoamines (dopamine, serotonin, their metabolites, the levels of the main excitatory and inhibitory neurotransmitters glutamate and γ-aminobutyric acid and the levels of tryptophan and its metabolites from the kynurenine catabolic pathway. Further, we focused on histopathological and morphological markers related to pathogenesis of brain diseases--glial cell activation, neurodegeneration, hippocampal volume reduction and dopaminergic synthesis in the substantia nigra. Our results show that early immune stimulation in adult animals alters the levels of neurotransmitters and their metabolites, activates the kynurenine pathway of tryptophan metabolism and leads to astrogliosis, hippocampal volume reduction and a decrease of tyrosine hydroxylase immunoreactivity in the substantia nigra. These findings support the crucial pathophysiological role of early immune stimulation in the above mentioned neuropsychiatric disorders.

  10. Predictive factors for early failure of transarterial embolization in blunt hepatic injury patients

    International Nuclear Information System (INIS)

    Lee, Y.-H.; Wu, C.-H.; Wang, L.-J.; Wong, Y.-C.; Chen, H.-W.; Wang, C.-J.; Lin, B.-C.; Hsu, Y.-P.

    2014-01-01

    Aim: To evaluate the early success of transarterial embolization (TAE) in patients with traumatic liver haemorrhage and to determine independent factors for its failure. Materials and methods: From January 2009 to December 2012, TAE was performed in 48 patients for traumatic liver haemorrhage. Their medical charts were reviewed for demographic information, pre-TAE vital signs and laboratory data, injury grade, type of contrast medium extravasation (CME) at CT, angiography findings, and early failure. “Early failure” was defined as the need for repeated TAE or a laparotomy for hepatic haemorrhage within 4 days after TAE. Variables were compared between the early success and early failure groups. Variables with univariate significance were also analysed using multivariate logistic regression for predictors of early failure. Results: Among 48 liver TAE cases, nine (18.8%) were early failures due to liver haemorrhage. Early failure was associated with injury grade (p = 0.039), major liver injury (grades 4 and 5; p = 0.007), multiple CMEs at angiography (p = 0.031), incomplete TAE (p = 0.002), and elevated heart rate (p = 0.026). Incomplete embolization (OR = 8; p = 0.042), and heart rate >110 beats/min (bpm; OR = 8; p = 0.05) were independent factors for early failure of TAE in the group with major liver injuries. Conclusion: Major hepatic injury is an important factor in early failure. Patients with a heart rate >110 bpm and incomplete embolization in the major injury group have an increased rate of early failure. The success rate of proximal TAE was comparable to that of the more time-consuming, superselective, distal TAE. - Highlights: • Early failure of TAE is associated with a higher grade of liver injury. • Incomplete embolization is more likely to suffer early failure of TAE. • A heart rate greater than 110 bpm is more likely to suffer early failure of TAE. • We recommend proximal embolization to prevent early failure of TAE

  11. A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer

    Science.gov (United States)

    2014-04-01

    the Fanconi Anemia Pathway- Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer PRINCIPAL INVESTIGATOR...GRANT NUMBER 4. TITLE AND SUBTITLE A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Fanconi anemia is the most prevalent inherited BMF syndromes, caused by mutations in

  12. Influence Of Feminine Hormones On Some Biochemical Parameters In Early And Late Menopausal Status

    International Nuclear Information System (INIS)

    KAMAL, A.M.

    2009-01-01

    Forty two healthy Egyptian women were participated in this study to evaluate the effect of early and late menopause on some biochemical and hormonal parameters. The women were divided into three equal groups. The first was the pre-menopausal group with regular menstrual cycle, the second was the late menopausal group comprised the menopausal female less than 5 years and the third group consisted of women that became menopause since 5-9 years. The second and third groups had almost the same age and body weight. After clinical examination, fasting blood samples were collected from all volunteers. Regarding the pre-menopausal women, blood was withdrawn between the 3 rd and the 5 th day post-menstruation (follicular phase). Follicle stimulating hormone (FSH), leutinizing hormone (LH), progesterone, prolactin (PRL), testosterone, leptin and thyroxine (T4) in addition to hemoglobin (Hb), blood glucose, calcium (Ca), inorganic phosphorous (P), magnesium (Mg) and uric acid were determined. Both menopausal groups showed significant increase in FSH and LH and significant decrease in PRL and late menopausal group experienced also multiple significant correlations between FSH, LH and other tested parameters. Prolongation of menopause exhibited decrease in leptin being significant as compared to pre-menopausal women than that experienced menopause at younger age. Due to the relation between leptin hormone and osteoporosis, the results of this investigation denoted that early cessation of annulations (menopause) in Egyptian women may lead to disturbance in bone metabolism causing inhibiting osteoblastogenesis and decreasing bone mass.

  13. Lower early postnatal oxygen saturation target and risk of ductus arteriosus closure failure.

    Science.gov (United States)

    Inomata, Kei; Taniguchi, Shinji; Yonemoto, Hiroki; Inoue, Takeshi; Kawase, Akihiko; Kondo, Yuichi

    2016-11-01

    Early postnatal hyperoxia is a major risk factor for retinopathy of prematurity (ROP) in extremely premature infants. To reduce the occurrence of ROP, we adopted a lower early postnatal oxygen saturation (SpO 2 ) target range (85-92%) from April 2011. Lower SpO 2 target range, however, may lead to hypoxemia and an increase in the risk of ductus arteriosus (DA) closure failure. The aim of this study was therefore to determine whether a lower SpO 2 target range, during the early postnatal stage, increases the risk of DA closure failure. Infants born at closure failure in period 2 (21%) was significantly higher than that in period 1 (1%). On multivariate logistic regression analysis, the lower oxygen saturation target range was an independent risk factor for DA closure failure. Lower early postnatal oxygen saturation target range increases the risk of DA closure failure. © 2016 Japan Pediatric Society.

  14. Influence of salinity on the early development and biochemical dynamics of a marine fish, Inimicus japonicus

    Science.gov (United States)

    Gong, Xu; Huang, Xuxiong; Wen, Wen

    2018-03-01

    Fertilised eggs of the devil stringer ( Inimicus japonicus) were incubated at different salinity levels (21, 25, 29, 33, and 37), and then the hatching performances, morphological parameters, and biochemical composition (protein, lipid and carbohydrate) of the larvae were assayed to determine the influence of salinity on the early development of I. japonicus. The tested salinity levels did not affect the times of hatching or mouth opening for yolk-sac larvae. However, the salinity significantly influenced the hatching and survival rates of open-mouthed larvae, as well as the morphology of yolk-sac larvae. The data indicated that 30.5 to 37.3 and 24.4 to 29.8 were suitable salinity ranges for the survival of embryos and larvae of I. japonicus, respectively. Larvae incubated at a salinity level of 29 had the greatest full lengths, and decreasing yolk volume was positively correlated with the environmental salinity. With increasing salinity, the individual dry weights of newly hatched larvae or open-mouthed larvae decreased significantly. Newly hatched larvae incubated at a salinity level of 29 had the greatest metabolic substrate contents and gross energy levels, while the openmouthed larvae's greatest values occurred at a salinity level of 25. Larvae incubated in the salinity range of 33 to 37 had the lowest nutritional reserves and energy values. Thus, the I. japonicus yolk-sac larvae acclimated more readily to the lower salinity level than the embryos, and higher salinity levels negatively influenced larval growth and development. In conclusion, the environmental salinity level should be maintained at 29-33 during embryogenesis and at 25-29 during early larval development for this species. Our results can be used to provide optimum aquaculture conditions for the early larval development of I. japonicus.

  15. Biochemical and Radiobiological Factors in the Early Detection of Radiation Injury in Mammals

    Energy Technology Data Exchange (ETDEWEB)

    Cole, L. J. [Life Sciences Division, Stanford Research Institute, Menlo Park, CA (United States)

    1971-03-15

    In considering the body of radiobiological knowledge upon which the present possibilities for the development of an objective quantitative laboratory procedure for early detection of radiation injury depend, it is evident that there are at least three general categories of radiation effects which are relevant to this objective: (1) Products of the enzymatic-chemical breakdown of macromolecules, and lysis of killed or dying cells from radiosensitive tissues, for example deoxypolynucleotides from lymphoid tissues and bone marrow; (2) Radiation-induced inhibition of synthesis of deoxyribonucleic acid (DNA) and/or other macromolecules, eliciting alterations in tissue and blood concentrations and pool size of metabolic intermediates in the synthesis, for example, deoxycytidine; (3) Radiation-induced alterations, suppression, or cessation of specialized cell function; of particular interest here is the immunological functions of lymphocytes, including those in the circulating blood. For rodents, the exquisite radiosensitivity of bone-marrow-stem cells as well as of lymphocytes has been precisely measured by modern cellular radiobiological techniques: the colony-forming technique of Till and McCulloch, yielding a D{sub 0} for bone-marrow cells of about 80 R; and the graft-versus-host reactivity of transplanted lymphocytes yielding a similar D{sub 0} value. In our own hands, a modified colony-formation technique for dog bone-marrow cells irradiated in.vitro and in vivo give D{sub 0} values of {approx}100 R. Thus, on the basis of radiation sensitivity and the time-relationships for interphase cell death for lymphocytes, it appears that this cell class is probably the best ''candidate'' source for an early radiation-injury detection system. However,- the important report by Zicha and Buric indicates that extrapolation of biochemical data on radiation dosimetry from rodents to man is not necessarily feasible, at least in the. case of the urinary excretion of deoxycytidine

  16. Early short-term management of control-actuator failures in a linear dynamic system

    International Nuclear Information System (INIS)

    Ben-Haim, Y.

    1989-01-01

    Early short-term management of malfunction attempts to maintain system stability during the early development stages of a failure. This is achieved in two stages. First, the failure is partially diagnosed by comparing observed system behavior against the performance expected for each of the selected set of hypothesized malfunctions. Second, the normal controller is replaced by a compensatory controller whose aim is to maintain system stability while compensating for the failure. Malfunctions involving control actuators are studied here. The aim of this study is to develop a technique for choosing the set of hypothesized failures and compensatory controllers which assure that the state of the system remains within specified bounds for a given duration after initiation of failure, regardless of the precise temporal development of the failure

  17. Defining biochemical recurrence after radical prostatectomy and timing of early salvage radiotherapy. Informing the debate

    International Nuclear Information System (INIS)

    Budaeus, Lars; Schiffmann, Jonas; Graefen, Markus; Huland, Hartwig; Tennstedt, Pierre; Siegmann, Alessandra; Boehmer, Dirk; Budach, Volker; Bartkowiak, Detlef; Wiegel, Thomas

    2017-01-01

    The optimal prostate-specific antigen (PSA) level after radical prostatectomy (RP) for defining biochemical recurrence and initiating salvage radiation therapy (SRT) is still debatable. Whereas adjuvant or extremely early SRT irrespective of PSA progression might be overtreatment for some patients, SRT at PSA >0.2 ng/ml might be undertreatment for others. The current study addresses the optimal timing of radiation therapy after RP. Cohort 1 comprised 293 men with PSA 0.1-0.19 ng/ml after RP. Cohort 2 comprised 198 men with SRT. PSA progression and metastases were assessed in cohort 1. In cohort 2, we compared freedom from progression according to pre-SRT PSA (0.03-0.19 vs. 0.2-0.499 ng/ml). Multivariable Cox regression analyses predicted progression after SRT. In cohort 1, 281 (95.9%) men had further PSA progression ≥0.2 ng/ml and 27 (9.2%) men developed metastases within a median follow-up of 74.3 months. In cohort 2, we recorded improved freedom from progression according to lower pre-SRT PSA (0.03-0.19 vs. 0.2-0.499 ng/ml: 69 vs. 53%; log-rank p = 0.051). Patients with higher pre-SRT PSA ≥0.2 ng/ml were at a higher risk of progression after SRT (hazard ratio: 1.8; p [de

  18. Hematological and biochemical indicators for the early diagnosis of dengue viral infection

    International Nuclear Information System (INIS)

    Butt, N.; Abbasi, A.; Sheikh, Q.H.

    2008-01-01

    To determine the haematological and biochemical indicators for the early diagnosis of dengue viral infection. Patients presenting with a fever of less than 2 weeks duration, generalized morbiliform rash and bleeding manifestations were included. Clinical history was recorded and patients were placed on fluid and haematological support. Diagnosis was established by Polymerase Chain Reaction (PCR) for dengue virus or detection of dengue virus specific IgM and IgG. One hundred and four patients met the inclusion criteria during the study period. Sixty six patients had clinical and haematological features suggestive of grade I Dengue Hemorrhagic Fever (DHF); 34 patients had grade II DHF and 4 had grade III DHF out of whom 3 progressed to grade IV DHF. All the patients presented with fever followed by generalized morbiliform rash (81.73%), vomiting (79.8%), abdominal pain (65.38%), backache (62.5%), depression (60.6%) and mucosal bleeding manifestations (34.6%). Clinically, conjunctival infection was present in 93 patients (89.4%), hepatomegaly 59 (56.7%), lymphadenopathy in 17 (16.3%), splenomegaly in 13 (12.5%), pleural effusion in 11 (10.5%) and ascites in 8 (7.6%). Common laboratory findings were thrombocytopenia in 100% patients, leucopenia in 55 (52.8%), raised hematocrit in 52 (50%), and elevated aminotransferases, gamma GT in 100 (96%) patients. The overall mortality was 2.88%. In this series clinical history and examination supported by the triad of thrombocytopenia, raised hematocrit and elevated liver enzymes was sufficient for the early diagnosis of dengue hemorrhagic fever without waiting for dengue serology. (author)

  19. Core Competencies and the Prevention of School Failure and Early School Leaving

    Science.gov (United States)

    Bradshaw, Catherine P.; O'Brennan, Lindsey M.; McNeely, Clea A.

    2008-01-01

    There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase…

  20. The correlation between the astro consensus panel definition of biochemical failure and clinical outcome for patients with prostate cancer treated with external beam irradiation

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Matter, Richard C.; Martinez, Alvaro A.

    1997-01-01

    Purpose: The ASTRO Consensus Panel on PSA After Radiation Therapy recently recommended a definition of biochemical failure (BF) following treatment of prostate cancer with radiation therapy. We reviewed our institution's experience treating patients with external beam irradiation (RT) to determine if the Consensus Panel definition correlates with clinical distant metastases free survival (DMFS), disease free survival (DFS), cause specific survival (CSS), and local control (LC) rates for a large group of patients from the PSA era. Methods And Materials: Between 1/1/87 and 12/31/92, 653 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. Of these patients, 568 had a minimum follow-up of 2 years and constitute the study population. The median pre-treatment PSA and Gleason score was 11 ng/ml and 6, respectively. The median dose to the prostate using megavoltage RT was 66.6 Gy (range: 60-70.4 Gy) using a four field or arc technique. No patient received hormonal therapy either prior to, during, or after radiotherapy unless local or distant failure was documented. Pre-treatment and post-treatment serum PSA levels were recorded. Biochemical failure was defined as three consecutive increases in post-treatment PSA after achieving a nadir. Biochemical failure was recorded as the time midway between the nadir and first increase in PSA. Five year actuarial rates of DMFS, DFS, CSS, and LC were calculated for patients who were biochemically controlled (BC) versus those who failed biochemically. Results: Median follow-up was 56 months (range: 24-118 months). The overall 5 year actuarial rates of DMFS, DFS, CSS, and LC were significantly better in patients who were biochemically controlled versus those who were not (p< 0.001). The median time to DM within the BF group was 21 months (range: 2-112 months). When stratifying by pre-treatment PSA, Gleason score, and T stage, these

  1. UAV Swarm Behavior Modeling for Early Exposure of Failure Modes

    Science.gov (United States)

    2016-09-01

    have felt like an absentee husband and father, through the rigor and struggles of completing this thesis, they not only continuously provided support...to understand their specific 12 product , they must now have a firm understanding of how their product fits into a plethora of other systems...mission in Monterey Phoenix (MP) proved to provide valuable insight into identifying failure modes and failsafe behaviors. A product of this research

  2. Dielectric Spectroscopic Detection of Early Failures in 3-D Integrated Circuits.

    Science.gov (United States)

    Obeng, Yaw; Okoro, C A; Ahn, Jung-Joon; You, Lin; Kopanski, Joseph J

    The commercial introduction of three dimensional integrated circuits (3D-ICs) has been hindered by reliability challenges, such as stress related failures, resistivity changes, and unexplained early failures. In this paper, we discuss a new RF-based metrology, based on dielectric spectroscopy, for detecting and characterizing electrically active defects in fully integrated 3D devices. These defects are traceable to the chemistry of the insolation dielectrics used in the through silicon via (TSV) construction. We show that these defects may be responsible for some of the unexplained early reliability failures observed in TSV enabled 3D devices.

  3. Health Visitor's Role in Prediction of Early Childhood Injuries and Failure to Thrive.

    Science.gov (United States)

    Dean, Janet G.; And Others

    1978-01-01

    Discusses the role of the health visitor in the prediction of early childhood injuries, abuse, and failure to thrive--based on a three-year study of the relationship between early maternal attitudes and subsequent child health. Journal availability: Pergamon Press Ltd., Headington Hill Hall, Oxford, OX3 OBW England. (DLS)

  4. Sheehan's Syndrome Presenting with Early Postpartum Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Shu-Yi Wang

    2005-08-01

    Full Text Available We report the case of a young woman with Sheehan's syndrome who presented with ventricular arrhythmia and congestive heart failure. The patient was admitted because of postpartum hemorrhage and hypovolemic shock; a massive blood transfusion was required to restore blood volume. After initial stabilization, the patient developed acute respiratory distress and congestive heart failure accompanied by hemodynamic instability 2 weeks after delivery. Episodes of ventricular tachycardia of the torsade de pointes type and a prolonged QT interval were noted on baseline electrocardiogram. A low cortisol level was found incidentally, which led to the suspicion of hypopituitarism. The diagnosis was later supported by laboratory findings of multiple pituitary hormone deficiencies. After administration of corticosteroids and thyroxine, the patient's clinical condition improved dramatically. A pituitary magnetic resonance imaging scan 32 days after delivery revealed a diminished and flattened pituitary gland with prominent intrasellar cerebrospinal fluid loculation, which was compatible with the clinical diagnosis of empty sella with panhypopituitarism. The syndrome of acute anterior pituitary necrosis secondary to postpartum hemorrhage and shock was first described by Sheehan in 1939. Although the occurrence of Sheehan's syndrome is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency. Appropriate hormone replacement therapy is essential and always results in dramatic clinical improvement.

  5. The correlation between the ASTRO consensus panel definition of biochemical failure and clinical outcome for patients with prostate cancer treated with external beam irradiation

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Martinez, Alvaro A.

    1998-01-01

    Purpose: We reviewed our institution's experience treating patients with external beam irradiation (RT) to determine if the ASTRO Consensus Panel definition of biochemical failure (BF) following radiation therapy correlates with clinical distant metastases free survival (DMFS), disease-free survival (DFS), cause-specific survival (CSS), and local control (LC). Methods and Materials: Between 1/1/87 and 12/31/92, 568 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital (median total dose 66.6 Gy; range: 60-70.4 Gy). Biochemical failure was defined as three consecutive increases in post-treatment prostate specific antigen (PSA) after achieving a nadir. Biochemical failure was recorded as the time midway between the nadir and the first rising PSA. Five-year actuarial rates of clinical DMFS, DFS, CSS, and LC were calculated for patients who were biochemically controlled (BC) versus those who failed biochemically. Median follow-up was 56 months (range: 24-118 months). Results: Five-year actuarial rates of DMFS, DFS, CSS, and LC were significantly greater in patients who were biochemically controlled versus those who were not (p < 0.001). In patients who were BC, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 99%, 99%, 98%, and 99% respectively. For patients who failed biochemically, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 74%, 64%, 89%, and 86% respectively. When stratifying by pretreatment PSA, Gleason score, and T stage these differences remained significant for DMFS, DFS, and CSS. The Cox proportional hazards model demonstrated that BC was the single most important predictor of clinical outcome for DMFS, DFS, CSS, and LC. Pretreatment PSA and Gleason score were also independent predictors of outcome for DMFS and DFS. Conclusions: The ASTRO Consensus Panel definition of BF following radiation therapy correlates well with clinical DMFS, DFS

  6. Early PET imaging with [68]Ga-PSMA-11 increases the detection rate of local recurrence in prostate cancer patients with biochemical recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Uprimny, Christian; Kroiss, Alexander Stephan; Decristoforo, Clemens; Kendler, Dorota; Guggenberg, Elisabeth von; Nilica, Bernhard; Maffey-Steffan, Johanna; Di Santo, Gianpaolo; Virgolini, Irene Johanna [Medical University Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Fritz, Josef [Medical University Innsbruck, Department of Medical Statistics, Informatics and Health Economics, Innsbruck (Austria); Bektic, Jasmin; Horninger, Wolfgang [Medical University Innsbruck, Department of Urology, Innsbruck (Austria)

    2017-09-15

    PET/CT using {sup 68}Ga-labelled prostate-specific membrane antigen PSMA-11 (HBEDD-CC) has emerged as a promising imaging method in the diagnostic evaluation of prostate cancer (PC) patients with biochemical recurrence. However, assessment of local recurrence (LR) may be limited by intense physiologic tracer accumulation in the urinary bladder on whole-body scans, normally conducted 60 min post-tracer injection (p.i.). It could be shown on early dynamic imaging studies that {sup 68}Ga-PSMA-11 uptake in PC lesions occurs earlier than tracer accumulation in the urinary bladder. This study aims to investigate whether early static PET acquisition increases detection rate of local recurrence on {sup 68}Ga-PSMA-11 PET/CT in comparison to PET imaging 60 min p.i. 203 consecutive PC patients with biochemical failure referred to {sup 68}Ga-PSMA-11 PET/CT were analysed retrospectively (median prostate specific antigen (PSA) value: 1.44 ng/ml). In addition to whole-body PET/CT scans 60 min p.i., early static imaging of the pelvis was performed, starting at a median time of 283 s p.i. (range: 243-491 s). Assessment was based on visual analysis and calculation of maximum standardized uptake value (SUV{sub max}) of pathologic lesions present in the pelvic area found on early PET imaging and on 60 min-PET scans. 26 patients (12.8%) were judged positive for LR on PET scans 60 min p.i. (median SUV{sub max}: 10.8; range: 4.7-40.9), whereas 50 patients (24.6%) revealed a lesion suggestive of LR on early PET imaging (median SUV{sub max}: 5.9; range: 2.9-17.6), resulting in a significant rise in detection rate (p < 0.001). Equivocal findings on PET scans 60 min p.i. decreased significantly with the help of early imaging (15.8% vs. 4.5% of patients; p < 0.001). Tracer activity in the urinary bladder with a median SUV{sub max} of 8.2 was present in 63 patients on early PET scans (31.0%). However, acquisition starting time of early PET scans differed significantly in the patient groups

  7. Clinical indicators for success of misoprostol treatment after early pregnancy failure.

    Science.gov (United States)

    Robledo, C; Zhang, J; Troendle, J; Barnhart, K; Creinin, M D; Westhoff, C; Huang, X; Frederick, M

    2007-10-01

    To identify clinical indicators for success of misoprostol treatment after early pregnancy failure. A total of 473 women with early pregnancy failure received 800 microg of vaginal misoprostol on treatment day 1. At the follow-up visit on day 3, a second dose was given if expulsion was incomplete. On day 8, vacuum aspiration was offered if expulsion had not occurred. Ultrasonography was used as gold standard for success. A Classification and Regression Tree analysis was undertaken to derive two decision trees for the success of misoprostol treatment on study days 3 and 8. Heavy bleeding after the first dose and an open cervical os were identified as clinical indicators of treatment success on day 3. Treatment success occurred in 84% of women with either or both indicators. Reporting passage of tissue after a second misoprostol dose and old blood in the vagina were potential indicators of treatment success or failure on day 8. A woman with either of these indicators has a 65% chance of treatment success after the second dose. Conversely, a woman with neither indicator on day 8 has a 94% chance of treatment failure. Standard clinical findings may be useful as indicators for success or failure of medical management of early pregnancy failure in settings with limited or no access to ultrasonography. More research to identify even better indicators is warranted.

  8. Failure to thrive among neonates, associated factors and early neonatal outcome

    International Nuclear Information System (INIS)

    Thomas, Erica; Manji, Karim; Mpembeni Rose

    2005-01-01

    Failure to thrive or growth failure is an important feature of problems prevalent in the neonate. It remains one of the greatest challenges for the practicing pediatrician and it is a common pathway or outcome of several different underlaying infant and maternal conditions. To determine the prevalence, possible causes and early neonatal outcome of failure to thrive among young infants admitted to the Neonatal Unit in this hospital. A cross-sectional descriptive hospital based study, was carried for 10 months from April 2001 to January 2002 at the Neonatal Unit at Muhimbili National Hospital. (author)

  9. Defining biochemical recurrence after radical prostatectomy and timing of early salvage radiotherapy. Informing the debate

    Energy Technology Data Exchange (ETDEWEB)

    Budaeus, Lars; Schiffmann, Jonas; Graefen, Markus; Huland, Hartwig; Tennstedt, Pierre [University Medical Center Hamburg-Eppendorf, Martini-Clinic, Prostate Cancer Center, Hamburg (Germany); Siegmann, Alessandra; Boehmer, Dirk; Budach, Volker [Charite University Hospital, Department of Radiation Oncology, Berlin (Germany); Bartkowiak, Detlef; Wiegel, Thomas [University Hospital Ulm, Department of Radiation Oncology, Ulm (Germany)

    2017-09-15

    The optimal prostate-specific antigen (PSA) level after radical prostatectomy (RP) for defining biochemical recurrence and initiating salvage radiation therapy (SRT) is still debatable. Whereas adjuvant or extremely early SRT irrespective of PSA progression might be overtreatment for some patients, SRT at PSA >0.2 ng/ml might be undertreatment for others. The current study addresses the optimal timing of radiation therapy after RP. Cohort 1 comprised 293 men with PSA 0.1-0.19 ng/ml after RP. Cohort 2 comprised 198 men with SRT. PSA progression and metastases were assessed in cohort 1. In cohort 2, we compared freedom from progression according to pre-SRT PSA (0.03-0.19 vs. 0.2-0.499 ng/ml). Multivariable Cox regression analyses predicted progression after SRT. In cohort 1, 281 (95.9%) men had further PSA progression ≥0.2 ng/ml and 27 (9.2%) men developed metastases within a median follow-up of 74.3 months. In cohort 2, we recorded improved freedom from progression according to lower pre-SRT PSA (0.03-0.19 vs. 0.2-0.499 ng/ml: 69 vs. 53%; log-rank p = 0.051). Patients with higher pre-SRT PSA ≥0.2 ng/ml were at a higher risk of progression after SRT (hazard ratio: 1.8; p < 0.05). The vast majority of patients with PSA ≥0.1 ng/ml after RP will progress to PSA ≥0.2 ng/ml. Additionally, early administration of SRT at post-RP PSA level <0.2 ng/ml might improve freedom from progression. Consequently, we suggest a PSA threshold of 0.1 ng/ml to define biochemical recurrence after RP. (orig.) [German] Der optimale Wert des prostataspezifischen Antigens (PSA) nach radikaler Prostatektomie (RP) zur Definition eines biochemischen Rezidivs und zur Initiierung einer Salvage-Strahlentherapie (SRT) ist noch immer umstritten. Waehrend eine adjuvante oder extrem fruehe SRT unabhaengig vom PSA-Verlauf fuer einige Patienten eine Uebertherapie bedeuten wuerde, waere eine SRT bei einem PSA >0,2 ng/ml fuer andere eine Untertherapie. In der vorliegenden Studie wird der optimale

  10. Establishment of a rat model of early-stage liver failure and Th17/Treg imbalance

    OpenAIRE

    LI Dong; LU Zhonghua; GAN Jianhe

    2016-01-01

    ObjectiveTo investigate the methods for establishing a rat model of early-stage liver failure and the changes in Th17, Treg, and Th17/Treg after dexamethasone and thymosin interventions. MethodsA total of 64 rats were randomly divided into carbon tetrachloride (CCl4) group and endotoxin [lipopolysaccharide (LPS)]/D-galactosamine (D-GalN) combination group to establish the rat model of early-stage liver failure. The activities of the rats and changes in liver function and whole blood Th17 and ...

  11. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: Recommendations of the RTOG-ASTRO Phoenix Consensus Conference

    International Nuclear Information System (INIS)

    Roach, Mack; Hanks, Gerald; Thames, Howard; Schellhammer, Paul; Shipley, William U.; Sokol, Gerald H.; Sandler, Howard

    2006-01-01

    In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined 'at call' (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to 'adequate follow-up.' To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature

  12. Relation between body composition and biochemical markers of bone turnover among early postmenopausal women

    DEFF Research Database (Denmark)

    Hla, M M; Davis, J W; Ross, P D

    2000-01-01

    , and whole body bone mineral content (BMC) with biochemical markers of bone formation (serum osteocalcin) and resorption (urinary type I collagen crosslinked N-telopeptides [NTX]). Per interquartile range (IQR) (the difference between 75th and 25th percentiles) increase in fat mass and whole body BMC...

  13. Deriving Prostate Alpha-Beta Ratio Using Carefully Matched Groups, Long Follow-Up and the Phoenix Definition of Biochemical Failure

    International Nuclear Information System (INIS)

    Shaffer, Richard; Pickles, Tom; Lee, Richard; Moiseenko, Vitali

    2011-01-01

    Purpose: Prior studies have derived low values of alpha-beta ratio (a/ss) for prostate cancer of approximately 1-2 Gy. These studies used poorly matched groups, differing definitions of biochemical failure, and insufficient follow-up. Methods and Materials: National Comprehensive Cancer Network low- or low-intermediate risk prostate cancer patients, treated with external beam radiotherapy or permanent prostate brachytherapy, were matched for prostate-specific antigen, Gleason score, T-stage, percentage of positive cores, androgen deprivation therapy, and era, yielding 118 patient pairs. The Phoenix definition of biochemical failure was used. The best-fitting value for a/ss was found for up to 90-month follow-up using maximum likelihood analysis, and the 95% confidence interval using the profile likelihood method. Linear quadratic formalism was applied with the radiobiological parameters of relative biological effectiveness = 1.0, potential doubling time = 45 days, and repair half-time = 1 hour. Bootstrap analysis was performed to estimate uncertainties in outcomes, and hence in a/ss. Sensitivity analysis was performed by varying the values of the radiobiological parameters to extreme values. Results: The value of a/ss best fitting the outcomes data was >30 Gy, with lower 95% confidence limit of 5.2 Gy. This was confirmed on bootstrap analysis. Varying parameters to extreme values still yielded best-fit a/ss of >30 Gy, although the lower 95% confidence interval limit was reduced to 0.6 Gy. Conclusions: Using carefully matched groups, long follow-up, the Phoenix definition of biochemical failure, and well-established statistical methods, the best estimate of a/ss for low and low-tier intermediate-risk prostate cancer is likely to be higher than that of normal tissues, although a low value cannot be excluded.

  14. Phenomenological uncertainty analysis of early containment failure at severe accident of nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Won

    2011-02-15

    The severe accident has inherently significant uncertainty due to wide range of conditions and performing experiments, validation and practical application are extremely difficult because of its high temperature and pressure. Although internal and external researches were put into practice, the reference used in Korean nuclear plants were foreign data of 1980s and safety analysis as the probabilistic safety assessment has not applied the newest methodology. Also, it is applied to containment pressure formed into point value as results of thermal hydraulic analysis to identify the probability of containment failure in level 2 PSA. In this paper, the uncertainty analysis methods for phenomena of severe accident influencing early containment failure were developed, the uncertainty analysis that apply Korean nuclear plants using the MELCOR code was performed and it is a point of view to present the distribution of containment pressure as a result of uncertainty analysis. Because early containment failure is important factor of Large Early Release Frequency(LERF) that is used as representative criteria of decision-making in nuclear power plants, it was selected in this paper among various modes of containment failure. Important phenomena of early containment failure at severe accident based on previous researches were comprehended and methodology of 7th steps to evaluate uncertainty was developed. The MELCOR input for analysis of the severe accident reflected natural circulation flow was developed and the accident scenario for station black out that was representative initial event of early containment failure was determined. By reviewing the internal model and correlation for MELCOR model relevant important phenomena of early containment failure, the uncertainty factors which could affect on the uncertainty were founded and the major factors were finally identified through the sensitivity analysis. In order to determine total number of MELCOR calculations which can

  15. [11C]Choline PET/CT predicts survival in hormone-naive prostate cancer patients with biochemical failure after radical prostatectomy

    International Nuclear Information System (INIS)

    Giovacchini, Giampiero; Incerti, Elena; Mapelli, Paola; Gianolli, Luigi; Picchio, Maria; Kirienko, Margarita; Briganti, Alberto; Gandaglia, Giorgio; Montorsi, Francesco

    2015-01-01

    Over the last decade, PET/CT with radiolabelled choline has been shown to be useful for restaging patients with prostate cancer (PCa) who develop biochemical failure. The limitations of most clinical studies have been poor validation of [ 11 C]choline PET/CT-positive findings and lack of survival analysis. The aim of this study was to assess whether [ 11 C]choline PET/CT can predict survival in hormone-naive PCa patients with biochemical failure. This retrospective study included 302 hormone-naive PCa patients treated with radical prostatectomy who underwent [ 11 C]choline PET/CT from 1 December 2004 to 31 July 2007 because of biochemical failure (prostate-specific antigen, PSA, >0.2 ng/mL). Median PSA was 1.02 ng/mL. PCa-specific survival was estimated using Kaplan-Meier curves. Cox regression analysis was used to evaluate the association between clinicopathological variables and PCa-specific survival. The coefficients of the covariates included in the Cox regression analysis were used to develop a novel nomogram. Median follow-up was 7.2 years (1.4 - 18.9 years). [ 11 C]Choline PET/CT was positive in 101 of 302 patients (33 %). Median PCa-specific survival after prostatectomy was 14.9 years (95 % CI 9.7 - 20.1 years) in patients with positive [ 11 C]choline PET/CT. Median survival was not achieved in patients with negative [ 11 C]choline PET/CT. The 15-year PCa-specific survival probability was 42.4 % (95 % CI 31.7 - 53.1 %) in patients with positive [ 11 C]choline PET/CT and 95.5 % (95 % CI 93.5 - 97.5 %) in patients with negative [ 11 C]choline PET/CT. In multivariate analysis, [ 11 C]choline PET/CT (hazard ratio 6.36, 95 % CI 2.14 - 18.94, P < 0.001) and Gleason score >7 (hazard ratio 3.11, 95 % CI 1.11 - 8.66, P = 0.030) predicted PCa-specific survival. An internally validated nomogram predicted 15-year PCa-specific survival probability with an accuracy of 80 %. Positive [ 11 C]choline PET/CT after biochemical failure predicts PCa-specific survival in hormone

  16. Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate.

    Science.gov (United States)

    Quast, Michaela B; Sviggum, Hans P; Hanson, Andrew C; Stoike, David E; Martin, David P; Niesen, Adam D

    2018-05-01

    Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. Retrospective study. Postoperative recovery unit and inpatient hospital floor. 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database. Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model. 119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449). These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed. Copyright © 2018. Published by Elsevier Inc.

  17. Chronicity of Anterior Cruciate Ligament Deficiency, Part 2: Radiographic Predictors of Early Graft Failure.

    Science.gov (United States)

    Tanaka, Yoshinari; Kita, Keisuke; Takao, Rikio; Amano, Hiroshi; Uchida, Ryohei; Shiozaki, Yoshiki; Yonetani, Yasukazu; Kinugasa, Kazutaka; Mae, Tatsuo; Horibe, Shuji

    2018-02-01

    Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear. We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI). Cohort study; Level of evidence, 3. A total of 358 patients who had undergone anatomic ACL reconstruction with hamstring grafts were divided into 5 groups based on chronicity of ACLD: (1) 0 to 6 months, (2) 6 months to 1 year, (3) 1 to 2 years, (4) 2 to 5 years, and (5) longer than 5 years. Preoperatively and immediately postoperatively, lateral radiographs in full extension were taken in all patients to evaluate the tibiofemoral relationship, specifically with regard to ATS, space for the ACL (sACL), and extension angle. All patients underwent MRI at 6 months to reveal graft status. Groups with a high rate of graft failure were further analyzed to compare demographic and radiographic factors between the intact and failure subgroups, followed by multivariate logistic regression analysis to identify predisposing factors. Graft failure without trauma was observed in 4 (1.8%), 0 (0%), 1 (3.7%), 3 (9.7%), and 8 patients (17.7%) in groups 1, 2, 3, 4, and 5, respectively. Of the 76 patients in groups 4 and 5, significant differences were noted between the failure and intact subgroups in preoperative ATS (4.9 vs 2.4 mm, respectively; P failure (odds ratio, 3.2; 95% CI, 1.37-7.46). Early graft failure at 6 months increased in patients with ACLD

  18. Early Treatment Outcome in Failure to Thrive: Predictions from a Transactional Model.

    Science.gov (United States)

    Drotar, Dennis

    Children diagnosed with environmentally based failure to thrive early during their first year of life were seen at 12 and 18 months for assessment of psychological development (cognition, language, symbolic play, and behavior during testing). Based on a transactional model of outcome, factors reflecting biological vulnerability (wasting and…

  19. The difference in causes of early and late ultrafiltration failure in peritoneal dialysis

    NARCIS (Netherlands)

    Smit, Watske; Parikova, Alena; Struijk, Dirk G.; Krediet, Raymond T.

    2005-01-01

    OBJECTIVE: Ultrafiltration failure (UFF) is a major complication of peritoneal dialysis. Although it seems associated with long-term treatment, it can also occur in recently started patients. To identify the causes of this complication in patients with early and late UFF we studied a group of 48

  20. Proposed salvage treatment strategy for biochemical failure after radical prostatectomy in patients with prostate cancer: a retrospective study

    International Nuclear Information System (INIS)

    Miyake, Makito; Tanaka, Nobumichi; Asakawa, Isao; Morizawa, Yosuke; Anai, Satoshi; Torimoto, Kazumasa; Aoki, Katsuya; Yoneda, Tatsuo; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2014-01-01

    Treatment options for patients with recurrent disease after radical prostatectomy include salvage radiotherapy of the prostatic bed and/or androgen deprivation therapy. To establish an effective treatment strategy for recurrent disease after radical prostatectomy, we retrospectively analyzed the outcome of salvage radiation monotherapy in such cases. Data from 61 men who had undergone salvage radiation monotherapy for biochemical recurrent disease after radical prostatectomy were retrospectively reviewed. In all patients, salvage radiotherapy consisted of iraradiation to the prostatic bed (70 Gy) using three-dimensional conformal radiotherapy techniques. Treatment outcome was analyzed to identify predictive factors of salvage radiotherapy. The biochemical recurrence-free survival after salvage radiation monotherapy at 2 and 5 years was 55% and 38%, respectively. Cox proportional regression models revealed that the independent predictive factors for biochemical recurrence were Gleason Score ≥ 8, negative surgical margin, and PSA velocity ≥ 0.38 ng/mL/year. Negative surgical margin and PSA velocity ≥ 0.8 ng/mL/year were significantly associated with poor response in the serum PSA levels after salvage radiotherapy. Based on our findings, we propose a treatment strategy for biochemical recurrent disease after radical prostatectomy. Patients with Gleason score ≤ 7, positive surgical margin, and PSA velocity < 0.38 ng/mL/year are categorized the most favorable group, so that eradication by salvage radiation monotherapy could be expected. Other patients could be divided to two groups depending on surgical margin status and PSA velocity: 1) patients who might require combination of SRT and short-term androgen deprivation therapy and 2) patients who should be treated by androgen deprivation monotherapy

  1. Risk factors for and impact of respiratory failure on mortality in the early phase of acute pancreatitis

    DEFF Research Database (Denmark)

    Dombernowsky, Tilde; Kristensen, Marlene Østermark; Rysgaard, Sisse

    2016-01-01

    : Retrospective cohort study including 359 patients admitted with acute pancreatitis. Information was gathered from electronic patient records. We defined respiratory failure based on the modified Marshall scoring system in the revised Atlanta criteria. Predictors of respiratory failure were evaluated......, or pneumonia may develop respiratory failure, suggests that acute lung injury, possibly associated with systemic inflammation, may be important.......BACKGROUND: The incidence of respiratory failure and other respiratory complications in the early phase of acute pancreatitis (AP) is not well investigated. OBJECTIVE: To evaluate the incidence and risk factors of respiratory failure, and its impact on mortality in the early phase AP. METHODS...

  2. Outcome of Early Initiation of Peritoneal Dialysis in Patients with End-Stage Renal Failure

    Science.gov (United States)

    Oh, Kook-Hwan; Hwang, Young-Hwan; Cho, Jung-Hwa; Kim, Mira; Ju, Kyung Don; Joo, Kwon Wook; Kim, Dong Ki; Kim, Yon Su; Ahn, Curie

    2012-01-01

    Recent studies reported that early initiation of hemodialysis may increase mortality. However, studies that assessed the influence of early initiation of peritoneal dialysis (PD) yielded controversial results. In the present study, we evaluated the prognosis of early initiation of PD on the various outcomes of end stage renal failure patients by using propensity-score matching methods. Incident PD patients (n = 491) who started PD at SNU Hospital were enrolled. The patients were divided into 'early starters (n = 244)' and 'late starters (n = 247)' on the basis of the estimated glomerular filtration rate (eGFR) at the start of dialysis. The calculated propensity-score was used for one-to-one matching. After propensity-score-based matching (n = 136, for each group), no significant differences were observed in terms of all-cause mortality (P = 0.17), technique failure (P = 0.62), cardiovascular event (P = 0.96) and composite event (P = 0.86) between the early and late starters. Stratification analysis in the propensity-score quartiles (n = 491) exhibited no trend toward better or poorer survival in terms of all-cause mortality. In conclusion, early commencement of PD does not reduce the mortality risk and other outcomes. Although the recent guidelines suggest that initiation of dialysis at higher eGFR, physicians should not determine the time to initiate PD therapy simply rely on the eGFR alone. PMID:22323864

  3. Successes and failures of DFT functionals in acid/base and redox reactions of organic and biochemical interest

    OpenAIRE

    Silva, Pedro J.; Ramos, Maria João

    2011-01-01

    The performance of 18 different DFT functionals in the prediction of absolute and relative energies of organic and biochemical acid/base and redox reactions was evaluated, using MP2 extrapolated to the complete basis set limit and CCSD(T)/aug-cc-pVTZ energies as benchmark. Absolute reduction energies were predicted with relatively large average errors (2–4 kcal mol−1) except for the best functional, PBE0 (1.3 ± 1.2 kcal mol−1). The DFT predictions of relative reduction energies afforded mean ...

  4. Biochemical failure after radical prostatectomy in intermediate-risk group men increases with the number of risk factors

    Directory of Open Access Journals (Sweden)

    Nobuki Furubayashi

    2017-01-01

    Conclusion: The number of intermediate risk factors is significantly associated with the PSA failure-free survival rate after radical prostatectomy in the intermediate-risk group. Patients classified into the intermediate-risk group based on all three intermediate risk factors are less likely to achieve a complete cure through surgery alone.

  5. Electrocardiographic, hemodynamic, and biochemical responses to acute particulate matter (PM) exposure in aged heart failure-prone rats

    Science.gov (United States)

    Human exposure to ambient PM from fossil-fuel emissions is linked to cardiovascular disease and death. This association strengthens in people with preexisting cardiac disease-especially heart failure (HF). The mechanisms explaining PM-induced exacerbation ofHF are unclear. Some o...

  6. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non......-traumatic lower-extremity amputation. METHODS: We studied a consecutive one-year series of 36 men and 34 women with a median (25-75% quartiles) age of 72 (63-83) years who were treated in an acute orthopaedic ward; 44 below-knee and 26 above-knee amputees of whom 47 had an American Society of Anesthesiologists...... rating above two. Patient characteristics and other factors potentially influencing early amputation failure within 30 days were evaluated. RESULTS: Eleven patients died (16%) and 11 (16%) had a re-amputation at a higher level, whereas four (6%) had a major revision at the same level within 30 days...

  7. Interval to Biochemical Failure Predicts Clinical Outcomes in Patients With High-Risk Prostate Cancer Treated by Combined-Modality Radiation Therapy

    International Nuclear Information System (INIS)

    Shilkrut, Mark; McLaughlin, P. William; Merrick, Gregory S.; Vainshtein, Jeffrey M.; Feng, Felix Y.; Hamstra, Daniel A.

    2013-01-01

    Purpose: To validate the prognostic value of interval to biochemical failure (IBF) in patients with high-risk prostate cancer (HiRPCa) treated with combined-modality radiation therapy (CMRT) with or without androgen deprivation therapy (ADT). Methods and Materials: We conducted a retrospective review of HiRPCa (prostate-specific antigen >20 ng/mL, Gleason score [GS] 8-10, or clinical T stage T3-T4) treated with either dose-escalated external beam radiation therapy (EBRT) or CMRT. Interval to biochemical failure was classified as ≤18 or >18 months from the end of all therapy to the date of biochemical failure (BF). Kaplan-Meier methods and Cox proportional hazards regression were used to evaluate the prognostic value of IBF ≤18 months for distant metastasis (DM) and prostate cancer-specific mortality (PCSM). Results: Of 958 patients with a median follow-up of 63.2 months, 175 patients experienced BF. In those with BF, there were no differences in pretreatment clinical characteristics between the EBRT and CMRT groups, except for a higher proportion of patients with GS 8-10 in the CMRT group (70% vs 52%, P=.02). Median IBF after all therapy was 24.0 months (interquartile range 9.6-46.0) in the EBRT group and 18.9 months (interquartile range 9.2-34.5) in the CMRT group (P=.055). On univariate analysis, IBF ≤18 months was associated with increased risk of DM and PCSM in the entire cohort and the individual EBRT and CMRT groups. On multivariate analysis, only GS 9-10 and IBF ≤18 months, but not the radiation therapy regimen or ADT use, predicted DM (hazard ratio [HR] 3.7, P<.01, 95% confidence interval [CI] 1.4-10.3 for GS 9-10; HR 3.9, P<.0001, 95% CI 2.4-6.5 for IBF ≤18 months) and PCSM (HR 14.8, P<.009, 95% CI 2.0-110 for GS 9-10; HR 4.4, P<.0001, 95% CI 2.4-8.1 for IBF ≤18 months). Conclusions: Short IBF was highly prognostic for higher DM and PCSM in patients with HiRPCa. The prognostic value of IBF for DM and PCSM was not affected by the radiation

  8. Proinflammatory Cytokines, Enolase and S-100 as Early Biochemical Indicators of Hypoxic-Ischemic Encephalopathy Following Perinatal Asphyxia in Newborns.

    Science.gov (United States)

    Chaparro-Huerta, Verónica; Flores-Soto, Mario Eduardo; Merin Sigala, Mario Ernesto; Barrera de León, Juan Carlos; Lemus-Varela, María de Lourdes; Torres-Mendoza, Blanca Miriam de Guadalupe; Beas-Zárate, Carlos

    2017-02-01

    Estimation of the neurological prognosis of infants suffering from perinatal asphyxia and signs of hypoxic-ischemic encephalopathy is of great clinical importance; however, it remains difficult to satisfactorily assess these signs with current standard medical practices. Prognoses are typically based on data obtained from clinical examinations and neurological tests, such as electroencephalography (EEG) and neuroimaging, but their sensitivities and specificities are far from optimal, and they do not always reliably predict future neurological sequelae. In an attempt to improve prognostic estimates, neurological research envisaged various biochemical markers detectable in the umbilical cord blood of newborns (NB). Few studies examining these biochemical factors in the whole blood of newborns exist. Thus, the aim of this study was to determine the expression and concentrations of proinflammatory cytokines (TNF-α, IL-1β and IL-6) and specific CNS enzymes (S-100 and enolase) in infants with perinatal asphyxia. These data were compared between the affected infants and controls and were related to the degree of HIE to determine their utilities as biochemical markers for early diagnosis and prognosis. The levels of the proinflammatory cytokines and enzymes were measured by enzyme-linked immunosorbent assay (ELISA) and Reverse Transcription polymerase chain reaction (RT-PCR). The expression and serum levels of the proinflammatory cytokines, enolase and S-100 were significantly increased in the children with asphyxia compared with the controls. The role of cytokines after hypoxic-ischemic insult has been determined in studies of transgenic mice that support the use of these molecules as candidate biomarkers. Similarly, S-100 and enolase are considered promising candidates because these markers have been correlated with tissue damage in different experimental models. Copyright © 2016. Published by Elsevier B.V.

  9. Physiological and biochemical stress responses in grassland species are influenced by both early-season ozone exposure and interspecific competition

    Energy Technology Data Exchange (ETDEWEB)

    Scebba, Francesca [Department of Agricultural Chemistry and Biotechnology, University of Pisa, Via del Borghetto 80, 56124 Pisa (Italy); Canaccini, Francesca [Department of Agricultural Chemistry and Biotechnology, University of Pisa, Via del Borghetto 80, 56124 Pisa (Italy); Castagna, Antonella [Department of Agricultural Chemistry and Biotechnology, University of Pisa, Via del Borghetto 80, 56124 Pisa (Italy); Bender, Juergen [Institute of Agroecology, FAL, Bundesallee 50, 38116 Braunschweig (Germany); Weigel, Hans-Joachim [Institute of Agroecology, FAL, Bundesallee 50, 38116 Braunschweig (Germany); Ranieri, Annamaria [Department of Agricultural Chemistry and Biotechnology, University of Pisa, Via del Borghetto 80, 56124 Pisa (Italy)]. E-mail: aranieri@agr.unipi.it

    2006-08-15

    The effects of two-year early season ozone exposure on physiological and biochemical stress response were investigated in model plant communities. Achillea millefolium and Veronica chamaedrys target plants were grown in monocultures and in mixed cultures with Poa pratensis (phytometer) and exposed in open-top chambers over two years for five weeks to charcoal-filtered (CF) air plus 25 nl l{sup -1} O{sub 3} (control) and non-filtered (NF) air plus 50 nl l{sup -1} O{sub 3}. Significant O{sub 3} effects were detected in different physiological and biochemical parameters, evidencing interspecific differences in metabolic stress responses and a strong influence of the competition factor. O{sub 3} induced strong oxidative effects in Achillea irrespective to the different growth modality. Veronica showed less O{sub 3}-induced effects in monoculture than when grown in competition with the phytometer. Poa exhibited a different behaviour against O{sub 3} depending on the species in competition, showing an overall higher sensitivity to O{sub 3} when in mixture with Achillea. - The competition between species modulates the ozone effect in a short-term.

  10. Physiological and biochemical stress responses in grassland species are influenced by both early-season ozone exposure and interspecific competition

    International Nuclear Information System (INIS)

    Scebba, Francesca; Canaccini, Francesca; Castagna, Antonella; Bender, Juergen; Weigel, Hans-Joachim; Ranieri, Annamaria

    2006-01-01

    The effects of two-year early season ozone exposure on physiological and biochemical stress response were investigated in model plant communities. Achillea millefolium and Veronica chamaedrys target plants were grown in monocultures and in mixed cultures with Poa pratensis (phytometer) and exposed in open-top chambers over two years for five weeks to charcoal-filtered (CF) air plus 25 nl l -1 O 3 (control) and non-filtered (NF) air plus 50 nl l -1 O 3 . Significant O 3 effects were detected in different physiological and biochemical parameters, evidencing interspecific differences in metabolic stress responses and a strong influence of the competition factor. O 3 induced strong oxidative effects in Achillea irrespective to the different growth modality. Veronica showed less O 3 -induced effects in monoculture than when grown in competition with the phytometer. Poa exhibited a different behaviour against O 3 depending on the species in competition, showing an overall higher sensitivity to O 3 when in mixture with Achillea. - The competition between species modulates the ozone effect in a short-term

  11. Physiological and biochemical stress responses in grassland species are influenced by both early-season ozone exposure and interspecific competition.

    Science.gov (United States)

    Scebba, Francesca; Canaccini, Francesca; Castagna, Antonella; Bender, Jürgen; Weigel, Hans-Joachim; Ranieri, Annamaria

    2006-08-01

    The effects of two-year early season ozone exposure on physiological and biochemical stress response were investigated in model plant communities. Achillea millefolium and Veronica chamaedrys target plants were grown in monocultures and in mixed cultures with Poa pratensis (phytometer) and exposed in open-top chambers over two years for five weeks to charcoal-filtered (CF) air plus 25 nl l(-1) O3 (control) and non-filtered (NF) air plus 50 nl l(-1) O3. Significant O3 effects were detected in different physiological and biochemical parameters, evidencing interspecific differences in metabolic stress responses and a strong influence of the competition factor. O3 induced strong oxidative effects in Achillea irrespective to the different growth modality. Veronica showed less O3-induced effects in monoculture than when grown in competition with the phytometer. Poa exhibited a different behaviour against O3 depending on the species in competition, showing an overall higher sensitivity to O3 when in mixture with Achillea.

  12. Towards Early Biochemical screening for Fetal Aneupliody in the First Trimester

    DEFF Research Database (Denmark)

    Tørring, Niels

    2011-01-01

    Objectives At Aarhus University Hospital, Denmark, the first trimester screening has been performed with the blood sample taken as early as gestational week 7 since 2003. We hereby present the status for the screening program. Methods: The study includes singleton pregnancies with complete first......: Screening for fetal aneuploidy can be performed with good results with the blood sample taken as early as the 7th week of gestation. Taking the blood sample before the 10th gestational week showed a high detection rate of fetal trisomy 21, with no difference in the detection of fetal trisomy 18, 13...

  13. Clavicular bone tunnel malposition leads to early failures in coracoclavicular ligament reconstructions.

    Science.gov (United States)

    Cook, Jay B; Shaha, James S; Rowles, Douglas J; Bottoni, Craig R; Shaha, Steven H; Tokish, John M

    2013-01-01

    Modern techniques for the treatment of acromioclavicular (AC) joint dislocations have largely centered on free tendon graft reconstructions. Recent biomechanical studies have demonstrated that an anatomic reconstruction with 2 clavicular bone tunnels more closely matches the properties of native coracoclavicular (CC) ligaments than more traditional techniques. No study has analyzed tunnel position in regard to risk of early failure. To evaluate the effect of clavicular tunnel position in CC ligament reconstruction as a risk of early failure. Case series; Level of evidence, 4. A retrospective review was performed of a consecutive series of CC ligament reconstructions performed with 2 clavicular bone tunnels and a free tendon graft. The population was largely a young, active-duty military group of patients. Radiographs were analyzed for the maintenance of reduction and location of clavicular bone tunnels using a picture archiving and communication system. The distance from the lateral border of the clavicle to the center of each bone tunnel was divided by the total clavicular length to establish a ratio. Medical records were reviewed for operative details and functional outcome. Failure was defined as loss of intraoperative reduction. The overall failure rate was 28.6% (8/28) at an average of 7.4 weeks postoperatively. Comparison of bone tunnel position showed that medialized bone tunnels were a significant predictor for early loss of reduction for the conoid (a ratio of 0.292 vs 0.248; P = .012) and trapezoid bone tunnels (a ratio of 0.171 vs 0.128; P = .004); this correlated to an average of 7 to 9 mm more medial in the reconstructions that failed. Reconstructions performed with a conoid ratio of ≥0.30 were significantly more likely to fail (5/5, 100%) than were those performed lateral to a ratio of 0.30 (3/23, 13.0%) (P < .01). There were no failures when the conoid ratio was <0.25 (0/10, 0%). Conoid tunnel placement was also statistically significant for

  14. Early detection of crop injury from herbicide glyphosate by leaf biochemical parameter inversion

    Science.gov (United States)

    Early detection of crop injury from glyphosate is of significant importance in crop management. In this paper, we attempt to detect glyphosate-induced crop injury by PROSPECT (leaf optical PROperty SPECTra model) inversion through leaf hyperspectral reflectance measurements for non-Glyphosate-Resist...

  15. Early Diagnosis of Breast Cancer using Molecular, Biochemical and Pathological Markers

    OpenAIRE

    Salah E.D. El-Assal; Adel A. El-Tarras; Samir M. Abd-alla

    2011-01-01

    Problem statement: Laboratory diagnosis of breast cancer in most of the hospitals has traditionally been performed using cell culture and the direct hormone receptor assay, which are money and time consuming. Approach: This study was performed in order to direct the attention toward increasing the efficiency of early diagnosis in clinical laboratories at the western region of KSA and Egypt using recent PCR-dependent protocols i.e., Randomly Amplified Polymorphic DNA (RAPDs) and Reverse Transc...

  16. Predictors of biochemical failure in patients undergoing prostate whole-gland salvage cryotherapy: a novel risk stratification model.

    Science.gov (United States)

    Spiess, Philippe E; Levy, David A; Mouraviev, Vladimir; Pisters, Louis L; Jones, J Stephen

    2013-08-01

    What's known on the subject? and what does the study add?: Previous studies have identified the most important prognostic factors of the likely outcomes of salvage prostate whole-gland ablation, including initial clinical stage, biopsy Gleason score, and PSA (total and doubling time). There is potential for further optimization of candidate selection for salvage cryoablation with curative intent and nadir PSA achieved after whole-gland cryotherapy may provide additional prognostic value. The study shows that the most important prognostic factors of biochemical progression-free survival for patients who have undergone whole-gland salvage prostate cryotherapy are nadir PSA achieved after therapy and pre-therapy biopsy Gleason score. Based on these two prognostic variables, we have identified risk stratification groups (low, intermediate and high) which help predict the expected outcomes of salvage whole-gland prostate cryotherapy in a given patient. This risk stratification constitutes a useful clinical tool in defining which patients maybe best suited for this local salvage treatment method. To assess the prognostic variables predicting the risk of biochemical progression-free survival (bPFS) after salvage prostate whole-gland cryotherapy using the Phoenix definition of bPFS. A total of 132 patients underwent prostate whole-gland salvage cryotherapy with curative intent. No patient underwent neoadjuvant/adjuvant hormonal ablative therapy, and all had extended post-salvage prostate-specific antigen (PSA) follow-up data. Cox univariate and multivariate logistic regression analyses of potential predictors of bPFS were conducted. Kaplan-Meier analyses of bPFS was also performed. At a mean (range) follow-up of 4.3 (0.9-12.7) years, the median (range) post-cryotherapy nadir PSA achieved was 0.17 (0-33.9) ng/mL. On multivariate analysis, predictors of bPFS were nadir PSA post-cryotherapy and pre-salvage biopsy Gleason score (P 2.5 ng/mL or biopsy Gleason score ≥ 7, with

  17. [Early detection, prevention and management of renal failure in liver transplantation].

    Science.gov (United States)

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  18. Unification of a common biochemical failure definition for prostate cancer treated with brachytherapy or external beam radiotherapy with or without androgen deprivation

    International Nuclear Information System (INIS)

    Fitch, Dwight L.; McGrath, Samuel; Martinez, Alvaro A.; Vicini, Frank A.; Kestin, Larry L.

    2006-01-01

    Purpose: Minimal data are available regarding selection of an optimal biochemical failure (BF) definition for patients treated with brachytherapy, external beam radiotherapy (EBRT), and combinations of these treatments with or without androgen deprivation (AD). We retrospectively analyzed our institution's experience treating localized prostate cancer in an attempt to determine a BF definition that could be applied for these various treatment modalities. Methods and Materials: A total of 2376 patients with clinical stage T1-T3 N0 M0 prostate cancer were treated with conventional dose (median, 66.6 Gy) EBRT (n = 1201), high-dose (median, 75.6 Gy) adaptive radiation therapy (n = 465), EBRT + high-dose-rate brachytherapy boost (n 416), or brachytherapy alone (n = 294) between 1987 and 2003. A total of 496 patients (21%) received neoadjuvant AD with radiation therapy. There were 21924 posttreatment prostate-specific antigen (PSA) measurements. Multiple BF definitions were tested for their sensitivity, specificity, positive predictive value (+PV), and negative PV (-PV) in predicting subsequent clinical failure (CF) (any local failure or distant metastasis), overall survival (OS), and cause-specific survival (CSS). Median follow-up was 4.5 years. The date of BF was the date BF criteria were met (e.g., date of third rise). Results: A total of 290 patients (12%) experienced CF at a median interval of 3.6 years (range, 0.2-15.2 years). The 5- and 10-year CF rates were 12% and 26%, respectively. Three consecutive rises yielded a 46% sensitivity and 84% specificity for predicting CF. The 10-year CF for those 475 patients who experienced three rises (BF) was 37% vs. 17% for those patients who did not meet these criteria (biochemically controlled [BC]). For all patients, the following definitions were superior to three rises for predicting CF for both +PV, and -PV: n + 1 (≥1 ng/mL above nadir), n + 2, n + 3, threshold 2 (any PSA ≥2.0 ng/mL at or after nadir), threshold 3

  19. Three linked nomograms for predicting biochemical failure in prostate cancer treated with radiotherapy plus androgen deprivation therapy

    International Nuclear Information System (INIS)

    Lopez-Torrecilla, Jose; Boladeras, Anna; Angeles Cabeza, Maria; Zapatero, Almudena; Jove, Josep; Esteban, Luis M.; Henriquez, Ivan; Casana, Manuel; Mengual, Jose Luis; Gonzalez-San Segundo, Carmen; Gomez-Caamano, Antonio; Hervas, Asuncion; Munoz, Julia Luisa; Sanz, Gerardo

    2015-01-01

    Nomograms were established to predict biochemical recurrence (BCR) after radiotherapy (RT) with a low weight of the characteristic variables of RT and androgen deprivation therapy (ADT). Our aim is to provide a new stratified tool for predicting BCR at 4 and 7 years in patients treated using RT with radical intent. A retrospective, nonrandomized analysis was performed on 5044 prostate cancer (PCa) patients with median age 70 years, who received RT - with or without ADT - between November 1992 and May 2007. Median follow-up was 5.5 years. BCR was defined as a rise in serum prostate-specific antigen (PSA) of 2 ng/ml over the post-treatment PSA nadir. Univariate association between predictor variables and BCR was assessed by the log-rank test, and three linked nomograms were created for multivariate prognosis of BCR-free survival. Each nomogram corresponds to a category of the Gleason score - either 6,7, or 8-10 - and all of them were created from a single proportional hazards regression model stratified also by months of ADT (0, 1-6, 7-12, 13-24, 25-36, 36-60). The performance of this model was analyzed by calibration, discrimination, and clinical utility. Initial PSA, clinical stage, and RT dose were significant variables (p < 0.01). The model showed a good calibration. The concordance probability was 0.779, improving those obtained with other nomograms (0.587, 0.571, 0.554) in the database. Survival curves showed best clinical utility in a comparison with National Comprehensive Cancer Network (NCCN) risk groups. For each Gleason score category, the nomogram provides information on the benefit of adding ADT to a specific RT dose. (orig.) [de

  20. Noise diagnosis - a method for early detection of failures in a nuclear plant

    International Nuclear Information System (INIS)

    Brinckmann, H.F.

    1981-01-01

    Noise diagnosis constitutes one method for early detection of plant failures. The method is based on the fact that nearly all undesired processes in a nuclear power plant make a measurable contribution to the noise portion of signals. Well-known examples of undesired processes in pressurized water reactors include core-barrel movement, the vibration of control elements, the appearance of loose parts in the coolant flow, and the process of coolant boiling. Each of these processes has been implicated in past nuclear plant failures. In the German Democratic Republic (GDR) P. Liewers and his colleagues have introduced noise analysis systems into the primary circuit of WWER-440 pressurized water reactors (PWR). The most progressive version (RAS-II) has become a prototype for research and routine investigations. This system is described. (author)

  1. Early prophylactic and treatment role of melatonin against certain biochemical disorders in irradiated rats

    International Nuclear Information System (INIS)

    El-Massry, F.S.

    2005-01-01

    The aim of the present study is to evaluate the possible early prophylactic and therapeutic role of melatonin on irradiated rats. The experimental animals were divided into five groups: control, injected intraperitoneally with melatonin (10 mg/ kg b.wt.), irradiated at 6 Gy, injected with melatonin before irradiation and injected with melatonin after gamma irradiation. Blood, liver and brain samples from rats were collected at three time intervals of 7, 10, 14 days after terminating all treatments. Protein content and glutathione were estimated in blood and tissues, whereas testosterone and cortisol were assayed in blood of rats after whole body gamma irradiation at 6 Gy. Administration of melatonin (10 mg/kg) before whole body gamma irradiation markedly reduced the radiation injury and controlled the changes in most of the studied parameters, but following the administration of melatonin after irradiation, there were no changes in these parameters

  2. Early administration of tolvaptan preserves renal function in elderly patients with acute decompensated heart failure.

    Science.gov (United States)

    Kimura, Kazuhiro; Momose, Tomoyasu; Hasegawa, Tomoya; Morita, Takehiro; Misawa, Takuo; Motoki, Hirohiko; Izawa, Atsushi; Ikeda, Uichi

    2016-05-01

    Loop diuretics used in the treatment of heart failure often induce renal impairment. This study was conducted in order to evaluate the renal protective effect of adding tolvaptan (TLV), compared to increasing the furosemide (FRM) dose, for the treatment of acute decompensated heart failure (ADHF) in a real-world elderly patient population. This randomized controlled trial enrolled 52 consecutive hospitalized patients (age 83.4±9.6 years) with ADHF. The patients were assigned alternately to either the TLV group (TLV plus conventional treatment, n=26) or the FRM group (increasing the dose of FRM, n=26). TLV was administered within 24h from admission. The incidence of worsening renal function (WRF) within 7 days from admission was significantly lower in the TLV group (26.9% vs. 57.7%, p=0.025). Furthermore, the rates of occurrence of persistent and late-onset (≥5 days from admission) WRF were significantly lower in the TLV group. Persistent and late-onset WRF were significantly associated with a higher incidence of cardiac death or readmission for worsening heart failure in the 90 days following discharge, compared to transient and early-onset WRF, respectively. Early administration of TLV, compared to increased FRM dosage, reduces the incidence of WRF in real-world elderly ADHF patients. In addition, it reduces the occurrence of 'worse' WRF-persistent and late-onset WRF-which are associated with increased rates of cardiac death or readmission for worsening heart failure in the 90 days after discharge. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  3. Anesthetic-Induced Myocardial Preconditioning and Some Biochemical Markers for Cardiac and Coronary Failures after Aortocoronary Bypass Surgery

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2013-01-01

    Full Text Available Objective: to provide a rationale for the efficiency of sevoflurane-induced cardiac preconditioning (CPC, by assessing the pattern of recovery of heart rate and by estimating troponin I levels and changes in NT-proBNP concentrations in patients undergoing aortocoronary bypass surgery (ACBS under extracorporeal circulation (EC. Subjects and methods. Sixty patients aged 60.6±8 years (M±& were examined after elective ACBS using EC and divided into two groups of 30 patients each: 1 inhalation induction and maintenance of anesthesia (IIMA with sevoflurane and fentanyl, with CPC being simulated; 2 total intravenous anesthesia (TIA with propofol and fentanyl. Inhalation induction of sevoflurane anesthesia was performed in the IIMA group. Ten minutes before aortic ligation, the dose of the anesthetic was increased up to 2 MAC for CPC. Inhaled anesthetics were not used in the TIA group. The authors assessed the pattern of cardiac performance recovery and estimated the level of NT-proBNP 24 and 48 hours after tracheal intubation and that of troponin I following 24 hours of the intubation. Results. Defibrillation was required in one patient from the TIA group who developed ventricular fibrillation. The baseline levels of NT-proBNP were comparable in both groups. Following 24 hours, its level was more than thrice higher in the TIA group than that in the IIMA one (p<0.05. By the end of 2 days, the concentration of NT-proBNP continued to rise (up to 480% of the baseline level in the TIA group and returned to the preoperative values in the IIMA group (p=0.05. Twenty-four hours after tracheal intubation the level of troponin I was insignificantly higher in the TIA group than that in the IIMA group (p=0.1. Conclusion. Sevoflurane has cardioprotective properties in preventing and/or reducing the degree of heart failure after ACBS using EC. There is a need to continue the study in increased cohort to provide evidence that sevoflurane-induced CPC can lower

  4. An integrated lipidomics and metabolomics reveal nephroprotective effect and biochemical mechanism of Rheum officinale in chronic renal failure

    Science.gov (United States)

    Zhang, Zhi-Hao; Vaziri, Nosratola D.; Wei, Feng; Cheng, Xian-Long; Bai, Xu; Zhao, Ying-Yong

    2016-01-01

    Chronic renal failure (CRF) is a major public health problem worldwide. Earlier studies have revealed salutary effects of rhubarb extracts in CRF. In this study, we employed lipidomic and metabolomic approaches to identify the plasma biomarkers and to determine the effect of treatment with petroleum ether, ethyl acetate and n-butanol extracts of rhubarb in a rat model of CRF with adenine-induced chronic tubulointerstitial nephropathy. In addition, clinical biochemistry, histological evaluation and pro-fibrotic protein expression were analyzed. Significant changes were found between the CRF and control groups representing characteristic phenotypes of rats with CRF. Treatment with the three rhubarb extracts improved renal injury and dysfunction, either fully or partially reversed the plasma metabolites abnormalities and attenuated upregulation of pro-fibrotic proteins including TGF-β1, α-SMA, PAI-1, CTGF, FN and collagen-1. The nephroprotective effect of ethyl acetate extract was better than other extracts. The differential metabolites were closely associated with glycerophospholipid, fatty acid and amino acid metabolisms. The results revealed a strong link between renal tubulointerstitial fibrosis and glycerophospholipid metabolism and L-carnitine metabolism in the development of CRF. Amelioration of CRF with the three rhubarb extracts was associated with the delayed development and/or reversal the disorders in key metabolites associated with adenine-induced CRF. PMID:26903149

  5. Rescue surgery post-failure of the radiotherapy in early glottis carcinoma

    International Nuclear Information System (INIS)

    Dodero, Alberto; Piazza, Carlos; Ugarte, Marcelo; Kulay, Yolanda

    2006-01-01

    The treatment of the laryngeal carcinoma is controversial in the otolaryngology literature; in glottis cancer that can be managed with radiotherapy, conservative laryngeal surgery and micro-endoscope by laser. At present time, the main objective in the treatment of the early glottis cancer is the control of the tumor and preservation of a good voice. In small injuries, the surgery and the radiotherapy offer equivalent cure rates. The handling of the failure of radiotherapy is controversial; the options go from the resection endoscope with laser, to the total laryngectomy, with local controls [es

  6. Value of serum PCT in early diagnosis of bacterial infection in patients with liver failure

    Directory of Open Access Journals (Sweden)

    WANG Chuanmin

    2017-06-01

    Full Text Available ObjectiveTo investigate the value of serum procalcitonin (PCT in early diagnosis of bacterial infection in patients with liver failure. MethodsA total of 463 patients with hepatitis B were selected from January to December, 2014, in the Department of Infectious Diseases, Taihe Hospital. According to the degree of liver injury, the patients were divided into four groups: mild liver injury group (n=120, moderate liver injury group (n=222, sever liver injury group (n=53, and liver failure group (n=68. Serum PCT was measured for all patients, and the white blood cell count (WBC and high-sensitivity C-reactive protein (hsCRP were measured for patients with liver failure. The clinical manifestations were observed and recorded. The t test was used for comparison of normally distributed continuous data, while the Kruskal-Wallis H test was used for non-normally distributed continuous data; the Mann-Whitney U test was used for pairwise comparison of continuous data. The chi-square test was used for comparison of categorical data. The receiver operating characteristic (ROC curve was used for the analysis of predictive value. ResultsThe liver failure group had a significantly higher PCT level than the severe liver injury group, moderate liver injury group, and mild liver injury group (0.81[0.34-2.15] vs 0.53[0.21-1.59], 0.35[010-1.18], and 0.17[0.10-0.60], χ2=25.091, P<0.05. The liver failure patients with PCT levels of <0.25 ng/ml (n=10, 0.25-0.5 ng/ml (n=10, and >0.5 ng/ml (n=48 had infection rates of 20%, 30%, and 66.7%, respectively, with a significant difference between the patients with a PCT level of >0.5 ng/ml and those with PCT levels of <0.25 ng/ml and 0.25-0.5 ng/ml (χ2=5631,4650,P=0018,0031. Among the liver failure patients, the infection cases had significantly higher PCT, WBC, and hsCRP than the non-infection cases (PCT: 3.72±1.33 ng/ml vs 0.34±0.12 ng/ml, t=-2.547, P=0.015; hsCRP: 16.70±7.03 mg

  7. Three linked nomograms for predicting biochemical failure in prostate cancer treated with radiotherapy plus androgen deprivation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Torrecilla, Jose [Hospital General Universitario, Servicio Oncologia Radioterapica- ERESA, Valencia (Spain); Boladeras, Anna [Institut Catala d' Oncologia, S.Oncologia Radioterapica, Hospitalet (Spain); Angeles Cabeza, Maria [Hospital Universitario Doce de Octubre, S.Oncologia Radioterapica, Madrid (Spain); Zapatero, Almudena [Hospital Universitario de la Princesa, S.Oncologia Radioterapica, Madrid (Spain); Jove, Josep [Institut Catala d' Oncologia, S.Oncologia Radioterapica, Badalona (Spain); Esteban, Luis M. [Universidad de Zaragoza, Escuela Universitaria Politecnica de La Almunia, Zaragoza (Spain); Henriquez, Ivan [Hospital Universitari Sant Joan de Reus, S.Oncologia Radioterapica, Reus (Spain); Casana, Manuel; Mengual, Jose Luis [Fundacion Instituto Valenciano de Oncologia, S.Oncologia Radioterapica, Valencia (Spain); Gonzalez-San Segundo, Carmen [Hospital Universitario Gregorio Maranon, S.Oncologia Radioterapica, Madrid (Spain); Gomez-Caamano, Antonio [Hospital Clinico Universitario de Santiago, S.Oncologia Radioterapica, Santiago de Compostela (Spain); Hervas, Asuncion [Hospital Universitario Ramon y Cajal, S.Oncologia Radioterapica, Madrid (Spain); Munoz, Julia Luisa [Hospital Infanta Cristina, S.Oncologia Radioterapica, Badajoz (Spain); Sanz, Gerardo [Universidad de Zaragoza, Departamento de Metodos Estadisticos, Zaragoza (Spain)

    2015-10-15

    Nomograms were established to predict biochemical recurrence (BCR) after radiotherapy (RT) with a low weight of the characteristic variables of RT and androgen deprivation therapy (ADT). Our aim is to provide a new stratified tool for predicting BCR at 4 and 7 years in patients treated using RT with radical intent. A retrospective, nonrandomized analysis was performed on 5044 prostate cancer (PCa) patients with median age 70 years, who received RT - with or without ADT - between November 1992 and May 2007. Median follow-up was 5.5 years. BCR was defined as a rise in serum prostate-specific antigen (PSA) of 2 ng/ml over the post-treatment PSA nadir. Univariate association between predictor variables and BCR was assessed by the log-rank test, and three linked nomograms were created for multivariate prognosis of BCR-free survival. Each nomogram corresponds to a category of the Gleason score - either 6,7, or 8-10 - and all of them were created from a single proportional hazards regression model stratified also by months of ADT (0, 1-6, 7-12, 13-24, 25-36, 36-60). The performance of this model was analyzed by calibration, discrimination, and clinical utility. Initial PSA, clinical stage, and RT dose were significant variables (p < 0.01). The model showed a good calibration. The concordance probability was 0.779, improving those obtained with other nomograms (0.587, 0.571, 0.554) in the database. Survival curves showed best clinical utility in a comparison with National Comprehensive Cancer Network (NCCN) risk groups. For each Gleason score category, the nomogram provides information on the benefit of adding ADT to a specific RT dose. (orig.) [German] Es wurden Nomogramme etabliert, um ein biochemisches Rezidiv (BCR) nach einer Strahlentherapie (RT) vorhersagen zu koennen und den Einfluss der charakteristischen Variablen der RT und der Androgendeprivationstherapie (ADT) dabei moeglichst gering zu halten. Unser Ziel ist es, ein neues stratifiziertes Instrument

  8. Factors associated with early failure of arteriovenous fistulae for haemodialysis access.

    Science.gov (United States)

    Wong, V; Ward, R; Taylor, J; Selvakumar, S; How, T V; Bakran, A

    1996-08-01

    The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery.

  9. Early Shear Failure Prediction in Incremental Sheet Forming Process Using FEM and ANN

    Science.gov (United States)

    Moayedfar, Majid; Hanaei, Hengameh; Majdi Rani, Ahmad; Musa, Mohd Azam Bin; Sadegh Momeni, Mohammad

    2018-03-01

    The application of incremental sheet forming process as a rapid forming technique is rising in variety of industries such as aerospace, automotive and biomechanical purposes. However, the sheet failure is a big challenge in this process which leads wasting lots of materials. Hence, this study tried to propose a method to predict the early sheet failure in this process using mathematical solution. For the feasibility of the study, design of experiment with the respond surface method is employed to extract a set of experiments data for the simulation. The significant forming parameters were recognized and their integration was used for prediction system. Then, the results were inserted to the artificial neural network as input parameters to predict a vast range of applicable parameters avoiding sheet failure in ISF. The value of accuracy R2 ∼0.93 was obtained and the maximum sheet stretch in the depth of 25mm were recorded. The figures generate from the trend of interaction between effective parameters were provided for future studies.

  10. Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

    Science.gov (United States)

    Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.

    2015-12-01

    Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism

  11. Early embryonic failure: Expression and imprinted status of candidate genes on human chromosome 21

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, L.S.; Bennett, P.R.; Moore, G.E. [Queen Charlotte`s and Chelsea Hospital, London (United Kingdom)

    1994-09-01

    Two cases of maternal uniparental (hetero)disomy for human chromosome 21 (mUPD21) have been identified in a systematic search for UPD in 23 cases of early embryonic failure (EEF). Bi-parental origin of the other chromosome pairs was confirmed using specific VNTR probes or dinucleotide repeat analysis. Both maternally and paternally derived isochromosomes 21q have previously been identified in two individuals with normal phenotypes. Full UPD21 has a different mechanism of origin than uniparental isochromosome 21q and its effect on imprinted genes and phenotypic outcome will therefore not necessarily be the same. EEF associated with mUPD21 suggests that developmentally important genes on HSA 21 may be imprinted such that they are only expressed from either the maternally or paternally derived alleles. We have searched for monoallelic expression of candidate genes on HSA 21 in human pregnancy (CBS, IFNAR, COL6A1) using intragenic DNA polymorphisms. These genes were chosen either because their murine homologues lie in imprinted regions or because they are potentially important in embryogenesis. Once imprinted candidate genes have been identified, their methylation status and expression in normal, early embryonic failure and uniparental disomy 21 pregnancies will be studied. At the same time, a larger number of cases of EEF are being examined to further investigate the incidence of UPD21 in this group.

  12. The early indicators of financial failure: a study of bankrupt and solvent health systems.

    Science.gov (United States)

    Coyne, Joseph S; Singh, Sher G

    2008-01-01

    This article presents a series of pertinent predictors of financial failure based on analysis of solvent and bankrupt health systems to identify which financial measures show the clearest distinction between success and failure. Early warning signals are evident from the longitudinal analysis as early as five years before bankruptcy. The data source includes seven years of annual statements filed with the Securities and Exchange Commission by 13 health systems before they filed bankruptcy. Comparative data were compiled from five solvent health systems for the same seven-year period. Seven financial solvency ratios are included in this study, including four cash liquidity measures, two leverage measures, and one efficiency measure. The results show distinct financial trends between solvent and bankrupt health systems, in particular for the operating-cash-flow-related measures, namely Ratio 1: Operating Cash Flow Percentage Change, from prior to current period; Ratio 2: Operating Cash Flow to Net Revenues; and Ratio 4: Cash Flow to Total Liabilities, indicating sensitivity in the hospital industry to cash flow management. The high dependence on credit from third-party payers is cited as a reason for this; thus, there is a great need for cash to fund operations. Five managerial policy implications are provided to help health system managers avoid financial solvency problems in the future.

  13. Inversion Method for Early Detection of ARES-1 Case Breach Failure

    Science.gov (United States)

    Mackey, Ryan M.; Kulikov, Igor K.; Bajwa, Anupa; Berg, Peter; Smelyanskiy, Vadim

    2010-01-01

    A document describes research into the problem of detecting a case breach formation at an early stage of a rocket flight. An inversion algorithm for case breach allocation is proposed and analyzed. It is shown how the case breach can be allocated at an early stage of its development by using the rocket sensor data and the output data from the control block of the rocket navigation system. The results are simulated with MATLAB/Simulink software. The efficiency of an inversion algorithm for a case breach location is discussed. The research was devoted to the analysis of the ARES-l flight during the first 120 seconds after the launch and early prediction of case breach failure. During this time, the rocket is propelled by its first-stage Solid Rocket Booster (SRB). If a breach appears in SRB case, the gases escaping through it will produce the (side) thrust directed perpendicular to the rocket axis. The side thrust creates torque influencing the rocket attitude. The ARES-l control system will compensate for the side thrust until it reaches some critical value, after which the flight will be uncontrollable. The objective of this work was to obtain the start time of case breach development and its location using the rocket inertial navigation sensors and GNC data. The algorithm was effective for the detection and location of a breach in an SRB field joint at an early stage of its development.

  14. Early dystrophin loss is coincident with the transition of compensated cardiac hypertrophy to heart failure.

    Directory of Open Access Journals (Sweden)

    Fernanda P Prado

    Full Text Available Hypertension causes cardiac hypertrophy, one of the most important risk factors for heart failure (HF. Despite the importance of cardiac hypertrophy as a risk factor for the development of HF, not all hypertrophied hearts will ultimately fail. Alterations of cytoskeletal and sarcolemma-associated proteins are considered markers cardiac remodeling during HF. Dystrophin provides mechanical stability to the plasma membrane through its interactions with the actin cytoskeleton and, indirectly, to extracellular matrix proteins. This study was undertaken to evaluate dystrophin and calpain-1 in the transition from compensated cardiac hypertrophy to HF. Wistar rats were subjected to abdominal aorta constriction and killed at 30, 60 and 90 days post surgery (dps. Cardiac function and blood pressure were evaluated. The hearts were collected and Western blotting and immunofluorescence performed for dystrophin, calpain-1, alpha-fodrin and calpastatin. Statistical analyses were performed and considered significant when p<0.05. After 90 dps, 70% of the animals showed hypertrophic hearts (HH and 30% hypertrophic+dilated hearts (HD. Systolic and diastolic functions were preserved at 30 and 60 dps, however, decreased in the HD group. Blood pressure, cardiomyocyte diameter and collagen content were increased at all time points. Dystrophin expression was lightly increased at 30 and 60 dps and HH group. HD group showed decreased expression of dystrophin and calpastatin and increased expression of calpain-1 and alpha-fodrin fragments. The first signals of dystrophin reduction were observed as early as 60 dps. In conclusion, some hearts present a distinct molecular pattern at an early stage of the disease; this pattern could provide an opportunity to identify these failure-prone hearts during the development of the cardiac disease. We showed that decreased expression of dystrophin and increased expression of calpains are coincident and could work as possible

  15. Detection of Taenia solium taeniasis coproantigen is an early indicator of treatment failure for taeniasis.

    Science.gov (United States)

    Bustos, Javier A; Rodriguez, Silvia; Jimenez, Juan A; Moyano, Luz M; Castillo, Yesenia; Ayvar, Viterbo; Allan, James C; Craig, Philip S; Gonzalez, Armando E; Gilman, Robert H; Tsang, Victor C W; Garcia, Hector H

    2012-04-01

    Taenia solium causes taeniasis and cysticercosis, a zoonotic complex associated with a significant burden of epilepsy in most countries. Reliable diagnosis and efficacious treatment of taeniasis are needed for disease control. Currently, cure can be confirmed only after a period of at least 1 month, by negative stool microscopy. This study assessed the performance of detection by a coproantigen enzyme-linked immunosorbent assay (CoAg-ELISA) for the early evaluation of the efficacy of antiparasitic treatment of human T. solium taeniasis. We followed 69 tapeworm carriers who received niclosamide as standard treatment. Stool samples were collected on days 1, 3, 7, 15, 30, and 90 after treatment and were processed by microscopy and CoAg-ELISA. The efficacy of niclosamide was 77.9% (53/68). Thirteen patients received a second course of treatment and completed the follow-up. CoAg-ELISA was therefore evaluated for a total of 81 cases (68 treatments, 13 retreatments). In successful treatments (n = 64), the proportion of patients who became negative by CoAg-ELISA was 62.5% after 3 days, 89.1% after 7 days, 96.9% after 15 days, and 100% after 30 days. In treatment failures (n = 17), the CoAg-ELISA result was positive for 70.6% of patients after 3 days, 94.1% after 7 days, and 100% after 15 and 30 days. Only 2 of 17 samples in cases of treatment failure became positive by microscopy by day 30. The presence of one scolex, but not multiple scolices, in posttreatment stools was strongly associated with cure (odds ratio [OR], 52.5; P taeniasis. Early assessment at day 15 would detect treatment failure before patients become infective.

  16. The role of overall treatment time in the outcome of radiotherapy of prostate cancer: An analysis of biochemical failure in 4839 men treated between 1987 and 1995

    International Nuclear Information System (INIS)

    Thames, Howard D.; Kuban, Deborah; Levy, Larry B.; Horwitz, Eric M.; Kupelian, Patrick; Martinez, Alvaro; Michalski, Jeffrey; Pisansky, Thomas; Sandler, Howard; Shipley, William; Zelefsky, Michael; Zietman, Anthony

    2010-01-01

    Purpose: Assess the importance of overall time (OT) and dose for biochemical failure (BF) after external-beam radiotherapy of prostate cancer in a retrospective analysis of a nine-institution database with 4839 patients. Patients and methods: Relevant baseline factors (T stage, Gleason score, initial PSA) were available for 4338 men. Cox models were used to estimate the effects of dose and OT corrected for baseline factors, treatment year, institution and interactions, and differences in post-treatment PSA-measurement intervals. After exclusion of very short and long intervals, patient numbers were 1445 events/3426 at risk (endpoint all BFs), and 1177 events/3354 at risk (endpoint exclusion of BFs that were likely distant failures). Separate analyses were carried out by risk group for men who received <70 Gy and ≥70 Gy. Results: Neither dose nor OT was significant when the analysis was restricted to doses <70 Gy, while for patients treated to 70 Gy or higher there were significant influences of both dose and OT on outcome in low- and intermediate-risk patients. These effects were quantified as a relative increase after 5 years followup of 6% in BFs for a 1-week increase in OT, a relative decrease of 15% in BFs for a 6-Gy increase in dose, and a dose equivalent of proliferation of 0.24 Gy/day. As the dose per fraction was nearly constant, the data contain no information on the α/β ratio. Conclusion: The results show that OT and dose are significant determinants of outcome of radiotherapy in low- and intermediate-risk patients treated to 70 Gy or higher, and suggest that meaningful improvements in outcome may be targeted by modest increases in total dose and decreases in OT.

  17. [11C]-Acetoacetate PET imaging: a potential early marker for cardiac heart failure

    International Nuclear Information System (INIS)

    Croteau, Etienne; Tremblay, Sébastien; Gascon, Suzanne; Dumulon-Perreault, Véronique; Labbé, Sébastien M.; Rousseau, Jacques A.; Cunnane, Stephen C.; Carpentier, André C.; Bénard, François; Lecomte, Roger

    2014-01-01

    The ketone body acetoacetate could be used as an alternate nutrient for the heart, and it also has the potential to improve cardiac function in an ischemic–reperfusion model or reduce the mitochondrial production of oxidative stress involved in cardiotoxicity. In this study, [ 11 C]-acetoacetate was investigated as an early marker of intracellular damage in heart failure. Methods: A rat cardiotoxicity heart failure model was induced by doxorubicin, Dox(+). [ 14 C]-Acetoacetate, a non-positron (β −) emitting radiotracer, was used to characterize the arterial blood input function and myocardial mitochondrial uptake. Afterward, [ 11 C]-acetoacetate (β +) myocardial PET images were obtained for kinetic analysis and heart function assessment in control Dox(−) (n = 15) and treated Dox(+) (n = 6) rats. The uptake rate (K 1 ) and myocardial clearance rate (k 2 or k mono ) were extracted. Results: [ 14 C]-Acetoacetate in the blood was increased in Dox(+), from 2 min post-injection until the last withdrawal point when the heart was harvested, as well as the uptake in the heart and myocardial mitochondria (unpaired t-test, p < 0.05). PET kinetic analysis of [ 11 C]-acetoacetate showed that rate constants K 1 , k 2 and k mono were decreased in Dox(+) (p < 0.05) combined with a reduction of 24% of the left ventricular ejection fraction (p < 0.001). Conclusion: Radioactive acetoacetate ex vivo analysis [ 14 C], and in vivo kinetic [ 11 C] studies provided evidence that [ 11 C]-acetoacetate can assess heart failure Dox(+). Contrary to myocardial flow reserve (rest–stress protocol), [ 11 C]-acetoacetate can be used to assess reduced kinetic rate constants without requirement of hyperemic stress response. The proposed [ 11 C]-acetoacetate cardiac radiotracer in the investigation of heart disease is novel and paves the way to a potential role for [ 11 C]-acetoacetate in cardiac pathophysiology

  18. Effects of topical bevacizumab application on early bleb failure after trabeculectomy: observational case series

    Directory of Open Access Journals (Sweden)

    Klos-Rola J

    2013-09-01

    Full Text Available Justyna Klos-Rola, Maria Tulidowicz-Bielak, Tomasz Zarnowski Department of Ophthalmology, Medical University of Lublin, Lublin, Poland Background: The aim of this study was to evaluate the influence of topical bevacizumab on the formation and function of filtering blebs in eyes with early bleb failure after antiglaucoma surgery. Methods: Of all patients who underwent mitomycin-augmented trabeculectomy for glaucoma in the Department of Ophthalmology at the Medical University in Lublin, Poland, between March 2009 and March 2010, a total of 21 eyes from 20 patients with injected filtration bleb 9.8 ± 4.7 days after surgery were included in this observational case series. All patients were treated with standard steroid therapy and topical bevacizumab 5 mg/mL five times a day for 20.9 ± 9.8 days. Patients were followed up every other day, and a full eye examination was performed 14, 30, 60, and 180 days after initiation of treatment. Blebs were evaluated for vascularity by slit-lamp examination with concomitant photographic documentation and intraocular pressure measurement. Results: Elevated functional bleb with significantly reduced vascularity was present in 16 eyes, and was flat and nonfunctional in five eyes. Intraocular pressure in all eyes decreased from a mean of 26.6 ± 9.6 mmHg before surgery to 14.6 ± 7.7 mmHg and 15.8 ± 8.3 mmHg at 2 and 6 months after surgery, respectively. Filtration bleb leak was noted in three eyes while on treatment with bevacizumab. Conclusion: Topical application of bevacizumab might favor functional bleb formation after trabeculectomy in eyes with a high risk of failure. Keywords: glaucoma, trabeculectomy, bleb failure, bevacizumab

  19. Screening and treatment for heritable thrombophilia in pregnancy failure: inconsistencies among UK early pregnancy units.

    Science.gov (United States)

    Norrie, Gillian; Farquharson, Roy G; Greaves, Mike

    2009-01-01

    The significance of heritable thrombophilia in pregnancy failure is controversial. We surveyed all UK Early Pregnancy Units and 70% responded. The majority test routinely for heritable thrombophilias; 80%, 76% and 88% undertook at least one screening test in late miscarriage, recurrent miscarriage and placental abruption, respectively. The range of thrombophilias sought is inconsistent: testing for proteins C and S deficiency and F5 R506Q (factor V Leiden) is most prevalent. Detection of heritable thrombophilia frequently leads to administration of antithrombotics in subsequent pregnancies. Thus, thrombophilia testing and use of antithrombotics are widespread in the UK despite controversies regarding the role of heritable thrombophilia in the pathogenesis of pregnancy complications, and the lack of robust evidence for the efficacy of antithrombotic therapy.

  20. Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

    International Nuclear Information System (INIS)

    Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan

    1999-01-01

    To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

  1. Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan [Aju University SChool of Medicine, Suwon (Korea, Republic of)

    1999-06-15

    To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

  2. Renin-Angiotensin Activation and Oxidative Stress in Early Heart Failure with Preserved Ejection Fraction

    Directory of Open Access Journals (Sweden)

    Smita I. Negi

    2015-01-01

    Full Text Available Animal models have suggested a role of renin-angiotensin system (RAS activation and subsequent cardiac oxidation in heart failure with preserved ejection fraction (HFpEF. Nevertheless, RAS blockade has failed to show efficacy in treatment of HFpEF. We evaluated the role of RAS activation and subsequent systemic oxidation in HFpEF. Oxidative stress markers were compared in 50 subjects with and without early HFpEF. Derivatives of reactive oxidative metabolites (DROMs, F2-isoprostanes (IsoPs, and ratios of oxidized to reduced glutathione (Eh GSH and cysteine (Eh CyS were measured. Angiotensin converting enzyme (ACE levels and activity were measured. On univariate analysis, HFpEF was associated with male sex (p=0.04, higher body mass index (BMI (p=0.003, less oxidized Eh CyS (p=0.001, lower DROMs (p=0.02, and lower IsoP (p=0.03. Higher BMI (OR: 1.3; 95% CI: 1.1–1.6 and less oxidized Eh CyS (OR: 1.2; 95% CI: 1.1–1.4 maintained associations with HFpEF on multivariate analysis. Though ACE levels were higher in early HFpEF (OR: 1.09; 95% CI: 1.01–1.05, ACE activity was similar to that in controls. HFpEF is not associated with significant systemic RAS activation or oxidative stress. This may explain the failure of RAS inhibitors to alter outcomes in HFpEF.

  3. Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice.

    Science.gov (United States)

    Adamski, Mateusz G; Sternak, Magdalena; Mohaissen, Tasnim; Kaczor, Dawid; Wierońska, Joanna M; Malinowska, Monika; Czaban, Iwona; Byk, Katarzyna; Lyngsø, Kristina S; Przyborowski, Kamil; Hansen, Pernille B L; Wilczyński, Grzegorz; Chlopicki, Stefan

    2018-03-26

    Although advanced heart failure (HF) is a clinically documented risk factor for vascular cognitive impairment, the occurrence and pathomechanisms of vascular cognitive impairment in early stages of HF are equivocal. Here, we characterize vascular cognitive impairment in the early stages of HF development and assess whether cerebral hypoperfusion or prothrombotic conditions are involved. Tgαq*44 mice with slowly developing isolated HF triggered by cardiomyocyte-specific overexpression of G-αq*44 protein were studied before the end-stage HF, at the ages of 3, 6, and 10 months: before left ventricle dysfunction; at the stage of early left ventricle diastolic dysfunction (with preserved ejection fraction); and left ventricle diastolic/systolic dysfunction, respectively. In 6- to 10-month-old but not in 3-month-old Tgαq*44 mice, behavioral and cognitive impairment was identified with compromised blood-brain barrier permeability, most significantly in brain cortex, that was associated with myelin sheet loss and changes in astrocytes and microglia. Brain endothelial cells displayed increased E-selectin immunoreactivity, which was accompanied by increased amyloid-β 1-42 accumulation in piriform cortex and increased cortical oxidative stress (8-OHdG immunoreactivity). Resting cerebral blood flow measured by magnetic resonance imaging in vivo was preserved, but ex vivo NO-dependent cortical arteriole flow regulation was impaired. Platelet hyperreactivity was present in 3- to 10-month-old Tgαq*44 mice, but it was not associated with increased platelet-dependent thrombogenicity. We report for the first time that vascular cognitive impairment is already present in the early stage of HF development, even before left ventricle systolic dysfunction. The underlying pathomechanism, independent of brain hypoperfusion, involves preceding platelet hyperreactivity and brain endothelium inflammatory activation. © 2018 The Authors. Published on behalf of the American Heart

  4. Phrenic Nerve Conduction Study in the Early Stage of Guillain-Barre Syndrome as a Predictor of Respiratory Failure.

    Science.gov (United States)

    Sen, Barun Kumar; Pandit, Alak

    2018-01-01

    Guillain-Barré syndrome (GBS) has unpredictable clinical course with severe complication of respiratory failure. To identify clinical profiles and electrophysiological study particularly non-invasive Phrenic nerve conduction study in patients of early GBS to predict respiratory failure. 64 adult (age≥18yrs) patients of early GBS (onset ≤ 14 days) during the study period from January 2014 to October 2015 were evaluated by clinical profiles of age, gender, antecedent infection, time to peak disability, single breath counts, cranial nerve involvement, autonomic dysfunction and non-invasive Phrenic nerve conduction study. Patients with predisposition factors of polyneuropathy like diabetes mellitus, hypothyroidism, vitamin deficiency, renal failure were excluded. Among 64 patients abnormal phrenic nerve conduction study was seen in 65.62% cases (42/64) and 45.23% (19/42) of them developed respiratory failure. Phrenic nerve sum latency, amplitude, duration and area were abnormal in those who developed respiratory failure and they had sum of phrenic nerve latency >28 msec, sum of CMAP amplitude 50 msec and sum of area phrenic nerve study developed respiratory failure. It was found that age, gender, preceding infection, autonomic involvement and types of GB syndrome had no influence on development of respiratory failure (p>0.05). Rapid disease progression to peak disability, more severe disease, shorter single breath counts and cranial nerve involvement were seen more often in patients with respiratory failure. Abnormal Phrenic nerve conduction study in the early Guillain-Barré syndrome might be of great value independently in predicting impending respiratory failure.

  5. Phrenic Nerve Conduction Study in the Early Stage of Guillain–Barre Syndrome as a Predictor of Respiratory Failure

    Science.gov (United States)

    Sen, Barun Kumar; Pandit, Alak

    2018-01-01

    Background: Guillain-Barré syndrome (GBS) has unpredictable clinical course with severe complication of respiratory failure. Objective: To identify clinical profiles and electrophysiological study particularly non-invasive Phrenic nerve conduction study in patients of early GBS to predict respiratory failure. Methods: 64 adult (age≥18yrs) patients of early GBS (onset ≤ 14 days) during the study period from January 2014 to October 2015 were evaluated by clinical profiles of age, gender, antecedent infection, time to peak disability, single breath counts, cranial nerve involvement, autonomic dysfunction and non-invasive Phrenic nerve conduction study. Patients with predisposition factors of polyneuropathy like diabetes mellitus, hypothyroidism, vitamin deficiency, renal failure were excluded. Results: Among 64 patients abnormal phrenic nerve conduction study was seen in 65.62% cases (42/64) and 45.23% (19/42) of them developed respiratory failure. Phrenic nerve sum latency, amplitude, duration and area were abnormal in those who developed respiratory failure and they had sum of phrenic nerve latency >28 msec, sum of CMAP amplitude 50 msec and sum of area phrenic nerve study developed respiratory failure. It was found that age, gender, preceding infection, autonomic involvement and types of GB syndrome had no influence on development of respiratory failure (p>0.05). Rapid disease progression to peak disability, more severe disease, shorter single breath counts and cranial nerve involvement were seen more often in patients with respiratory failure. Conclusion: Abnormal Phrenic nerve conduction study in the early Guillain-Barré syndrome might be of great value independently in predicting impending respiratory failure. PMID:29720799

  6. Breast conservation treatment of early stage breast cancer: patterns of failure

    Energy Technology Data Exchange (ETDEWEB)

    Leborgne, Felix; Leborgne, Jose H; Ortega, Bettys; Doldan, Raquel; Zubizarreta, Eduardo

    1995-02-15

    Purpose: This study retrospectively assesses the patterns of failure in conservatively treated early stage breast cancer patients by correlating various clinical, pathologic, and treatment-related factors with local, axillary, and distant relapse. Methods and Materials: Between 1973 and 1990, 796 patients (817 breasts) received breast conservation surgery followed by radiotherapy. Local recurrences were counted as events even if they occurred simultaneously or after the appearance of axillary or distant metastases. Results: The 10-year actuarial relative disease-free survival (DFS) rate for T1N0, T2N0, and T1-2N1 was 82%, 71%, and 54%, respectively. Stage N0 patients had a significant DFS advantage over N1 patients (p = 0.02). The 15-year actuarial local recurrence-free rate for T1 and T2 tumors was 82% and 87%, respectively (p = nonsignificant). Univariate analysis identified three significant risk factors for local relapse: (a) 48 breasts with tumors showing an extensive intraductal component had a crude local recurrence rate of 23% compared to 8% for 769 breasts without intraductal component (p 0.0016); (b) the actuarial 10-year local recurrence-free rate for patients under age 40 years was 64% compared to 88% for patients over 40 years (p < 0.0001); (c) the 10-year actuarial local recurrence-free rate for 416 postmenopausal women without adjuvant tamoxifen was 83% compared to 97% for 107 postmenopausal women with tamoxifen (p = 0.0479). Salvage therapy for operable local recurrent patients resulted in a 8-year actuarial DFS rate of 47%, significantly lower than that obtained with primary treatment. The incidence of axillary relapse as the first sign of recurrence was 2%, and could be correlated with the lack of axillary dissection (p < 0.0000005) and primary tumor size (p = 0.03). Radiotherapy to the axilla did not influence axillary relapse. Actuarial 5-year DFS rate after treatment of isolated axillary recurrence was 27%. Axillary failure was a marker for

  7. Breast conservation treatment of early stage breast cancer: patterns of failure

    International Nuclear Information System (INIS)

    Leborgne, Felix; Leborgne, Jose H.; Ortega, Bettys; Doldan, Raquel; Zubizarreta, Eduardo

    1995-01-01

    Purpose: This study retrospectively assesses the patterns of failure in conservatively treated early stage breast cancer patients by correlating various clinical, pathologic, and treatment-related factors with local, axillary, and distant relapse. Methods and Materials: Between 1973 and 1990, 796 patients (817 breasts) received breast conservation surgery followed by radiotherapy. Local recurrences were counted as events even if they occurred simultaneously or after the appearance of axillary or distant metastases. Results: The 10-year actuarial relative disease-free survival (DFS) rate for T1N0, T2N0, and T1-2N1 was 82%, 71%, and 54%, respectively. Stage N0 patients had a significant DFS advantage over N1 patients (p = 0.02). The 15-year actuarial local recurrence-free rate for T1 and T2 tumors was 82% and 87%, respectively (p = nonsignificant). Univariate analysis identified three significant risk factors for local relapse: (a) 48 breasts with tumors showing an extensive intraductal component had a crude local recurrence rate of 23% compared to 8% for 769 breasts without intraductal component (p 0.0016); (b) the actuarial 10-year local recurrence-free rate for patients under age 40 years was 64% compared to 88% for patients over 40 years (p < 0.0001); (c) the 10-year actuarial local recurrence-free rate for 416 postmenopausal women without adjuvant tamoxifen was 83% compared to 97% for 107 postmenopausal women with tamoxifen (p = 0.0479). Salvage therapy for operable local recurrent patients resulted in a 8-year actuarial DFS rate of 47%, significantly lower than that obtained with primary treatment. The incidence of axillary relapse as the first sign of recurrence was 2%, and could be correlated with the lack of axillary dissection (p < 0.0000005) and primary tumor size (p = 0.03). Radiotherapy to the axilla did not influence axillary relapse. Actuarial 5-year DFS rate after treatment of isolated axillary recurrence was 27%. Axillary failure was a marker for

  8. Early biomarkers of acute kidney failure after heart angiography or heart surgery in patients with acute coronary syndrome or acute heart failure.

    Science.gov (United States)

    Torregrosa, Isidro; Montoliu, Carmina; Urios, Amparo; Elmlili, Nisrin; Puchades, María Jesús; Solís, Miguel Angel; Sanjuán, Rafael; Blasco, Maria Luisa; Ramos, Carmen; Tomás, Patricia; Ribes, José; Carratalá, Arturo; Juan, Isabel; Miguel, Alfonso

    2012-01-01

    Acute kidney injury (AKI) is a common complication in cardiac surgery and coronary angiography, which worsens patients' prognosis. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions. To assess the sensitivity and specificity of neutrophil gelatinase-associated lipocalin in urine (uNGAL), interleukin-18 (IL-18) in urine and cystatin C in serum for the early detection of AKI in patients with acute coronary syndrome or heart failure, and who underwent cardiac surgery or catheterization. The study included 135 patients admitted to the intensive care unit for acute coronary syndrome or heart failure due to coronary or valvular pathology and who underwent coronary angiography or cardiac bypass surgery or valvular replacement. The biomarkers were determined 12 hours after surgery and serum creatinine was monitored during the next six days for the diagnosis of AKI. The area under the ROC curve (AUC) for NGAL was 0.983, and for cystatin C and IL-18 the AUCs were 0.869 and 0.727, respectively. At a cut-off of 31.9 ng/ml for uNGAL the sensitivity was 100% and the specificity was 91%. uNGAL is an early marker of AKI in patients with acute coronary syndrome or heart failure and undergoing cardiac surgery and coronary angiography, with a higher predictive value than cystatin C or IL-18.

  9. Pattern of occult nodal relapse diagnosed with 18F-fluoro-choline PET/CT in prostate cancer patients with biochemical failure after prostate-only radiotherapy

    International Nuclear Information System (INIS)

    Lépinoy, Alexis; Cochet, Alexandre; Cueff, Adèle; Cormier, Luc; Martin, Etienne; Maingon, Philippe; Bosset, Jean François; Brunotte, François; Créhange, Gilles

    2014-01-01

    Introduction: The purpose of this study was to describe the pattern of nodal relapse with 18 F-fluoro-choline (FCH) Positron Emission Tomography/Computerized Tomography (PET/CT) in prostate cancer patients after radiotherapy. Materials and methods: Eighty-three patients had a FCH PET/CT at time of biochemical failure. Of 65 patients with positive findings, 33 had positive nodes. This analysis included 31 patients who had undergone prior prostate-only radiotherapy with or without a prior radical prostatectomy. Each FCH positive node was assigned to a lymph node station with respect to the CTV defined by the RTOG guidelines (CTV RTOG ). 3D mapping was performed after each node was manually placed in a reference planning CT scan after automatic co-registration of the two scans based on bone anatomy. Eighteen patients (58%) underwent focal salvage FCH PET-guided stereotactic radiotherapy with no hormones. Results: Fourteen patients (45.2%) had a relapse outside the CTV RTOG . Of the 17 patients with a positive node inside the CTV RTOG , 15 had a single node (88.2%) while seven patients out of the 13 evaluable patients (53.9%) who had a relapse outside the CTV RTOG had ⩾2 positive nodes on FCH PET/CT (OR = 8.75, [95% CI: 1.38–54.80], p = 0.020). Relapses that occurred outside the CTV RTOG involved the proximal common iliac (19.3%) and lower periaortic nodes (19.3%) up to L2–L3. Conclusion: 3D mapping of nodal relapses evaluated with FCH PET/CT suggests that with IMRT the upper field limit of pelvic radiotherapy could be extended to L2–L3 safely to cover 95% of nodal stations at risk of an occult relapse

  10. Context-Dependent Effects of Genome-Wide Association Study Genotypes and Macro-Environmental Factors on Time to Biochemical (PSA) Failure after Prostatectomy

    Science.gov (United States)

    Rebbeck, Timothy R.; Weber, Anita L.; Walker, Amy H.; Stefflova, Klara; Tran, Teo V.; Spangler, Elaine; Chang, Bao-Li; Zeigler-Johnson, Charnita M.

    2010-01-01

    Background Disparities in cancer defined by race, age, or gender are well established. However, demographic metrics are surrogates for the complex contributions of genotypes, exposures, health care, socioeconomic and sociocultural environment, and many other factors. Macro-environmental factors represent novel surrogates for exposures, lifestyle and other factors that are difficult to measure but may influence cancer outcomes. Methods We applied a “multilevel molecular epidemiology” approach using a prospective cohort of 444 White prostate cancer cases who underwent prostatectomy and were followed until biochemical failure (BF) or censoring without BF. We applied Cox regression models to test for joint effects of 86 genome-wide association study-identified genotypes and macro-environmental contextual effects after geocoding all cases to their residential census tracts. All analyses were adjusted for age at diagnosis and tumor aggressiveness. Results Residents living in macroenvironments with a high proportion of older single heads of household, high rates of vacant housing, or high unemployment had shorter time until BF post-surgery after adjustment for patient age and tumor aggressiveness. After correction for multiple testing, genotypes alone did not predict time to BF, but interactions predicting time to BF were observed for MSMB (rs10993994) and percent of older single head of households (p=0.0004), and for HNF1B/TCF2 (rs4430796) and macroenvironment per capita income (p=0.0002). Conclusions Context-specific macro-environmental effects of genotype may improve the ability to identify groups that may experience poor prostate cancer outcomes. Impact Risk estimation and clinical translation of genotype information may require an understanding of both individual-level and macroenvironmental context. PMID:20826827

  11. Context-dependent effects of genome-wide association study genotypes and macroenvironment on time to biochemical (prostate specific antigen) failure after prostatectomy.

    Science.gov (United States)

    Rebbeck, Timothy R; Weber, Anita L; Walker, Amy H; Stefflova, Klara; Tran, Teo V; Spangler, Elaine; Chang, Bao-Li; Zeigler-Johnson, Charnita M

    2010-09-01

    Disparities in cancer defined by race, age, or gender are well established. However, demographic metrics are surrogates for the complex contributions of genotypes, exposures, health care, socioeconomic and sociocultural environment, and many other factors. Macroenvironmental factors represent novel surrogates for exposures, lifestyle, and other factors that are difficult to measure but might influence cancer outcomes. We applied a "multilevel molecular epidemiology" approach using a prospective cohort of 444 White prostate cancer cases who underwent prostatectomy and were followed until biochemical failure (BF) or censoring without BF. We applied Cox regression models to test for joint effects of 86 genome-wide association study-identified genotypes and macroenvironment contextual effects after geocoding all cases to their residential census tracts. All analyses were adjusted for age at diagnosis and tumor aggressiveness. Residents living in census tracts with a high proportion of older single heads of household, high rates of vacant housing, or high unemployment had shorter time until BF postsurgery after adjustment for patient age and tumor aggressiveness. After correction for multiple testing, genotypes alone did not predict time to BF, but interactions predicting time to BF were observed for MSMB (rs10993994) and percentage of older single heads of households (P = 0.0004), and for HNF1B/TCF2 (rs4430796) and census tract per capita income (P = 0.0002). The context-specific macroenvironmental effects of genotype might improve the ability to identify groups that might experience poor prostate cancer outcomes. Risk estimation and clinical translation of genotype information might require an understanding of both individual- and macroenvironment-level context. (c) 2010 AACR.

  12. Comparison of biochemical failure rates between permanent prostate brachytherapy and radical retropubic prostatectomy as a function of posttherapy PSA nadir plus ‘X’

    International Nuclear Information System (INIS)

    Ahmed, Kamran A; Davis, Brian J; Mynderse, Lance A; Slezak, Jeffrey M; Bergstralh, Eric J; Wilson, Torrence M; Choo, C Richard

    2014-01-01

    Prostate-specific antigen (PSA) nadir + 2 ng/mL, also known as the Phoenix definition, is the definition most commonly used to establish biochemical failure (BF) after external beam radiotherapy for prostate cancer management. The purpose of this study is to compare BF rates between permanent prostate brachytherapy (PPB) and radical retropubic prostatectomy (RRP) as a function of PSA nadir plus varying values of X and examine the associated implications. We retrospectively searched for patients who underwent PPB or RRP at our institution between 1998 and 2004. Only primary patients not receiving androgen-deprivation therapy were included in the study. Three RRP patients were matched to each PPB patient on the basis of prognostic factors. BF rates were estimated for PSA nadirs + different values of X. A total of 1,164 patients were used for analysis: 873 in the RRP group and 291 in the PPB group. Patients were equally matched by clinical stage, biopsy Gleason sum, primary Gleason grade, and pretherapy PSA value. Median follow-up was 3.1 years for RRP patients and 3.6 years in the PPB group (P = .01). Using PSA nadir + 0.1 ng/mL for the definition of BF, the 5-year BF rate was 16.3% for PPB patients and 13.5% for RRP patients (P = .007), whereas at nadir + 2 ng/mL or greater, the BF rates were less than 3% and were indistinguishable between PPB and RRP patients. In a cohort of well-matched patients who had prostatectomy or brachytherapy, we examined BF as a function of nadir + X, where X was treated as a continuous variable. As X increases from 0.1 to 2.0 ng/mL, the BF curves converge, and above 2.0 ng/mL they are essentially indistinguishable. The data presented are of interest as BF definitions continue to evolve

  13. Reprinted article "Factors associated with early failure of arteriovenous fistulae for haemodialysis access".

    Science.gov (United States)

    Wong, V; Ward, R; Taylor, J; Selvakumar, S; How, T V; Bakran, A

    2011-09-01

    The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery. Copyright © 2011. Published by Elsevier Ltd.

  14. Management of early pregnancy failure and induced abortion by family medicine educators.

    Science.gov (United States)

    Herbitter, Cara; Bennett, Ariana; Schubert, Finn D; Bennett, Ian M; Gold, Marji

    2013-01-01

    Reproductive health care, including treatment of early pregnancy failure (EPF) and induced abortion, is an integral part of patient-centered care provided by family physicians, but data suggest that comprehensive training is not widely available to family medicine residents. The purpose of this study was to assess EPF and induced abortion management practices and attitudes of family medicine physician educators throughout the United States and Canada. These data were collected as part of a cross-sectional survey conducted by the Council of Academic Family Medicine Educational Research Alliance that was distributed via E-mail to 3152 practicing physician members of Council of Academic Family Medicine organizations. The vast majority of respondents (88.2%) had treated EPF, whereas few respondents (15.3%) had provided induced medication or aspiration abortions. Of those who had treated EPF, most had offered medication management (72.7%), whereas a minority had provided aspiration management (16.4%). Almost all respondents (95%) agreed that EPF management is within the scope of family medicine, and nearly three-quarters (73.2%) agreed that early induced abortion is within the scope of family medicine. Our findings suggest that family physician educators are more experienced with EPF management than elective abortion. Given the overlap of skills needed for provision of these services, there is the potential to increase the number of family physician faculty members providing induced abortions.

  15. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae; Kang, Dae Hwan [Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

    2013-11-15

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  16. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    International Nuclear Information System (INIS)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk; Jeon, Ung Bae; Kang, Dae Hwan

    2013-01-01

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  17. Larger Maximum Tumor Diameter at Radical Prostatectomy Is Associated With Increased Biochemical Failure, Metastasis, and Death From Prostate Cancer After Salvage Radiation for Prostate Cancer

    International Nuclear Information System (INIS)

    Johnson, Skyler B.; Hamstra, Daniel A.; Jackson, William C.; Zhou, Jessica; Foster, Benjamin; Foster, Corey; Song, Yeohan; Li, Darren; Palapattu, Ganesh S.; Kunju, Lakshmi; Mehra, Rohit; Sandler, Howard; Feng, Felix Y.

    2013-01-01

    Purpose: To investigate the maximum tumor diameter (MTD) of the dominant prostate cancer nodule in the radical prostatectomy specimen as a prognostic factor for outcome in patients treated with salvage external beam radiation therapy (SRT) for a rising prostate-specific antigen (PSA) value after radical prostatectomy. Methods and Materials: From an institutional cohort of 575 patients treated with SRT, data on MTD were retrospectively collected. The impact of MTD on biochemical failure (BF), metastasis, and prostate cancer-specific mortality (PCSM) was assessed on univariate and multivariate analysis using Kaplan-Meier and Cox proportional hazards models. Results: In the 173 patients with MTD data available, median follow-up was 77 months (interquartile range, 47-104 months) after SRT, and median MTD was 18 mm (interquartile range, 13-22 mm). Increasing MTD correlated with increasing pT stage, Gleason score, presence of seminal vesicle invasion, and lymph node invasion. Receiver operating characteristic curve analysis identified MTD of >14 mm to be the optimal cut-point. On univariate analysis, MTD >14 mm was associated with an increased risk of BF (P=.02, hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.2-2.8), metastasis (P=.002, HR 4.0, 95% CI 2.1-7.5), and PCSM (P=.02, HR 8.0, 95% CI 2.9-21.8). On multivariate analysis MTD >14 mm remained associated with increased BF (P=.02, HR 1.9, 95% CI 1.1-3.2), metastasis (P=.02, HR 3.4, 95% CI 1.2-9.2), and PCSM (P=.05, HR 9.7, 95% CI 1.0-92.4), independent of extracapsular extension, seminal vesicle invasion, positive surgical margins, pre-RT PSA value, Gleason score, and pre-RT PSA doubling time. Conclusions: For patients treated with SRT for a rising PSA value after prostatectomy, MTD at time of radical prostatectomy is independently associated with BF, metastasis, and PCSM. Maximum tumor diameter should be incorporated into clinical decision making and future clinical risk assessment tools for those patients

  18. Characterization of the early events in dengue virus cell entry by biochemical assays and single-virus tracking

    NARCIS (Netherlands)

    van der Schaar, Hilde M.; Rust, Michael J.; Waarts, Barry-Lee; van der Ende-Metselaarl, Heidi; Kuhn, Richard J.; Wilschut, Jan; Zhuang, Xiaowei; Smit, Jolanda M.

    In this study, we investigated the cell entry characteristics of dengue virus (DENV) type 2 strain SI on mosquito, BHK-15, and BS-C-1 cells. The concentration of virus particles measured by biochemical assays was found to be substantially higher than the number of infectious particles determined by

  19. Characterization of the early events in dengue virus cell entry by biochemical assays and single-virus tracking

    NARCIS (Netherlands)

    van der Schaar, Hilde M.; Rust, Michael J.; Waarts, Barry-Lee; van der Ende-Metselaarl, Heidi; Kuhn, Richard J.; Wilschut, Jan; Zhuang, Xiaowei; Smit, Jolanda M.

    2007-01-01

    In this study, we investigated the cell entry characteristics of dengue virus (DENV) type 2 strain SI on mosquito, BHK-15, and BS-C-1 cells. The concentration of virus particles measured by biochemical assays was found to be substantially higher than the number of infectious particles determined by

  20. Failure to Achieve a PSA Level ≤1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

    International Nuclear Information System (INIS)

    Mitchell, Darren M.; McAleese, Jonathan; Park, Richard M.; Stewart, David P.; Stranex, Stephen; Eakin, Ruth L.; Houston, Russell F.; O'Sullivan, Joe M.

    2007-01-01

    Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to ≤1 ng/mL after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was ≤1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was ≤1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of ≤1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of ≤1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments

  1. Renal impairment and heart failure with preserved ejection fraction early post-myocardial infarction

    Science.gov (United States)

    Jorapur, Vinod; Lamas, Gervasio A; Sadowski, Zygmunt P; Reynolds, Harmony R; Carvalho, Antonio C; Buller, Christopher E; Rankin, James M; Renkin, Jean; Steg, Philippe Gabriel; White, Harvey D; Vozzi, Carlos; Balcells, Eduardo; Ragosta, Michael; Martin, C Edwin; Srinivas, Vankeepuram S; Wharton III, William W; Abramsky, Staci; Mon, Ana C; Kronsberg, Shari S; Hochman, Judith S

    2010-01-01

    AIM: To study if impaired renal function is associated with increased risk of peri-infarct heart failure (HF) in patients with preserved ejection fraction (EF). METHODS: Patients with occluded infarct-related arteries (IRAs) between 1 to 28 d after myocardial infarction (MI) were grouped into chronic kidney disease (CKD) stages based on estimated glomerular filtration rate (eGFR). Rates of early post-MI HF were compared among eGFR groups. Logistic regression was used to explore independent predictors of HF. RESULTS: Reduced eGFR was present in 71.1% of 2160 patients, with significant renal impairment (eGFR < 60 mL/min every 1.73 m2) in 14.8%. The prevalence of HF was higher with worsening renal function: 15.5%, 17.8% and 29.4% in patients with CKD stages 1, 2 and 3 or 4, respectively (P < 0.0001), despite a small absolute difference in mean EF across eGFR groups: 48.2 ± 10.0, 47.9 ± 11.3 and 46.2 ± 12.1, respectively (P = 0.02). The prevalence of HF was again higher with worsening renal function among patients with preserved EF: 10.1%, 13.6% and 23.6% (P < 0.0001), but this relationship was not significant among patients with depressed EF: 27.1%, 26.2% and 37.9% (P = 0.071). Moreover, eGFR was an independent correlate of HF in patients with preserved EF (P = 0.003) but not in patients with depressed EF (P = 0.181). CONCLUSION: A significant proportion of post-MI patients with occluded IRAs have impaired renal function. Impaired renal function was associated with an increased rate of early post-MI HF, the association being strongest in patients with preserved EF. These findings have implications for management of peri-infarct HF. PMID:20885993

  2. Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure.

    Science.gov (United States)

    Smith, Sonali M; Godfrey, James; Ahn, Kwang Woo; DiGilio, Alyssa; Ahmed, Sairah; Agrawal, Vaibhav; Bachanova, Veronika; Bacher, Ulrike; Bashey, Asad; Bolaños-Meade, Javier; Cairo, Mitchell; Chen, Andy; Chhabra, Saurabh; Copelan, Edward; Dahi, Parastoo B; Aljurf, Mahmoud; Farooq, Umar; Ganguly, Siddhartha; Hertzberg, Mark; Holmberg, Leona; Inwards, David; Kanate, Abraham S; Karmali, Reem; Kenkre, Vaishalee P; Kharfan-Dabaja, Mohamed A; Klein, Andreas; Lazarus, Hillard M; Mei, Matthew; Mussetti, Alberto; Nishihori, Taiga; Ramakrishnan Geethakumari, Praveen; Saad, Ayman; Savani, Bipin N; Schouten, Harry C; Shah, Nirav; Urbano-Ispizua, Alvaro; Vij, Ravi; Vose, Julie; Sureda, Anna; Hamadani, Mehdi

    2018-04-12

    Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P = .0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  3. Equivalent biochemical failure-free survival after external beam radiation therapy or radical prostatectomy in patients with a pretreatment prostate specific antigen of > 4-20 ng/ml

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Whittington, Richard; Kaplan, Irving; Beard, Clair; Jiroutek, Michael; Malkowicz, S. Bruce; Wein, Alan; Coleman, C. Norman

    1997-01-01

    Purpose: Biochemical failure-free survival stratified by the pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (bGl) is determined for prostate cancer patients managed definitively with external beam radiation therapy or radical retropubic prostatectomy. Methods and Materials: A Cox regression multivariable analysis evaluating the variables of PSA, bGl, and clinical stage was used to evaluate the end point of time to PSA failure in 867 and 757 consecutive prostate cancer patients managed definitively with external beam radiation therapy or radical retropubic prostatectomy, respectively. PSA failure-free survival was determined using Kaplan-Meier analysis. Comparisons were made using the log rank test. Results: The pretreatment PSA, bGl, and clinical stage (T3,4 vs. T1,T2) were found to be independent predictors of time to post-treatment PSA failure for both surgically and radiation managed patients using Cox regression multivariable analysis. Patients with a pretreatment PSA of > 4 ng/ml and ≤ 20 ng/ml could be classified into risk groups for time to post-therapy PSA failure: low = PSA > 4-10 ng/ml and bGl ≤ 4; intermediate = PSA > 4-10 and bGl 5-7; or PSA > 10-20 ng/ml and bGl ≤ 7; high = PSA > 4-20 ng/ml and bGl ≥ 8. Two-year PSA failure-free survival for surgically managed and radiation-managed patients, respectively, were 98% vs. 92% (p = 0.45), 77% vs. 81% (p = 0.86), and 51% vs. 53% (p = 0.48) for patients at low, intermediate, and high risk for post-therapy PSA failure. Conclusions: There was no statistical difference in the 2-year PSA failure-free survival for potentially curable patients managed definitively with surgery or radiation therapy when a retrospective comparison stratifying for the pretreatment PSA and bGl was performed

  4. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the R.T.O.G.-Astro phoenix consensus conference

    International Nuclear Information System (INIS)

    Roach, M.; Hanks, G.; Thames, H.; Schellhammer, P.; Shipley, W.U.; Sokol, G.H.; Sandler, H.

    2008-01-01

    In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and back-dating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined 'at call' (not back-dated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to 'adequate follow-up.' To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature. (authors)

  5. Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

    Science.gov (United States)

    Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

    2017-11-01

    To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, caffeine in the first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Early osteoarthritis and microdialysis: a novel in vivo approach for measurements of biochemical markers in the perisynovium and intraarticularly

    DEFF Research Database (Denmark)

    Helmark, Ida Carøe; Mikkelsen, U R; Krogsgaard, M R

    2010-01-01

    The microdialysis technique was evaluated as a possible method to obtain local measurements of biochemical markers from knee joints with degenerative changes. Seven patients scheduled for arthroscopy of the knee due to minor to moderate degenerative changes had microdialysis catheters inserted...... under ultrasonographic guidance, intraarticularly and in the synovium-close tissue. Catheters were perfused at a rate of 2 μl/min for approximately 100 min with a Ringer solution containing radioactively labeled glucose, and the positions of the catheters were later visualized during arthroscopy. All...

  7. Early plant growth and biochemical responses induced by Azospirillum brasilense Sp245 lipopolysaccharides in wheat (Triticum aestivum L.) seedlings are attenuated by procyanidin B2.

    Science.gov (United States)

    Vallejo-Ochoa, Juan; López-Marmolejo, Mariel; Hernández-Esquivel, Alma Alejandra; Méndez-Gómez, Manuel; Suárez-Soria, Laura Nicolasa; Castro-Mercado, Elda; García-Pineda, Ernesto

    2018-03-01

    This study analyzes the effects of procyanidin B2 on early wheat plant growth and plant biochemical responses promoted by lipopolysaccharides (LPS) derived from the rhizobacteria Azospirillum brasilense Sp245. Measurements of leaf, root length, fresh weight, and dry weight showed in vitro plant growth stimulation 4 days after treatment with A. brasilense as well as LPS. Superoxide anion (O 2 ·- ) and hydrogen peroxide (H 2 O 2 ) levels increased in seedling roots treated with LPS (100 μg mL -1 ). The chlorophyll content in leaf decreased while the starch content increased 24 h after treatment in seedling roots. The LPS treatment induced a high increase in total peroxidase (POX) (EC 1.11.1.7) activity and ionically bound cell wall POX content in roots, when compared to respective controls. Early plant growth and biochemical responses observed in wheat seedlings treated with LPS were inhibited by the addition of procyanidin B2 (5 μg mL -1 ), a B type proanthocyanidin (PAC), plant-derived polyphenolic compound with binding properties of LPS. All results suggest first that the ionically bound cell wall POX enzymes could be a molecular target of A. brasilense LPS, and second that the recognition or association of LPS by plant cells is required to activate plant responses. This last event could play a critical role during plant growth regulation by A. brasilense LPS.

  8. Ergospirometry and Echocardiography in Early Stage of Heart Failure with Preserved Ejection Fraction and in Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Eduardo Lima Garcia

    2015-01-01

    Full Text Available Abstract Background: Heart failure with preserved ejection fraction is a syndrome characterized by changes in diastolic function; it is more prevalent among the elderly, women, and individuals with systemic hypertension (SH and diabetes mellitus. However, in its early stages, there are no signs of congestion and it is identified in tests by adverse remodeling, decreased exercise capacity and diastolic dysfunction. Objective: To compare doppler, echocardiographic (Echo, and cardiopulmonary exercise test (CPET variables - ergospirometry variables - between two population samples: one of individuals in the early stage of this syndrome, and the other of healthy individuals. Methods: Twenty eight outpatients diagnosed with heart failure according to Framingham’s criteria, ejection fraction > 50% and diastolic dysfunction according to the european society of cardiology (ESC, and 24 healthy individuals underwent Echo and CPET. Results: The group of patients showed indexed atrial volume and left ventricular mass as well as E/E’ and ILAV/A´ ratios significantly higher, in addition to a significant reduction in peak oxygen consumption and increased VE/VCO2 slope, even having similar left ventricular sizes in comparison to those of the sample of healthy individuals. Conclusion: There are significant differences between the structural and functional variables analyzed by Echo and CPET when comparing two population samples: one of patients in the early stage of heart failure with ejection fraction greater than or equal to 50% and another of healthy individuals.

  9. Dietary Sodium Modulation of Aldosterone Activation and Renal Function During the Progression of Experimental Heart Failure Miller: Dietary Sodium and Early Heart Failure

    Science.gov (United States)

    Miller, Wayne L.; Borgeson, Daniel D.; Grantham, J. Aaron; Luchner, Andreas; Redfield, Margaret M.; Burnett, John C.

    2015-01-01

    Aims Aldosterone activation is central to the sodium-fluid retention that marks the progression of heart failure (HF). The actions of dietary sodium restriction, a mainstay in HF management, on cardiorenal and neuroendocrine adaptations during the progression of HF are poorly understood. The study aim was to assess the role of dietary sodium during the progression of experimental HF. Methods and Results Experimental HF was produced in a canine model by rapid right ventricular pacing which evolves from early mild HF to overt, severe HF. Dogs were fed one of three diets: 1) high sodium [250 mEq (5.8 grams) per day, n=6]; 2) standard sodium [58 mEq (1.3 grams) per day, n=6]; and 3) sodium restriction [11 mEq (0.25 grams) per day, n=6]. During the 38 day study hemodynamics, renal function, renin activity (PRA), and aldosterone were measured. Changes in hemodynamics at 38 days were similar in all three groups, as were changes in renal function. Aldosterone activation was demonstrated in all three groups, however, dietary sodium restriction, in contrast to high sodium, resulted in early (10 days) activation of PRA and aldosterone. High sodium demonstrated significant suppression of aldosterone activation over the course of HF progression. Conclusions Excessive dietary sodium restriction particularly in early stage HF results in early aldosterone activation, while normal and excess sodium intake are associated with delayed or suppressed activation. These findings warrant evaluation in humans to determine if dietary sodium manipulation, particularly during early stage HF, may have a significant impact on neuroendocrine disease progression. PMID:25823360

  10. Salvage radiotherapy for patients with P.S.A. relapse after radical prostatectomy: comparisons among Astro and Phoenix biochemical failure definitions

    International Nuclear Information System (INIS)

    Quero, L.; Hennequin, V.; Maylin, C.; Hennequin, C.; Ravery, V.; Mongiat-Artus, P.; Desgrandchamps, F.

    2009-01-01

    Purpose Study about the efficacy of salvage radiotherapy (R.T.), in terms of biochemical disease free survival (b.D.F.S.), according to Astro and Phoenix (nadir + 2) definitions, for persistent or rising P.S.A. after radical prostatectomy. Patients and methods Retrospective analysis of 59 patients who underwent R.T. between 1990 and 2003 for P.S.A. recurrence after radical prostatectomy. Patients received a median of 66 Gy to the prostate bed with 3D or 2D R.T.. The main end point was b.D.F.S. according to Astro and Phoenix (nadir + 2) definitions. Different criterion sets were analysed to calculate b.D.F.S. and pretreatment factors that might predict biochemical relapse were sought for each. Results After a 38-month median follow-up, the 3-year b.D.F.S. rates were: 60 and 72% for Astro and Phoenix (nadir + 2 ng/ml) definitions respectively. According to univariate analysis, pre-R.T. P.S.A. = 1 ng/ml and seminal vesicle involvement were associated with biochemical relapse. Multivariate analysis retained only pre-R.T. P.S.A. = 1 ng/ml as an independent predictor of biochemical relapse for the two definitions. Conclusion Salvage R.T. is an effective treatment after radical prostatectomy according to Astro or Phoenix definitions. Only pre-R.T. P.S.A. = 1 ng/ml predicted relapse. (authors)

  11. Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

    Science.gov (United States)

    Bhattacharyya, D; Prasad, Bnbm; Tampi, P S; Ramprasad, R

    2011-10-01

    Non-invasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute hypercapnic respiratory failure. Patients with hypercapnic respiratory failure requiring ventilation therapy (respiratory rate [RR] of > 30 breaths per minutes, PaCO2 > 55 mmHg and arterial pH success group and these parameters continued to improve even after four and 24 hours of NIPPV treatment. Out of 24 (24%) patients who failed to respond, 13 (54%) needed endotracheal intubation within one hour. The failure group had higher baseline HR than the success group. Improvement in HR, RR, pH, and PCO2 one hour after putting the patient on NIPPV predicts success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

  12. Early Adoption of Sacubitril/Valsartan for Patients With Heart Failure With Reduced Ejection Fraction: Insights From Get With the Guidelines-Heart Failure (GWTG-HF).

    Science.gov (United States)

    Luo, Nancy; Fonarow, Gregg C; Lippmann, Steven J; Mi, Xiaojuan; Heidenreich, Paul A; Yancy, Clyde W; Greiner, Melissa A; Hammill, Bradley G; Hardy, N Chantelle; Turner, Stuart J; Laskey, Warren K; Curtis, Lesley H; Hernandez, Adrian F; Mentz, Robert J; O'Brien, Emily C

    2017-04-01

    The aim of this study was to assess the prevalence and variation in angiotensin receptor/neprilysin inhibitor (ARNI) prescription among a real-world population with heart failure with reduced ejection fraction (HFrEF). The U.S. Food and Drug Administration approved sacubitril/valsartan for patients with HFrEF in July 2015. Little is known about the early patterns of use of this novel therapy. The study included patients discharged alive from hospitals in Get With the Guidelines-Heart Failure (GWTG-HF), a registry of hospitalized patients with heart failure, between July 2015 and June 2016 who had documentation of whether ARNIs were prescribed at discharge. Patient and hospital characteristics were compared among patients with HFrEF (ejection fraction ≤40%) with and without ARNI prescription at discharge, excluding those with documented contraindications to ARNIs. To evaluate hospital variation, hospitals with at least 10 eligible hospitalizations during the study period were assessed. Of 21,078 patients hospitalized with HFrEF during the study period, 495 (2.3%) were prescribed ARNIs at discharge. Patients prescribed ARNIs were younger (median age 65 years vs. 70 years; p < 0.001), had lower ejection fractions (median 23% vs. 25%; p < 0.001), and had higher use of aldosterone antagonists (45% vs. 31%; p < 0.001) at discharge. At the 241 participating hospitals with 10 or more eligible admissions, 125 (52%) reported no discharge prescriptions of ARNIs. Approximately 2.3% of patients hospitalized for HFrEF in a national registry were prescribed ARNI therapy in the first 12 months following Food and Drug Administration approval. Further study is needed to identify and overcome barriers to implementing new evidence into practice, such as ARNI use among eligible patients with HFrEF. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Renal failure in patients with multiple myeloma.

    Science.gov (United States)

    Almueilo, Samir H

    2015-01-01

    Renal dysfunction is encountered in 20-25% of patients with multiple myeloma (MM) at the time of diagnosis. There is often a precipitating event. Several biochemical and clinical correlations with renal failure in MM have been reported. Renal failure in MM is associated with worse outcome of the disease. We retrospectively analyzed the medical records of 64 patients with MM admitted to our institution during the period January 1992 to December 2012. Abnormal renal function was observed in 24 (37.5%) patients and 17 (26.6%) of them had renal failure; 14 of the 17 (82.4%) of patients with renal failure had Stage III MM. Urine Bence- Jones protein was positive in ten (58.8%) patients with renal failure versus ten (21.3%) patients without renal failure (P = 0.004). Potential precipitating factors of renal failure were determined in nine patients. Renal function normalized in 11 patients with simple measures, while six patients required hemodialysis; one remained dialysis dependent till time of death. Early mortality occurred in five (29.4%) patients with renal failure as compared with two (4.3%) patients in the group without renal failure (P = 0.005). In conclusion, renal failure is associated with a higher tumor burden and Bence-Jones proteinuria in patients with MM. It is reversible in the majority of patients; however, early mortality tends to be higher in patients with persistent renal failure.

  14. Expected dose for the early failure scenario classes in the 2008 performance assessment for the proposed high-level radioactive waste repository at Yucca Mountain, Nevada

    International Nuclear Information System (INIS)

    Helton, J.C.; Hansen, C.W.; Sallaberry, C.J.

    2014-01-01

    Extensive work has been carried out by the U.S. Department of Energy (DOE) in the development of a proposed geologic repository at Yucca Mountain (YM), Nevada, for the disposal of high-level radioactive waste. In support of this development and an associated license application to the U.S. Nuclear Regulatory Commission (NRC), the DOE completed an extensive performance assessment (PA) for the proposed YM repository in 2008. This presentation describes the determination of expected dose to the reasonably maximally exposed individual (RMEI) specified in the NRC regulations for the YM repository for the early waste package (WP) failure scenario class and the early drip shield (DS) failure scenario class in the 2008 YM PA. The following topics are addressed: (i) properties of the early failure scenario classes and the determination of dose and expected dose the RMEI, (ii) expected dose and uncertainty in expected dose to the RMEI from the early WP failure scenario class, (iii) expected dose and uncertainty in expected dose to the RMEI from the early DS failure scenario class, (iv) expected dose and uncertainty in expected dose to the RMEI from the combined early WP and early DS failure scenario class with and without the inclusion of failures resulting from nominal processes, and (v) uncertainty in the occurrence of early failure scenario classes. The present article is part of a special issue of Reliability Engineering and System Safety devoted to the 2008 YM PA; additional articles in the issue describe other aspects of the 2008 YM PA. - Highlights: • Extensive work has been carried out by the U.S. DOE in the development of a proposed geologic repository at Yucca Mountain (YM), Nevada, for the disposal of high-level radioactive waste. • Properties of the early failure scenario classes (i.e. early waste package failure and early drip shield failure) in the 2008 YM performance assessment are described. • Determination of dose, expected dose and expected (mean

  15. Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

    Science.gov (United States)

    Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

    2003-10-01

    Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

  16. PSA Nadir of <0.5 ng/mL Following Brachytherapy for Early-Stage Prostate Adenocarcinoma is Associated With Freedom From Prostate-Specific Antigen Failure

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eric C. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Stone, Nelson N. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Department of Urology, Mount Sinai Medical Center, New York, NY (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States)

    2012-06-01

    Purpose: Because limited information exists regarding whether the rate or magnitude of PSA decline following brachytherapy predicts long-term clinical outcomes, we evaluated whether achieving a prostate-specific antigen (PSA) nadir (nPSA) <0.5 ng/mL following brachytherapy is associated with decreased PSA failure and/or distant metastasis. Methods and Materials: We retrospectively analyzed our database of early-stage prostate adenocarcinoma patients who underwent brachytherapy, excluding those receiving androgen-deprivation therapy and those with <2 years follow-up. Median and mean pretreatment PSA were 6 ng/mL and 7.16 ng/mL, respectively. By clinical stage, 775 were low risk ({<=}T2a), 126 were intermediate risk (T2b), and 20 were high risk (>T2b). By Gleason score, 840 were low risk ({<=}6), 71 were intermediate risk (7), and 10 were high risk (>7). Patients were treated with brachytherapy only (I-125, n = 779, or Pd-103, n = 47), or brachytherapy + external-beam radiation therapy (n = 95). Median follow-up was 6.3 years. We noted whether nPSA <0.5 ng/mL was achieved and the time to achieve this nadir and tested for associations with pretreatment risk factors. We also determined whether this PSA endpoint was associated with decreased PSA failure or distant metastasis. Results: Absence of high-risk factors in clinical stage ({<=}T2b), Gleason score ({<=}7), and pretreatment PSA ({<=}20 ng/mL) was significantly associated with achieving nPSA <0.5 ng/mL. By Kaplan-Meier analysis, patients achieving nPSA <0.5 ng/mL had significantly higher long-term freedom from biochemical failure (FFBF) than nonresponders (5-year FFBF: 95.2 {+-} 0.8% vs. 71.5 {+-} 6.7%; p < 0.0005). Among responders, those who achieved nPSA <0.5 ng/mL in {<=}5 years had higher FFBF than those requiring >5 years (5-year FFBF: 96.7 {+-} 0.7% vs. 80.8 {+-} 4.6%; p < 0.0005). On multivariate analysis, patients who achieved nPSA <0.5 ng/mL in {<=}5 years had significantly higher FFBF than other

  17. Laser light and magnetic field stimulation effect on biochemical, enzymes activities and chlorophyll contents in soybean seeds and seedlings during early growth stages.

    Science.gov (United States)

    Asghar, Tehseen; Jamil, Yasir; Iqbal, Munawar; Zia-Ul-Haq; Abbas, Mazhar

    2016-12-01

    Laser and magnetic field bio-stimulation attracted the keen interest of scientific community in view of their potential to enhance seed germination, seedling growth, physiological, biochemical and yield attributes of plants, cereal crops and vegetables. Present study was conducted to appraise the laser and magnetic field pre-sowing seed treatment effects on soybean sugar, protein, nitrogen, hydrogen peroxide (H 2 O 2 ) ascorbic acid (AsA), proline, phenolic and malondialdehyde (MDA) along with chlorophyll contents (Chl "a" "b" and total chlorophyll contents). Specific activities of enzymes such as protease (PRT), amylase (AMY), catalyst (CAT), superoxide dismutase (SOD) and peroxides (POD) were also assayed. The specific activity of enzymes (during germination and early growth), biochemical and chlorophyll contents were enhanced significantly under the effect of both laser and magnetic pre-sowing treatments. Magnetic field treatment effect was slightly higher than laser treatment except PRT, AMY and ascorbic acid contents. However, both treatments (laser and magnetic field) effects were significantly higher versus control (un-treated seeds). Results revealed that laser and magnetic field pre-sowing seed treatments have potential to enhance soybean biological moieties, chlorophyll contents and metabolically important enzymes (degrade stored food and scavenge reactive oxygen species). Future study should be focused on growth characteristics at later stages and yield attributes. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Evaluation of the cool-down behaviour of ITER FW beryllium tiles for an early failure detection

    Directory of Open Access Journals (Sweden)

    Thomas Weber

    2016-12-01

    Full Text Available The design of the first wall in ITER foresees several hundred thousand beryllium tiles, which are bonded to the water-cooled CuCrZr supporting structure. Due to the nature of a Tokamak reactor this bonding is faced to thermal fatigue. Since the failure of a single tile might already have a major impact on the operability of ITER, comprehensive high heat flux tests are performed on prototypes prior to the acceptance of manufacturing procedures. For a deeper understanding of the temperature curves, which were and will be measured by IR devices of these first wall prototypes, thermo-mechanical FEM simulations shall demonstrate the possibilities of an early bonding failure detection. Hereby, the maximum temperatures for each cycle as well as the cool-down behaviour are the input data.

  19. Prognostic importance of renal function in patients with early heart failure and mild left ventricular dysfunction

    NARCIS (Netherlands)

    Smilde, Tom; Hillege, Hans; Voors, Adriaan; Dunselman, P.H.J.; Van Veldhuisen, D.J.

    2004-01-01

    We evaluated the prognostic value of renal function in an initially “untreated” population with mild heart failure and compared the prognosis of this population with a matched controlled population. During a follow-up of 13 years (mean 11.7), 90 patients (56%) died. Mortality was higher compared

  20. Success after Failure: Academic Effects and Psychological Implications of Early Universal Algebra Policies

    Science.gov (United States)

    Howard, Keith A.; Scott, Allison; Romero, Martin; Saddler, Derrick

    2015-01-01

    In this article, the authors use the High School Longitudinal Study 2009 (HSLS:09) national database to analyze the relationships between algebra failure, subsequent performance, motivation, and college readiness. Students who failed eighth-grade Algebra I did not differ significantly in mathematics proficiency from those who passed lower-level…

  1. Growth at the Age of 4 Years Subsequent to Early Failure to Thrive.

    Science.gov (United States)

    Kristiansson, Bengt; Fallstrom, Sven P.

    1987-01-01

    Followup at age 4 of 55 children, previously investigated for failure to thrive (FFT) at 4-18 months of age, indicated normal growth for most children with organic causes of FFT, but persisting suboptimal growth patterns for children with nonorganic FFT, particularly for those children with higher numbers of risk factors. (Author/DB)

  2. Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction

    NARCIS (Netherlands)

    Matsue, Yuya; ter Maaten, Jozine M.; Suzuki, Makoto; Torii, Sho; Yamaguchi, Satoshi; Fukamizu, Seiji; Ono, Yuichi; Fujii, Hiroyuki; Kitai, Takeshi; Nishioka, Toshihiko; Sugi, Kaoru; Onishi, Yuko; Noda, Makoto; Kagiyama, Nobuyuki; Satoh, Yasuhiro; Yoshida, Kazuki; van der Meer, Peter; Damman, Kevin; Voors, Adriaan A.; Goldsmith, Steven R.

    2017-01-01

    Background: Poor response to diuretics is associated with worse prognosis in patients with acute heart failure (AHF). We hypothesized that treatment with tolvaptan improves diuretic response in patients with AHF. Methods: We performed a secondary analysis of the AQUAMARINE open-label randomized

  3. GLUT12 deficiency during early development results in heart failure and a diabetic phenotype in zebrafish

    NARCIS (Netherlands)

    Jiménez-Amilburu, Vanesa; Jong-Raadsen, Susanne; Bakkers, Jeroen; Spaink, Herman P.; Marín-Juez, Rubén

    2015-01-01

    Cardiomyopathies-associated metabolic pathologies (e.g., type 2 diabetes and insulin resistance) are a leading cause of mortality. It is known that the association between these pathologies works in both directions, for which heart failure can lead to metabolic derangements such as insulin

  4. GLUT12 deficiency during early development results in heart failure and a diabetic phenotype in zebrafish

    NARCIS (Netherlands)

    Jiménez-Amilburu, Vanesa; Jong-Raadsen, Susanne; Bakkers, Jeroen; Spaink, Herman P; Marín-Juez, Rubén

    Cardiomyopathies-associated metabolic pathologies (e.g., type 2 diabetes and insulin resistance) are a leading cause of mortality. It is known that the association between these pathologies works in both directions, for which heart failure can lead to metabolic derangements such as insulin

  5. Extended prediction rule to optimise early detection of heart failure in older persons with non-acute shortness of breath : A cross-sectional study

    NARCIS (Netherlands)

    Van Riet, Evelien E S; Hoes, Arno W.; Limburg, Alexander; Landman, Marcel A J; Kemperman, Hans; Rutten, Frans H.

    2016-01-01

    Objectives: There is a need for a practical tool to aid general practitioners in early detection of heart failure in the elderly with shortness of breath. In this study, such a screening rule was developed based on an existing rule for detecting heart failure in older persons with a diagnosis of

  6. Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

    Science.gov (United States)

    Collins, Sean; Storrow, Alan B; Albert, Nancy M; Butler, Javed; Ezekowitz, Justin; Felker, G Michael; Fermann, Gregory J; Fonarow, Gregg C; Givertz, Michael M; Hiestand, Brian; Hollander, Judd E; Lanfear, David E; Levy, Phillip D; Pang, Peter S; Peacock, W Frank; Sawyer, Douglas B; Teerlink, John R; Lenihan, Daniel J

    2015-01-01

    Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Clinico-biochemical factors to early predict biliary etiology of acute pancreatitis: age, female gender, and ALT.

    Science.gov (United States)

    Zarnescu, N O; Costea, R; Zarnescu Vasiliu, E C; Neagu, S

    2015-01-01

    Background/ Aims: Despite the existence of an easy tool to diagnose biliary tract disease as an etiology for acute pancreatitis (AP), the sensitivity of abdominal ultrasound is around 80%, which can be even lower in certain conditions. We have retrospectively reviewed data of 146 patients admitted for acute pancreatitis between 1999 and 2013. Bivariate analysis for clinical and biochemical variables was performed with respect to etiology of AP (biliary versus non-biliary). Multivariate analysis was performed by using binary logistic regression. There were 87 males (59.6%) and 59 females (40.4%), with a median age of 51. The etiology of acute pancreatitis was biliary in 71 patients (48.6%). Bivariate analysis found the following as significant association (p=0.001) with biliary pancreatitis: older age, female gender, and elevated AST, ALT. A binary logistic regression analysis identified as predictor factors for biliary etiology of acute pancreatitis: age OR = 1.031 (95% CI 1.004 - 1.059, p = 0.024), sex (female) OR = 2.34 (95% CI 1.022 - 5.359, p = 0.044) and ALT OR = 1.004 (95% CI 1.001 - 1.007, p =0.004). The two clinical scores included the three variables (A.S.ALT scores) in categorical format were generated and then checked with the ROC curves (areas under curve are 0.768 and 0.778). Age, female gender, and elevated ALT can help identifying cases with biliary etiology of acute pancreatitis.

  8. Characterization of the behavior of three definitions of prostate-specific antigen-based biochemical failure in relation to detection and follow-up biases: comparison with the American Society for Therapeutic Radiology and Oncology consensus definition.

    Science.gov (United States)

    Williams, Scott G

    2006-03-01

    To examine the impact of detection biases on three prostate cancer biochemical failure (bF) definitions in comparison with the existing American Society for Therapeutic Radiology and Oncology Consensus Definition (ACD). Three alternative bF definitions were tested against the ACD: three rises in prostate-specific antigen (PSA) level without backdating, nadir plus 2 ng/mL, and a threshold PSA level of >3 ng/mL, according to data from 1050 men. The mean time between PSA tests (MTBT), regularity of collection, and calendar year of analysis were examined in each bF definition. The MTBT produced a statistically significant difference in the derived hazard ratio for identification of bF in all definitions. The influence of test regularity was statistically significant beyond the median level of regularity in all definitions. The year of analysis impacted greatly on the ACD, whereas the three alternative definitions exhibited minor follow-up duration variations by comparison. The alternative definitions had reliable follow-up when the crude median time to censoring was at least 1.6 times greater than that of failure. Detection biases will always be a significant issue in defining bF. A number of alternative failure definitions have more predictable interactions with these biases than the existing ACD.

  9. Characterization of the behavior of three definitions of prostate-specific antigen-based biochemical failure in relation to detection and follow-up biases: Comparison with the American Society for Therapeutic Radiology and Oncology consensus definition

    International Nuclear Information System (INIS)

    Williams, Scott G.

    2006-01-01

    Purpose: To examine the impact of detection biases on three prostate cancer biochemical failure (bF) definitions in comparison with the existing American Society for Therapeutic Radiology and Oncology Consensus Definition (ACD). Methods and Materials: Three alternative bF definitions were tested against the ACD: three rises in prostate-specific antigen (PSA) level without backdating, nadir plus 2 ng/mL, and a threshold PSA level of >3 ng/mL, according to data from 1050 men. The mean time between PSA tests (MTBT), regularity of collection, and calendar year of analysis were examined in each bF definition. Results: The MTBT produced a statistically significant difference in the derived hazard ratio for identification of bF in all definitions. The influence of test regularity was statistically significant beyond the median level of regularity in all definitions. The year of analysis impacted greatly on the ACD, whereas the three alternative definitions exhibited minor follow-up duration variations by comparison. The alternative definitions had reliable follow-up when the crude median time to censoring was at least 1.6 times greater than that of failure. Conclusions: Detection biases will always be a significant issue in defining bF. A number of alternative failure definitions have more predictable interactions with these biases than the existing ACD

  10. Patients with the worst outcomes after paracetamol (acetaminophen)-induced liver failure have an early monocytopenia.

    Science.gov (United States)

    Moore, J K; MacKinnon, A C; Man, T Y; Manning, J R; Forbes, S J; Simpson, K J

    2017-02-01

    Acute liver failure (ALF) is associated with significant morbidity and mortality. Studies have implicated the immune response, especially monocyte/macrophages as being important in dictating outcome. To investigate changes in the circulating monocytes and other immune cells serially in patients with ALF, relate these with cytokine concentrations, monocyte gene expression and patient outcome. In a prospective case-control study in the Scottish Liver Transplant Unit, Royal Infirmary Edinburgh, 35 consecutive patients admitted with paracetamol-induced liver failure (POD-ALF), 10 patients with non-paracetamol causes of ALF and 16 controls were recruited. The peripheral blood monocyte phenotype was analysed by flow cytometry, circulating cytokines quantified by protein array and monocyte gene expression array performed and related to outcome. On admission, patients with worst outcomes after POD-ALF had a significant monocytopenia, characterised by reduced classical and expanded intermediate monocyte population. This was associated with reduced circulating lymphocytes and natural killer cells, peripheral cytokine patterns suggestive of a 'cytokine storm' and increased concentrations of cytokines associated with monocyte egress from the bone marrow. Gene expression array did not differentiate patient outcome. At day 4, there was no significant difference in monocyte, lymphocyte or natural killer cells between survivors and the patients with adverse outcomes. Severe paracetamol liver failure is associated with profound changes in the peripheral blood compartment, particularly in monocytes, related with worse outcomes. This is not seen in patients with non-paracetamol-induced liver failure. Significant monocytopenia on admission may allow earlier clarification of prognosis, and it highlights a potential target for therapeutic intervention. © 2016 John Wiley & Sons Ltd.

  11. Biochemical and hematologic reference values for free-ranging, chemically immobilized wild norwegian reindeer (rangifer tarandus tarandus) during early winter.

    Science.gov (United States)

    Miller, Andrea L; Evans, Alina L; Os, Øystein; Arnemo, Jon M

    2013-04-01

    Hematologic and serum biochemistry values were evaluated in free-ranging, wild Norwegian reindeer (Rangifer tarandus tarandus) as part of a reintroduction program in southwestern Norway in November 1995 and 1996. Animals were immobilized with medetomidine-ketamine by dart from a helicopter. Blood was drawn for serum chemistry from 31 adults (nine males and 22 females) and for hematology from 29 adults (eight males and 21 females). Significant differences (Ppaper provides the first report of baseline hematologic and serum biochemistry reference ranges for free-ranging, wild Norwegian reindeer during early winter.

  12. Early Phase Contingency Trajectory Design for the Failure of the First Lunar Orbit Insertion Maneuver: Direct Recovery Options

    Science.gov (United States)

    Song, Young-Joo; Bae, Jonghee; Kim, Young-Rok; Kim, Bang-Yeop

    2017-12-01

    To ensure the successful launch of the Korea pathfinder lunar orbiter (KPLO) mission, the Korea Aerospace Research Institute (KARI) is now performing extensive trajectory design and analysis studies. From the trajectory design perspective, it is crucial to prepare contingency trajectory options for the failure of the first lunar brake or the failure of the first lunar orbit insertion (LOI) maneuver. As part of the early phase trajectory design and analysis activities, the required time of flight (TOF) and associated delta-V magnitudes for each recovery maneuver (RM) to recover the KPLO mission trajectory are analyzed. There are two typical trajectory recovery options, direct recovery and low energy recovery. The current work is focused on the direct recovery option. Results indicate that a quicker execution of the first RM after the failure of the first LOI plays a significant role in saving the magnitudes of the RMs. Under the conditions of the extremely tight delta-V budget that is currently allocated for the KPLO mission, it is found that the recovery of the KPLO without altering the originally planned mission orbit (a 100 km circular orbit) cannot be achieved via direct recovery options. However, feasible recovery options are suggested within the boundaries of the currently planned delta-V budget. By changing the shape and orientation of the recovered final mission orbit, it is expected that the KPLO mission may partially pursue its scientific mission after successful recovery, though it will be limited.

  13. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients

    International Nuclear Information System (INIS)

    Zelefsky, Michael J.; Fuks, Zvi; Hunt, Margie; Yamada, Yoshiya; Marion, Christine; Ling, C. Clifton; Amols, Howard; Venkatraman, E.S.; Leibel, Steven A.

    2002-01-01

    Purpose: To report the acute and late toxicity and preliminary biochemical outcomes in 772 patients with clinically localized prostate cancer treated with high-dose intensity-modulated radiotherapy (IMRT). Methods and Materials: Between April 1996 and January 2001, 772 patients with clinically localized prostate cancer were treated with IMRT. Treatment was planned using an inverse-planning approach, and the desired beam intensity profiles were delivered by dynamic multileaf collimation. A total of 698 patients (90%) were treated to 81.0 Gy, and 74 patients (10%) were treated to 86.4 Gy. Acute and late toxicities were scored by the Radiation Therapy Oncology Group morbidity grading scales. PSA relapse was defined according to The American Society of Therapeutic Radiation Oncology Consensus Statement. The median follow-up time was 24 months (range: 6-60 months). Results: Thirty-five patients (4.5%) developed acute Grade 2 rectal toxicity, and no patient experienced acute Grade 3 or higher rectal symptoms. Two hundred seventeen patients (28%) developed acute Grade 2 urinary symptoms, and one experienced urinary retention (Grade 3). Eleven patients (1.5%) developed late Grade 2 rectal bleeding. Four patients (0.1%) experienced Grade 3 rectal toxicity requiring either one or more transfusions or a laser cauterization procedure. No Grade 4 rectal complications have been observed. The 3-year actuarial likelihood of ≥ late Grade 2 rectal toxicity was 4%. Seventy-two patients (9%) experienced late Grade 2 urinary toxicity, and five (0.5%) developed Grade 3 urinary toxicity (urethral stricture). The 3-year actuarial likelihood of ≥ late Grade 2 urinary toxicity was 15%. The 3-year actuarial PSA relapse-free survival rates for favorable, intermediate, and unfavorable risk group patients were 92%, 86%, and 81%, respectively. Conclusions: These data demonstrate the feasibility of high-dose IMRT in a large number of patients. Acute and late rectal toxicities seem to be

  14. Six-Year Survival and Early Failure Rate of 2918 Implants with Hydrophobic and Hydrophilic Enossal Surfaces

    Directory of Open Access Journals (Sweden)

    Olivier Le Gac

    2015-02-01

    Full Text Available The aim of this chart review was to obtain an objective, quantitative assessment of the clinical performance of an implant line used in an implantological office setting. Implants with hydrophilic (INICELL and hydrophobic (TST; both: Thommen Medical AG, Grenchen, Switzerland enossal surfaces were compared and the cumulative implant survival rate was calculated. The data of 1063 patients that received 2918 implants (1337 INICELL, 1581 TST was included. The average follow up time was 2.1 (1.1–5.4 years for INICELL and 4.5 (1.3–5.9 years for TST implants (Thommen Medical AG, Switzerland. In the reported period 7 implants with INICELL (0.5% and 23 TST implants (1.5% failed. This difference was statistically significant. The analysis of cases treated and followed up in a single implantological office for 6 years confirmed the very good clinical outcome that was achieved with both used implant lines. Within the limitations of this retrospective analysis, the overall early failure rate of the hydrophilic implants was significantly lower than that of hydrophobic implants. The use of hydrophilic implants allows the clinician to obtain less early failures, hence the interest of an up-to-date surface for the daily work of an implant practice.

  15. Six-Year Survival and Early Failure Rate of 2918 Implants with Hydrophobic and Hydrophilic Enossal Surfaces.

    Science.gov (United States)

    Gac, Olivier Le; Grunder, Ueli

    2015-02-05

    The aim of this chart review was to obtain an objective, quantitative assessment of the clinical performance of an implant line used in an implantological office setting. Implants with hydrophilic (INICELL) and hydrophobic (TST; both: Thommen Medical AG, Grenchen, Switzerland) enossal surfaces were compared and the cumulative implant survival rate was calculated. The data of 1063 patients that received 2918 implants (1337 INICELL, 1581 TST) was included. The average follow up time was 2.1 (1.1-5.4) years for INICELL and 4.5 (1.3-5.9) years for TST implants (Thommen Medical AG, Switzerland). In the reported period 7 implants with INICELL (0.5%) and 23 TST implants (1.5%) failed. This difference was statistically significant. The analysis of cases treated and followed up in a single implantological office for 6 years confirmed the very good clinical outcome that was achieved with both used implant lines. Within the limitations of this retrospective analysis, the overall early failure rate of the hydrophilic implants was significantly lower than that of hydrophobic implants. The use of hydrophilic implants allows the clinician to obtain less early failures, hence the interest of an up-to-date surface for the daily work of an implant practice.

  16. Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review.

    Science.gov (United States)

    Esposito, Marco; Grusovin, Maria Gabriella; Loli, Vasiliki; Coulthard, Paul; Worthington, Helen V

    2010-01-01

    Marco Esposito is the first author of two of the included studies; however, he was not involved in the quality assessment of these trials. This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications' published in The Cochrane Library (see http://www.cochrane.org for more information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic/placebo administration and, if antibiotics are of benefit, to find which type, dosage and duration is the most effective. The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up to 2 June 2010 for randomised controlled clinical trials (RCTs) with a follow-up of at least 3 months comparing the administration of various prophylactic antibiotic regimens versus no antibiotics to patients undergoing dental implant placement. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Meta-analyses were

  17. Possibilities And Influencing Parameters For The Early Detection Of Sheet Metal Failure In Press Shop Operations

    International Nuclear Information System (INIS)

    Gerlach, Joerg; Kessler, Lutz; Paul, Udo; Roesen, Hartwig

    2007-01-01

    The concept of forming limit curves (FLC) is widely used in industrial practice. The required data should be delivered for typical material properties (measured on coils with properties in a range of +/- of the standard deviation from the mean production values) by the material suppliers. In particular it should be noted that its use for the validation of forming robustness providing forming limit curves for the variety of scattering in the mechanical properties is impossible. Therefore a forecast of the expected limit strains without expensive cost and time-consuming experiments is necessary. In the paper the quality of a regression analysis for determining forming limit curves based on tensile test results is presented and discussed.Owing to the specific definition of limit strains with FLCs following linear strain paths, the significance of this failure definition is limited. To consider nonlinear strain path effects, different methods are given in literature. One simple method is the concept of limit stresses. It should be noted that the determined value of the critical stress is dependent on the extrapolation of the tensile test curve. When the yield curve extrapolation is very similar to an exponential function, the definition of the critical stress value is very complicated due to the low slope of the hardening function at large strains.A new method to determine general failure behavior in sheet metal forming is the common use and interpretation of three criteria: onset on material instability (comparable with FLC concept), value of critical shear fracture and the value of ductile fracture. This method seems to be particularly successful for newly developed high strength steel grades in connection with more complex strain paths for some specific material elements. Nevertheless the identification of the different failure material parameters or functions will increase and the user has to learn with the interpretation of the numerical results

  18. Effects of feeding fatty acid calcium and the interaction of forage quality on production performance and biochemical indexes in early lactation cow.

    Science.gov (United States)

    Hu, Z Y; Yin, Z Y; Lin, X Y; Yan, Z G; Wang, Z H

    2015-10-01

    Multiparous early lactation Holstein cows (n = 16) were used in a randomized complete block design to determine the effects of feeding fatty acid calcium and the interaction of forage quality on production performance and biochemical indexes in early lactation cow. Treatments were as follows: (i) feeding low-quality forage without supplying fatty acid calcium (Diet A), (ii) feeding low-quality forage with supplying 400 g fatty acid calcium (Diet B), (iii) feeding high-quality forage without supplying fatty acid calcium (Diet C) and (iv) feeding high-quality forage with supplying 400 g fatty acid calcium. This experiment consisted 30 days. The milk and blood samples were collected in the last day of the trail. Intakes were recorded in the last 2 days of the trail. Supplementation of fatty acid calcium decreased significantly dry matter intake (DMI) (p < 0.01). Addition fatty acid calcium decreased milk protein percentage (p < 0.01) and milk SNF percentage (p < 0.01), but increased MUN (p < 0.05). Supplemented fatty acid decreased concentration of blood BHBA (p < 0.05), but increased TG, NEFA, glucagon, GLP-1, CCK, leptin, ApoA-IV, serotonin and MSH concentration in blood, the CCK concentration and feed intake showed a significant negative correlation (p < 0.05). Journal of Animal Physiology and Animal Nutrition © 2015 Blackwell Verlag GmbH.

  19. Early Detection of Plant Equipment Failures: A Case Study in Just-in-Time Maintenance

    International Nuclear Information System (INIS)

    Parlos, Alexander G.; Kim, Kyusung; Bharadwaj, Raj M.

    2001-01-01

    The development and testing of a model-based fault detection system for electric motors is briefly presented. The fault detection system was developed using only motor nameplate information. The fault detection results presented utilize only motor voltage and current sensor information, minimizing the need for expensive or intrusive sensors. Dynamic recurrent neural networks are used to predict the input-output response of a three-phase induction motor while using an estimate of the motor speed signal. Multiresolution (or wavelet) signal-processing techniques are used in combination with more traditional methods to estimate fault features for use in winding insulation and motor mechanical and electromechanical failure detection

  20. Early Detection of Plant Equipment Failures: A Case Study in Just-in-Time Maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Parlos, Alexander G.; Kim, Kyusung; Bharadwaj, Raj M.

    2001-06-17

    The development and testing of a model-based fault detection system for electric motors is briefly presented. The fault detection system was developed using only motor nameplate information. The fault detection results presented utilize only motor voltage and current sensor information, minimizing the need for expensive or intrusive sensors. Dynamic recurrent neural networks are used to predict the input-output response of a three-phase induction motor while using an estimate of the motor speed signal. Multiresolution (or wavelet) signal-processing techniques are used in combination with more traditional methods to estimate fault features for use in winding insulation and motor mechanical and electromechanical failure detection.

  1. OS090. Performance of candidate clinical and biochemical markers in screening early in pregnancy to detect women at high risk to develop preeclampsia.

    Science.gov (United States)

    Forest, J-C; Massé, J; Bujold, E; Rousseau, F; Charland, M; Thériault, S; Lafond, J; Giguère, Y

    2012-07-01

    The advent of early preventive measures, such as low-dose aspirin targeting women at high risk of preeclampsia (PE), emphasizes the need for better detection. Despite the emergence of promising biochemical markers linked to the pathophysiological processes, systematic reviews have shown that, until now, no single tests fulfill the criteria set by WHO for biomarkers to screen for a disease. However, recent literature reveals that by combining various clinical, biophysical and biochemical markers into multivariate algorithms, one can envisage to estimate the risk of PE with a performance that would reach clinical utility and cost-effectiveness, but this remains to be demonstrated in various environments and health care settings. To investigate, in a prospective study, the clinical utility of candidate biomarkers and clinical data to detect, early in pregnancy, women at risk to develop PE and to propose a multivariate prediction algorithm combining clinical parameters to biochemical markers. 7929 pregnant women prospectively recruited at the first prenatal visit, provided blood samples, clinical and sociodemographic information. 214 pregnant women developed hypertensive disorders of pregnancy (HDP) of which 88 had PE (1.2%), including 44 with severe PE (0.6%). A nested case-control study was performed including for each case of HDP two normal pregnancies matched for maternal age, gestational age at recruitment, ethnicity, parity, and smoking status. Based on the literature we selected the most promising markers in a multivariate logistic regression model: mean arterial pressure (MAP), BMI, placental growth factor (PlGF), soluble Flt-1, inhibin A and PAPP-A. Biomarker results measured between 10-18 weeks gestation were expressed as multiples of the median. Medians were determined for each gestational week. When combined with MAP at the time of blood sampling and BMI at the beginning of pregnancy, the four biochemical markers discriminate normal pregnancies from those

  2. [Early exercise training after exacerbation in patients with chronic respiratory failure].

    Science.gov (United States)

    Takahashi, Hiromitsu; Molleyres, Sandrine; Dousse, Nicolas; Contal, Olivier; Janssens, Jean-Paul

    2011-11-23

    Patients who suffered from an exacerbation of a chronic respiratory disorder are often very limited in terms of their exercise capacity because of severe dyspnea and amyotrophy of peripheral muscles. Early implementation of pulmonary rehabilitation may help these patients to avoid the complications of a prolonged bedridden period, and increase more rapidly their mobility. Early rehabilitation has become more frequent, but requires special skills from the care givers (chest therapists). Techniques which enhance muscular performance and motility of patients who are recovering from an exacerbation such as electromoystimulation or mobilisation under non-invasive ventilation, give encouraging results; their impact on length of hospital stay requires further studies.

  3. Radiographic pseudochondrocalcinosis in early failure of a cemented total knee replacement

    NARCIS (Netherlands)

    Kloen, P.; Burke, D. W.; Chew, F. S.; Mildrum, R.

    1998-01-01

    We observed a case of early-onset osteolysis in a cemented total knee arthroplasty. Preoperative radiographs suggested numerous radiopaque particles covering the polyethylene insert. Findings at the time of revision confirmed the presence of small radiopaque polymethylmethacrylate particles on the

  4. Early post transplantation renal allograft perfusion failure due to intimal dissection of the renal artery

    Directory of Open Access Journals (Sweden)

    Khattab Omar

    2009-01-01

    Full Text Available Transplant renal artery stenosis (TRAS is a recognized and potentially curable cause of post transplant arterial hypertension, allograft dysfunction, and graft loss. It usually occurs 3 months to 2 years after transplantation, but early or later presentations are not uncommon. We present a case of renal artery narrowing due to intimal dissection that was managed medically.

  5. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees.

    Science.gov (United States)

    Miller, Bradley S; Spratt, Eve G; Himes, John H; Condon, Doreen; Summer, Andrea; Papa, Carrie E; Brady, Kathleen T

    2015-01-01

    The long-lasting impact of different neglectful environments on growth in children is not well studied. Three groups of children, 3-10 years old, were recruited (n=60): previously institutionalized international adoptees living in stable home environments for at least 2 years (IA; n=15), children with a history of neglect born in the USA (USN; n=17), and controls (n=28). Children underwent physical examination, anthropometry, and collection of serum for growth parameters. Mean height standard deviation scores (SDS) were different (pneglected children. IGF-1 adjusted for age and weight SDS were different (pneglect groups. The degree of growth failure in height and HC in IAs was more severe than neglected US children. These findings may reflect differences between the impact of chronic and intermittent deprivation on the growth hormone system.

  6. Prognostic influence of clinical stage for distant failure in conservation treatment of early breast cancer

    International Nuclear Information System (INIS)

    Janjan, N.A.; Murray, K.J.; Walker, A.P.; Derus, S.B.; Komaki, R.U.; Cox, J.D.; Wilson, J.F.

    1987-01-01

    One-hundred twelve patients with clinical stage I-II mammary carcinoma treated with radiation therapy following breast-conserving surgery from 1975 through 1985 were evaluated. Median follow-up was 21 months (range, 2-80 months). This study demonstrates the importance of evaluating patients on the basis of tumor and axillary node findings rather than by clinical stage alone. In the authors' series, all T1 patients with positive axillary lymph nodes achieved the same excellent local and distant control as node-negative T1 and T2 patients. Distant failure occurred in 70% of T2 N1 patients despite systemic chemotherapy given to the majority of patients. The significance of these data regarding future trials are discussed

  7. EARLY-ESLI study: Long-term experience with eslicarbazepine acetate after first monotherapy failure.

    Science.gov (United States)

    Villanueva, V; Bermejo, P; Montoya, J; Toledo, M; Gómez-Ibáñez, A; Garcés, M; Vilella, L; López-González, F J; Rodriguez-Osorio, X; Campos, D; Martínez, P; Giner, P; Zurita, J; Rodríguez-Uranga, J; Ojeda, J; Mauri, J A; Camacho, J L; Ruiz-Giménez, J; Poza, J J; Massot-Tarrús, A; Galiano, M L; Bonet, M

    2017-09-01

    Evaluate real-life experience with eslicarbazepine acetate (ESL) after first monotherapy failure in a large series of patients with focal epilepsy. Multicentre, retrospective, 1-year, observational study in patients older than 18 years, with focal epilepsy, who had failed first antiepileptic drug monotherapy and who received ESL. Data from clinical records were analysed at baseline, 3, 6 and 12 months to assess effectiveness and tolerability. Eslicarbazepine acetate was initiated in 253 patients. The 1-year retention rate was 92.9%, and the final median dose of ESL was 800 mg. At 12 months, 62.3% of patients had been seizure free for 6 months; 37.3% had been seizure free for 1 year. During follow-up, 31.6% of the patients reported ESL-related adverse events (AEs), most commonly somnolence (8.7%) and dizziness (5.1%), and 3.6% discontinued due to AEs. Hyponatraemia was observed in seven patients (2.8%). After starting ESL, 137 patients (54.2%) withdrew the prior monotherapy and converted to ESL monotherapy; 75.9% were seizure free, 87.6% were responders, 4.4% worsened, and 23.4% reported ESL-related AEs. Use of ESL after first monotherapy failure was associated with an optimal seizure control and tolerability profile. Over half of patients were converted to ESL monotherapy during follow-up. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Using recurrent neural network models for early detection of heart failure onset.

    Science.gov (United States)

    Choi, Edward; Schuetz, Andy; Stewart, Walter F; Sun, Jimeng

    2017-03-01

    We explored whether use of deep learning to model temporal relations among events in electronic health records (EHRs) would improve model performance in predicting initial diagnosis of heart failure (HF) compared to conventional methods that ignore temporality. Data were from a health system's EHR on 3884 incident HF cases and 28 903 controls, identified as primary care patients, between May 16, 2000, and May 23, 2013. Recurrent neural network (RNN) models using gated recurrent units (GRUs) were adapted to detect relations among time-stamped events (eg, disease diagnosis, medication orders, procedure orders, etc.) with a 12- to 18-month observation window of cases and controls. Model performance metrics were compared to regularized logistic regression, neural network, support vector machine, and K-nearest neighbor classifier approaches. Using a 12-month observation window, the area under the curve (AUC) for the RNN model was 0.777, compared to AUCs for logistic regression (0.747), multilayer perceptron (MLP) with 1 hidden layer (0.765), support vector machine (SVM) (0.743), and K-nearest neighbor (KNN) (0.730). When using an 18-month observation window, the AUC for the RNN model increased to 0.883 and was significantly higher than the 0.834 AUC for the best of the baseline methods (MLP). Deep learning models adapted to leverage temporal relations appear to improve performance of models for detection of incident heart failure with a short observation window of 12-18 months. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  9. Signs for early diagnosis of heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Devroey D

    2011-09-01

    Full Text Available Dirk Devroey1,2, Viviane Van Casteren11Scientific Institute of Public Health, Unit of Epidemiology, Brussels, Belgium; 2Vrije Universiteit Brussel (VUB, Department of Family Medicine, Brussels, BelgiumObjective: The current guidelines for the diagnosis of heart failure (HF are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.Materials/subjects and methods: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.Results: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018. From a logistic regression, breathlessness on exercise (P < 0.001, limitations of physical activity (P = 0.003, and orthopnea (P = 0.040 were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001, peripheral edema (P < 0.001, and raised jugular venous pressure (P = 0.039. An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.Conclusion: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.Keywords: heart failure, primary health care, diagnostic clinical signs

  10. Increased Risk of Biochemical and Clinical Failure for Prostate Patients with a Large Rectum at Radiotherapy Planning: Results from the Dutch Trial of 68 GY Versus 78 Gy

    International Nuclear Information System (INIS)

    Heemsbergen, Wilma D.; Hoogeman, Mischa S.; Witte, Marnix G.; Peeters, Stephanie T.H.; Incrocci, Luca; Lebesque, Joos V.

    2007-01-01

    Purpose: To investigate whether a large rectum filling visible on the planning CT scan was associated with a decrease in freedom from any failure (FFF) and freedom from clinical failure (FFCF) for prostate cancer patients. Methods and Materials: Patients from the Dutch trial (78 Gy vs. 68 Gy) with available acute toxicity data were analyzed (n = 549). A 10-mm margin was applied for the first 68 Gy and 0-5 mm for the 10-Gy boost. The dose in the seminal vesicles (SVs) was prescribed within four treatment groups according to the estimated risk of SV involvement. Two potential risk factors (RFs) for a geometric miss were defined: (1) an anorectal volume ≥ 90 cm 3 and ≥ 25% of treatment-time diarrhea (RF1); and (2) the mean cross-sectional area of the anorectum (RF2). We tested whether these were significant predictors for FFF and FFCF within each treatment group. Results: Significant results were observed only for patients with a risk of SV involvement > 25% (dose of 68-78 Gy to the SVs, n = 349). We found a decrease in FFF (p = 0.001) and FFCF (p = 0.01) for the 87 patients with RF1 (for RF2, p = 0.02 and p = 0.01, respectively). The estimated decrease in the FFCF rate at 5 years was 15%. Conclusion: Tumor control was significantly decreased in patients with a risk of SV involvement > 25% and at risk of geometric miss. Current image guidance techniques offer several solutions to geometrically optimize the treatment. Additional research is needed to evaluate whether geometric misses can be prevented using these techniques

  11. Trunnion Corrosion and Early Failure in Monolithic Metal-on-Polyethylene TMZF Femoral Components: A Case Series

    Directory of Open Access Journals (Sweden)

    Peter Walker

    2016-09-01

    Full Text Available We describe four patients who were treated with primary total hip arthroplasty (THA at two tertiary academic Australian teaching hospitals that experienced premature failure of head-neck trunnions through dissociation of the head-neck taper junction. This retrospective case series have similar clinical presentations and macroscopic pathology with severe head-neck taper junction loss of material, corrosion and early catastrophic failure. It is proposed that the accelerated wear is related to use of varus offset neck in a proprietary beta titanium alloy (Ti-12Mo-6Zr-2Fe  or TMZFÒ Stryker Osteonics, Mahwah NJ, USA TMZF femoral stem, longer head-neck combination in a relatively active, older, male patient population. In this limited case series presentation was on average 80 months (range 53-92 following index procedure. In three of the four patients, a prodromal period of groin or buttock pain was reported for between 1 week and 2 months prior to acute presentation. Significant metallosis and local tissue damage including gluteal muscle insufficiency was evident. Each stem revised was well fixed. An extended trochanteric osteotomy was required in two of the four cases for stem extraction. We recommend caution and further evaluation on the relationship between TMZF metal alloy and its longevity in higher demand patients with high neck offset, varus stem geometry and large CoCr bearing heads.

  12. The failure of anxiolytic therapies in early clinical trials: what needs to be done.

    Science.gov (United States)

    Stewart, Adam Michael; Nguyen, Michael; Poudel, Manoj K; Warnick, Jason E; Echevarria, David J; Beaton, Elliott A; Song, Cai; Kalueff, Allan V

    2015-04-01

    Anxiety spectrum disorders (ASDs) are highly prevalent psychiatric illnesses that affect millions of people worldwide. Strongly associated with stress, common ASDs include generalized anxiety disorder, panic, social anxiety, phobias and drug-abuse-related anxiety. In addition to ASDs, several other prevalent psychiatric illnesses represent trauma/stressor-related disorders, such as post-traumatic stress disorder and acute stress disorder. Anxiolytic drugs, commonly prescribed to treat ASDs and trauma/stressor-related disorders, form a highly heterogenous group, modulating multiple neurotransmitters and physiological mechanisms. However, overt individual differences in efficacy and the potential for serious side-effects (including addiction and drug interaction) indicate a need for further drug development. Yet, over the past 50 years, there has been relatively little progress in the development of novel anxiolytic medications, especially when promising candidate drugs often fail in early clinical trials. Herein, the authors present recommendations of the Task Force on Anxiolytic Drugs of the International Stress and Behavior Society on how to improve anxiolytic drug discovery. These recommendations cover a wide spectrum of aspects, ranging from methodological improvements to conceptual insights and innovation. In order to improve the success of anxiolytic drugs in early clinical trials, the goals of preclinical trials may need to be adjusted from a clinical perspective and better synchronized with those of clinical studies. Indeed, it is important to realize that the strategic goals and approaches must be similar if we want to have a smoother transition between phases.

  13. Descemet membrane endothelial keratoplasty (DMEK) early stage graft failure in eyes with preexisting glaucoma.

    Science.gov (United States)

    Treder, Maximilian; Alnawaiseh, Maged; Eter, Nicole

    2017-07-01

    To evaluate the effect of a preexisting glaucoma on the early postoperative outcome of a descemet membrane endothelial keratoplasty (DMEK). All patients who underwent DMEK surgery at the Department of Ophthalmology of the University of Muenster with a follow-up of at least 3 months (90d) were included in this study. The best corrected distance visual acuity (BCDVA), the intraocular pressure (IOD), the rate of re-keratoplasty and the rebubbling rate were inter alia recorded. The results of patients with (group 1) and without a preexisting glaucoma (group 2) were compared. 74 eyes of 59 patients with a mean follow-up of 152 ± 70 days were included. 65 eyes were in group 1 and 9 eyes in group 2. The BCDVA significantly improved in both groups after surgery (p glaucoma compared to patients with a preexisting glaucoma. In the early stage outcome of DMEK no significant impact of a preexisting glaucoma was found.

  14. Cancer-affine radiopharmaceuticals for the study of biochemical nature of cancer and in the early diagnosis and follow-up of cancer and its systemic therapy

    International Nuclear Information System (INIS)

    Shukla, S.K.; Cipriani, C.; Atzei, G.

    1998-01-01

    Cancer patient needs less diagnosis but an effective therapy. The systemic nature of cancer, often right from its inception, requires systemic therapy with cancer-affine radiopharmaceuticals which contain radionuclide species recognizing both the primary and secondary cancers which have generally different biochemical properties. Cancers may be classified into two groups: I. CATIONIC COMPLEX-AFFINE TUMOURS; Lung cancer, thyroid cancer, primary breast cancer, renal cell carcinoma, bone metastases from anionic complex-affine cancers, ...; II. ANIONIC COMPLEX-AFFINE TUMOURS; Primary prostate cancer, melanoma, hepatocellular carcinoma, osteosarcoma, Ewing's sarcoma, bone metastases from cationic complex-affine cancer. With cancer-affine citratogallate-67 complexes we have diagnosed and followed up, and with citratoyttrate-90 complexes we have treated advanced breast, prostate, renal cell cancer patients. The patient preparation by advising to avoid cancer risk factors and to take cancer preventing and radiopharmaceutical stabilizing diets during diagnosis and therapy have given better results. Friendliness, caring visits and telephone calls from the therapist group help to obtain better outcomes of the diagnosis, and mainly of the therapy. The complexes of these radionuclides with other chelating agents EDTA and DPTA are expected to give better images and cure of advanced cancer patients. Cancer-affine formulations of Tc-99m(V), Re-186(V) and Re-188(V)-DMSA are being studied for their future use in early diagnosis and follow-up, and for the systemic therapy of cancer which will show affinity for them. (author)

  15. Clinical and Biochemical Characteristics of Brain-Dead Donors as Predictors of Early- and Long-Term Renal Function After Transplant.

    Science.gov (United States)

    Kwiatkowska, Ewa; Domański, Leszek; Bober, Joanna; Safranow, Krzysztof; Pawlik, Andrzej; Ciechanowski, Kazimierz; Wiśniewska, Magda; Kędzierska, Karolina

    2017-08-01

    Organs from brain-dead donors are the main source of allografts for transplant. Comparisons between living-donor and brain-dead donor kidneys show that the latter are more likely to demonstrate delayed graft function and lower long-term survival. This study aimed to assess the effects of various clinical and biochemical factors of donors on early- and long-term renal function after transplant. We analyzed data from kidney recipients treated between 2006 and 2008 who received organs from brain-dead donors. Data from 54 donors and 89 recipients were analyzed. No relation was observed between donor sodium concentration and the presence of delayed graft function. Donor height was positively correlated with creatinine clearance in recipients in the 1 to 3 months after renal transplant. Donor diastolic blood pressure was negatively correlated with estimated glomerular filtration rate throughout the observation period. Donor age was negatively correlated with the allograft recipient's estimated glomerular filtration rate throughout 4 years of observation. Donor estimated glomerular filtration rate was positively correlated with that of the recipient throughout 3 years of observation. The results of this study indicate that various factors associated with allograft donors may influence graft function.

  16. Predicting Failure in Early Acute Prosthetic Joint Infection Treated With Debridement, Antibiotics, and Implant Retention: External Validation of the KLIC Score.

    Science.gov (United States)

    Löwik, Claudia A M; Jutte, Paul C; Tornero, Eduard; Ploegmakers, Joris J W; Knobben, Bas A S; de Vries, Astrid J; Zijlstra, Wierd P; Dijkstra, Baukje; Soriano, Alex; Wouthuyzen-Bakker, Marjan

    2018-03-27

    Debridement, antibiotics, and implant retention (DAIR) is a widely used treatment modality for early acute prosthetic joint infection (PJI). A preoperative risk score was previously designed for predicting DAIR failure, consisting of chronic renal failure (K), liver cirrhosis (L), index surgery (I), cemented prosthesis (C), and C-reactive protein >115 mg/L (KLIC). The aim of this study was to validate the KLIC score in an external cohort. We retrospectively evaluated patients with early acute PJI treated with DAIR between 2006 and 2016 in 3 Dutch hospitals. Early acute PJI was defined as infection-related death within 60 days after debridement. A total of 386 patients were included. Failure occurred in 148 patients (38.3%). Patients with KLIC scores of ≤2, 2.5-3.5, 4-5, 5.5-6.5, and ≥7 had failure rates of 27.9%, 37.1%, 49.3%, 54.5%, and 85.7%, respectively (P < .001). The receiver-operating characteristic curve showed an area under the curve of 0.64 (95% confidence interval 0.59-0.69). A KLIC score higher than 6 points showed a specificity of 97.9%. The KLIC score is a relatively good preoperative risk score for DAIR failure in patients with early acute PJI and appears to be most useful in clinical practice for patients with low or high KLIC scores. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Investigation of Effectiveness of Some Vibration-Based Techniques in Early Detection of Real-Time Fatigue Failure in Gears

    Directory of Open Access Journals (Sweden)

    Hasan Ozturk

    2010-01-01

    Full Text Available Bending fatigue crack is a dangerous and insidious mode of failure in gears. As it produces no debris in its early stages, it gives little warning during its progression, and usually results in either immediate loss of serviceability or greatly reduced power transmitting capacity. This paper presents the applications of vibration-based techniques (i.e. conventional time and frequency domain analysis, cepstrum, and continuous wavelet transform to real gear vibrations in the early detection, diagnosis and advancement monitoring of a real tooth fatigue crack and compares their detection and diagnostic capabilities on the basis of experimental results. Gear fatigue damage is achieved under heavy-loading conditions and the gearbox is allowed to run until the gears suffer badly from complete tooth breakage. It has been found that the initiation and progression of fatigue crack cannot be easily detected by conventional time and frequency domain approaches until the fault is significantly developed. On the contrary, the wavelet transform is quite sensitive to any change in gear vibration and reveals fault features earlier than other methods considered.

  18. Slippage theory and the flanker paradigm: an early-selection account of selective attention failures.

    Science.gov (United States)

    Gaspelin, Nicholas; Ruthruff, Eric; Jung, Kyunghun

    2014-06-01

    In the flanker paradigm, participants identify a target letter while attempting to ignore an irrelevant flanker. When the identity of this flanker mismatches the target, target identification is slowed (called the flanker compatibility effect). Interestingly, reducing the array set size greatly increases flanker compatibility effects. This finding inspired 2 prominent explanations: perceptual load (mandatory capacity spillover) and dilution (visual interference). However, an alternative explanation, based on early selection theory and attention capture research, can also explain the data pattern. According to this "slippage" account, observers sometimes accidentally allocate spatial attention to the flanker (see Lachter, Forster, & Ruthruff, 2004), especially when the flanker has the property used to find the target (cf. contingent capture). In Experiments 1 through 4, deterring slippage to the flanker nearly eliminated flanker compatibility effects, even at the low set size. In Experiment 5, promoting slippage to the flanker dramatically enhanced compatibility effects, even at the high set size. Thus, slippage strongly modulates flanker effects and can, by itself, readily explain the impact of set size. The perceptual load and dilution accounts are, at best, incomplete, and, at worst, not needed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  19. Probability elicitation to inform early health economic evaluations of new medical technologies: a case study in heart failure disease management.

    Science.gov (United States)

    Cao, Qi; Postmus, Douwe; Hillege, Hans L; Buskens, Erik

    2013-06-01

    Early estimates of the commercial headroom available to a new medical device can assist producers of health technology in making appropriate product investment decisions. The purpose of this study was to illustrate how this quantity can be captured probabilistically by combining probability elicitation with early health economic modeling. The technology considered was a novel point-of-care testing device in heart failure disease management. First, we developed a continuous-time Markov model to represent the patients' disease progression under the current care setting. Next, we identified the model parameters that are likely to change after the introduction of the new device and interviewed three cardiologists to capture the probability distributions of these parameters. Finally, we obtained the probability distribution of the commercial headroom available per measurement by propagating the uncertainty in the model inputs to uncertainty in modeled outcomes. For a willingness-to-pay value of €10,000 per life-year, the median headroom available per measurement was €1.64 (interquartile range €0.05-€3.16) when the measurement frequency was assumed to be daily. In the subsequently conducted sensitivity analysis, this median value increased to a maximum of €57.70 for different combinations of the willingness-to-pay threshold and the measurement frequency. Probability elicitation can successfully be combined with early health economic modeling to obtain the probability distribution of the headroom available to a new medical technology. Subsequently feeding this distribution into a product investment evaluation method enables stakeholders to make more informed decisions regarding to which markets a currently available product prototype should be targeted. Copyright © 2013. Published by Elsevier Inc.

  20. Very early screening for sleep-disordered breathing in acute coronary syndrome in patients without acute heart failure.

    Science.gov (United States)

    Van den Broecke, Sandra; Jobard, Olivier; Montalescot, Gilles; Bruyneel, Marie; Ninane, Vincent; Arnulf, Isabelle; Similowski, Thomas; Attali, Valérie

    2014-12-01

    Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission. A telemonitoring (TM) system was set up to remotely monitor the signals and repair faulty sensors. The 27 recordings were analyzed as respiratory polygraphy (RP) and as PSG, and the results were compared. The TM system allowed successful intervention in 48% of recordings, resulting in excellent quality PSG for 89% of cases. The prevalence of SDB [apnea-hypopnea index (AHI) ≥ 15/h] was 82% and mainly consisted of central SDB and periodic breathing, except three patients with OSA. Compared with PSG, RP underestimated AHI, probably due to the poor sleep efficiency, reduction of slow-wave sleep, and alteration of rapid eye movement sleep. An early SDB screening by remote-attended PSG is feasible in ACS patients shortly after admission to CCU. The TM enhanced the quality of PSG. A high prevalence of central SDB was noticed, for which the etiology remains unknown. Further large-scale studies are needed to determine whether central SDB is an incidental finding in early ACS and whether the presence and severity of SDB have a prognostic impact. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Development of ProCaRS Clinical Nomograms for Biochemical Failure-free Survival Following Either Low-Dose Rate Brachytherapy or Conventionally Fractionated External Beam Radiation Therapy for Localized Prostate Cancer

    Science.gov (United States)

    Warner, Andrew; Pickles, Tom; Crook, Juanita; Martin, Andre-Guy; Souhami, Luis; Catton, Charles; Lukka, Himu

    2015-01-01

    Purpose: Although several clinical nomograms predictive of biochemical failure-free survival (BFFS) for localized prostate cancer exist in the medical literature, making valid comparisons can be challenging due to variable definitions of biochemical failure, the disparate distribution of prognostic factors, and received treatments in patient populations. The aim of this investigation was to develop and validate clinically-based nomograms for 5-year BFFS using the ASTRO II “Phoenix” definition for two patient cohorts receiving low-dose rate (LDR) brachytherapy or conventionally fractionated external beam radiation therapy (EBRT) from a large Canadian multi-institutional database. Methods and Materials: Patients were selected from the GUROC (Genitourinary Radiation Oncologists of Canada) Prostate Cancer Risk Stratification (ProCaRS) database if they received (1) LDR brachytherapy ≥ 144 Gy (n=4208) or (2) EBRT ≥ 70 Gy  (n=822). Multivariable Cox regression analysis for BFFS was performed separately for each cohort and used to generate clinical nomograms predictive of 5-year BFFS. Nomograms were validated using calibration plots of nomogram predicted probability versus observed probability via Kaplan-Meier estimates. Results: Patients receiving LDR brachytherapy had a mean age of 64 ± 7 years, a mean baseline PSA of 6.3 ± 3.0 ng/mL, 75% had a Gleason 6, and 15% had a Gleason 7, whereas patients receiving EBRT had a mean age of 70 ± 6 years, a mean baseline PSA of 11.6 ± 10.7 ng/mL, 30% had a Gleason 6, 55% had a Gleason 7, and 14% had a Gleason 8-10. Nomograms for 5-year BFFS included age, use and duration of androgen deprivation therapy (ADT), baseline PSA, T stage, and Gleason score for LDR brachytherapy and an ADT (months), baseline PSA, Gleason score, and biological effective dose (Gy) for EBRT. Conclusions: Clinical nomograms examining 5-year BFFS were developed for patients receiving either LDR brachytherapy or conventionally fractionated EBRT and

  2. North Kona slump: Submarine flank failure during the early(?) tholeiitic shield stage of Hualalai Volcano

    Science.gov (United States)

    Lipman, P.W.; Coombs, M.L.

    2006-01-01

    vesicles during flowage downslope after eruption in shallow water. The glass volatile compositions suggest that the tholeiitic lavas that drape the slump blocks were erupted either (1) early during shield-stage tholeiitic volcanism prior to emergence of a large subaerial edifice, or alternatively (2) from submarine radial vents during subaerial shield-building. Because no radial vents have been documented on land or underwater for the unbuttressed flanks of any Hawaii volcano, alternative (1) is favored. In comparison to other well-documented Hawaiian slumps and landslides, North Kona structures suggest a more incipient slump event, with smaller down-slope motions and lateral displacements.

  3. Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort.

    Directory of Open Access Journals (Sweden)

    Miyeun Han

    Full Text Available It remains inconclusive whether hyperuricemia is a true risk factor for kidney graft failure. In the current study, we investigated the association of hyperuricemia and graft outcome. We performed a multi-center cohort study that included 2620 kidney transplant recipients. The patients were classified as either normouricemic or hyperuricemic at 3 months after transplantation. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL in males or ≥ 6.0 mg/dL in females or based on the use of urate-lowering medications. The two groups were compared before and after propensity score matching. A total of 657 (25.1% patients were classified as hyperuricemic. The proportion of hyperuricemic patients increased over time, reaching 44.2% of the total cohort at 5 years after transplantation. Estimated glomerular filtration rate and donor type were independently associated with hyperuricemia. Hyperuricemia was associated with graft loss according to multiple Cox regression analysis before propensity score matching (hazard ratio [HR] = 1.56, 95% confidence interval [CI] = 1.14-2.13, P = 0.005 as well as after matching (HR = 1.65, 95% CI = 1.13-2.42, p = 0.010. Cox regression models using time-varying hyperuricemia or marginal structural models adjusted with time-varying eGFR also demonstrated significant hazards of hyperuricemia for graft loss. Cardiovascular events and recipient survival were not associated with hyperuricemia. Overall, hyperuricemia, especially early onset after transplantation, showed an increased risk for graft failure. Further studies are warranted to determine whether lowering serum uric acid levels would be beneficial to graft survival.

  4. Homozygous EEF1A2 mutation causes dilated cardiomyopathy, failure to thrive, global developmental delay, epilepsy and early death.

    Science.gov (United States)

    Cao, Siqi; Smith, Laura L; Padilla-Lopez, Sergio R; Guida, Brandon S; Blume, Elizabeth; Shi, Jiahai; Morton, Sarah U; Brownstein, Catherine A; Beggs, Alan H; Kruer, Michael C; Agrawal, Pankaj B

    2017-09-15

    Eukaryotic elongation factor 1A (EEF1A), is encoded by two distinct isoforms, EEF1A1 and EEF1A2; whereas EEF1A1 is expressed almost ubiquitously, EEF1A2 expression is limited such that it is only detectable in skeletal muscle, heart, brain and spinal cord. Currently, the role of EEF1A2 in normal cardiac development and function is unclear. There have been several reports linking de novo dominant EEF1A2 mutations to neurological issues in humans. We report a pair of siblings carrying a homozygous missense mutation p.P333L in EEF1A2 who exhibited global developmental delay, failure to thrive, dilated cardiomyopathy and epilepsy, ultimately leading to death in early childhood. A third sibling also died of a similar presentation, but DNA was unavailable to confirm the mutation. Functional genomic analysis was performed in S. cerevisiae and zebrafish. In S. cerevisiae, there was no evidence for a dominant-negative effect. Previously identified putative de novo mutations failed to complement yeast strains lacking the EEF1A ortholog showing a major growth defect. In contrast, the introduction of the mutation seen in our family led to a milder growth defect. To evaluate its function in zebrafish, we knocked down eef1a2 expression using translation blocking and splice-site interfering morpholinos. EEF1A2-deficient zebrafish had skeletal muscle weakness, cardiac failure and small heads. Human EEF1A2 wild-type mRNA successfully rescued the morphant phenotype, but mutant RNA did not. Overall, EEF1A2 appears to be critical for normal heart function in humans, and its deficiency results in clinical abnormalities in neurologic function as well as in skeletal and cardiac muscle defects. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Surveillance and monitoring experiences of chemical water-steam cycle in combined-cycle power plants (CCCs in Spanish acronyms) for early diagnosis of failures

    International Nuclear Information System (INIS)

    Santaolalla losada, E.

    2010-01-01

    In the present work is made a brief comparative review of the treatments effected in water of the cycle, their purpose, types, monitoring and tracking. Moreover, are described the most important failure mechanisms that can be related to the chemistry of cycle with the aim to establish monitoring guidelines to increase the reliability of the power plant and enable an early diagnosis. (Author)

  6. The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature

    NARCIS (Netherlands)

    Berg, J. van den; Gordon, B.B.; Snijders, M.P.M.L.; Vandenbussche, F.P.H.A.; Coppus, S.F.P.J.

    2015-01-01

    OBJECTIVE(S): Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation

  7. A simplified early-warning system for imminent landslide prediction based on failure index fragility curves developed through numerical analysis

    Directory of Open Access Journals (Sweden)

    Ugur Ozturk

    2016-07-01

    Full Text Available Early-warning systems (EWSs are crucial to reduce the risk of landslide, especially where the structural measures are not fully capable of preventing the devastating impact of such an event. Furthermore, designing and successfully implementing a complete landslide EWS is a highly complex task. The main technical challenges are linked to the definition of heterogeneous material properties (geotechnical and geomechanical parameters as well as a variety of the triggering factors. In addition, real-time data processing creates a significant complexity, since data collection and numerical models for risk assessment are time consuming tasks. Therefore, uncertainties in the physical properties of a landslide together with the data management represent the two crucial deficiencies in an efficient landslide EWS. Within this study the application is explored of the concept of fragility curves to landslides; fragility curves are widely used to simulate systems response to natural hazards, i.e. floods or earthquakes. The application of fragility curves to landslide risk assessment is believed to simplify emergency risk assessment; even though it cannot substitute detailed analysis during peace-time. A simplified risk assessment technique can remove some of the unclear features and decrease data processing time. The method is based on synthetic samples which are used to define the approximate failure thresholds for landslides, taking into account the materials and the piezometric levels. The results are presented in charts. The method presented in this paper, which is called failure index fragility curve (FIFC, allows assessment of the actual real-time risk in a case study that is based on the most appropriate FIFC. The application of an FIFC to a real case is presented as an example. This method to assess the landslide risk is another step towards a more integrated dynamic approach to a potential landslide prevention system. Even if it does not define

  8. Early serum creatinine changes and outcomes in patients admitted for acute heart failure: the cardio-renal syndrome revisited.

    Science.gov (United States)

    Núñez, Julio; Garcia, Sergio; Núñez, Eduardo; Bonanad, Clara; Bodí, Vicent; Miñana, Gema; Santas, Enrique; Escribano, David; Bayes-Genis, Antonio; Pascual-Figal, Domingo; Chorro, Francisco J; Sanchis, Juan

    2017-08-01

    The changes in renal function that occurred in patients with acute decompensated heart failure (ADHF) are prevalent, and have multifactorial etiology and dissimilar prognosis. To what extent the prognostic role of such changes may vary according to the presence of renal insufficiency at admission is not clear. Accordingly, we sought to determine whether early creatinine changes (ΔCr) (admission to 48-72 hours) had an effect on 1-year mortality relative to the presence of renal insufficiency at admission. We included 705 consecutive patients admitted with the diagnosis of ADHF. Admission renal insufficiency was defined as serum creatinine ≥1.4mg/dl (A-RI cr ) or estimated glomerular filtration rate renal insufficiency (24.7% and 42.8% for A-RIcr and A-RIGFR, respectively) had higher prevalence of extreme values in ΔCr in either direction (increasing/decreasing). At 1-year follow-up, 114 (16.2%) deaths were registered. The multivariable analysis showed a significant interaction between admission renal insufficiency and ΔCr ( p=0.004 and p=0.019 for A-RIcr and A-RIGFR, respectively). In the presence of renal insufficiency, the continuum of ΔCr followed a positive and almost linear relationship with mortality risk. Conversely, in patients without renal insufficiency, those changes adopted a 'J-shape' trajectory with increased mortality at both ends of the curve distribution. In patients with ADHF the effect of ΔCr on 1-year mortality varied according to its magnitude and the presence of admission renal insufficiency. There was a graded-association with mortality when renal insufficiency was present on admission.

  9. Can baseline ultrasound results help to predict failure to achieve DAS28 remission after 1 year of tight control treatment in early RA patients?

    Science.gov (United States)

    Ten Cate, D F; Jacobs, J W G; Swen, W A A; Hazes, J M W; de Jager, M H; Basoski, N M; Haagsma, C J; Luime, J J; Gerards, A H

    2018-01-30

    At present, there are no prognostic parameters unequivocally predicting treatment failure in early rheumatoid arthritis (RA) patients. We investigated whether baseline ultrasonography (US) findings of joints, when added to baseline clinical, laboratory, and radiographical data, could improve prediction of failure to achieve Disease Activity Score assessing 28 joints (DAS28) remission (baseline. Clinical, laboratory, and radiographical parameters were recorded. Primary analysis was the prediction by logistic regression of the absence of DAS28 remission 12 months after diagnosis and start of therapy. Of 194 patients included, 174 were used for the analysis, with complete data available for 159. In a multivariate model with baseline DAS28 (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.2), the presence of rheumatoid factor (OR 2.3, 95% CI 1.1-5.1), and type of monitoring strategy (OR 0.2, 95% CI 0.05-0.85), the addition of baseline US results for joints (OR 0.96, 95% CI 0.89-1.04) did not significantly improve the prediction of failure to achieve DAS28 remission (likelihood ratio test, 1.04; p = 0.31). In an early RA population, adding baseline ultrasonography of the hands, wrists, and feet to commonly available baseline characteristics did not improve prediction of failure to achieve DAS28 remission at 12 months. Clinicaltrials.gov, NCT01752309 . Registered on 19 December 2012.

  10. EARLY DIAGNOSIS OF IMMUNE DISTURBANCES AND ITS CORRECTION IN THE TREATMENT OF MULTIORGAN FAILURE AND SEPTIC COMPLICATIONS AFTER OPERATIONS WITH ARTIFICIAL AND ASSIST CIRCULATION

    Directory of Open Access Journals (Sweden)

    V. S. Suskova

    2009-01-01

    Full Text Available The study has shown that early diagnosis of the type and degree of immune disturbances in preparation for the operation and the first signs of multiorgan failure and septic complications in the postoperative period in cardiac surgery patients were the rationale for the earlier substitution immunocorrection by immunomodulators of cytokine nature and intravenous immunoglobulin. It allowed increasing the efficiency of the treatment of postoperative complications and lower mortality after operations with artificial and assist circulation. 

  11. Autologous Transplantation in Follicular Lymphoma with Early Therapy Failure: A National LymphoCare Study and Center for International Blood and Marrow Transplant Research Analysis.

    Science.gov (United States)

    Casulo, Carla; Friedberg, Jonathan W; Ahn, Kwang W; Flowers, Christopher; DiGilio, Alyssa; Smith, Sonali M; Ahmed, Sairah; Inwards, David; Aljurf, Mahmoud; Chen, Andy I; Choe, Hannah; Cohen, Jonathon; Copelan, Edward; Farooq, Umar; Fenske, Timothy S; Freytes, Cesar; Gaballa, Sameh; Ganguly, Siddhartha; Jethava, Yogesh; Kamble, Rammurti T; Kenkre, Vaishalee P; Lazarus, Hillard; Lazaryan, Aleksandr; Olsson, Richard F; Rezvani, Andrew R; Rizzieri, David; Seo, Sachiko; Shah, Gunjan L; Shah, Nina; Solh, Melham; Sureda, Anna; William, Basem; Cumpston, Aaron; Zelenetz, Andrew D; Link, Brian K; Hamadani, Mehdi

    2017-12-11

    Patients with follicular lymphoma (FL) experiencing early therapy failure (ETF) within 2 years of frontline chemoimmunotherapy have poor overall survival (OS). We analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR) and the National LymphoCare Study (NLCS) to determine whether autologous hematopoietic cell transplant (autoHCT) can improve outcomes in this high-risk FL subgroup. ETF was defined as failure to achieve at least partial response after frontline chemoimmunotherapy or lymphoma progression within 2 years of frontline chemoimmunotherapy. We identified 2 groups: the non-autoHCT cohort (patients from the NLCS with ETF not undergoing autoHCT) and the autoHCT cohort (CIBMTR patients with ETF undergoing autoHCT). All patients received rituximab-based chemotherapy as frontline treatment; 174 non-autoHCT patients and 175 autoHCT patients were identified and analyzed. There was no difference in 5-year OS between the 2 groups (60% versus 67%, respectively; P = .16). A planned subgroup analysis showed that patients with ETF receiving autoHCT soon after treatment failure (≤1 year of ETF; n = 123) had higher 5-year OS than those without autoHCT (73% versus 60%, P = .05). On multivariate analysis, early use of autoHCT was associated with significantly reduced mortality (hazard ratio, .63; 95% confidence interval, .42 to .94; P = .02). Patients with FL experiencing ETF after frontline chemoimmunotherapy lack optimal therapy. We demonstrate improved OS when receiving autoHCT within 1 year of treatment failure. Results from this unique collaboration between the NLCS and CIBMTR support consideration of early consolidation with autoHCT in select FL patients experiencing ETF. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Analysis of cause-specific failure endpoints using simple proportions: an example from a randomized controlled clinical trial in early breast cancer

    International Nuclear Information System (INIS)

    Panzarella, Tony; Meakin, J. William

    1998-01-01

    Purpose: To describe a statistically valid method for analyzing cause-specific failure data based on simple proportions, that is easy to understand and apply, and outline under what conditions its implementation is well-suited. Methods and Materials: In the comparison of treatment groups, time to first failure (in any site) was analyzed first, followed by an analysis of the pattern of first failure, preferably at the latest complete follow-up time common to each group. Results: A retrospective analysis of time to contralateral breast cancer in 777 early breast cancer patients was undertaken. Patients previously treated by mastectomy plus radiation therapy to the chest wall and regional nodal areas were randomized to receive further radiation and prednisone (R+P), radiation alone (R), or no further treatment (NT). Those randomized to R+P had a statistically significantly delayed time to first failure compared to the group randomized to NT (p = 0.0008). Patients randomized to R also experienced a delayed time to first failure compared to NT, but the difference was not statistically significant (p 0.14). At 14 years from the date of surgery (the latest common complete follow-up time) the distribution of first failures was statistically significantly different between R+P and NT (p = 0.005), but not between R and NT (p = 0.09). The contralateral breast cancer first failure rate at 14 years from surgery was 7.2% for NT, 4.6% for R, and 3.7% for R+P. The corresponding Kaplan-Meier estimates were 13.2%, 8.2%, and 5.4%, respectively. Conclusion: Analyzing cause-specific failure data using methods developed for survival endpoints is problematic. We encourage the use of the two-step analysis strategy described when, as in the example presented, competing causes of failure are not likely to be statistically independent, and when a treatment comparison at a single time-point is clinically relevant and feasible; that is, all patients have complete follow-up to this point

  13. Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND-HF.

    Science.gov (United States)

    Fudim, Marat; O'Connor, Christopher M; Dunning, Allison; Ambrosy, Andrew P; Armstrong, Paul W; Coles, Adrian; Ezekowitz, Justin A; Greene, Stephen J; Metra, Marco; Starling, Randall C; Voors, Adriaan A; Hernandez, Adrian F; Michael Felker, G; Mentz, Robert J

    2018-02-01

    Patients hospitalized for heart failure (HF) are at high risk for 30-day readmission. This study sought to examine the timings and causes of readmission within 30 days of an HF hospitalization. Timing and cause of readmission in the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure) trial were assessed. Early and late readmissions were defined as admissions occurring within 0-7 days and 8-30 days post-discharge, respectively. Patients who died in hospital or remained hospitalized at day 30 post-randomization were excluded. Patients were compared by timing and cause of readmission. Logistic and Cox proportional hazards regression analyses were used to identify independent risk factors for early vs. late readmission and associations with 180-day outcomes. Of the 6584 patients (92%) in the ASCEND-HF population included in this analysis, 751 patients (11%) were readmitted within 30 days for any cause. Overall, 54% of readmissions were for non-HF causes. The median time to rehospitalization was 11 days (interquartile range: 6-18 days) and 33% of rehospitalizations occurred by day 7. Rehospitalization within 30 days was independently associated with increased risk for 180-day all-cause death [hazard ratio (HR) 2.38, 95% confidence interval (CI) 1.93-2.94; P readmission (HR 0.99, 95% CI 0.67-1.45; P = 0.94). In this hospitalized HF trial population, a significant majority of 30-day readmissions were for non-HF causes and one-third of readmissions occurred in the first 7 days. Early and late readmissions within the 30-day timeframe were associated with similarly increased risk for death. Continued efforts to optimize multidisciplinary transitional care are warranted to improve rates of early readmission. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  14. SU-D-204-07: Retrospective Correlation of Dose Accuracy with Regions of Local Failure for Early Stage Lung Cancer Patients Treated with Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Devpura, S; Li, H; Liu, C; Fraser, C; Ajlouni, M; Movsas, B; Chetty, I [Henry Ford Health System, Detroit, MI (United States)

    2016-06-15

    Purpose: To correlate dose distributions computed using six algorithms for recurrent early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT), with outcome (local failure). Methods: Of 270 NSCLC patients treated with 12Gyx4, 20 were found to have local recurrence prior to the 2-year time point. These patients were originally planned with 1-D pencil beam (1-D PB) algorithm. 4D imaging was performed to manage tumor motion. Regions of local failures were determined from follow-up PET-CT scans. Follow-up CT images were rigidly fused to the planning CT (pCT), and recurrent tumor volumes (Vrecur) were mapped to the pCT. Dose was recomputed, retrospectively, using five algorithms: 3-D PB, collapsed cone convolution (CCC), anisotropic analytical algorithm (AAA), AcurosXB, and Monte Carlo (MC). Tumor control probability (TCP) was computed using the Marsden model (1,2). Patterns of failure were classified as central, in-field, marginal, and distant for Vrecur ≥95% of prescribed dose, 95–80%, 80–20%, and ≤20%, respectively (3). Results: Average PTV D95 (dose covering 95% of the PTV) for 3-D PB, CCC, AAA, AcurosXB, and MC relative to 1-D PB were 95.3±2.1%, 84.1±7.5%, 84.9±5.7%, 86.3±6.0%, and 85.1±7.0%, respectively. TCP values for 1-D PB, 3-D PB, CCC, AAA, AcurosXB, and MC were 98.5±1.2%, 95.7±3.0, 79.6±16.1%, 79.7±16.5%, 81.1±17.5%, and 78.1±20%, respectively. Patterns of local failures were similar for 1-D and 3D PB plans, which predicted that the majority of failures occur in centraldistal regions, with only ∼15% occurring distantly. However, with convolution/superposition and MC type algorithms, the majority of failures (65%) were predicted to be distant, consistent with the literature. Conclusion: Based on MC and convolution/superposition type algorithms, average PTV D95 and TCP were ∼15% lower than the planned 1-D PB dose calculation. Patterns of failure results suggest that MC and convolution

  15. Early treatment failure in concurrent dengue and mixed malaria species infection with suspected resistance to artemisinin combination therapy from a tertiary care center in Delhi: a case report.

    Science.gov (United States)

    Saksena, Rushika; Matlani, Monika; Singh, Vineeta; Kumar, Amit; Anveshi, Anupam; Kumar, Dilip; Gaind, Rajni

    2017-01-01

    Concurrent dengue and mixed malaria infections in a single patient present with overlapping clinical manifestations which pose a diagnostic challenge and management dilemma in areas of common endemicities. We report a case of a young male who tested positive for both Plasmodium vivax and Plasmodium falciparum along with dengue infection. He showed signs of early treatment failure to artemisinin combination therapy (artesunate with sulfadoxine+pyrimethamine). Molecular analysis for the drug resistance genes viz: chloroquine resistance ( pfcrt ), multidrug resistance ( pfmdr-1 ), sulfadoxine ( pfdhps ), pyrimethamine ( pfdhfr ), and artemisinin resistance ( keltch 13 ) was performed. A rise in parasitemia from treatment. Mutations in pfcrt , pfmdr-1 , pfdhfr , and pfdhps genes were detected as a possible cause of treatment failure. Increased severity, overlapping symptoms, and suspected resistance to treatment warrants a multidimensional diagnostic approach and diligent therapeutic monitoring.

  16. Management of Men with Prostate-specific Antigen Failure After Prostate Radiotherapy: The Case Against Early Androgen Deprivation.

    Science.gov (United States)

    Brand, Douglas; Parker, Chris

    2018-04-01

    In men with prostate-specific antigen failure after radical radiotherapy, androgen deprivation therapy should be delayed until the site of recurrence is known to allow consideration of curative treatment options, to delay androgen deprivation therapy-related morbidity, and to enable earlier access to abiraterone and docetaxel. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  17. Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.

    Science.gov (United States)

    Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C

    2013-07-01

    Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.

  18. Utility of CD4 cell counts for early prediction of virological failure during antiretroviral therapy in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Lawn Stephen D

    2008-07-01

    Full Text Available Abstract Background Viral load monitoring is not available for the vast majority of patients receiving antiretroviral therapy in resource-limited settings. However, the practical utility of CD4 cell count measurements as an alternative monitoring strategy has not been rigorously assessed. Methods In this study, we used a novel modelling approach that accounted for all CD4 cell count and VL values measured during follow-up from the first date that VL suppression was achieved. We determined the associations between CD4 counts (absolute values and changes during ART, VL measurements and risk of virological failure (VL > 1,000 copies/ml following initial VL suppression in 330 patients in South Africa. CD4 count changes were modelled both as the difference from baseline (ΔCD4 count and the difference between consecutive values (CD4 count slope using all 3-monthly CD4 count measurements during follow-up. Results During 7093.2 patient-months of observation 3756 paired CD4 count and VL measurements were made. In patients who developed virological failure (n = 179, VL correlated significantly with absolute CD4 counts (r = - 0.08, P = 0.003, ΔCD4 counts (r = - 0.11, P P P = 0.99, P = 0.92 and P = 0.75, respectively. Moreover, in a receiver operating characteristic (ROC curve, the association between a negative CD4 count slope and virological failure was poor (area under the curve = 0.59; sensitivity = 53.0%; specificity = 63.6%; positive predictive value = 10.9%. Conclusion CD4 count changes correlated significantly with VL at group level but had very limited utility in identifying virological failure in individual patients. CD4 count is an inadequate alternative to VL measurement for early detection of virological failure.

  19. BISEN: Biochemical simulation environment

    NARCIS (Netherlands)

    Vanlier, J.; Wu, F.; Qi, F.; Vinnakota, K.C.; Han, Y.; Dash, R.K.; Yang, F.; Beard, D.A.

    2009-01-01

    The Biochemical Simulation Environment (BISEN) is a suite of tools for generating equations and associated computer programs for simulating biochemical systems in the MATLAB® computing environment. This is the first package that can generate appropriate systems of differential equations for

  20. Evaluation of Left Ventricular Diastolic Dysfunction with Early Systolic Dysfunction Using Two-Dimensional Speckle Tracking Echocardiography in Canine Heart Failure Model.

    Science.gov (United States)

    Wu, Wei-Chun; Ma, Hong; Xie, Rong-Ai; Gao, Li-Jian; Tang, Yue; Wang, Hao

    2016-04-01

    This study evaluated the role of two-dimensional speckle tracking echocardiography (2DSTE) for predicting left ventricular (LV) diastolic dysfunction in pacing-induced canine heart failure. Pacing systems were implanted in 8 adult mongrel dogs, and continuous rapid right ventricular pacing (RVP, 240 beats/min) was maintained for 2 weeks. The obtained measurements from 2DSTE included global strain rate during early diastole (SRe) and during late diastole (SRa) in the longitudinal (L-SRe, L-SRa), circumferential (C-SRe, C-SRa), and radial directions (R-SRe, R-SRa). Changes in heart morphology were observed by light microscopy and transmission electron microscopy at 2 weeks. The onset of LV diastolic dysfunction with early systolic dysfunction occurred 3 days after RVP initiation. Most of the strain rate imaging indices were altered at 1 or 3 days after RVP onset and continued to worsen until heart failure developed. Light and transmission electron microscopy showed myocardial vacuolar degeneration and mitochondrial swelling in the left ventricular at 2 weeks after RVP onset. Pearson's correlation analysis revealed that parameters of conventional echocardiography and 2DSTE showed moderate correlation with LV pressure parameters, including E/Esep' (r = 0.58, P echocardiography and strain rate imaging could effectively predict LV diastolic dysfunction (area under the curve: E/Esep' 0.78; L-SRe 0.84; E/L-SRe 0.80; R-SRe 0.80). 2DSTE was a sensitive and accurate technique that could be used for predicting LV diastolic dysfunction in canine heart failure model. © 2015, Wiley Periodicals, Inc.

  1. STUDY OF FACTORS INFLUENCING EARLY SYMPTOMATIC IMPROVEMENT, RETURN TO NORMOXIA AND RADIOLOGICAL RESOLUTION IN SWINE FLU PATIENTS WITH RESPIRATORY FAILURE IN RICU

    Directory of Open Access Journals (Sweden)

    Vamsidhar Reddy Manne

    2017-05-01

    Full Text Available BACKGROUND Since 2009, swine influenza outbreaks have been recorded virtually every year, although their extent and severity have varied widely. Localised outbreaks are taking place at variable intervals, usually every 1-3 years. The most recent outbreak has been from December 2016 through April 2017. We still are in the midst of one. This study of factors influencing early clinical and radiological improvement and reversion to normoxia in swine flu patients with respiratory failure helps in saving precious lives. MATERIALS AND METHODS This is a cross-sectional study conducted at RICU, Department of Pulmonary Medicine, S.V.R.R. Government General Hospital/S.V. Medical College, Tirupathi, Andhra Pradesh, between January 2017 and April 2017. Study sample was the total number of swine flu patients admitted to the RICU of the Department of Pulmonary Medicine with respiratory failure. RESULTS Out of 42 patients who tested positive for swine flu, 37 had respiratory failure and were immediately admitted in RICU. Oxygen support, oseltamivir and higher antibiotics were immediately started, injectable steroids given where necessary. Comorbidities were meticulously managed. 19 were males and 18 were females. 21 patients (>50% were above 50 years. Cough and breathlessness were present in all patients (100%. At admission, all 37 showed SpO2 <85% and at discharge all of them were normoxic. 18 patients had either multilobar pneumonia or ARDS on CXR, which had resolved by the time of discharge. The shortest duration of stay was 7 days and the longest duration of stay was 11 days. 35 patients were discharged and 2 patients died. CONCLUSION Good oxygenation, starting of oseltamivir on day 1 of admission prevents further complications and hastens recovery. Swine flu patients with normal chest x-ray and no comorbidities can still end up with respiratory failure. Steroids decrease cough and breathlessness, but have no role in hastening recovery. No residual symptoms

  2. Predictors of early dyspnoea relief in acute heart failure and the association with 30-day outcomes: findings from ASCEND-HF

    Science.gov (United States)

    Mentz, Robert J.; Hernandez, Adrian F.; Stebbins, Amanda; Ezekowitz, Justin A.; Felker, G. Michael; Heizer, Gretchen M.; Atar, Dan; Teerlink, John R.; Califf, Robert M.; Massie, Barry M.; Hasselblad, Vic; Starling, Randall C.; O'Connor, Christopher M.; Ponikowski, Piotr

    2013-01-01

    Aims To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. Methods and results ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 patients hospitalized with acute HF in which dyspnoea relief at 6 h was measured on a 7-point Likert scale. Patients were classified as having early dyspnoea relief if they experienced moderate or marked dyspnoea improvement at 6 h. We analysed the clinical characteristics, geographical variation, and outcomes (mortality, mortality/HF hospitalization, and mortality/hospitalization at 30 days) associated with early dyspnoea relief. Early dyspnoea relief occurred in 2984 patients (43%). In multivariable analyses, predictors of dyspnoea relief included older age and oedema on chest radiograph; higher systolic blood pressure, respiratory rate, and natriuretic peptide level; and lower serum blood urea nitrogen (BUN), sodium, and haemoglobin (model mean C index = 0.590). Dyspnoea relief varied markedly across countries, with patients enrolled from Central Europe having the lowest risk-adjusted likelihood of improvement. Early dyspnoea relief was associated with lower risk-adjusted 30-day mortality/HF hospitalization [hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.68–0.96] and mortality/hospitalization (HR 0.85; 95% CI 0.74–0.99), but similar mortality. Conclusion Clinical characteristics such as respiratory rate, pulmonary oedema, renal function, and natriuretic peptide levels are associated with early dyspnoea relief, and moderate or marked improvement in dyspnoea was associated with a lower risk for 30-day outcomes. PMID:23159547

  3. Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lahmer, G.; Lotter, M.; Kreppner, S.; Fietkau, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-08-15

    Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects. Patients and methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.6 Gy/h, 24 h per day) corresponding to a total dose of 60 Gy. Dose volume adaptation was performed with the aim of optimal coverage of the whole prostate (V{sub 100} > 95 %) simultaneously respecting the protocol-based dose volume constraints for the urethra (D{sub 0.1} {sub cc} < 130 %) and the rectum (D{sub 2} {sub cc} < 50-60 %) taking into account the previous radiation therapy. Local relapse after radiotherapy (external beam irradiation, brachytherapy with J-125 seeds or combination) was confirmed mostly via choline-PET and increased PSA levels. The primary endpoint was treatment-related late toxicities - particularly proctitis, anal incontinence, cystitis, urinary incontinence, urinary frequency/urgency, and urinary retention according to the Common Toxicity Criteria. The secondary endpoint was PSA-recurrence-free survival. Results: We registered urinary toxicities only. Grade 2 and grade 3 toxicities were observed in up to 11.1 % (2/18) and 16.7 % (3/18) of patients, respectively. The most frequent late-event grade 3 toxicity was urinary retention in 17 % (3/18) of patients. No late gastrointestinal side effects occurred. The biochemical PSA-recurrence-free survival probability at 3 years was 57.1 %. The overall survival at 3 years was 88.9 %; 22 % (4/18) of patients developed metastases. The median follow-up time for all patients after salvage BT was 21 months (range, 8-77 months). Conclusion: Salvage PDR

  4. Of cuts and cracks: data analytics on constrained graphs for early prediction of failure in cementitious materials

    Directory of Open Access Journals (Sweden)

    Kahagalage Sanath

    2017-01-01

    Full Text Available Using data from discrete element simulations, we develop a data analytics approach using network flow theory to study force transmission and failure in a ‘dog-bone’ concrete specimen submitted to uniaxial tension. With this approach, we establish the extent to which the bottlenecks, i.e., a subset of contacts that impedes flow and are prone to becoming overloaded, can predict the location of the ultimate macro-crack. At the heart of this analysis is a capacity function that quantifies, in relative terms, the maximum force that can be transmitted through the different contacts or edges in the network. Here we set this function to be solely governed by the size of the contact area between the deformable spherical grains. During all the initial stages of the loading history, when no bonds are broken, we find the bottlenecks coincide consistently with, and therefore predict, the location of the crack that later forms in the failure regime after peak force. When bonds do start to break, they are spread throughout the specimen: in, near, and far from, the bottlenecks. In one stage leading up to peak force, bonds collectively break in the lower portion of the specimen, momentarily shifting the bottlenecks to this location. Just before and around peak force, however, the bottlenecks return to their original location and remain there until the macro-crack emerges right along the bottlenecks.

  5. Probability Elicitation to Inform Early Health Economic Evaluations of New Medical Technologies : A Case Study in Heart Failure Disease Management

    NARCIS (Netherlands)

    Cao, Qi; Postmus, Douwe; Hillege, Hans L.; Buskens, Erik

    Objectives: Early estimates of the commercial headroom available to a new medical device can assist producers of health technology in making appropriate product investment decisions. The purpose of this study was to illustrate how this quantity can be captured probabilistically by combining

  6. A pilot study to explore the effectiveness of "early" rehabilitation after a hospital admission for chronic heart failure.

    Science.gov (United States)

    Houchen, Linzy; Watt, Amye; Boyce, Sally; Singh, Sally

    2012-07-01

    People with chronic heart failure (CHF) experience acute exacerbations of their symptoms. These episodes are costly to patients and the health service. The study was a single group, pretest and posttest design. Seventeen patients with left ventricular systolic dysfunction (LVSD) started rehabilitation within 4 weeks of hospital discharge. The 6 week rehabilitation programme included exercise and self-management education. The hospital anxiety and depression scale (HADS), the incremental and endurance shuttle walking tests (ISWT/ESWT) were assessed at baseline and after rehabilitation. The number and duration of any CHF admissions in the year before and the year after rehabilitation were also recorded. Improvements in the ISWT, ESWT, and depression were, mean (95% confidence interval [CI]) 60.6 (36.0-85.2) metres, 356.0 (173.0-539.0) seconds (both p≤0.001) and (-)1.0 ((-)1.8-(-)0.2) points (precovery are unknown.

  7. Case Study: IBM Watson Analytics Cloud Platform as Analytics-as-a-Service System for Heart Failure Early Detection

    Directory of Open Access Journals (Sweden)

    Gabriele Guidi

    2016-07-01

    Full Text Available In the recent years the progress in technology and the increasing availability of fast connections have produced a migration of functionalities in Information Technologies services, from static servers to distributed technologies. This article describes the main tools available on the market to perform Analytics as a Service (AaaS using a cloud platform. It is also described a use case of IBM Watson Analytics, a cloud system for data analytics, applied to the following research scope: detecting the presence or absence of Heart Failure disease using nothing more than the electrocardiographic signal, in particular through the analysis of Heart Rate Variability. The obtained results are comparable with those coming from the literature, in terms of accuracy and predictive power. Advantages and drawbacks of cloud versus static approaches are discussed in the last sections.

  8. Ultra-Sensitive NT-proBNP Quantification for Early Detection of Risk Factors Leading to Heart Failure

    Directory of Open Access Journals (Sweden)

    Keum-Soo Song

    2017-09-01

    Full Text Available Cardiovascular diseases such as acute myocardial infarction and heart failure accounted for the death of 17.5 million people (31% of all global deaths in 2015. Monitoring the level of circulating N-terminal proBNP (NT-proBNP is crucial for the detection of people at risk of heart failure. In this article, we describe a novel ultra-sensitive NT-proBNP test (us-NT-proBNP that allows the quantification of circulating NT-proBNP in 30 min at 25 °C in the linear detection range of 7.0–600 pg/mL. It is a first report on the application of a fluorescence bead labeled detection antibody, DNA-guided detection method, and glass fiber membrane platform for the quantification of NT-proBNP in clinical samples. Limit of blank, limit of detection, and limit of quantification were 2.0 pg/mL, 3.7 pg/mL, and 7 pg/mL, respectively. The coefficient of variation was found to be less than 10% in the entire detection range of 7–600 pg/mL. The test demonstrated specificity for NT-proBNP without interferences from bilirubin, intra-lipid, biotin, and hemoglobin. The serial dilution test for plasma samples containing various NT-proBNP levels showed the linear decrement in concentration with the regression coefficient of 0.980–0.998. These results indicate that us-NT-proBNP test does not suffer from the interference of the plasma components for the measurement of NT-proBNP in clinical samples.

  9. Stunting at birth: recognition of early-life linear growth failure in the western highlands of Guatemala.

    Science.gov (United States)

    Solomons, Noel W; Vossenaar, Marieke; Chomat, Anne-Marie; Doak, Colleen M; Koski, Kristine G; Scott, Marilyn E

    2015-07-01

    Measurements of length at birth, or in the neonatal period, are challenging to obtain and often discounted for lack of validity. Hence, classical 'under-5' stunting rates have been derived from surveys on children from 6 to 59 months of age. Guatemala has a high prevalence of stunting (49.8%), but the age of onset of growth failure is not clearly defined. The objective of the study was to assess length-for-age within the first 1.5 months of life among Guatemalan infants. As part of a cross-sectional observational study, supine length was measured in young infants. Mothers' height was measured. Length-for-age Z-scores (HAZ) were generated and stunting was defined as HAZ Guatemala. Three hundred and six newborns with a median age of 19 d. The median rural HAZ was -1.56 and prevalence of stunting was 38%; the respective urban values were -1.41 and 25%. Linear regression revealed no relationship between infant age and HAZ (r = 0.101, r(2) = 0.010, P = 0.077). Maternal height explained 3% of the variability in HAZ (r = 0.171, r(2) = 0.029, P = 0.003). Stunting must be carried over from in utero growth retardation in short-stature Guatemalan mothers. As linear growth failure in this setting begins in utero, its prevention must be linked to maternal care strategies during gestation, or even before. A focus on maternal nutrition and health in an intergenerational dimension is needed to reduce its prevalence.

  10. Radiation therapy for early stage (T1 - T2) sarcomatoid carcinoma of true vocal cords: outcomes and patterns of failure

    International Nuclear Information System (INIS)

    Ballo, Matthew T.; Garden, Adam S.; El-Naggar, Adel K.; Morrison, William H.; Ang, K. Kian

    1997-01-01

    Objectives/hypothesis: Sarcomatoid carcinoma of head and neck mucosal sites is a rare malignancy surrounded with much controversy. One factor consistently reported yet not well supported throughout the literature is their relative radioresistance and a general belief that surgery is the treatment of choice. Our objective was to determine if patients treated with radiation for early glottic carcinoma with this histologic diagnosis had worse outcomes than typical squamous cell carcinoma of similar stage. Materials and Methods: Twenty-eight cases of early stage sarcomatoid carcinoma of the larynx treated with definitive doses of megavoltage irradiation between 1969 and 1995 at the University of Texas M.D. Anderson Cancer Center form the cohort for this analysis. All pathologic material was reviewed to confirm the diagnosis. Follow-up ranged from 1.5 - 24 years (median, 10 years). Results: Twenty-one patients were staged T1 and 7 patients had stage T2 disease. Sixteen tumors had the more typical polypoid morphology of sarcomatoid carcinoma. All patients were treated with small laryngeal fields, median size 20 cm2, and to a median dose of 65 Gy. Four patients (14%) had local disease recurrence. All 4 patients had salvage total laryngectomies and remained free of local disease. Only one patient manifested regional and distant disease. The 10-year actuarial survival rate was 63%. Conclusions: Patients with early staged sarcomatoid carcinoma of the glottis treated with radiation had similar control rates to irradiated patients with similar volume disease with the more typical squamous cell carcinoma. We do not believe that the histologic diagnosis of sarcomatoid carcinoma by itself should influence the decision to not treat a patient with early staged glottic disease with irradiation

  11. Long-term failure of alveologenesis after an early short-term exposure to a PDGF-receptor antagonist.

    Science.gov (United States)

    Lau, Mandy; Masood, Azhar; Yi, Man; Belcastro, Rosetta; Li, Jun; Tanswell, A Keith

    2011-04-01

    Survivors of moderate-to-severe bronchopulmonary dysplasia have impaired alveologenesis lasting at least into early adult life. The mechanisms underlying this long-term effect are unknown. We hypothesized that short-term inhibition of growth factor-mediated early alveolar formation would result in a long-term impairment of subsequent alveologenesis. Neonatal rats were injected daily with the platelet-derived growth factor (PDGF) receptor antagonist, imatinib mesylate, from day 1-7 of life, to inhibit the early alveolar formation occurring by in-growth of secondary crests into precursor saccules. The pups were then allowed to recover for 7, 14, 21, or 58 days. In imatinib-treated pups, DNA synthesis in total lung cells, and specifically in cells of secondary crests, was reduced at day 8 of life, had rebounded on day 14 of life but was then again reduced by day 28 of life. At day 8 of life, imatinib-treated pups had impaired alveologenesis as reflected by a decrease in secondary crests, an increase in alveolar size, and an overall decrease in both estimated alveolar number and generations compared with age-matched controls. No meaningful recovery was observed, even after a 21- or 58-day recovery period. The lungs of imatinib-treated pups had increased fibulin-5 content and an abnormal deposition of elastin. We conclude that reduced signaling through the PDGF pathways, at an early stage of alveologenesis, can result in long-lasting changes in lung architecture. A likely mechanism is through impaired formation of the elastin scaffold required for alveolarization.

  12. Age-related differences during simple working memory decisions: ERP indices of early recognition and compensation failure.

    Science.gov (United States)

    Tays, William J; Dywan, Jane; Capuana, Lesley J; Segalowitz, Sidney J

    2011-06-01

    Imaging data has identified frontal cortical activation in older adults during simple recognition tasks that relates positively with performance and could, therefore, be considered compensatory. However, in a previous electrophysiological study involving a Sternberg task with proactive interference manipulations, we observed a frontal positive scalp potential between 400 and 500 ms that was unique to older adults and predictive of poorer performance. These results led us to ask whether unique frontal activation in older adults serves a compensatory role only during relatively simple tasks when stimulus familiarity provides an unambiguous basis for response selection. In the current study, we tested this hypothesis by having younger and older adults complete a verbal Sternberg task without interference manipulations. In younger adults, we observed an early posterior negativity (90-120 ms) that predicted performance accuracy. Older adults failed to show this early negativity but did produce the expected frontal positivity. However, the frontal positivity was again associated with poorer performance. These data support the view that younger adults are able to bias early target discrimination to benefit response selection whereas older adults rely on later controlled processes that are not always effective in buffering against normative age-related decline. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. External Validity of a Risk Stratification Score Predicting Early Distant Brain Failure and Salvage Whole Brain Radiation Therapy After Stereotactic Radiosurgery for Brain Metastases.

    Science.gov (United States)

    Press, Robert H; Boselli, Danielle M; Symanowski, James T; Lankford, Scott P; McCammon, Robert J; Moeller, Benjamin J; Heinzerling, John H; Fasola, Carolina E; Burri, Stuart H; Patel, Kirtesh R; Asher, Anthony L; Sumrall, Ashley L; Curran, Walter J; Shu, Hui-Kuo G; Crocker, Ian R; Prabhu, Roshan S

    2017-07-01

    A scoring system using pretreatment factors was recently published for predicting the risk of early (≤6 months) distant brain failure (DBF) and salvage whole brain radiation therapy (WBRT) after stereotactic radiosurgery (SRS) alone. Four risk factors were identified: (1) lack of prior WBRT; (2) melanoma or breast histologic features; (3) multiple brain metastases; and (4) total volume of brain metastases external patient population. We reviewed the records of 247 patients with 388 brain metastases treated with SRS between 2010 at 2013 at Levine Cancer Institute. The Press (Emory) risk score was calculated and applied to the validation cohort population, and subsequent risk groups were analyzed using cumulative incidence. The low-risk (LR) group had a significantly lower risk of early DBF than did the high-risk (HR) group (22.6% vs 44%, P=.004), but there was no difference between the HR and intermediate-risk (IR) groups (41.2% vs 44%, P=.79). Total lesion volume externally valid, but the model was able to stratify between 2 levels (LR and not-LR [combined IR and HR]) for early (≤6 months) DBF. These results reinforce the importance of validating predictive models in independent cohorts. Further refinement of this scoring system with molecular information and in additional contemporary patient populations is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Application of some pattern recognition methods for the early detection of failures at NPP components by means of noise diagnosis

    International Nuclear Information System (INIS)

    Weiss, F.P.

    1985-01-01

    The automation of the decisions on normality or abnormality of the plant condition being based on automated measurements is an essential step for the integration of noise diagnostics into the control and safety system of a nuclear power plant. By reason of the stochastic character of noise diagnostic measuring quantities principles of statistical pattern recognition are used in order automatically to get a decision on the plant condition. Four different pattern recognition methods complementing each other have been developed respectively tested with data from a WWER-440 type reactor. These four methods are included in a specially written software package. According to stationarity, correlation and probability distribution type of the state describing features and according to the necessary detection sensitivity to failures either the decorrelation method, the cluster method, the Parzen method or the distribution test of Wilcoxon, Mann and Whitney has to be applied. The efficiency and the limits of the investigated methods are discussed in detail. In context with the surveillance of the WWER-440 core by means of the power spectral densities of neutron flux fluctuations it could as well experimentally as theoretically be shown that the logarithmic power spectral densities follow a Gaussian probability distribution. (author)

  15. Analyses of patterns-of-failure and prognostic factors according to radiation fields in early-stage Hodgkin lymphoma

    International Nuclear Information System (INIS)

    Krebs, Lorraine; Guillerm, Sophie; Menard, Jean; Hennequin, Christophe; Quero, Laurent; Amorin, Sandy; Brice, Pauline

    2017-01-01

    Doses and volumes of radiation therapy (RT) for early stages of Hodgkin lymphoma (HL) have been reduced over the last 30 years. Combined modality therapy (CMT) is currently the standard treatment for most patients with early-stage HL. The aim of this study was to analyze the site of relapse after RT according to the extent of radiation fields. Between 1987 and 2011, 427 patients were treated at our institution with RT ± chemotherapy for stage-I/II HL. Among these, 65 patients who experienced a relapse were retrospectively analyzed. Most patients had nodular sclerosis histology (86 %) and stage-II disease (75.9 %). Bulky disease was present in 21 % and 56 % of patients belonged to the unfavorable risk group according to European Organization for Research and Treatment of Cancer (EORTC)/The Lymphoma Study Association (LYSA) definitions. CMT was delivered to 91 % of patients. All patients received RT with doses ranging from 20 to 45 Gy (mean = 34 ± 5.3 Gy). The involved-field RT technique was used in 59 % of patients. The mean time between diagnosis and relapse was 4.2 years (range 0.3-24.5). Out-of-field relapses were suffered by 53 % of patients. Relapses occurred more frequently at out-of-field sites in patients with a favorable disease status, whereas in-field relapses were associated with bulky mediastinal disease. Relapses occurred later for favorable compared with the unfavorable risk group (3.5 vs. 2.9 years, p = 0.5). From multivariate analyses, neither RT dose nor RT field size were predictive for an in-field relapse (p = 0.25 and p = 0.8, respectively), only bulky disease was predictive (p = 0.018). In patients with bulky disease, RT dose and RT field size were not predictive for an in-field relapse. In this subgroup of patients, chemotherapy should be intensified. We confirmed the bad prognosis of early relapses. (orig.) [de

  16. Stereotactic Body Radiation Therapy for Early-Stage Non-Small-Cell Lung Cancer: The Pattern of Failure Is Distant

    International Nuclear Information System (INIS)

    Bradley, Jeffrey D.; El Naqa, Issam; Drzymala, Robert E.; Trovo, Marco; Jones, Griffin; Denning, Mary Dee

    2010-01-01

    Background: Stereotactic body radiation therapy (SBRT) represents a substantial paradigm shift in the treatment of patients with medically inoperable Stage I/II non-small-cell lung cancer. We reviewed our experience using either three- or five-fraction SBRT for peripheral or central tumors, respectively. Methods and Materials: A total of 91 patients signed an institutional review board-approved consent form, were treated with SBRT, and have had ≥6 months of follow-up. Patients were referred for SBRT because of underlying comorbidities (poor performance status in 31 or poor lung function in 52) or refusal of surgery (8 patients). Of the cancers, 83 were peripheral and eight were central. Peripheral cancers received a mean dose of 18 Gy x three fractions. Cancers within 2 cm of the bronchus, esophagus, or brachial plexus were treated with 9 Gy x five fractions. Results: The median follow-up duration for these patients was 18 months (range, 6-42 months). TNM staging was as follows: 58 patients with T1N0M0, 22 with T2N0M0, 2 with T3N0M0 (chest wall), and 6 with T1N0M1 cancers. The median tumor diameter was 2 cm (range, 1-5 cm). The median forced expiratory volume in 1 s was 46% (range, 17-133%) and the median carbon monoxide diffusing capacity (DLCO) was 49% (range, 15-144%). Two-year local tumor control was achieved in 86% of patients. The predominant pattern of failure was the development of distant metastasis or second lung cancer. The development of distant metastasis was the only significant prognostic factor for overall survival on multivariate analysis. Conclusions: Local tumor control was shown to be high using SBRT for non-small-cell lung cancer. Overall survival is highly coerrelated with the development of distant metastasis.

  17. A population based study of variations in operation rates for breast cancer, of comorbidity and prognosis at diagnosis: failure to operate for early breast cancer in older women.

    Science.gov (United States)

    Bates, T; Evans, T; Lagord, C; Monypenny, I; Kearins, O; Lawrence, G

    2014-10-01

    Older women are less likely to have surgery for operable breast cancer. This population-based study examines operation rates by age and identifies groups which present with early or late disease. 37 000 cancer registrations for 2007 were combined with Hospital Episode Statistics comorbidity data for England. Operation rates were examined by age, ethnicity, deprivation, comorbidity, screen-detection, tumour size, grade and nodal status. Early and late presentation were correlated with Nottingham Prognostic Index (NPI) groups and tumour size. The proportion of women not having surgery increased from 7-10% at ages 35-69 to 82% from age 90. From age 70, the proportion not having surgery rose by an average of 3.1% per year of age. Women with a Charlson Comorbidity Index score of ≥1 (which increased with age), with tumours >50 mm or who were node positive, were less likely to have surgery. Although women aged 70-79 were more likely to have larger tumours, their tumours were also more likely to have an excellent or good NPI (p ethnic groups (p ethnic groups presented with more advanced tumours. Older women had larger tumours which were otherwise of good prognosis, and this would not account for the failure to operate which may in part be related to comorbidity in this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. THE SUCCESSFUL TREATMENT OF A PERIPHERAL VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE ACUTE RESPIRATORY FAILURE IN THE EARLY PERIOD AFTER ADULT LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2014-01-01

    Full Text Available Aim: of our clinical study was to present own experience of veno-venous extracorporeal membrane oxygenation (VV ECMO for the treatment of an adult patient (female, 28 yrs, 150 cm, 35 kg with acute respiratory distress syndrome (ARDS in the early period after liver transplantation against satisfactory liver graft function. Materials and methods. Double-lumen cannula 22 F was placed percutaneously in the right internal jugular vein. The ext- racorporeal contour reduced in length and the polymethylpeptene oxygenator (priming volume 175 ml were also. Results. In 1 hour after the beginning of VV ECMO, we registered the noted improvement of arterial blood gas and acid-base balance (regress of respiratory acidosis, improvement of arterial oxygenation which allowed us to use the «protective» mode of mechanical ventilation. Improvement of gas exchange and regress of clinical and radiological manifestations of ARDS allowed for VV ECMO weaning and decannulation on day 7. The patient was discharged from ICU and then from our Centre to a homestay respectively on the 9th and 16th day after VV ECMO weaning with the satisfactory liver graft and lungs function. Conclusion. VV ECMO can be successfully applied to correct the life-threatening acute respiratory failure in the early period after liver transplantation. 

  19. Histologic Subtype in Core Lung Biopsies of Early-Stage Lung Adenocarcinoma is a Prognostic Factor for Treatment Response and Failure Patterns After Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Leeman, Jonathan E.; Rimner, Andreas [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Montecalvo, Joseph [Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Hsu, Meier; Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Reibnitz, Donata von; Panchoo, Kelly [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Yorke, Ellen [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Adusumilli, Prasad S. [Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Travis, William [Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Wu, Abraham J., E-mail: wua@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2017-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) has emerged as an effective treatment for early-stage lung cancer. The histologic subtype of surgically resected lung adenocarcinoma is recognized as a prognostic factor, with the presence of solid or micropapillary patterns predicting poor outcomes. We describe the outcomes after SBRT for early-stage lung adenocarcinoma stratified by histologic subtype. Methods and Materials: We identified 119 consecutive patients (124 lesions) with stage I to IIA lung adenocarcinoma who had undergone definitive SBRT at our institution from August 2008 to August 2015 and had undergone core biopsy. Histologic subtyping was performed according to the 2015 World Health Organization classification. Of the 124 tumors, 37 (30%) were a high-risk subtype, defined as containing a component of solid and/or micropapillary pattern. The cumulative incidences of local, nodal, regional, and distant failure were compared between the high-risk and non–high-risk adenocarcinoma subtypes using Gray's test, and multivariable-adjusted hazard ratios (HRs) were estimated from propensity score–weighted Cox regression models. Results: The median follow-up for the entire cohort was 17 months and for surviving patients was 21 months. The 1-year cumulative incidence of and adjusted HR for local, nodal, regional, and distant failure in high-risk versus non–high-risk lesions was 7.3% versus 2.7% (HR 16.8; 95% confidence interval [CI] 3.5-81.4), 14.8% versus 2.6% (HR 3.8; 95% CI 0.95-15.0), 4.0% versus 1.2% (HR 20.9; 95% CI 2.3-192.3), and 22.7% versus 3.6% (HR 6.9; 95% CI 2.2-21.1), respectively. No significant difference was seen with regard to overall survival. Conclusions: The outcomes after SBRT for early-stage adenocarcinoma of the lung correlate highly with histologic subtype, with micropapillary and solid tumors portending significantly higher rates of locoregional and metastatic progression. In this context, the histologic subtype

  20. Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer

    International Nuclear Information System (INIS)

    Verstegen, Naomi E.; Maat, Alexander P. W. M.; Lagerwaard, Frank J.; Paul, Marinus A.; Versteegh, Michel I; Joosten, Joris J.; Lastdrager, Willem; Smit, Egbert F.; Slotman, Ben J.; Nuyttens, Joost J. M. E.; Senan, Suresh

    2016-01-01

    The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases. Complications were scored using the Dindo-Clavien-classification. Nine patients who underwent surgery for a local recurrence were identified. Median time to local recurrence was 22 months. Recurrences were diagnosed with CT- and/or 18FDG-PET-imaging, with four patients also having a pre-surgical pathological diagnosis. Extensive adhesions were observed during two resections, requiring conversion from a thoracoscopic procedure to thoracotomy during one of these procedures. Three patients experienced complications post-surgery; grade 2 (N = 2) and grade 3a (N = 1), respectively. All resection specimens showed viable tumor cells. Median length of hospital stay was 8 days (range 5–15 days) and 30-day mortality was 0 %. Lymph node dissection revealed mediastinal metastases in 3 patients, all of whom received adjuvant therapy. Our experience with nine surgical procedures for local recurrences post-SABR revealed two grade IIIa complications, and a 30-day mortality of 0 %, suggesting that salvage surgery can be safely performed after SABR

  1. Plasma Atrial Natriuretic Peptide as a non-invasive biochemical ...

    African Journals Online (AJOL)

    Plasma Atrial Natriuretic Peptide as a non-invasive biochemical marker of dyspnoea in congestive heart failure patients. ... University of Mauritius Research Journal ... score assessed by a 10 graded visual analogue scale in the control group (mean score = 1) and an increased from 1.6 to 6.4 in the heart failure patients.

  2. The role of early nephrostomy in the management of patients with hyperkalaemia and renal failure due to ureteric obstruction

    Institute of Scientific and Technical Information of China (English)

    Bhaskar Kumar Somani; Harun Gupta; Alastair Todd

    2014-01-01

    Objective:To assess the outcomes of early percutaneous nephrostomy in obstructed hydronephrosis and hyperkalaemia from ureteric obstruction. Methods:Patients were diagnosed with hyperkalaemia with serum potassium >5.0 mmol/L and hyperkalaemia was graded as mild(5.0-6.0 mmol/L), moderate(6.1-7.0 mmol/L) or severe(>7.1 mmol/L).Data on age, sex, clinical presentation, presence of concurrent disease, creatinine, potassium, haemoglobin concentration, time interval in doing the nephrostomy since their first presentation, any prenephrostomy medical correction of hyperkalaemia and complications were collected. Results:A total of61 patients(40 males and21 females) with mean age of69.7 years(ranged35 to94 years) underwent69 procedures.Prior to the nephrostomy, the serum potassium was mildly elevated in42 cases, moderately elevated in17 cases and severely elevated in10 cases.The overall mean level of potassium before intervention was6.1 mmol/L(range:5.1 mmol/L-9.3 mmol/L).Forty(58%) had nephrostomy without prior medical treatment of the hyperkalaemia.The mean serum potassium in these patients was5.6 mmol/L(range:5.1 mmol/L-7.5 mmol/L).Twentynine (42%) had medical treatment of the hyperkalaemia prior to nephrostomy.The mean potassium level in these patients was reduced from6.7 mmol/L(range5.4 mmol/L-9.3 mmol/L) before medical treatment to5.8 mmol/L(4.0 mmol/L-7.4 mmol/L).Five patients(7%) had complications from percutaneous nephrostomy including temporary atrial fibrillation in3 patients and transient pyrexia in2 patients. Conclusions:Percutaneous nephrostomy as the initial management for hyperkalaemia from ureteric obstruction is a safe procedure with acceptable complication rates.

  3. New Electric Online Oil Condition Monitoring Sensor – an Innovation in Early Failure Detection of Industrial Gears

    Directory of Open Access Journals (Sweden)

    Manfred Mauntz

    2013-02-01

    Full Text Available A new online diagnostics system for the continuous condition monitoring of lubricating oils in industrial gearboxes is presented. Characteristic features of emerging component damage, such as wear, contamination or chemical aging, are identified in an early stage. The OilQSens® sensor effectively controls the proper operation conditions of bearings and cogwheels in gears. Also, the condition of insulating oils in transformers can be monitored. The online diagnostics system measures components of the specific complex impedance of oils. For instance, metal abrasion due to wear debris, broken oil molecules, forming acids or oil soaps result in an increase of the electrical conductivity, which directly correlates with the degree of contamination in the oil. The dielectrical properties of the oils are particularly determined by the water content that becomes accessible via an additional accurate measurement of the dielectric constant. For additivated oils, statements on the degradation of additives can also be derived from changes in the dielectric constant. For an efficient machine utilization and targeted damage prevention, the new OilQSens® online condition monitoring sensor system allows for timely preventative maintenance on demand rather than in rigid inspection intervals. The determination of impurities or reduction in the quality of the oil and the quasi continuous evaluation of wear and chemical aging follow the holistic approach of a real-time monitoring of a change in the condition of the oil-machine system. Once the oil condition monitoring sensors are installed on the plants, the measuring data can be displayed and evaluated elsewhere. The measuring signals are transmitted to a web-based condition monitoring system via LAN, WLAN or serial interfaces of the sensor system. Monitoring of the damage mechanisms during proper operation below the tolerance limits of the components enables specific preventive maintenance independent of rigid

  4. Analyses of patterns-of-failure and prognostic factors according to radiation fields in early-stage Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Krebs, Lorraine; Guillerm, Sophie; Menard, Jean; Hennequin, Christophe; Quero, Laurent [Saint Louis Hospital, Radiation Oncology Department, Paris (France); Amorin, Sandy; Brice, Pauline [Saint Louis Hospital, AP-HP, Hematooncology Department, Paris (France)

    2017-02-15

    Doses and volumes of radiation therapy (RT) for early stages of Hodgkin lymphoma (HL) have been reduced over the last 30 years. Combined modality therapy (CMT) is currently the standard treatment for most patients with early-stage HL. The aim of this study was to analyze the site of relapse after RT according to the extent of radiation fields. Between 1987 and 2011, 427 patients were treated at our institution with RT ± chemotherapy for stage-I/II HL. Among these, 65 patients who experienced a relapse were retrospectively analyzed. Most patients had nodular sclerosis histology (86 %) and stage-II disease (75.9 %). Bulky disease was present in 21 % and 56 % of patients belonged to the unfavorable risk group according to European Organization for Research and Treatment of Cancer (EORTC)/The Lymphoma Study Association (LYSA) definitions. CMT was delivered to 91 % of patients. All patients received RT with doses ranging from 20 to 45 Gy (mean = 34 ± 5.3 Gy). The involved-field RT technique was used in 59 % of patients. The mean time between diagnosis and relapse was 4.2 years (range 0.3-24.5). Out-of-field relapses were suffered by 53 % of patients. Relapses occurred more frequently at out-of-field sites in patients with a favorable disease status, whereas in-field relapses were associated with bulky mediastinal disease. Relapses occurred later for favorable compared with the unfavorable risk group (3.5 vs. 2.9 years, p = 0.5). From multivariate analyses, neither RT dose nor RT field size were predictive for an in-field relapse (p = 0.25 and p = 0.8, respectively), only bulky disease was predictive (p = 0.018). In patients with bulky disease, RT dose and RT field size were not predictive for an in-field relapse. In this subgroup of patients, chemotherapy should be intensified. We confirmed the bad prognosis of early relapses. (orig.) [German] Waehrend der letzten 30 Jahre wurden die Strahlentherapie-(RT-)Dosis und die RT-Volumina fuer die Behandlung der Fruehstadien

  5. Eigentumors for prediction of treatment failure in patients with early-stage breast cancer using dynamic contrast-enhanced MRI: a feasibility study

    Science.gov (United States)

    Chan, H. M.; van der Velden, B. H. M.; E Loo, C.; Gilhuijs, K. G. A.

    2017-08-01

    We present a radiomics model to discriminate between patients at low risk and those at high risk of treatment failure at long-term follow-up based on eigentumors: principal components computed from volumes encompassing tumors in washin and washout images of pre-treatment dynamic contrast-enhanced (DCE-) MR images. Eigentumors were computed from the images of 563 patients from the MARGINS study. Subsequently, a least absolute shrinkage selection operator (LASSO) selected candidates from the components that contained 90% of the variance of the data. The model for prediction of survival after treatment (median follow-up time 86 months) was based on logistic regression. Receiver operating characteristic (ROC) analysis was applied and area-under-the-curve (AUC) values were computed as measures of training and cross-validated performances. The discriminating potential of the model was confirmed using Kaplan-Meier survival curves and log-rank tests. From the 322 principal components that explained 90% of the variance of the data, the LASSO selected 28 components. The ROC curves of the model yielded AUC values of 0.88, 0.77 and 0.73, for the training, leave-one-out cross-validated and bootstrapped performances, respectively. The bootstrapped Kaplan-Meier survival curves confirmed significant separation for all tumors (P  <  0.0001). Survival analysis on immunohistochemical subgroups shows significant separation for the estrogen-receptor subtype tumors (P  <  0.0001) and the triple-negative subtype tumors (P  =  0.0039), but not for tumors of the HER2 subtype (P  =  0.41). The results of this retrospective study show the potential of early-stage pre-treatment eigentumors for use in prediction of treatment failure of breast cancer.

  6. Raman spectroscopic biochemical mapping of tissues

    Science.gov (United States)

    Stone, Nicholas; Hart Prieto, Maria C.; Kendall, Catherine A.; Shetty, Geeta; Barr, Hugh

    2006-02-01

    Advances in technologies have brought us closer to routine spectroscopic diagnosis of early malignant disease. However, there is still a poor understanding of the carcinogenesis process. For example it is not known whether many cancers follow a logical sequence from dysplasia, to carcinoma in situ, to invasion. Biochemical tissue changes, triggered by genetic mutations, precede morphological and structural changes. These can be probed using Raman or FTIR microspectroscopy and the spectra analysed for biochemical constituents. Local microscopic distribution of various constituents can then be visualised. Raman mapping has been performed on a number of tissues including oesophagus, breast, bladder and prostate. The biochemical constituents have been calculated at each point using basis spectra and least squares analysis. The residual of the least squares fit indicates any unfit spectral components. The biochemical distribution will be compared with the defined histopathological boundaries. The distribution of nucleic acids, glycogen, actin, collagen I, III, IV, lipids and others appear to follow expected patterns.

  7. The early onset of peripheral neuropathy might be a robust predictor for time to treatment failure in patients with metastatic breast cancer receiving chemotherapy containing paclitaxel.

    Directory of Open Access Journals (Sweden)

    Ippei Fukada

    Full Text Available Paclitaxel plays a central role in chemotherapy for breast cancer. Peripheral neuropathy, a well-known toxicity with paclitaxel, may be of interest in predicting the efficacy of paclitaxel therapy for patients with metastatic breast cancer. We performed a retrospective analysis assessing whether the early occurrence of peripheral neuropathy (EPN was a predictive marker for better efficacy in patients with metastatic breast cancer receiving chemotherapy containing paclitaxel.Between January 2000 and August 2008, we examined the records of 168 patients with metastatic breast cancer treated with paclitaxel in our hospital. EPN was defined as a symptom of Grade 2 or more during first three months of treatment. The overall response rate (ORR and time to treatment failure (TTF in each group were analyzed retrospectively.Of 168 patients with metastatic breast cancer who were treated with paclitaxel, EPN was documented in 101 patients (60.1%. The clinical benefit rate (CR, PR, and SD ≥ 6 months was 72.3% in the EPN group and 49.3% in the non-EPN group (p = 0.002. The TTF of the EPN group (median 11.2 months, 95% CI: 9.5-12.9 was significantly longer than that of the non-EPN group (5.7 months, 95% CI: 4.6-6.8 (p<0.001. Multivariate analysis demonstrated that EPN (p<0.001, dose intensity of less than 70% (p<0.001, and the history of microtubule agents (p = 0.001 were the significant favorable prognostic factors for TTF.The early onset of peripheral neuropathy might be a robust predictor for TTF in patients with metastatic breast cancer treated with paclitaxel.

  8. Estimation of Te-132 distribution in Fukushima Prefecture at the early stage of the Fukushima Daiichi Nuclear Power Plant reactor failures.

    Science.gov (United States)

    Tagami, Keiko; Uchida, Shigeo; Ishii, Nobuyoshi; Zheng, Jian

    2013-05-21

    Tellurium-132 ((132)Te, half-life: 3.2 d) has been assessed as the radionuclide with the third largest release from the Fukushima Daiichi Nuclear Power Plant (FDNPP) in March 2011; thus it would have made some dose contribution during the early stage of the reactor failures. The available data for (132)Te are, however, limited. In this study, available reported values of other isotopes of Te were compiled to estimate (132)Te concentration (in MBq m(-2)). It was found that (132)Te and (129m)Te (half-life: 33.6 d) concentrations were well correlated (R = 0.99, p < 0.001) by t test. Thus, (132)Te concentrations on March 11, 2011 were estimated from (129m)Te using the concentration conversion factor ((132)Te /(129m)Te) of 14.5. It was also found that since deposited (129m)Te was well retained in the soil, the data collected in March-May of 2011 were applicable to (132)Te estimation. It was possible to obtain the first (132)Te concentration contour map for the eastern part of Fukushima Prefecture, including data from within the 20-km exclusion zone around the FDNPP, using these newly available estimated (132)Te data sets.

  9. Medical management of early pregnancy failure (EPF): a retrospective analysis of a combined protocol of mifepristone and misoprostol used in clinical practice.

    Science.gov (United States)

    Colleselli, Valeria; Schreiber, Courtney A; D'Costa, Elisabeth; Mangesius, Stephanie; Wildt, Ludwig; Seeber, Beata E

    2014-06-01

    To evaluate the efficacy of a combined protocol of mifepristone and misoprostol in the management of early pregnancy failure (EPF) and the average time to expulsion of tissue and rate of side effects. Retrospective chart review of all consecutive women treated with primary medical management for EPF at our institution from 2006 to 2012. 168 patients were included in the present study. The overall success rate, defined as the absence of the need for surgical intervention, was 61 % and did not differ by calendar year. There was no difference in success rate grouped by diagnosis [intrauterine embryonic/fetal demise (IUED/IUFD) vs. anembryonic gestation; p = 0.30] or gestational age (800 μg (68 vs. 50 %, p = 0.029). Of the possible predictive factors of success, only the dose of misoprostol required was a significant independent negative predictor. Mean and median time to tissue expulsion after the first dose of misoprostol were 8.4 and 5.5 h, respectively. The incidence of side effects was low with no blood transfusions required. The success rate in this study is markedly below published data. This can possibly be attributed to retrospective study design, allowing for physician subjectivity and patients' wishes in the absence of strict study requirements. The protocol was well tolerated with a paucity of side effects. We make suggestions for enhancing success rates in the clinical setting by optimizing medication protocols, establishing precise treatment guidelines and training physicians in the accurate interpretation of treatment outcomes.

  10. Multimodal brain monitoring in fulminant hepatic failure

    Science.gov (United States)

    Paschoal Jr, Fernando Mendes; Nogueira, Ricardo Carvalho; Ronconi, Karla De Almeida Lins; de Lima Oliveira, Marcelo; Teixeira, Manoel Jacobsen; Bor-Seng-Shu, Edson

    2016-01-01

    Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation. In the past, neuromonitoring was restricted to serial clinical neurologic examination and, in some cases, intracranial pressure monitoring. Over the years, this monitoring has proven insufficient, as brain abnormalities were detected at late and irreversible stages. The need for real-time monitoring of brain functions to favor prompt treatment and avert irreversible brain injuries led to the concepts of multimodal monitoring and neurophysiological decision support. New monitoring techniques, such as brain tissue oxygen tension, continuous electroencephalogram, transcranial Doppler, and cerebral microdialysis, have been developed. These techniques enable early diagnosis of brain hemodynamic, electrical, and biochemical changes, allow brain anatomical and physiological monitoring-guided therapy, and have improved patient survival rates. The purpose of this review is to discuss the multimodality methods available for monitoring patients with FHF in the neurocritical care setting. PMID:27574545

  11. Anal canal carcinoma: Early-stage tumors ≤10 mm (T1 or Tis): Therapeutic options and original pattern of local failure after radiotherapy

    International Nuclear Information System (INIS)

    Ortholan, Cecile; Ramaioli, Alain; Peiffert, Didier; Lusinchi, Antoine; Romestaing, Pascale; Chauveinc, Laurent; Touboul, Emmanuel; Peignaux, Karine; Bruna, Antoine; La Roche, Guy de; Lagrange, Jean-Leon; Alzieu, Christian; Gerard, Jean Pierre

    2005-01-01

    Purpose: To investigate the clinical history, management, and pattern of recurrence of very early-stage anal canal cancer in a French retrospective survey. Methods: The study group consisted of 69 patients with Stage Tis and T1 anal canal carcinoma ≤1 cm treated between 1990 and 2000 (12 were in situ, 57 invasive, 66 Stage N0, and 3 Stage N1). The median patient age was 67 years (range, 27-83 years). Of the 69 patients, 66 received radiotherapy (RT) and 3 with in situ disease were treated by local excision alone without RT. Twenty-six patients underwent local excision before RT (12 with negative and 14 with positive surgical margins). Of the 66 patients who underwent RT, 8 underwent brachytherapy alone (median dose, 55 Gy), 38 underwent external beam RT (median dose, 45 Gy) plus a brachytherapy boost (median boost dose, 20 Gy), and 20 underwent external beam RT alone (median dose, 55 Gy). Results: Of the 69 patients, 68 had initial local control. Of the 66 patients treated by RT, 6 developed local recurrence at a median interval of 50 months (range, 13-78 months). Four patients developed local failure outside the initial tumor bed. Of the 3 patients with Tis treated by excision alone, 1 developed local recurrence. No relation was found among prior excision, dose, and local failure. The 5-year overall survival, colostomy-free survival, and disease-free survival rate was 94%, 85%, and 89%, respectively. The rate of late complications (Grade 1-3) was 28% and was 14% for those who received doses <60 Gy and 37% for those who received doses of ≥60 Gy (p = 0.04). Conclusion: Most recurrences occurred after a long disease-free interval after treatment and often outside the initial tumor site. These small anal cancers could be treated by RT using a small volume and moderate dose (40-50 Gy for subclinical lesions and 50-60 Gy for T1)

  12. Patterns and Predictors of Early Biochemical Recurrence After Radical Prostatectomy and Adjuvant Radiation Therapy in Men With pT3N0 Prostate Cancer: Implications for Multimodal Therapies

    International Nuclear Information System (INIS)

    Briganti, Alberto; Joniau, Steven; Gandaglia, Giorgio; Cozzarini, Cesare; Sun, Maxine; Tombal, Bertrand; Haustermans, Karin; Hinkelbein, Wolfgang; Shariat, Shahrokh F.; Karakiewicz, Pierre I.; Montorsi, Francesco; Van Poppel, Hein; Wiegel, Thomas

    2013-01-01

    Purpose: The aim of our study was to evaluate patterns and predictors of early biochemical recurrence (eBCR) after radical prostatectomy (RP) and adjuvant radiation therapy (aRT) in order to identify which individuals might benefit from additional treatments. Methods and Materials: We evaluated 390 patients with pT 3 N 0 prostate cancer (PCa) receiving RP and aRT at 6 European centers between 1993 and 2006. Patients who were free from BCR at 0.2 ng/mL within 2 or 3 years after aRT. Uni- and multivariable Cox regression analyses predicting overall and eBCR after aRT were fitted. Covariates consisted of preoperative PSA results, surgical margins, pathological stage, Gleason score, and aRT dose. Results: Overall, 5- and 8-year BCR-free survival rates were 77.1% and 70.8%, respectively. At a median follow-up of 86 months after aRT, 33 (8.8%) and 55 (14.6%) men experienced BCR within 2 or 3 years after aRT, respectively. In multivariable analyses, Gleason scores of 8 to 10 represented the only independent predictor of eBCR after aRT (all, P≤.01). The risk of BCR was significantly higher in patients with a Gleason score of 8 to 10 disease than in those with Gleason 2 to 6 within 24 months after treatment, after adjusting for all covariates (all, P≤.04). However, given a 24-month BCR free period, the risk of subsequent BCR for men with poorly differentiated disease was equal to that of men with less aggressive disease (all, P≥.3). Conclusions: High Gleason score represents the only predictor of eBCR after RP and aRT in patients affected by pT 3 N 0 PCa. Given the association between early PSA recurrence, clinical progression, and mortality, these patients might be considered candidates for adjuvant medical therapy and/or prophylactic whole-pelvis radiation therapy in addition to aRT, delivered to the prostatic bed

  13. Comparison of Mifepristone Followed by Misoprostol with Misoprostol Alone for Treatment of Early Pregnancy Failure: A Randomized Double-Blind Placebo-Controlled Trial.

    Science.gov (United States)

    Sinha, Priya; Suneja, Amita; Guleria, Kiran; Aggarwal, Richa; Vaid, Neelam B

    2018-02-01

    To compare the efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in the management of early pregnancy failure (EPF). A randomized double-blind placebo-controlled clinical trial. Ninety-two women with EPF ≤12 weeks were recruited and randomly allocated to receive either mifepristone 200 mg ( n  = 46) or placebo ( n  = 46). Forty-eight hours later, patients in both the groups were given 800 µg misoprostol per-vaginum. If no expulsion occurred within 4 h, repeat doses of 400 µg misoprostol were given orally at 3-hourly interval to a maximum of 2 doses in women ≤9 weeks by scan and 4 doses in women >9 weeks by scan. Pre-treatment of misoprostol with mifepristone significantly increased the complete abortion rate (86.7 vs. 57.8%, p  = 0.009) and, hence, reduced the need for surgical evacuation (13.3 vs. 42.2%, p  = 0.002), induction to expulsion interval (4.74 ± 2.24 vs. 8.03 ± 2.77 h, p  = 0.000), mean number of additional doses of misoprostol required (0.68 vs. 1.91, p  = 0.000), and side effects. Use of mifepristone prior to misoprostol in EPF significantly improves the efficacy and reduces the side effects of misoprostol alone.

  14. The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature.

    Science.gov (United States)

    van den Berg, Joyce; Gordon, Bernardus B M; Snijders, Marcus P M L; Vandenbussche, Frank P H A; Coppus, Sjors F P J

    2015-12-01

    Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation rates between 53% and 87%. Some reports suggest that sequential treatment with mifepristone and misoprostol leads to higher success rates than misoprostol alone. To evaluate the added value of mifepristone to current non-surgical treatment regimens in women with EPF we performed a systematic literature search. Electronic databases were searched: PubMed, Cochrane Library, Current Controlled Trials, and ClinicalTrials.gov. Clinical studies, both randomised and non-randomised trials, reporting on the added value of mifepristone to current non-surgical treatment regimens in women with EPF were included. Data of sixteen studies were extracted using a data extraction sheet (based on the Cochrane Consumers and Communication Review Group's data extraction template). The methodological quality was assessed using the Cochrane Collaboration Risk of Bias tool. In five randomised and eleven non-randomised trials, success rates of sequential treatment with mifepristone and misoprostol in case of EPF varied between 52% and 95%. Large heterogeneity existed in treatment regimens and comparators between studies. The existing evidence is insufficient to draw firm conclusions about the added value of mifepristone to misoprostol alone. A sufficiently powered randomised, double blinded placebo-controlled trial is urgently required to test whether, in EPF, the sequential combination of mifepristone with misoprostol is superior to misoprostol only. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Analysis of postoperative biochemical values and clinical outcomes after adrenalectomy for primary aldosteronism.

    Science.gov (United States)

    Swearingen, Andrew J; Kahramangil, Bora; Monteiro, Rosebel; Krishnamurthy, Vikram; Jin, Judy; Shin, Joyce; Siperstein, Allan; Berber, Eren

    2018-04-01

    Primary aldosteronism causes hypertension and hypokalemia and is often surgically treatable. Diagnosis includes elevated plasma aldosterone, suppressed plasma renin activity, and elevated aldosterone renin ratio. Adrenalectomy improves hypertension and hypokalemia. Postoperative plasma aldosterone and plasma renin activity may be useful in documenting cure or failure. A retrospective analysis of patients who underwent adrenalectomy for primary aldosteronism from 2010 to 2016 was performed, analyzing preoperative and postoperative plasma aldosterone, plasma renin activity, hypertension, and hypokalemia. The utility of postoperative testing was assessed. Clinical cure was defined as improved hypertension control and resolution of potassium loss. Biochemical cure was defined as aldosterone renin ratio reduction to <23.6. Forty-four patients were included; 20 had plasma aldosterone and plasma renin activity checked on postoperative day 1. In the study, 40/44 (91%) were clinically cured. All clinical failures had of biochemical failure at follow-up. Postoperative day 1aldosterone renin ratio <23.6 had PPV of 95% for clinical cure. Cured patients had mean plasma aldosterone drop of 33.1 ng/dL on postoperative day 1; noncured patient experienced 3.9 ng/dL increase. A cutoff of plasma aldosterone decrease of 10 ng/dL had high positive predictive value for clinical cure. Changes in plasma aldosterone and plasma renin activity after adrenalectomy correlate with improved hypertension and hypokalemia. The biochemical impact of adrenalectomy manifests as early as postoperative day 1. We propose a plasma aldosterone decrease of 10 ng/dL as a criterion to predict clinical cure. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Respiratory Failure

    Science.gov (United States)

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  17. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  18. Measures of Biochemical Sociology

    Science.gov (United States)

    Snell, Joel; Marsh, Mitchell

    2008-01-01

    In a previous article, the authors introduced a new sub field in sociology that we labeled "biochemical sociology." We introduced the definition of a sociology that encompasses sociological measures, psychological measures, and biological indicators Snell & Marsh (2003). In this article, we want to demonstrate a research strategy that would assess…

  19. Biochemical nature of Russell Bodies.

    Science.gov (United States)

    Mossuto, Maria Francesca; Ami, Diletta; Anelli, Tiziana; Fagioli, Claudio; Doglia, Silvia Maria; Sitia, Roberto

    2015-07-30

    Professional secretory cells produce and release abundant proteins. Particularly in case of mutations and/or insufficient chaperoning, these can aggregate and become toxic within or amongst cells. Immunoglobulins (Ig) are no exception. In the extracellular space, certain Ig-L chains form fibrils causing systemic amyloidosis. On the other hand, Ig variants lacking the first constant domain condense in dilated cisternae of the early secretory compartment, called Russell Bodies (RB), frequently observed in plasma cell dyscrasias, autoimmune diseases and chronic infections. RB biogenesis can be recapitulated in lymphoid and non-lymphoid cells by expressing mutant Ig-μ, providing powerful models to investigate the pathophysiology of endoplasmic reticulum storage disorders. Here we analyze the aggregation propensity and the biochemical features of the intra- and extra-cellular Ig deposits in human cells, revealing β-aggregated features for RB.

  20. Recommendations on pre-hospital & early hospital management of acute heart failure : a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine

    NARCIS (Netherlands)

    Mebazaa, Alexandre; Yilmaz, M. Birhan; Levy, Phillip; Ponikowski, Piotr; Peacock, W. Frank; Laribi, Said; Ristic, Arsen D.; Lambrinou, Ekaterini; Masip, Josep; Riley, Jillian P.; McDonagh, Theresa; Mueller, Christian; deFilippi, Christopher; Harjola, Veli-Pekka; Thiele, Holger; Piepoli, Massimo F.; Metra, Marco; Maggioni, Aldo; McMurray, John; Dickstein, Kenneth; Damman, Kevin; Seferovic, Petar M.; Ruschitzka, Frank; Leite-Moreira, Adelino F.; Bellou, Abdelouahab; Anker, Stefan D.; Filippatos, Gerasimos

    Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to

  1. Contraceptive failure

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  2. Heart Failure

    OpenAIRE

    McMurray, John; Ponikowski, Piotr

    2011-01-01

    Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure.

  3. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  4. Pattern Of Biochemical Derangements Seen In Chronic Renal ...

    African Journals Online (AJOL)

    Objective: To study the pattern of biochemical derangements in advanced renal failure patients. Subjects and Methods: Ninety adult patients [54 males and 36 females] were recruited from the renal clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu over a period of one year. History and physical ...

  5. Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?

    Directory of Open Access Journals (Sweden)

    Machado Cristiano V

    2011-06-01

    Full Text Available Abstract Background Left ventricular ejection fraction (LVEF has been considered a major determinant of early outcome in acute myocardial infarction (AMI. Myocardial performance index (MPI has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure (CHF specifically in patients with a first isolated ST-elevation AMI. Methods Echocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class ≥ II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF. Results Early in-hospital CHF occurred in 29 (31% of patients. LVEF ≤ 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables (odds ratio 17.0; [95% CI 4.1 - 70.8]; p Conclusion For patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.

  6. Biochemical Hypermedia: Galactose Metabolism.

    Directory of Open Access Journals (Sweden)

    J.K. Sugai

    2013-05-01

    Full Text Available Introduction: Animations of biochemical processes and virtual laboratory environments lead to true molecular simulations. The use of interactive software’s in education can improve cognitive capacity, better learning and, mainly, it makes information acquisition easier. Material and Methods: This work presents the development of a biochemical hypermedia to understanding of the galactose metabolism. It was developed with the help of concept maps, ISIS Draw, ADOBE Photoshop and FLASH MX Program. Results and Discussion: A step by step animation process shows the enzymatic reactions of galactose conversion to glucose-1-phosphate (to glycogen synthesis, glucose-6-phosphate (glycolysis intermediary, UDP-galactose (substrate to mucopolysaccharides synthesis and collagen’s glycosylation. There are navigation guide that allow scrolling the mouse over the names of the components of enzymatic reactions of via the metabolism of galactose. Thus, explanatory text box, chemical structures and animation of the actions of enzymes appear to navigator. Upon completion of the module, the user’s response to the proposed exercise can be checked immediately through text box with interactive content of the answer. Conclusion: This hypermedia was presented for undergraduate students (UFSC who revealed that it was extremely effective in promoting the understanding of the theme.

  7. Heart Failure

    Science.gov (United States)

    ... Other diseases. Chronic diseases — such as diabetes, HIV, hyperthyroidism, hypothyroidism, or a buildup of iron (hemochromatosis) or ... transplantation or support with a ventricular assist device. Prevention The key to preventing heart failure is to ...

  8. Identifying Clinical Factors Which Predict for Early Failure Patterns Following Resection for Pancreatic Adenocarcinoma in Patients Who Received Adjuvant Chemotherapy Without Chemoradiation.

    Science.gov (United States)

    Walston, Steve; Salloum, Joseph; Grieco, Carmine; Wuthrick, Evan; Diaz, Dayssy A; Barney, Christian; Manilchuk, Andrei; Schmidt, Carl; Dillhoff, Mary; Pawlik, Timothy M; Williams, Terence M

    2018-05-04

    The role of radiation therapy (RT) in resected pancreatic cancer (PC) remains incompletely defined. We sought to determine clinical variables which predict for local-regional recurrence (LRR) to help select patients for adjuvant RT. We identified 73 patients with PC who underwent resection and adjuvant gemcitabine-based chemotherapy alone. We performed detailed radiologic analysis of first patterns of failure. LRR was defined as recurrence of PC within standard postoperative radiation volumes. Univariate analyses (UVA) were conducted using the Kaplan-Meier method and multivariate analyses (MVA) utilized the Cox proportional hazard ratio model. Factors significant on UVA were used for MVA. At median follow-up of 20 months, rates of local-regional recurrence only (LRRO) were 24.7%, LRR as a component of any failure 68.5%, metastatic recurrence (MR) as a component of any failure 65.8%, and overall disease recurrence (OR) 90.5%. On UVA, elevated postoperative CA 19-9 (>90 U/mL), pathologic lymph node positive (pLN+) disease, and higher tumor grade were associated with increased LRR, MR, and OR. On MVA, elevated postoperative CA 19-9 and pLN+ were associated with increased MR and OR. In addition, positive resection margin was associated with increased LRRO on both UVA and MVA. About 25% of patients with PC treated without adjuvant RT develop LRRO as initial failure. The only independent predictor of LRRO was positive margin, while elevated postoperative CA 19-9 and pLN+ were associated with predicting MR and overall survival. These data may help determine which patients benefit from intensification of local therapy with radiation.

  9. Implantable biochemical fuel cell

    Energy Technology Data Exchange (ETDEWEB)

    Richter, G; Rao, J R

    1978-01-05

    Implantable biochemical fuel cells for the operation of heart pacemakers or artificial hearts convert oxidisable body substances such as glucose on the anode side and reduce the oxygen contained in body fluids at the cathode. The anode and cathode are separated by membranes which are impermeable to albumen and blood corpuscles in body fluids. A chemical shortcircuit cannot occur in practice if, according to the invention, one or more selective oxygen electrodes with carbon as catalyst are arranged so that the mixture which diffuses into the cell from body fluids during operation reaches the fuel cell electrode through the porous oxygen electrode. The membranes used must be permeable to water. Cellulose, polymerised polyvinyl alcohol or an ion exchanger with a buffering capacity between pH5 and 8 act as permeable materials.

  10. Marked improvement in the success rate of medical management of early pregnancy failure following the implementation of a novel institutional protocol and treatment guidelines: a follow-up study.

    Science.gov (United States)

    Colleselli, V; Nell, T; Bartosik, T; Brunner, C; Ciresa-Koenig, A; Wildt, L; Marth, C; Seeber, B

    2016-11-01

    To analyze the success rate, time to passage of tissue and subjective patient experience of a newly implemented protocol for medical management of early pregnancy failure (EPF) over a 2-year period. A retrospective chart review of all patients with early pregnancy failure primarily opting for medical management was performed. 200 mg mifepristone were administered orally, followed by a single vaginal dose of 800 mcg misoprostol after 36-48 h. We followed-up with our patients using a written questionnaire. 167 women were included in the present study. We observed an overall success rate of 92 %, defined as no need for surgical management after medication administration. We could not identify predictive values for success in a multivariate regression analysis. Most patients (84 %) passed tissue within 6 h after misoprostol administration. The protocol was well tolerated with a low incidence of side effects. Pain was managed well with sufficient analgesics. Responders to the questionnaire felt adequately informed prior to treatment and rated their overall experience as positive. The adaption of the institutional medical protocol resulted in a marked improvement of success rate when compared to the previously used protocol (92 vs. 61 %). We credit this increase to the adjusted medication schema as well as to targeted physician education on the expected course and interpretation of outcome measures. Our results underscore that the medical management of EPF is a safe and effective alternative to surgical evacuation in the clinical setting.

  11. Predictors of treatment failure among pulmonary tuberculosis ...

    African Journals Online (AJOL)

    Introduction: Early identification of Tuberculosis (TB) treatment failure using cost effective means is urgently needed in developing nations. The study set out to describe affordable predictors of TB treatment failure in an African setting. Objective: To determine the predictors of treatment failure among patients with sputum ...

  12. Paternal and maternal factors in preimplantation embryogenesis: interaction with the biochemical environment.

    Science.gov (United States)

    Ménézo, Yves J R

    2006-05-01

    Paternal effect on embryonic development occurs as early as fertilization. Incorrect formation of the spermatozoon due to centrosome defects and abnormal concentrations of any components involved in the activation process lead to failure immediately or in the subsequent cell cycles. Sperm chromosomal abnormalities result in early embryo developmental arrests. Generally poor spermatozoa lead to poor blastocyst formation. Sperm DNA fragmentation may impair even late post-implantation development. The DNA repair capacity of the oocytes is of major importance. Early preimplantation development, i.e. until maternal to zygotic transition, is maternally driven. Maternal mRNAs and proteins are of major importance, as there is an unavoidable turnover of these reserves. Polyadenylation of these mRNAs is precisely controlled, in order to avoid too early or too late transcription and translation of the housekeeping genes. An important set of maternal regulations, such as DNA stability, transcriptional regulation and protection against oxidative stress, are impaired by age. The embryo biochemical endogenous pool is very important and may depend upon the environment, i.e. the culture medium. Paternal, maternal and environmental factors are unavoidable parameters; they become evident when age impairs oocyte quality.

  13. Early Bayesian modeling of a potassium lab-on-a-chip for monitoring of heart failure patients at increased risk of hyperkalaemia.

    NARCIS (Netherlands)

    van de Wetering, Gijs; Steuten, Lotte Maria Gertruda; von Birgelen, Clemens; Adang, E.M.; IJzerman, Maarten Joost

    2012-01-01

    Objectives: Innovative point-of-care (POC) diagnostics are likely to have a strong impact on 18 health care. The aim of this study is to conduct an early assessment of a point-of-care chip 19 for the detection of a pathological deviation of the potassium levels in patients at increased 20 risk,

  14. Mitochondrial markers predict recurrence, metastasis and tamoxifen-resistance in breast cancer patients: Early detection of treatment failure with companion diagnostics.

    Science.gov (United States)

    Sotgia, Federica; Fiorillo, Marco; Lisanti, Michael P

    2017-09-15

    Here, we used a data-mining and informatics approach to discover new biomarkers of resistance to hormonal therapy in breast cancer. More specifically, we investigated whether nuclear-encoded genes associated with mitochondrial biogenesis can be used to predict tumor recurrence, distant metastasis and treatment failure in high-risk breast cancer patients. Overall, this strategy allowed us to directly provide in silico validation of the prognostic value of these mitochondrial components in large and clinically relevant patient populations, with >15 years of follow-up data. For this purpose, we employed a group of 145 ER(+) luminal A breast cancer patients, with lymph-node (LN) metastasis at diagnosis, that were treated with tamoxifen, but not any chemotherapy agents. Using this approach, we identified >60 new individual mitochondrial biomarkers that predicted treatment failure and tumor recurrence, with hazard-ratios (HR) of up to 4.17 ( p =2.2e-07). These include mitochondrial chaperones (HSPD1, HSPA9), membrane proteins (VDAC2, TOMM70A) and anti-oxidants (SOD2), as well as 18 different mitochondrial ribosomal proteins (MRPs) and >20 distinct components of the OXPHOS complexes. In addition, we combined 4 mitochondrial proteins (HSPD1, UQCRB, MRPL15, COX17), to generate a compact mitochondrial gene signature, associated with a HR of 5.34 ( p =1e-09). This signature also successfully predicted distant metastasis and was effective in larger groups of ER(+) ( N =2,447), basal ( N =540) and HER2(+) ( N =193) breast cancers. It was also effective in all breast cancers ( N =3,180), if considered together as a single group. Based on this analysis, we conclude that mitochondrial biogenesis should be considered as a new therapeutic target for overcoming tumor recurrence, distant metastasis and treatment failure in patients with breast cancer. In summary, we identified individual mitochondrial biomarkers and 2 compact mitochondrial gene signatures that can be used to predict

  15. Failure Modes

    DEFF Research Database (Denmark)

    Jakobsen, K. P.; Burcharth, H. F.; Ibsen, Lars Bo

    1999-01-01

    The present appendix contains the derivation of ten different limit state equations divided on three different failure modes. Five of the limit state equations can be used independently of the characteristics of the subsoil, whereas the remaining five can be used for either drained or undrained s...

  16. Lipoprotein (a) and biochemical parameters in elderly

    OpenAIRE

    Yuttana Sudjaroen

    2016-01-01

    Background: Lipoprotein (a) [Lp(a)] is an low-density lipoprotein like particle and is an important independent risk factor for coronary artery diseases (CAD). Few studies on Lp(a) level in Thai elderly to screening risk of CAD may concerned. Aims: To study the relation of Lp(a) level and routine biochemical parameters including lipid profiles and fasting blood glucose in elderly and to determine risk of subclinical symptoms by using Lp(a) levels as early risk predictor. Settings and Design: ...

  17. the Early Effects of Gamma radiation on the diurnal changes of Some Biochemical Parameters and the Role of α-lipoic acid as an Antioxidant in Male Albino rats

    International Nuclear Information System (INIS)

    Abdel-Fattah, K.I.; Yacoub, S.F.; Abdel-Aziz, N.

    2013-01-01

    In mammals most of the physiological and behavioral systems such as sleep-wake cycle, cardiovascular activity, endocrine system, blood pressure, body temperature and hepatic metabolism are regulated by the circadian clock. The aim of the present work was to investigate the disturbances induced after gamma irradiation on the metabolic diurnal rhythm and the role of α-alpha lipoic acid (ALA) in preventing/or decreasing these disorders in rat. Male Swiss albino rats were divided into 4 groups, one of which served as a normal control group, the second group was exposed to a single whole body gamma radiation dose of 6Gy, the third group was treated by gavage with ALA 100 mg/kg/day for 20 days and the fourth one was orally administered with ALA 100 mg/kg/day for 20 days before whole body gamma radiation at a dose of 6Gy. Rats were irradiated at 10 am and sacrificed at 11 am, 12 pm, 1 pm and 2 pm and then the biochemical analyses were performed. The results showed a significant increase in the level of lipid peroxidation products (MDA) at all time intervals. A significant increase was recorded also in the amount of free radicals at 11 am and 2 pm, and pyruvic acid level at 12 pm and 2 pm. A significant reduction of glutathione level (GSH) was recorded at 12 pm, 1 pm and 2 pm in the liver of the irradiated rats. Furthermore, a significant increase was registered in blood glucose level and blood aminotransferase activities (AST, ALT) in irradiated rats. Administration of ALA has significantly attenuated the radiation induced oxidative damage. It could be concluded that the biochemical changes induced by whole body gamma irradiation of rats are dependent on the circadian cycle. Further investigations are necessary to understand these complicated relations.

  18. Types of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and procedures related to heart disease and stroke. Heart Failure Questions to Ask Your Doctor Use these questions ...

  19. Classes of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

  20. An Early View of Real-World Patient Response to Sacubitril/Valsartan: A Retrospective Study of Patients with Heart Failure with Reduced Ejection Fraction.

    Science.gov (United States)

    Antol, Dana Drzayich; Casebeer, Adrianne Waldman; DeClue, Richard W; Stemkowski, Stephen; Russo, Patricia A

    2018-06-01

    Sacubitril/valsartan has been established as an effective treatment for heart failure (HF) with reduced ejection fraction based on clinical trial data; however, little is known about its use or impact in real-world practice. This study included data from medical and pharmacy claims and medical records review for patients (n = 200) who initiated sacubitril/valsartan between August 2015 and March 2016 preceding issuance of American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) focused update on new pharmacological therapy for HF (May 2016), which included recommendations for sacubitril/valsartan. A within-subject analysis compared symptoms and healthcare resource utilization before and after treatment initiation. Patients treated with sacubitril/valsartan had multiple comorbidities, and nearly all had previous treatment for HF. Most patients initiated sacubitril/valsartan at the lowest dose of 24/26 mg twice a day (BID), which remained unchanged during the observation period for half of the patients. During the first 6 weeks of treatment, few patients discontinued sacubitril/valsartan treatment (5.5%), and only 17% achieved the target dose of 97/103 mg BID after 4 months of treatment. The proportion of patients with ≥ 1 all-cause inpatient stay decreased significantly between the pre-initiation period (27.5%) and the post-initiation period (17.0%), P = 0.009. Fatigue was noted in 51.8% of patients pre-initiation and 39.5% post-initiation, P = 0.027. Shortness of breath was documented for 66.7% of patients pre-initiation and 51.8% post-initiation, P = 0.008. The findings of this real-world investigation suggest sacubitril/valsartan is associated with symptom improvements and a reduction in hospitalizations within 4 months of treatment for patients with HF and reduced ejection fraction. Novartis Pharmaceuticals Corporation.

  1. Failure Prediction for Autonomous Driving

    OpenAIRE

    Hecker, Simon; Dai, Dengxin; Van Gool, Luc

    2018-01-01

    The primary focus of autonomous driving research is to improve driving accuracy. While great progress has been made, state-of-the-art algorithms still fail at times. Such failures may have catastrophic consequences. It therefore is important that automated cars foresee problems ahead as early as possible. This is also of paramount importance if the driver will be asked to take over. We conjecture that failures do not occur randomly. For instance, driving models may fail more likely at places ...

  2. Failure Analysis

    International Nuclear Information System (INIS)

    Iorio, A.F.; Crespi, J.C.

    1987-01-01

    After ten years of operation at the Atucha I Nuclear Power Station a gear belonging to a pressurized heavy water reactor refuelling machine, failed. The gear box was used to operate the inlet-outlet heavy-water valve of the machine. Visual examination of the gear device showed an absence of lubricant and that several gear teeth were broken at the root. Motion was transmitted with a speed-reducing device with controlled adjustable times in order to produce a proper fitness of the valve closure. The aim of this paper is to discuss the results of the gear failure analysis in order to recommend the proper solution to prevent further failures. (Author)

  3. DNA double-strand breaks and Aurora B mislocalization induced by exposure of early mitotic cells to H2O2 appear to increase chromatin bridges and resultant cytokinesis failure.

    Science.gov (United States)

    Cho, Min-Guk; Ahn, Ju-Hyun; Choi, Hee-Song; Lee, Jae-Ho

    2017-07-01

    Aneuploidy, an abnormal number of chromosomes that is a hallmark of cancer cells, can arise from tetraploid/binucleated cells through a failure of cytokinesis. Reactive oxygen species (ROS) have been implicated in various diseases, including cancer. However, the nature and role of ROS in cytokinesis progression and related mechanisms has not been clearly elucidated. Here, using time-lapse analysis of asynchronously growing cells and immunocytochemical analyses of synchronized cells, we found that hydrogen peroxide (H 2 O 2 ) treatment at early mitosis (primarily prometaphase) significantly induced cytokinesis failure. Cytokinesis failure and the resultant formation of binucleated cells containing nucleoplasmic bridges (NPBs) seemed to be caused by increases in DNA double-strand breaks (DSBs) and subsequent unresolved chromatin bridges. We further found that H 2 O 2 induced mislocalization of Aurora B during mitosis. All of these effects were attenuated by pretreatment with N-acetyl-L-cysteine (NAC) or overexpression of Catalase. Surprisingly, the PARP inhibitor PJ34 also reduced H 2 O 2 -induced Aurora B mislocalization and binucleated cell formation. Results of parallel experiments with etoposide, a topoisomerase IIα inhibitor that triggers DNA DSBs, suggested that both DNA DSBs and Aurora B mislocalization contribute to chromatin bridge formation. Aurora B mislocalization also appeared to weaken the "abscission checkpoint". Finally, we showed that KRAS-induced binucleated cell formation appeared to be also H 2 O 2 -dependent. In conclusion, we propose that a ROS, mainly H 2 O 2 increases binucleation through unresolved chromatin bridges caused by DNA damage and mislocalization of Aurora B, the latter of which appears to augment the effect of DNA damage on chromatin bridge formation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Ouroboros - Playing A Biochemical

    Directory of Open Access Journals (Sweden)

    D. T. Rodrigues

    2014-08-01

    Full Text Available Ouroboros: Playing A Biochemical RODRIGUES,D.T.1,2;GAYER, M.C.1,2; ESCOTO, D.F.1; DENARDIN, E.L.G.2, ROEHRS, R.1,2 1Interdisciplinary Research Group on Teaching Practice, Graduate Program in Biochemistry, Unipampa, RS, Brazil 2Laboratory of Physicochemical Studies and Natural Products, Post Graduate Program in Biochemistry, Unipampa, RS, Brazil Introduction: Currently, teachers seek different alternatives to enhance the teaching-learning process. Innovative teaching methodologies are increasingly common tools in educational routine. The use of games, electronic or conventional, is an effective tool to assist in learning and also to raise the social interaction between students. Objective: In this sense our work aims to evaluate the card game and "Ouroboros" board as a teaching and learning tool in biochemistry for a graduating class in Natural Sciences. Materials and methods: The class gathered 22 students of BSc in Natural Sciences. Each letter contained a question across the board that was drawn to a group to answer within the allotted time. The questions related concepts of metabolism, organic and inorganic chemical reactions, bioenergetics, etc.. Before the game application, students underwent a pre-test with four issues involving the content that was being developed. Soon after, the game was applied. Then again questions were asked. Data analysis was performed from the ratio of the number of correct pre-test and post-test answers. Results and discussion: In the pre-test 18.1% of the students knew all issues, 18.1% got 3 correct answers, 40.9% answered only 2 questions correctly and 22.7% did not hit any. In post-test 45.4% answered all the questions right, 31.8% got 3 questions and 22.7% got 2 correct answers. The results show a significant improvement of the students about the field of content taught through the game. Conclusion: Generally, traditional approaches of chemistry and biochemistry are abstract and complex. Thus, through games

  5. Enzyme and biochemical producing fungi

    DEFF Research Database (Denmark)

    Lübeck, Peter Stephensen; Lübeck, Mette; Nilsson, Lena

    2010-01-01

    factories for sustainable production of important molecules. For developing fungi into efficient cell factories, the project includes identification of important factors that control the flux through the pathways using metabolic flux analysis and metabolic engineering of biochemical pathways....

  6. Pheochromocytoma-paraganglioma: Biochemical and genetic diagnosis.

    Science.gov (United States)

    Cano Megías, Marta; Rodriguez Puyol, Diego; Fernández Rodríguez, Loreto; Sención Martinez, Gloria Lisette; Martínez Miguel, Patricia

    Pheochromocytomas and paragangliomas are tumours derived from neural crest cells, which can be diagnosed by biochemical measurement of metanephrine and methoxytyramine. Advances in genetic research have identified many genes involved in the pathogenesis of these tumours, suggesting that up to 35-45% may have an underlying germline mutation. These genes have a singular transcriptional signature and can be grouped into 2 clusters (or groups): cluster 1 (VHL and SHDx), involved in angiogenesis and hypoxia pathways; and cluster 2 (MEN2 and NF1), linked to the kinase signalling pathway. In turn, these genes are associated with a characteristic biochemical phenotype (noradrenergic and adrenergic), and clinical features (location, biological behaviour, age of presentation, etc.) in a large number of cases. Early diagnosis of these tumours, accompanied by a correct genetic diagnosis, should eventually become a priority to enable better treatment, early detection of complications, proper screening of family members and related tumours, as well as an improvement in the overall prognosis of these patients. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Failure to establish and maintain a pregnancy in undernourished recipient ewes is associated with a poor endocrine milieu in the early luteal phase.

    Science.gov (United States)

    de Brun, Victoria; Meikle, Ana; Fernández-Foren, Andrea; Forcada, Fernando; Palacín, Inmaculada; Menchaca, Alejo; Sosa, Cecilia; Abecia, José-Alfonso

    2016-10-01

    Embryos from undernourished and control donor ewes were transferred to undernourished and control recipient ewes. Progesterone and metabolic hormones were investigated in recipient ewes to determine their association with pregnancy success. Forty-five donor and 52 recipient Rasa Aragonesa ewes were fed 1.5 (control group; donor n=20; recipient n=25) or 0.5 (low group; donor n=25; recipient n=27) times the daily requirements for maintenance from the onset of estrous synchronization treatment to embryo collection and transfer. The embryos were collected 7days after the onset of estrus (day 0), and two good-quality embryos were transferred into each recipient ewe. The percentage of pregnant ewes on day 18 and 40 did not differ between the two groups, although the recipient undernourished ewes tended to have greater late embryonic mortality (from days 18-40) than the control recipient ewes (P=0.11). No effect of the nutrition of the donor was found. Recipients that became pregnant had a higher ovulation rate than non-pregnant ewes (P=0.02). Undernourished ewes had lower plasma insulin concentrations than control ewes (P=0.03), and those that suffered late embryo mortality (from days 18-40) tended to have lower insulin and progesterone concentrations than their counterparts that remained pregnant (P=0.06 and P=0.07, respectively). In this study, pregnancy in control and undernourished recipient ewes was not associated with the origin of the embryo (undernourished and control donors). In conclusion, failure to establish and maintain a pregnancy was associated with lower progesterone and insulin levels one week after estrus in recipient ewes. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Leukemia in atomic bomb survivors. 1. General observations. Leukemia in survivors of atomic bombing. Cytologic and biochemical studies on the granulocytes in early leukemia among atomic bomb survivors. Leukemogenic effects of ionizing radiation on atomic bomb survivors in Hiroshima City

    Energy Technology Data Exchange (ETDEWEB)

    Lange, R D; Moloney, W C; Yamawaki, Tokuso; Kastenbaum, M A

    1959-01-01

    This document contains 4 separate reports on leukemia in survivals of the atomic explosions in Hiroshima and Nagasaki. In the first report, observations on seventy-five established cases of leukemia occurring in people exposed to atomic bomb radiation are presented. These data indicate a great increase in the incidence of leukemia among atomic bomb survivors due to a single massive exposure to ionizing radiation. The leukemogenic effects of radiation are manifested equally in both sexes and at all age levels represented in this series. The striking preponderance of chronic myelogenous leukemia compared to chronic lymphatic leukemia has been noted in exposed individuals but it is pointed out that chronic lymphatic leukemia is comparatively rare among the Japanese. Cases of leukemia are still appearing in atomic bomb survivors. However, since 1950 there has been a steady decline in the number of cases. The second report consists of a review of all cases of leukemia referred to the ABCC from 1948 to April 1952, a total of 75 cases. In the third report, hematological and biochemical findings in separated leukocytes of four cases of preclinical myelogenous leukemia developing in atomic bomb survivors are described. The incidence of leukemia among survivors in Hiroshima is the topic of the fourth report. 38 references, 8 figures, 10 tables.

  9. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  10. Paradoxical Effects of Sodium-Calcium Exchanger Inhibition on Torsade de Pointes and Early Afterdepolarization in a Heart Failure Rabbit Model.

    Science.gov (United States)

    Chang, Po-Cheng; Lu, Yu-Ying; Lee, Hui-Ling; Lin, Shien-Fong; Chu, Yen; Wen, Ming-Shien; Chou, Chung-Chuan

    2018-05-03

    Calcium homeostasis plays an important role in development of early afterdepolarizations (EADs) and torsade de pointes (TdP). The role of sodium-calcium exchanger (NCX) inhibition in genesis secondary Ca rise and EADs-TdP is still debated. Dual voltage and intracellular Ca optical mapping were conducted in 6 control and 9 failing rabbit hearts. After baseline electrophysiological and optical mapping studies, E4031 was given to simulate long QT syndrome. ORM-10103 was then administrated to examine the electrophysiological effects on EAD-TdP development. E4031 enhanced secondary Ca rise, EADs development and TdP inducibility in both control and failing hearts. The results showed that ORM-10103 reduced premature ventricular beats (PVBs) but was unable to suppress the inducibility of TdP or EADs. The electrophysiological effects of ORM-10103 included prolongation of action potential duration (APD) and increased APD heterogeneity in failing hearts. ORM10103 had a neutral effect on the amplitude of secondary Cai rise in control and HF groups. In this model, most EADs generated from the long-short APD junction area. In conclusion, highly selective NCX inhibition with ORM-10103 reduced PVB burden but was unable to suppress secondary Ca rise, EADs development nor inducibility of TdP. The possible electrophysiological mechanisms include APD prolongation and increased APD heterogeneity.

  11. Failure of RNA synthesis to recover after UV irradiation: an early defect in cells from individuals with Cockayne's syndrome and xeroderma pigmentosum

    International Nuclear Information System (INIS)

    Mayne, L.V.; Lehmann, A.R.

    1982-01-01

    Previous work has shown that in cells from the ultraviolet-sensitive genetic disorder, Cockayne's syndrome, DNA synthesis fails to recover after ultraviolet irradiation, despite the fact that these cells have no detectable defect in either excision or daughter-strand repair pathways. We now show that Cockayne cells, as well as cells from a number of patients with xeroderma pigmentosum, are sensitive to the lethal effects of UV irradiation in stationary phase under conditions in which no DNA is synthesized after irradiation. Furthermore, in normal and defective human fibroblasts, RNA synthesis is depressed after UV irradiation. In normal (dividing) cells, RNA synthesis recovers very rapidly, but this recovery does not occur in Cockayne cells, and it is reduced or absent in xeroderma pigmentosum cells from different complementation groups. Qualitatively, similar results are obtained with cells in stationary phase. The recovery of RNA synthesis in the various defective cell strains is not correlated with the overall extent of excision repair, but there is some correlation between recovery of RNA synthesis and cell survival after ultraviolet irradiation. These results implicate recovery of RNA synthesis as an important early response to ultraviolet irradiation

  12. Effect of early treatment with ivabradine combined with beta-blockers versus beta-blockers alone in patients hospitalised with heart failure and reduced left ventricular ejection fraction (ETHIC-AHF): A randomised study.

    Science.gov (United States)

    Hidalgo, Francisco J; Anguita, Manuel; Castillo, Juan C; Rodríguez, Sara; Pardo, Laura; Durán, Enrique; Sánchez, José J; Ferreiro, Carlos; Pan, Manuel; Mesa, Dolores; Delgado, Mónica; Ruiz, Martín

    2016-08-15

    To analyse the effect of the early coadministration of ivabradine and beta-blockers (intervention group) versus beta-blockers alone (control group) in patients hospitalised with heart failure and reduced left ventricular ejection fraction (HFrEF). A comparative, randomised study was performed to compare the treatment strategies of beta-blockers alone versus ivabradine and beta-blockers starting 24hours after hospital admission, for acute HF in patients with an left ventricular ejection fraction (EF)70bpm. A total of 71 patients were examined, 33 in the intervention group and 38 in the control group. No differences were observed with respect to their baseline characteristics or standard treatment at discharge. HR at 28days (64.3±7.5 vs. 70.3±9.3bpm, p=0.01) and at 4months (60.6±7.5 vs. 67.8±8bpm, p=0.004) after discharge were significantly lower in the intervention group. Significant differences were found with respect to the EF and brain natriuretic peptide levels at 4months. No differences in clinical events (rehospitalisation/death) were reported at 4months. No severe side effects attributable to the early administration of ivabradine were observed. The early coadministration of ivabradine and beta-blockers during hospital admission for acute HFrEF is feasible and safe, and it produces a significant decrease in HR at 28days and at 4months after hospital discharge. It also seemed to improve systolic function and functional and clinical parameters of HF patients at short-term. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Early and late effects of the DPP-4 inhibitor vildagliptin in a rat model of post-myocardial infarction heart failure

    Science.gov (United States)

    2011-01-01

    Background Progressive remodeling after myocardial infarction (MI) is a leading cause of morbidity and mortality. Recently, glucagon-like peptide (GLP)-1 was shown to have cardioprotective effects, but treatment with GLP-1 is limited by its short half-life. It is rapidly degraded by the enzyme dipeptidyl peptidase-4 (DPP-4), an enzyme which inhibits GLP-1 activity. We hypothesized that the DPP-4 inhibitor vildagliptin will increase levels of GLP-1 and may exert protective effects on cardiac function after MI. Methods Sprague-Dawley rats were either subjected to coronary ligation to induce MI and left ventricular (LV) remodeling, or sham operation. Parts of the rats with an MI were pre-treated for 2 days with the DPP-4 inhibitor vildagliptin (MI-Vildagliptin immediate, MI-VI, 15 mg/kg/day). The remainder of the rats was, three weeks after coronary artery ligation, subjected to treatment with DPP-4 inhibitor vildagliptin (MI-Vildagliptin Late, MI-VL) or control (MI). At 12 weeks, echocardiography and invasive hemodynamics were measured and molecular analysis and immunohistochemistry were performed. Results Vildagliptin inhibited the DPP-4 enzymatic activity by almost 70% and increased active GLP-1 levels by about 3-fold in plasma in both treated groups (p vildagliptin, either early or late, did not reverse cardiac remodeling. ANP (atrial natriuretic peptide) and BNP (brain natriuretic peptide) mRNA levels were significantly increased in all 3 MI groups, but no significant reductions were observed in both vildagliptin groups. Vildagliptin also did not change cardiomyocyte size or capillary density after MI. No effects were detected on glucose level and body weight in the post-MI remodeling model. Conclusion Vildagliptin increases the active GLP-1 level via inhibition of DPP-4, but it has no substantial protective effects on cardiac function in this well established long-term post-MI cardiac remodeling model. PMID:21955567

  14. Heart failure - home monitoring

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000113.htm Heart failure - home monitoring To use the sharing features on ... your high blood pressure Fast food tips Heart failure - discharge Heart failure - fluids and diuretics Heart failure - what to ...

  15. Radiotherapy after radical prostatectomy. Immediate or early delayed?

    International Nuclear Information System (INIS)

    Bottke, D.; Bartkowiak, D.; Schrader, M.; Wiegel, T.

    2012-01-01

    Background: Biochemical recurrence after radical prostatectomy (RP) is associated with risk indicators, including Gleason score, preoperative PSA level, tumor stage, seminal vesicle invasion, and positive surgical margins. The 5-year biochemical progression rate among predisposed patients is as high as 50-70%. Post-RP treatment options include adjuvant radiotherapy (ART, for men with undetectable PSA) or salvage radiotherapy (SRT, for PSA persisting or re-rising above detection threshold). Presently, there are no published randomized trials evaluating ART vs. SRT directly. Methods: Published data on ART and SRT were reviewed to allow a comparison of the two treatment approaches. Results: Three randomized phase III trials demonstrated an almost 20% absolute benefit for biochemical progression-free survival after ART (60-64 Gy) compared to a 'wait and see' policy. The greatest benefit was achieved in patients with positive margins and pT3 tumors. SRT can be offered to patients with elevated PSA after RP. In 30-70% of SRT patients, PSA will decrease to an undetectable level, thus giving a second curative chance. The rate of side effects for both treatments is comparably low. The role of irradiation of pelvic lymph nodes and the additional use of hormone therapy and radiation dose are discussed. Conclusion: It remains unclear whether early SRT initiated after PSA failure is equivalent to ART. Where SRT is indicated, it should be started as early as possible. (orig.)

  16. Premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2012-01-01

    Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

  17. Great Historical Events That Were Significantly Affected by the Weather: Part 10, Crop Failure in Britain in 1799 and 1800 and the British Decision to Send a Naval Force to the Baltic Early in 1801.

    Science.gov (United States)

    Neumann, J.; Kington, J.

    1992-02-01

    In 1799 and 1800, crop failures struck the British Isles. The crop failure of 1799 was due to the combined effects of the cold winter of 1798-99 and the cool and rainy growing season of the year. The summer was characterized by the prevalence of low-pressure systems resembling cyclonic weather patterns of the winter.The crop failure of 1800 was mainly due to a drought early in summer. In July there was either no rain at all (especially in the south) or the amounts were negligible. The general synoptic situation indicated an extension of the Azores High to Britain and beyond to central Europe. In the London area the pressure in duly was never below 1020 mb.The wheat harvests of 1799 and 1800 were about one-half and three-quarters of the average, respectively. The deficiencies could not be made up by imports, for, at least in 1799, the weather conditions were also unfavorable to grain production in the countries of northern Europe that were "traditional" exporters of grain to Britain. We estimate that in the "bread-consumption year", October 1799 to September 1800, harvest and imports accounted for but 60% of the required quantity of wheat, the principal ingredient of bread in England and Wales at the time. In consequence of the bread scarcity, there were sharp rises in the price of bread and in bread riots. Some of the slogans of the rioters made mention of the French Revolution.In parallel with the increasing scarcity of bread, diplomatic relations between Britain and Russia worsened from 1799 on. Its significance on the bread crisis, as well as a crisis of naval supplies, was that the Baltic ports through which the grain of the northern countries (East Prussia, Poland, and Russia) was channeled for Britain stood under the tsar's direct or indirect control. The strained relations between Britain and Russia peaked in November 1800. On 18 November, Tsar Paul I imposed an embargo on British ships and their crews. This embargo meant that the bread scarcity was to

  18. The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome

    International Nuclear Information System (INIS)

    Vance, Waseet; Tucker, Susan L.; Crevoisier, Renaud de; Kuban, Deborah A.; Cheung, M. Rex

    2007-01-01

    Purpose: To determine the value of a 2-year post-radiotherapy (RT) prostate biopsy for predicting eventual biochemical failure in patients who were treated for localized prostate cancer. Methods and Materials: This study comprised 164 patients who underwent a planned 2-year post-RT prostate biopsy. The independent prognostic value of the biopsy results for forecasting eventual biochemical outcome and overall survival was tested with other factors (the Gleason score, 1992 American Joint Committee on Cancer tumor stage, pretreatment prostate-specific antigen level, risk group, and RT dose) in a multivariate analysis. The current nadir + 2 (CN + 2) definition of biochemical failure was used. Patients with rising prostate-specific antigen (PSA) or suspicious digital rectal examination before the biopsy were excluded. Results: The biopsy results were normal in 78 patients, scant atypical and malignant cells in 30, carcinoma with treatment effect in 43, and carcinoma without treatment effect in 13. Using the CN + 2 definition, we found a significant association between biopsy results and eventual biochemical failure. We also found that the biopsy status provides predictive information independent of the PSA status at the time of biopsy. Conclusion: A 2-year post-RT prostate biopsy may be useful for forecasting CN + 2 biochemical failure. Posttreatment prostate biopsy may be useful for identifying patients for aggressive salvage therapy

  19. Biochemical reactions of the organism

    International Nuclear Information System (INIS)

    Fedorova, A.V.

    1984-01-01

    Effects of mercury, strontium chloride, GMDA, trichlorfon as well as some radionuclides ( 89 Sr, 137 Cs, 203 Hg) were studied on rats. Changes in biochemical parameters (histamine content, activity of cholinesterase and histaminase) are noted. Most noticeable changes were observed in enzymatic activity. Distortion of enzymatic systems and accumulation of intermediate exchange and decay products of tissues in excess quantities affecting other systems can be the reason for changes in the organism. The observed changes in biochemical parameters should be necessarily taken into account at hygienic regulations of harmful effects of enviroment

  20. Understanding Early Post-Mortem Biochemical Processes Underlying Meat Color and pH Decline in the Longissimus thoracis Muscle of Young Blond d'Aquitaine Bulls Using Protein Biomarkers.

    Science.gov (United States)

    Gagaoua, Mohammed; Terlouw, E M Claudia; Micol, Didier; Boudjellal, Abdelghani; Hocquette, Jean-François; Picard, Brigitte

    2015-08-05

    Many studies on color biochemistry and protein biomarkers were undertaken in post-mortem beef muscles after ≥24 hours. The present study was conducted on Longissimus thoracis muscles of 21 Blond d'Aquitaine young bulls to evaluate the relationships between protein biomarkers present during the early post-mortem and known to be related to tenderness and pH decline and color development. pH values at 45 min, 3 h, and 30 h post-mortem were correlated with three, seven, and six biomarkers, respectively. L*a*b* color coordinates 24 h post-mortem were correlated with nine, five, and eight protein biomarkers, respectively. Regression models included Hsp proteins and explained between 47 and 59% of the variability between individuals in pH and between 47 and 65% of the variability in L*a*b* color coordinates. Proteins correlated with pH and/or color coordinates were involved in apoptosis or had antioxidative or chaperone activities. The main results include the negative correlations between pH45 min, pH3 h, and pHu and Prdx6, which may be explained by the antioxidative and phospholipase activities of this biomarker. Similarly, inducible Hsp70-1A/B and μ-calpain were correlated with L*a*b* coordinates, due to the protective action of Hsp70-1A/B on the proteolytic activities of μ-calpain on structural proteins. Correlations existed further between MDH1, ENO3, and LDH-B and pH decline and color stability probably due to the involvement of these enzymes in the glycolytic pathway and, thus, the energy status of the cell. The present results show that research using protein indicators may increase the understanding of early post-mortem biological mechanisms involved in pH and beef color development.

  1. Biochemical Manifestation of HIV Lipodystrophy Syndrome.

    Science.gov (United States)

    Ihenetu, Kenneth; Mason, Darius

    2012-01-01

    Highly active anti-retroviral therapy (HAART), including protease inhibitors (PI) have led to dramatic improvements in the quality and quantity of life in patients with acquired immunodeficiency syndrome (AIDS). However, a significant number of AIDS patients on HAART develop characteristic changes in body fat redistribution referred to as lipodystrophy syndrome (LDS). Features of LDS include hypertrophy in the neck fat pad (buffalo hump), increased fat in the abdominal region (protease paunch), gynecomastia and loss of fat in the mid-face and extremities. The aim of this paper is to review the current knowledge regarding this syndrome. This article reviews the published investigations on biochemical manifestation of HIV lipodystrophy syndrome. It is estimated that approximately 64% of patients treated with PI will experience this syndrome. Biochemically, these patients have increased triglycerides (Trig), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and extremely low high-density lipoprotein-cholesterol (HDL-C). It is hoped that awareness of this syndrome would aid in early diagnosis and better patient management, possibly leading to a lower incidence of cardiovascular complications among these patients.

  2. Circadian Clocks: Unexpected Biochemical Cogs.

    Science.gov (United States)

    Mori, Tetsuya; Mchaourab, Hassane; Johnson, Carl Hirschie

    2015-10-05

    A circadian oscillation can be reconstituted in vitro from three proteins that cycles with a period of ∼ 24 h. Two recent studies provide surprising biochemical answers to why this remarkable oscillator has such a long time constant and how it can switch effortlessly between alternating enzymatic modes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Circadian Clocks: Unexpected Biochemical Cogs

    OpenAIRE

    Mori, Tetsuya; Mchaourab, Hassane; Johnson, Carl Hirschie

    2015-01-01

    A circadian oscillation can be reconstituted in vitro from three proteins that cycles with a period of ~24 h. Two recent studies provide surprising biochemical answers to why this remarkable oscillator has such a long time constant and how it can switch effortlessly between alternating enzymatic modes.

  4. Stereotactic body radiation therapy versus conventional radiation therapy in patients with early stage non-small cell lung cancer - An updated retrospective study on local failure and survival rates

    International Nuclear Information System (INIS)

    Jeppesen, Stefan S.; Schytte, Tine; Hansen, Olfred; Jensen, Henrik R.; Brink, Carsten

    2013-01-01

    Introduction: Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) is now an accepted and patient friendly treatment, but still controversy exists about its comparability to conventional radiation therapy (RT). The purpose of this single-institutional report is to describe survival outcome for medically inoperable patients with early stage NSCLC treated with SBRT compared with high dose conventional RT. Material and methods: From August 2005 to June 2012, 100 medically inoperable patients were treated with SBRT at Odense Univ. Hospital. The thoracic RT consisted of 3 fractions (F) of 15-22 Gy delivered in nine days. For comparison a group of 32 medically inoperable patients treated with conventional RT with 80 Gy/35-40 F (5 F/week) in the period of July 1998 to August 2011 were analyzed. All tumors had histological or cytological proven NSCLC T1-2N0M0. Results: The median overall survival was 36.1 months versus 24.4 months for SBRT and conventional RT, respectively (p = 0.015). Local failure-free survival rates at one year were in SBRT group 93 % versus 89 % in the conventional RT group and at five years 69 % versus 66 %, SBRT and conventional RT respectively (p = 0.99). On multivariate analysis, female gender and performance status of 0-1 and SBRT predicted improved prognosis. Conclusion: In a cohort of patients with NSCLC there was a significant difference in overall survival favoring SBRT. Performance status of 0-1, female gender and SBRT predicted improved prognosis. However, staging procedure, confirmation procedure of recurrence and technical improvements of radiation treatment is likely to influence outcomes. However, SBRT seems to be as efficient as conventional RT and is a more convenient treatment for the patients

  5. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    International Nuclear Information System (INIS)

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R

    2015-01-01

    We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed. Medium follow-up time was 50 months (range, 1–85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS. BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive

  6. Accuracy of circulating histones in predicting persistent organ failure and mortality in patients with acute pancreatitis.

    Science.gov (United States)

    Liu, T; Huang, W; Szatmary, P; Abrams, S T; Alhamdi, Y; Lin, Z; Greenhalf, W; Wang, G; Sutton, R; Toh, C H

    2017-08-01

    Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014. Blood samples were obtained within 48 h of abdominal pain onset and relevant clinical data during the hospital stay were collected. Healthy volunteers were enrolled as controls. The primary endpoint was occurrence of persistent organ failure. The predictive values of circulating histones, clinical scores and other biomarkers were determined. Among 236 patients with acute pancreatitis, there were 156 (66·1 per cent), 57 (24·2 per cent) and 23 (9·7 per cent) with mild, moderate and severe disease respectively, according to the revised Atlanta classification. Forty-seven healthy volunteers were included. The area under the receiver operating characteristic (ROC) curve (AUC) for circulating histones in predicting persistent organ failure and mortality was 0·92 (95 per cent c.i. 0·85 to 0·99) and 0·96 (0·92 to 1·00) respectively; histones were at least as accurate as clinical scores or biochemical markers. For infected pancreatic necrosis and/or sepsis, the AUC was 0·78 (0·62 to 0·94). Histones did not predict or correlate with local pancreatic complications, but correlated negatively with leucocyte cell viability (r = -0·511, P = 0·001). Quantitative assessment of circulating histones in plasma within 48 h of abdominal pain onset can predict persistent organ failure and mortality in patients with acute pancreatitis. Early death of immune cells may contribute to raised circulating histone levels in acute pancreatitis. © 2017 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS

  7. Elevation of PSA after prostate radiotherapy: Rebound or biochemical recurrence?

    International Nuclear Information System (INIS)

    Toledano, A.; Kanoui, A.; Chiche, R.; Lamallem, H.; Beley, S.; Thibault, F.; Sebe, P.

    2008-01-01

    The fact that external beam radiotherapy and brachytherapy are now considered to be curative techniques has led to major review of the modalities of follow-up after radiotherapy for prostate cancer. The problem concerns both the diagnosis of recurrence, rapidly announced by elevation of prostatic-specific antigen (PSA), usually at a subclinical stage, and the validity of criteria of biochemical recurrence to allow comparison of various study. Physicians involved in follow-up should be aware of the potential of bounce in PSA follow-up after external beam radiotherapy or brachytherapy. The PSA bounce phenomenon was defined by a rise of PSA values (+ 0.1 -0.8 ng/ml) with a subsequent fall. Biochemical failure after external beam radiotherapy or brachytherapy (with or without hormonotherapy) was defined by Phoenix criteria by a rise of 2 ng/ml above an initial PSA nadir. This definition was more correlated to PSA bounce phenomenon. (authors)

  8. Focal salvage iodine-125 brachytherapy for prostate cancer recurrences after primary radiotherapy: A retrospective study regarding toxicity, biochemical outcome and quality of life

    International Nuclear Information System (INIS)

    Peters, Max; Maenhout, Metha; Voort van Zyp, Jochem R.N. van der; Moerland, Marinus A.; Moman, Maaike R.; Steuten, Lotte M.G.; Deursen, Marijke J.H. van; Vulpen, Marco van

    2014-01-01

    Purpose: Whole-gland salvage for recurrent prostate cancer (PCa) shows high failure and toxicity rates. Early and adequate localization of recurrences enables focal salvage, thereby potentially improving functional outcomes, while maintaining cancer control. Materials and methods: Retrospective analysis yielded 20 focal salvage I125 brachytherapy patients for locally recurrent PCa after primary radiotherapy. Tumor was defined by multiparametric MRI and correspondence with transrectal biopsies. Dose data were obtained intra-operatively. The tumor was prescribed ⩾144 Gy. Toxicity was scored by the Common Terminology Criteria for Adverse Events version 4 (CTCAE-4). Biochemical failure (BF) was defined using the Phoenix criteria (PSA-nadir + 2.0 ng/ml). Quality of life (QoL) was measured by SF-36 Health Survey and European Organization of Research and Treatment of Cancer (EORTC) C30+3 and PR25 questionnaires. Results: With a median follow-up of 36 months (range 10–45), six patients experienced BF, of which three had no initial response. Grade 3 genitourinary (GU) toxicity occurred in one patient (a urethral stricture). The five previously potent patients retained erectile function. QoL remained decreased with regard to urinary symptoms. Conclusion: Focal salvage I125 brachytherapy showed one grade 3 GU toxicity in the 20 treated patients. Biochemical response and QoL were acceptable

  9. Biochemical Process Development and Integration | Bioenergy | NREL

    Science.gov (United States)

    Biochemical Process Development and Integration Biochemical Process Development and Integration Our conversion and separation processes to pilot-scale integrated process development and scale up. We also Publications Accounting for all sugar produced during integrated production of ethanol from lignocellulosic

  10. Field failure mechanisms for photovoltaic modules

    Science.gov (United States)

    Dumas, L. N.; Shumka, A.

    1981-01-01

    Beginning in 1976, Department of Energy field centers have installed and monitored a number of field tests and application experiments using current state-of-the-art photovoltaic modules. On-site observations of module physical and electrical degradation, together with in-depth laboratory analysis of failed modules, permits an overall assessment of the nature and causes of early field failures. Data on failure rates are presented, and key failure mechanisms are analyzed with respect to origin, effect, and prospects for correction. It is concluded that all failure modes identified to date are avoidable or controllable through sound design and production practices.

  11. Parenteral Nutrition and Intestinal Failure.

    Science.gov (United States)

    Bielawska, Barbara; Allard, Johane P

    2017-05-06

    Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient's home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

  12. Biochemical markers of bone turnover

    International Nuclear Information System (INIS)

    Kim, Deog Yoon

    1999-01-01

    Biochemical markers of bone turnover has received increasing attention over the past few years, because of the need for sensitivity and specific tool in the clinical investigation of osteoporosis. Bone markers should be unique to bone, reflect changes of bone less, and should be correlated with radiocalcium kinetics, histomorphometry, or changes in bone mass. The markers also should be useful in monitoring treatment efficacy. Although no bone marker has been established to meet all these criteria, currently osteocalcin and pyridinium crosslinks are the most efficient markers to assess the level of bone turnover in the menopausal and senile osteoporosis. Recently, N-terminal telopeptide (NTX), C-terminal telopeptide (CTX) and bone specific alkaline phosphatase are considered as new valid markers of bone turnover. Recent data suggest that CTX and free deoxypyridinoline could predict the subsequent risk of hip fracture of elderly women. Treatment of postmenopausal women with estrogen, calcitonin and bisphosphonates demonstrated rapid decrease of the levels of bone markers that correlated with the long-term increase of bone mass. Factors such as circadian rhythms, diet, age, sex, bone mass and renal function affect the results of biochemical markers and should be appropriately adjusted whenever possible. Each biochemical markers of bone turnover may have its own specific advantages and limitations. Recent advances in research will provide more sensitive and specific assays

  13. Biochemical toxicology of environmental agents

    International Nuclear Information System (INIS)

    Bruin, A. de

    1976-01-01

    A thorough and up-to-date account of the molecular-biological aspects of harmful agents - both chemical and physical - is given. This current treatise is principally intended to serve as an informative reference work for researchers in various areas of the field. In the pursuit of this aim, a devision of the entire field into 42 chapters has been made. Each chapter starts with a short introductory account dealing with the biochemical essentials of the particular subject. Radiation effects are discussed briefly at the end of each treatise. In order to make the treatise useful as a source book, a substantial collection of pertinent literature references is provided which are numbered in order of citation in the text. Initial chapters are devoted to the metabolic fate of the major classes of xenobiotic compounds. Peripheral topics, closely related to metabolism and dealing with modification of xenobiotic-metabolizing ability, as well as interaction phenomena follow (chs. 5-8). Subjects that draw heavily on the practical field of occupational hygiene are dealt with in chapters 9 and 10. The systematic treatment of how chemical and physical agents interact with the various biochemical and enzymatic systems they encounter during their passage through the organism occupies quantitatively the main part of the book (chs. 11-36). Finally, radiation biochemistry is discussed from the viewpoint of its high degree of scientific advancement, and secondly because the type of biochemical changes produced in vivo by X-rays closely parallel those evoked by chemical agents

  14. EVALUATION OF LIVER FAILURE STAGE IN CHILDREN

    Directory of Open Access Journals (Sweden)

    G. V. Volynets

    2013-01-01

    Full Text Available Aim: to develop a system of evaluation of liver failure stage in children based on the International classification of functioning, disability and health (ICF. Patients and methods: based on the retrospective analysis of 14 biochemical markers, characterizing hepatic role in proteins, lipids and carbohydrates metabolism, of 115 children without liver diseases, 15 children who died of liver failure and 220 patients with various hepatic disorders, being followed-up in the SCCH of RAMS, a score system of evaluation of liver failure stage in children as an additional diagnostic tool was developed. Each of the biochemical markers was assessed according to the 5-point rating scale in dependence of its changes intensity. Results: the sum of points was considered to be a criterion of liver failure stage. According to the ICF recommendations, decrease of points on 0–4% (54–56 points corresponds with absence of liver failure; 5–24% (43–53 points — as mild dysfunction, 25–49% (29–42 points — as moderate; 50-95% (3–28 points — as severe; and 96–100% (0-2 points — as absolute failure. Conclusions: score system of evaluation of liver failure stage can be applied at any step of diagnostics and treatment of children of any age, due to independence of the used markers from the age. It can be used in assessment of the severity of disorder in dynamics, in determination of the prognosis and as criterion of indications to liver transplantation, as well as during medico-social examination.

  15. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  16. The Spectrum of Renal Allograft Failure.

    Directory of Open Access Journals (Sweden)

    Sourabh Chand

    Full Text Available Causes of "true" late kidney allograft failure remain unclear as study selection bias and limited follow-up risk incomplete representation of the spectrum.We evaluated all unselected graft failures from 2008-2014 (n = 171; 0-36 years post-transplantation by contemporary classification of indication biopsies "proximate" to failure, DSA assessment, clinical and biochemical data.The spectrum of graft failure changed markedly depending on the timing of allograft failure. Failures within the first year were most commonly attributed to technical failure, acute rejection (with T-cell mediated rejection [TCMR] dominating antibody-mediated rejection [ABMR]. Failures beyond a year were increasingly dominated by ABMR and 'interstitial fibrosis with tubular atrophy' without rejection, infection or recurrent disease ("IFTA". Cases of IFTA associated with inflammation in non-scarred areas (compared with no inflammation or inflammation solely within scarred regions were more commonly associated with episodes of prior rejection, late rejection and nonadherence, pointing to an alloimmune aetiology. Nonadherence and late rejection were common in ABMR and TCMR, particularly Acute Active ABMR. Acute Active ABMR and nonadherence were associated with younger age, faster functional decline, and less hyalinosis on biopsy. Chronic and Chronic Active ABMR were more commonly associated with Class II DSA. C1q-binding DSA, detected in 33% of ABMR episodes, were associated with shorter time to graft failure. Most non-biopsied patients were DSA-negative (16/21; 76.1%. Finally, twelve losses to recurrent disease were seen (16%.This data from an unselected population identifies IFTA alongside ABMR as a very important cause of true late graft failure, with nonadherence-associated TCMR as a phenomenon in some patients. It highlights clinical and immunological characteristics of ABMR subgroups, and should inform clinical practice and individualised patient care.

  17. Early onset of organ failure is the best predictor of mortality in acute pancreatitis El fracaso orgánico precoz como mejor factor predictivo de mortalidad en la pancreatitis aguda

    Directory of Open Access Journals (Sweden)

    I. Poves Prim

    2004-10-01

    Full Text Available Background: APACHE II is a multifactorial scoring system for predicting severity in acute pancreatitis (AP. Organ failure (OF has been correlated with mortality in AP. Objectives: to evaluate the usefulness of APACHE II as an early predictor of severity in AP, its correlation with OF, and the relevance of an early establishment of OF during the course of AP. Patients and methods: from January 1999 to November 2001, 447 consecutive cases of AP were studied. APACHE II scores and Atlanta criteria were used for defining severity and OF. Results: twenty-five percent of patients had severe acute pancreatitis (SAP. APACHE II at 24 h after admission showed a sensitivity, specificity, and positive and negative predictive value of 52, 77, 46, and 84%, respectively, for predicting severity. Mortality for SAP was 20.5%. Seventy percent of patients who developed OF did so within the first 24 hours of admission, and their mortality was 52%. Mortality was statistically significant (p Introducción: el APACHE II se ha utilizado como factor predictivo de gravedad en la pancratitis aguda (PA. La instauración de fracaso orgánico (FO en la PA se correlaciona con una mayor mortalidad. Objetivos: evaluar la utilidad del APACHE II como factor predictivo precoz de gravedad en la PA, su correlación con el FO y la relevancia del establecimiento precoz del FO en la PA. Pacientes y métodos: desde enero de 1999 hasta noviembre de 2001 se estudiaron 447 pacientes ingresados consecutivamente por PA. Se utilizó el sistema APACHE II y los criterios de Atlanta para evaluar la gravedad. Resultados: el 25% de los pacientes presentaron una pancreatitis aguda grave (PAG. El APACHE II a las 24 horas del ingreso mostró una sensibilidad, especificidad, valor predictivo positivo y negativo del 52, 77, 46 y 84%, respectivamente, como marcador de gravedad. La mortalidad global de la PAG fue del 20,5%. El 70% de los pacientes que presentaron FO lo hicieron en las primeras 24 horas

  18. Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

    International Nuclear Information System (INIS)

    Horwitz, Eric; Ziaja, Ellen; Vicini, Frank; Dmuchowski, Carl; Gonzalez, Jose; Stromberg, Jannifer; Brabbins, Donald; Hollander, Jay; Chen, Peter; Martinez, Alvaro

    1995-01-01

    Purpose: Biochemical control is rapidly becoming the standard to assess treatment outcome of clinically localized prostate cancer. However, no standardized definition of biochemical control has been established. We reviewed our experience treating patients with localized prostate cancer and applied 3 different commonly used definitions to estimate the variability in rates of biochemical control. Materials and Methods: Between (1(87)) and (12(91)), 480 patients with clinically localized prostate cancer received uniform treatment with external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. The median dose to the prostate was 66.6 Gy (range 58 to 70.4 Gy) through a 4 field technique. A total of 14 patients received pelvic nodal RT (median dose 45 Gy). Four hundred seventy patients had post-treatment (posttx) PSA values and 414 patients had pre-treatment (pretx) PSA values. Three different definitions of biochemical control were used: 1) Biochemical control was defined as posttx PSA nadir < 1 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 2) Biochemical control was defined as posttx PSA nadir < 1.5 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 3) Posttx PSA nadir < 4 ng/ml without a time limit. Once the nadir was achieved, and it did not rise above normal, the patient was considered controlled. Clinical local control was defined as no palpable prostate nodularity beyond 18 months, no new prostate nodularity, or a negative biopsy. If hormonal therapy was started, the patient was censored for biochemical failure at that time. Results: Median follow-up is 48 months (range 3 to 112 months). Pre-treatment PSA values were correlated with biochemical response using the 3 definitions of biochemical control as well as clinical local

  19. Incipient ovarian failure and premature ovarian failure show the same immunological profile

    NARCIS (Netherlands)

    van Kasteren, YM; von Blomberg, M; Hoek, A; de Koning, C; Lambalk, N; van Montfrans, J; Kuik, J

    PROBLEM: Incipient ovarian failure (IOF) is characterized by regular menstrual cycles, infertility and a raised early-follicular FSH in women under 40. IOF might be a precursor or a mitigated form of premature ovarian failure (POF). Disturbances in the immune system may play a role in ovarian

  20. Congenital hypopituitarism and renal failure

    Directory of Open Access Journals (Sweden)

    Gaurav Atreja

    2011-01-01

    Full Text Available Congenital hypopituitarism is potentially fatal in the newborn period but treatable if the diagnosis is made early. We report a neonate who presented with hypothermia and severe hypoglycemia. He also had undescended testis and micropenis. Initial screening revealed panhypopituitarism, which was corrected promptly. He developed renal failure due to initial cardiovascular compromise related to hypotension but recovered quickly with standard management. Magnetic resonance imaging revealed absent stalk of anterior pituitary.

  1. Clinical heterogeneity in autoimmune acute liver failure

    Science.gov (United States)

    Chavez-Tapia, Norberto C; Martinez-Salgado, Julio; Granados, Julio; Uribe, Misael; Tellez-Avila, Felix I

    2007-01-01

    AIM: To describe the outcome and prognosis in a cohort of patients with acute liver failure due to autoimmune hepatitis without liver transplantation. METHODS: A retrospective trial was conducted in 11 patients with acute liver failure due to autoimmune hepatitis who attended the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran. Demographic, biochemical and severity indexes, and treatment and outcome were assessed. RESULTS: Among the 11 patients, with a median age of 31 years, 72% had inflammatory response syndrome, and six patients received corticosteroids. The mortality rate within four weeks was 56%, and the one-year survival was 27%. In the survivors, severity indexes were lower and 83% received corticosteroids. CONCLUSION: We observed a relatively high survival rate in patients with acute liver failure due to autoimmune hepatitis. This survival rate could be influenced by severity of the disease and/or use of corticosteroids. PMID:17465474

  2. Advanced Heart Failure

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:May 9,2017 When heart failure (HF) ... Making This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  3. Biochemical Abnormalities in Batten's Syndrome

    DEFF Research Database (Denmark)

    Clausen, Jytte Lene; Nielsen, Gunnar Gissel; Jensen, Gunde Egeskov

    1978-01-01

    The present data indicate that a group of ten patients with Batten's syndrome showed reduced activity of erythrocyte glutathione (GSH) peroxidase (Px) (glutathione: H2O2 oxidoreductase, EC 1.1.1.9.) using H2O2 as peroxide donor. Assay of erythrocyte GSHPx using H2O2, cumene hydroperoxide and t......-butyl hydroperoxide as donors also makes it possible biochemically to divide Batten's syndrome into two types: (1) one type with decreased values when H2O2 and cumene hydroperoxide are used, and (2) one type with increased values when t-butyl hydroperoxide is used. Furthermore an increased content of palmitic, oleic...

  4. Slot-waveguide biochemical sensor.

    Science.gov (United States)

    Barrios, Carlos A; Gylfason, Kristinn B; Sánchez, Benito; Griol, Amadeu; Sohlström, H; Holgado, M; Casquel, R

    2007-11-01

    We report an experimental demonstration of an integrated biochemical sensor based on a slot-waveguide microring resonator. The microresonator is fabricated on a Si3N4-SiO2 platform and operates at a wavelength of 1.3 microm. The transmission spectrum of the sensor is measured with different ambient refractive indices ranging from n=1.33 to 1.42. A linear shift of the resonant wavelength with increasing ambient refractive index of 212 nm/refractive index units (RIU) is observed. The sensor detects a minimal refractive index variation of 2x10(-4) RIU.

  5. Thermodynamic analysis of biochemical systems

    International Nuclear Information System (INIS)

    Yuan, Y.; Fan, L.T.; Shieh, J.H.

    1989-01-01

    Introduction of the concepts of the availability (or exergy), datum level materials, and the dead state has been regarded as some of the most significant recent developments in classical thermodynamics. Not only the available energy balance but also the material and energy balances of a biological system may be established in reference to the datum level materials in the dead state or environment. In this paper these concepts are illustrated with two examples of fermentation and are shown to be useful in identifying sources of thermodynamic inefficiency, thereby leading naturally to the rational definition of thermodynamic efficiency of a biochemical process

  6. Molecular Epidemiology of Heart Failure

    Directory of Open Access Journals (Sweden)

    J. Gustav Smith, MD, PhD

    2017-12-01

    Full Text Available Heart failure (HF is the end-stage of all heart disease and arguably constitutes the greatest unmet therapeutic need in cardiovascular medicine today. Classic epidemiological studies have established clinical risk factors for HF, but the cause remains poorly understood in many cases. Biochemical analyses of small case-control series and animal models have described a plethora of molecular characteristics of HF, but a single unifying pathogenic theory is lacking. Heart failure appears to result not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, metabolic, inflammatory, and other biochemical factors acting on the heart. Recent development of robust, high-throughput tools in molecular biology provides opportunity for deep molecular characterization of population-representative cohorts and HF cases (molecular epidemiology, including genome sequencing, profiling of myocardial gene expression and chromatin modifications, plasma composition of proteins and metabolites, and microbiomes. The integration of such detailed information holds promise for improving understanding of HF pathophysiology in humans, identification of therapeutic targets, and definition of disease subgroups beyond the current classification based on ejection fraction which may benefit from improved individual tailoring of therapy. Challenges include: 1 the need for large cohorts with deep, uniform phenotyping; 2 access to the relevant tissues, ideally with repeated sampling to capture dynamic processes; and 3 analytical issues related to integration and analysis of complex datasets. International research consortia have formed to address these challenges and combine datasets, and cohorts with up to 1 million participants are being collected. This paper describes the molecular epidemiology of HF and provides an overview of methods and tissue types and examples of published and ongoing efforts to systematically evaluate molecular

  7. Serum biochemical parameters of cows during pregnancy and early ...

    African Journals Online (AJOL)

    user

    disorders in indigenous and crossbred cattle in Nigeria. Although ... season, gestation and sampling method (Hewett, 1974), ... cows therefore will present a good diagnostic tool for ..... musculoskeletal problem (inability to stand on the legs).

  8. Early Biochemical Screening for Fetal Aneuploidy in the First Trimester

    DEFF Research Database (Denmark)

    Tørring, Niels

    2013-01-01

    Background Screening for fetal trisomy 21 in the first trimester includes analysis of the serological markers pregnancy-associated plasma protein A (PAPP-A) and free beta human choriogonadotropin (free βhCG). With the recent launch of the PAPP-A free βhCG and assays on the Roche Cobas and Elecsys...... assays showed slopes of 0.94 and 0.95 and Pearson’s correlation of r = 0.981 and r = 0.987 respectively. Similar comparison to AutoDELFIA PerkinElmer Perkin gave slopes of 0,83 (free βhCG) and 1.20 (PAPP-A). With a cut off at 1:300 the overall sensitivity of the first trimester screening including nuchal...

  9. Immune mediated liver failure

    OpenAIRE

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capac...

  10. Chronic heart failure

    OpenAIRE

    Hopper, Ingrid; Easton, Kellie

    2017-01-01

    1. The common symptoms and signs of chronic heart failure are dyspnoea, ankle swelling, raised jugular venous pressure and basal crepitations. Other conditions may be confused with chronic heart failure, including dependent oedema or oedema due to renal or hepatic disease. Shortness of breath may be due to respiratory disease or severe anaemia. Heart failure secondary to lung disease (cor pulmonale) should be distinguished from congestive cardiac failure. Heart failure may also present with l...

  11. Chronic renal failure secondary to polysubstance misuse | Odigie ...

    African Journals Online (AJOL)

    Chronic Renal Failure [CRF] is a progressive irreversible deterioration in renal function with a spectrum ranging from biochemical abnormalities [azotemia] to clinically evident abnormalities [uraemia] and end stage renal disease [ESRD]. The purpose of this paper is to highlight the significance of rare causes of CRF in the ...

  12. Predictors of treatment failure, incipient hypothyroidism, and weight gain following radioiodine therapy for Graves' thyrotoxicosis.

    Science.gov (United States)

    Gibb, F W; Zammitt, N N; Beckett, G J; Strachan, M W J

    2013-10-01

    Following radioiodine ((131)I) therapy, both late recognition of hypothyroidism and treatment failure may result in adverse outcomes. We sought to assess indicators of both incipient hypothyroidism and treatment failure following (131)I and determine factors predictive of weight gain. Retrospective study of 288 patients receiving (131)I for treatment of Graves' thyrotoxicosis. Primary outcome measures were thyroid status and weight change at 1 yr following (131)I. The treatment failure rate at 1 yr was 13.5%. Hypothyroidism developed in 80.9%, with 58.5% of patients having levels of free T4 (fT4) treatment failure (23.3%) than those with no thionamide exposure (6.3%, p=0.003), but also had more active Graves' disease. Following (131)I, development of a detectable TSH or low-normal fT4 levels was not associated with recurrent thyrotoxicosis. Median weight gain was 5.3 kg, although patients with nadir fT4 levels 6 pmol/l (p=0.05). The main predictor of weight gain was fT4 level immediately prior to treatment; those in the lowest tertile gained a median 3.1 kg whilst those in the highest tertile gained 7.4 kg (median difference 4.3 kg; 95% confidence interval: 2.5-6.2). Marked hypothyroidism following (131)I is common and often occurs early. Simple biochemical parameters may help identify incipient hypothyroidism and potentially limit excess weight gain. Treatment failure is common in patients with severe thyrotoxicosis and in such cases larger doses of (131)I may be warranted.

  13. Biochemical and molecular diagnosis of tyrosinemia type I with two novel FAH mutations in a Hong Kong chinese patient: recommendation for expanded newborn screening in Hong Kong.

    Science.gov (United States)

    Mak, Chloe Miu; Lam, Ching-Wan; Chim, Stella; Siu, Tak-Shing; Ng, King-Fai; Tam, Sidney

    2013-01-01

    Tyrosinemia type I is an autosomal recessive disorder in tyrosine metabolism. In areas without expanded newborn screening, patients present with acute hepatorenal failure in early infancy. Diagnosis can be elusive when clinical presentation is non-specific and biochemical abnormalities are masked by secondary changes. This is the first Hong Kong Chinese report. A two-month-old Chinese male infant with unremarkable antenatal and postnatal history presented with progressive abdominal distension for three days. He suffered from end-stage liver failure, hypoglycemia and hepatic encephalopathy. Diagnostic work-up was complicated starting from rule-out sepsis, intestinal obstruction, volvulus, peritonitis, septic ileus, poisoning to metabolic diseases. Clinical, biochemical and genetic data was described. The patient showed increases in multiple plasma amino acids including tyrosine, phenylalanine and methionine, and hyper-excretions of 4-hydroxyphenyl-acetate, -pyruvate, and -lactate, as well as N-acetyltyrosine which could be seen in liver failure due to both tyrosinemia type I and non-metabolic conditions. Because of the volatile nature, succinylacetone was almost undetectable. The diagnosis was confirmed by genetic analysis of FAH with two novel mutations, viz. NM_000137.2:c.1063-1G>A and NM_000137.2:c.1035_1037del. Living-related liver transplantation was done. However, the patient still suffered many complications after the severe metabolic insult with hypoxic ischemic encephalopathy, cerebral atrophy, global developmental delay and cortical visual impairment. Because of the lack of expanded newborn screening in Hong Kong, this child unfortunately presented in the most severe form of tyrosinemia type I. Expanded newborn screening can save life and reduce the burden of diagnostic complexity. This illustrates the need for expanded newborn screening in Hong Kong. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights

  14. Radiation dose and late failures in prostate cancer

    International Nuclear Information System (INIS)

    Morgan, Peter B.; Hanlon, Alexandra L.; Horwitz, Eric M.; Buyyounouski, Mark K.; Uzzo, Robert G.; Pollack, Alan

    2007-01-01

    Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF (p < 0.0001), nadir + 2 BF (p = 0.001), and DM (p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1-10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74-Gy group. In patients receiving ≥74 Gy, a reduction occurred in the risk of DM in the early and late waves, although the late wave appeared reduced to a greater degree. Conclusion: The ASTRO definition of BF systematically underestimated late BF because of backdating. Radiation dose escalation diminished and delayed BF; the delay suggested that local persistence may still be present in some patients. For DM, a greater radiation dose reduced the early and late waves, suggesting that persistence of local disease contributed to both

  15. Heart failure - surgeries and devices

    Science.gov (United States)

    ... surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure ... problem may cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or ...

  16. Resultados iniciais do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca de etiologia chagásica Early results of bone marrow cell transplantation to the myocardium of patients with heart failure due to chagas disease

    Directory of Open Access Journals (Sweden)

    Fábio Vilas-Boas

    2006-08-01

    Full Text Available OBJETIVO: Avaliar efeitos precoces do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca (IC de etiologia chagásica. MÉTODOS: A amostra consistiu de 28 pacientes, idade média 52,2±9,9 anos, 24 masculinos, 25 em classe NYHA III e 3 em NYHA IV, apesar de tratamento otimizado. O procedimento consistiu na aspiração de 50ml de medula óssea, separação da fração mononuclear e injeção intracoronariana. Foram avaliados os efeitos sobre a fração de ejeção ventricular esquerda (FEVE, distância no teste de 6 minutos, qualidade de vida, classe NYHA, efeitos arritmogênicos e bioquímicos. RESULTADOS: Não houve complicações relacionadas diretamente ao procedimento. A fração de ejeção ventricular esquerda em repouso antes do transplante era 20,1±6,8% e, após 60 dias, aumentou para 23,0±9,0%, p = 0,02. Houve melhora da classe NYHA (3,1±0,3 para 1,8±0,5; pOBJECTIVE: To evaluate early effects of bone marrow cell transplantation to the myocardium of patients with heart failure (CHF due to Chagas disease. METHODS: We studied 28 patients (mean age 52.2 ± 9.9, of whom 24 were male. Despite optimized treatment, 25 patients were in NYHA class III and three patients, in NYHA class IV. The procedure consisted of aspiration of 50 mL of bone marrow, separation of the mononuclear fraction, and intracoronary injection. Effects on left ventricle ejection fraction (LVEF, distance walked in the six-minute walking test, quality-of-life, NYHA class, arrhythmogenic and biochemical parameters, were all evaluated. RESULTS: There were no complications directly related to the procedure. Baseline left ventricular ejection fraction was 20.1 ± 6.8%, and 60 days after transplantation it increased to 23.0 ± 9.0%, p = 0.02. Significant improvements were observed in the NYHA class (3.1 ± 0.3 to 1.8 ± 0.5; p < 0.0001; quality-of-life (50.9 ± 11.7 to 21.8 ± 13.4; p < 0.0001; and distance walked in six

  17. Homocystein: A new biochemical marker in livestock sector

    Directory of Open Access Journals (Sweden)

    Suleyman Kozat

    2017-12-01

    Full Text Available The livestock sector is making great contributions to the world economy. Many different diseases, such as cardiovascular diseases, kidney and mineral substance insufficiency, cause huge losses in yield and production in the livestock sector. Early diagnosis is essential to combat these diseases. Today, homocysteine levels are used as biochemical markers in the diagnosis of the functions and diseases of many different organs in human medicine. Homocysteine is an amino acid that occurs in the process of methionine metabolism and does not enter the primary structure of proteins. Homocysteine is a biochemical marker used in the assessment of cardiovascular and renal diseases as well as other organ functions. In this review, homocysteine determination methods and detailed information about which organ and system diseases can be used in livestock sector will be given. [J Adv Vet Anim Res 2017; 4(4.000: 319-332

  18. Biochemical and biomechanical characterisation of equine cervical facet joint cartilage.

    Science.gov (United States)

    O'Leary, S A; White, J L; Hu, J C; Athanasiou, K A

    2018-04-15

    The equine cervical facet joint is a site of significant pathology. Located bilaterally on the dorsal spine, these diarthrodial joints work in conjunction with the intervertebral disc to facilitate appropriate spinal motion. Despite the high prevalence of pathology in this joint, the facet joint is understudied and thus lacking in viable treatment options. The goal of this study was to characterise equine facet joint cartilage and provide a comprehensive database describing the morphological, histological, biochemical and biomechanical properties of this tissue. Descriptive cadaver studies. A total of 132 facet joint surfaces were harvested from the cervical spines of six skeletally mature horses (11 surfaces per animal) for compiling biomechanical and biochemical properties of hyaline cartilage of the equine cervical facet joints. Gross morphometric measurements and histological staining were performed on facet joint cartilage. Creep indentation and uniaxial strain-to-failure testing were used to determine the biomechanical compressive and tensile properties. Biochemical assays included quantification of total collagen, sulfated glycosaminoglycan and DNA content. The facet joint surfaces were ovoid in shape with a flat articular surface. Histological analyses highlighted structures akin to articular cartilage of other synovial joints. In general, biomechanical and biochemical properties did not differ significantly between the inferior and superior joint surfaces as well as among spinal levels. Interestingly, compressive and tensile properties of cervical facet articular cartilage were lower than those of articular cartilage from other previously characterised equine joints. Removal of the superficial zone reduced the tissue's tensile strength, suggesting that this zone is important for the tensile integrity of the tissue. Facet surfaces were sampled at a single, central location and do not capture the potential topographic variation in cartilage properties. This

  19. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  20. Biochemical Markers in Neurocritical Care

    Directory of Open Access Journals (Sweden)

    Omidvar Rezae

    2016-07-01

    Full Text Available During the past two decades, a variety of serum or cerebrospinal fluid (CSF biochemical markers in daily clinical practice have been recommended to diagnose and monitor diverse diseases or pathologic situations. It will be essential to develop a panel of biomarkers, to be suitable for evaluation of treatment efficacy, representing distinct phases of injury and recovery and consider the temporal profile of those. Among the possible and different biochemical markers, S100b appeared to fulfill many of optimized criteria of an ideal marker. S100b, a cytosolic low molecular weight dimeric calciumbinding protein from chromosome 21, synthesized in glial cells throughout the CNS, an homodimeric diffusible, belongs to a family of closely related protein, predominantly expressed by astrocytes and Schwann cells and a classic immunohistochemical marker for these cells, is implicated in brain development and neurophysiology. Of the 3 isoforms of S-100, the BB subunit (S100B is present in high concentrations in central and peripheral glial and Schwann cells, Langerhans and anterior pituitary cells, fat, muscle, and bone marrow tissues. The biomarker has shown to be a sensitive marker of clinical and subclinical cerebral damage, such as stroke, traumatic brain injury, and spinal cord injury. Increasing evidence suggests that the biomarker plays a double function as an intracellular regulator and an extracellular signal of the CNS. S100b is found in the cytoplasm in a soluble form and also is associated with intracellular membranes, centrosomes, microtubules, and type III intermediate filaments. Their genomic organization now is known, and many of their target proteins have been identified, although the mechanisms of regulating S100b secretion are not completely understood and appear to be related to many factors, such as the proinflammatory cytokines, tumor necrosis factor alpha (TNF-a, interleukin (IL-1b, and metabolic stress. 

  1. Failure rate analysis using GLIMMIX

    International Nuclear Information System (INIS)

    Moore, L.M.; Hemphill, G.M.; Martz, H.F.

    1998-01-01

    This paper illustrates use of a recently developed SAS macro, GLIMMIX, for implementing an analysis suggested by Wolfinger and O'Connell (1993) in modeling failure count data with random as well as fixed factor effects. Interest in this software tool arose from consideration of modernizing the Failure Rate Analysis Code (FRAC), developed at Los Alamos National Laboratory in the early 1980's by Martz, Beckman and McInteer (1982). FRAC is a FORTRAN program developed to analyze Poisson distributed failure count data as a log-linear model, possibly with random as well as fixed effects. These statistical modeling assumptions are a special case of generalized linear mixed models, identified as GLMM in the current statistics literature. In the nearly 15 years since FRAC was developed, there have been considerable advances in computing capability, statistical methodology and available statistical software tools allowing worthwhile consideration of the tasks of modernizing FRAC. In this paper, the approaches to GLMM estimation implemented in GLIMMIX and in FRAC are described and a comparison of results for the two approaches is made with data on catastrophic time-dependent pump failures from a report by Martz and Whiteman (1984). Additionally, statistical and graphical model diagnostics are suggested and illustrated with the GLIMMIX analysis results

  2. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  3. In Support of Failure

    Science.gov (United States)

    Carr, Allison

    2013-01-01

    In this essay, I propose a concerted effort to begin devising a theory and pedagogy of failure. I review the discourse of failure in Western culture as well as in composition pedagogy, ultimately suggesting that failure is not simply a judgement or indication of rank but is a relational, affect-bearing concept with tremendous relevance to…

  4. Lycopene Supplementation in the Complementary Management of PSA Failure: A Randomized Placebo-Controlled Trial for Prostate Cancer Survivors

    National Research Council Canada - National Science Library

    Ukoli, Flora A; Kucuk, Omer; Fowke, Jay H

    2007-01-01

    ...) or whole-food supplement (Lyc-O-Mato(Registered)) in control of biochemical (PSA) failure in 78 African-American prostate cancer survivors treated initially by radical prostatectomy or radiation...

  5. Prevalence of biochemical and immunological abnormalities in ...

    African Journals Online (AJOL)

    Tile prevalence of biochemical and immunological abnormalities was studied in a group of 256 patients with rheumatoid arthritis (104 coloureds, 100 whites and 52 blacks). The most common biochemical abnormalities detected were a reduction in the serum creatinine value (43,4%), raised globulins (39,7%), raised serum ...

  6. The failure of earthquake failure models

    Science.gov (United States)

    Gomberg, J.

    2001-01-01

    In this study I show that simple heuristic models and numerical calculations suggest that an entire class of commonly invoked models of earthquake failure processes cannot explain triggering of seismicity by transient or "dynamic" stress changes, such as stress changes associated with passing seismic waves. The models of this class have the common feature that the physical property characterizing failure increases at an accelerating rate when a fault is loaded (stressed) at a constant rate. Examples include models that invoke rate state friction or subcritical crack growth, in which the properties characterizing failure are slip or crack length, respectively. Failure occurs when the rate at which these grow accelerates to values exceeding some critical threshold. These accelerating failure models do not predict the finite durations of dynamically triggered earthquake sequences (e.g., at aftershock or remote distances). Some of the failure models belonging to this class have been used to explain static stress triggering of aftershocks. This may imply that the physical processes underlying dynamic triggering differs or that currently applied models of static triggering require modification. If the former is the case, we might appeal to physical mechanisms relying on oscillatory deformations such as compaction of saturated fault gouge leading to pore pressure increase, or cyclic fatigue. However, if dynamic and static triggering mechanisms differ, one still needs to ask why static triggering models that neglect these dynamic mechanisms appear to explain many observations. If the static and dynamic triggering mechanisms are the same, perhaps assumptions about accelerating failure and/or that triggering advances the failure times of a population of inevitable earthquakes are incorrect.

  7. Craniometaphyseal dysplasia with obvious biochemical abnormality and rickets-like features.

    Science.gov (United States)

    Wu, Bo; Jiang, Yan; Wang, Ou; Li, Mei; Xing, Xiao-Ping; Xia, Wei-Bo

    2016-05-01

    Craniometaphyseal dysplasia (CMD) is a rare genetic disorder that is characterized by progressive sclerosis of the craniofacial bones and metaphyseal widening of long bones, and biochemical indexes were mostly normal. To further the understanding of the disease from a biochemical perspective, we reported a CMD case with obviously abnormal biochemical indexes. A 1-year-old boy was referred to our clinic. Biochemical test showed obviously increased alkaline phosphatase (ALP) and parathyroid hormone (PTH), mild hypocalcemia and hypophosphatemia. Moreover, significant elevated receptor activator of nuclear factor kappa-B ligand (RANKL) level, but normal β-C-terminal telopeptide of type I collagen (β-CTX) concentration were revealed. He was initially suspected of rickets, because the radiological examination also showed broadened epiphysis in his long bones. Supplementation with calcium and calcitriol alleviated biochemical abnormality. However, the patient gradually developed osteosclerosis which was inconformity with rickets. Considering that he was also presented with facial paralysis and nasal obstruction symptom, the diagnosis of craniometaphyseal dysplasia was suspected, and then was confirmed by the mutation analysis of ANKH of the proband and his family, which showed a de novo heterozygous mutation (C1124-1126delCCT) on exon 9. Our study revealed that obvious biochemical abnormality and rickets-like features might present as uncommon characteristics in CMD patients, and the calcium and calcitriol supplementation could alleviate biochemical abnormalities. Furthermore, although early osteoclast differentiation factor was excited in CMD patient, activity of osteoclast was still inert. Copyright © 2016. Published by Elsevier B.V.

  8. On-Board Particulate Filter Failure Prevention and Failure Diagnostics Using Radio Frequency Sensing

    Energy Technology Data Exchange (ETDEWEB)

    Sappok, Alex [Filter Sensing Technologies; Ragaller, Paul [Filter Sensing Technologies; Herman, Andrew [CTS Corporation; Bromberg, L. [Massachusetts Institute of Technology (MIT); Prikhodko, Vitaly Y [ORNL; Parks, II, James E [ORNL; Storey, John Morse [ORNL

    2017-01-01

    The increasing use of diesel and gasoline particulate filters requires advanced on-board diagnostics (OBD) to prevent and detect filter failures and malfunctions. Early detection of upstream (engine-out) malfunctions is paramount to preventing irreversible damage to downstream aftertreatment system components. Such early detection can mitigate the failure of the particulate filter resulting in the escape of emissions exceeding permissible limits and extend the component life. However, despite best efforts at early detection and filter failure prevention, the OBD system must also be able to detect filter failures when they occur. In this study, radio frequency (RF) sensors were used to directly monitor the particulate filter state of health for both gasoline particulate filter (GPF) and diesel particulate filter (DPF) applications. The testing included controlled engine dynamometer evaluations, which characterized soot slip from various filter failure modes, as well as on-road fleet vehicle tests. The results show a high sensitivity to detect conditions resulting in soot leakage from the particulate filter, as well as potential for direct detection of structural failures including internal cracks and melted regions within the filter media itself. Furthermore, the measurements demonstrate, for the first time, the capability to employ a direct and continuous monitor of particulate filter diagnostics to both prevent and detect potential failure conditions in the field.

  9. Organic and biochemical synthesis group

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Stable isotopes, because of their unique properties and non-radioactive nature, have great potential for many fields of science and technology. In particular, isotopes of carbon, nitrogen, oxygen, and sulfur (the basic building blocks of all biological molecules) would be widely used in biomedical and environmental research if they were economically available in sufficient quantities and in the required chemical forms. The major objective of our program continues to be stimulation of the widespread utilization of stable isotopes and commercial involvement through development and demonstration of applications which have potential requirements for large quantities of isotopes. Thus, demand will be created which is necessary for large-scale production of stable isotopes and labeled compounds and concomitant low unit costs. The program continues to produce a variety of labeled materials needed for clinical, biomedical, chemical, and environmental applications which serve as effective demonstrations of unique and advantageous utilization of stable isotopes. Future commercial involvement should benefit, and is a consideration in our research and development, from the technology transfer that can readily be made as a result of our organic and biochemical syntheses and also of various techniques involved in applications

  10. Influence by early plasma exchange on biochemical index and prognosis in severe hyperlipidemic ;pancreatitis patients%早期血浆置换对重症高脂血症性胰腺炎患者的生化指标及预后的影响

    Institute of Scientific and Technical Information of China (English)

    殷卫兵; 张西亮

    2016-01-01

    目的:观察早期血浆置换对重症高脂血症性胰腺炎(HLP)的生化指标改变及治疗效果。方法40例重症高脂血症性胰腺炎患者,随机分为对照组23例和治疗组17例。对照组采用内科传统治疗;治疗组在对照组的基础上给予早期单次床旁血浆置换治疗。比较两组血患者常规白细胞(WBC)、血清淀粉酶(AMY)、血糖(GLU)、甘油三酯(TG)指标。结果治疗前,两组患者血常规WBC、AMY、TG、GLU比较,差异无统计学意义(P>0.05)。治疗后第3天,两组患者血常规WBC、AMY、TG、GLU低于治疗前(P0.05). In the 3rd day after treatment, both groups had lower WBC, AMY, TG and GLU than those before treatment (P<0.01). The treatment group had all lower WBC as (7.89±1.53)×109/L, AMY as (201.32±18.20) U/L, GLU as (7.15±0.98) mmol/L and TG as (5.82±3.01) mmol/L than WBC as (9.26±2.06)×109/L, AMY as (252.43±19.08) U/L, GLU as (8.43±1.66) mmol/L and TG as (11.72±3.64) mmol/L in the control group (P<0.05). Conclusion Implement of early plasma exchange can remarkably improve biochemical index in patients with severe hyperlipidemic pancreatitis, reduce inflammatory reactions and prevent disease development.

  11. The pathophysiology of heart failure.

    Science.gov (United States)

    Kemp, Clinton D; Conte, John V

    2012-01-01

    Heart failure is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return. This common condition affects over 5 million people in the United States at a cost of $10-38 billion per year. Heart failure results from injury to the myocardium from a variety of causes including ischemic heart disease, hypertension, and diabetes. Less common etiologies include cardiomyopathies, valvular disease, myocarditis, infections, systemic toxins, and cardiotoxic drugs. As the heart fails, patients develop symptoms which include dyspnea from pulmonary congestion, and peripheral edema and ascites from impaired venous return. Constitutional symptoms such as nausea, lack of appetite, and fatigue are also common. There are several compensatory mechanisms that occur as the failing heart attempts to maintain adequate function. These include increasing cardiac output via the Frank-Starling mechanism, increasing ventricular volume and wall thickness through ventricular remodeling, and maintaining tissue perfusion with augmented mean arterial pressure through activation of neurohormonal systems. Although initially beneficial in the early stages of heart failure, all of these compensatory mechanisms eventually lead to a vicious cycle of worsening heart failure. Treatment strategies have been developed based upon the understanding of these compensatory mechanisms. Medical therapy includes diuresis, suppression of the overactive neurohormonal systems, and augmentation of contractility. Surgical options include ventricular resynchronization therapy, surgical ventricular remodeling, ventricular assist device implantation, and heart transplantation. Despite significant understanding of the underlying pathophysiological mechanisms in heart failure, this disease causes significant morbidity and carries a 50% 5-year mortality. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Studies on some biochemical parameters in viral hepatitis patients

    International Nuclear Information System (INIS)

    El-Sherbiny, E.M.

    2002-01-01

    The present investigation deals with studying liver amino transferases (ALT. AST). Cholesterol and triglycerides. As well as testosterone and protection hormones in blood of Egyptian men infected with hepatitis C virus.hepatitis B virus and mixed B and C viruses. These biochemical parameters were evaluated to be used in diagnosis and prognosis of viral hepatitis. Which considered the most important health problem in Egypt and developing countries. Biochemical analysis were performed using spectrophotometric and radioimmunoassay techniques. All data will be subjected to statistical analysis in order to detect the most suitable biochemical analysis that can be used as specific tests for early diagnosis of viral hepatitis and to detect the parameters that show abnormalities among the different groups of infected patients. The data revealed that AST and ALT levels were increased in all patient groups. Concerning the level of triglycerides, it was increased only in the group of mixed viral hepatitis B and C, while cholesterol showed non-significant changes in all viral hepatitis groups. The sex hormone testosterone was decreased in all infected patients while the prolactin level was increased only in case of patients infected with mixed B and C viruses. However, these abnormal values in such sex hormones play a serious role in male sterility

  13. Managing Feelings about Heart Failure

    Science.gov (United States)

    ... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

  14. Automated multiple failure FMEA

    International Nuclear Information System (INIS)

    Price, C.J.; Taylor, N.S.

    2002-01-01

    Failure mode and effects analysis (FMEA) is typically performed by a team of engineers working together. In general, they will only consider single point failures in a system. Consideration of all possible combinations of failures is impractical for all but the simplest example systems. Even if the task of producing the FMEA report for the full multiple failure scenario were automated, it would still be impractical for the engineers to read, understand and act on all of the results. This paper shows how approximate failure rates for components can be used to select the most likely combinations of failures for automated investigation using simulation. The important information can be automatically identified from the resulting report, making it practical for engineers to study and act on the results. The strategy described in the paper has been applied to a range of electrical subsystems, and the results have confirmed that the strategy described here works well for realistically complex systems

  15. Heart Failure in Women

    Science.gov (United States)

    Bozkurt, Biykem; Khalaf, Shaden

    2017-01-01

    Heart failure is an important cause of morbidity and mortality in women, and they tend to develop it at an older age compared to men. Heart failure with preserved ejection fraction is more common in women than in men and accounts for at least half the cases of heart failure in women. When comparing men and women who have heart failure and a low left ventricular ejection fraction, the women are more symptomatic and have a similarly poor outcome. Overall recommendations for guideline-directed medical therapies show no differences in treatment approaches between men and women. Overall, women are generally underrepresented in clinical trials for heart failure. Further studies are needed to shed light into different mechanisms, causes, and targeted therapies of heart failure in women. PMID:29744014

  16. Definition of containment failure

    International Nuclear Information System (INIS)

    Cybulskis, P.

    1982-01-01

    Core meltdown accidents of the types considered in probabilistic risk assessments (PRA's) have been predicted to lead to pressures that will challenge the integrity of containment structures. Review of a number of PRA's indicates considerable variation in the predicted probability of containment failure as a function of pressure. Since the results of PRA's are sensitive to the prediction of the occurrence and the timing of containment failure, better understanding of realistic containment capabilities and a more consistent approach to the definition of containment failure pressures are required. Additionally, since the size and location of the failure can also significantly influence the prediction of reactor accident risk, further understanding of likely failure modes is required. The thresholds and modes of containment failure may not be independent

  17. Preirradiation PSA predicts biochemical disease-free survival in patients treated with postprostatectomy external beam irradiation

    International Nuclear Information System (INIS)

    Crane, Christopher H.; Rich, Tyvin A.; Read, Paul W.; Sanfilippo, Nicholas J.; Gillenwater, Jay Y.; Kelly, Maria D.

    1997-01-01

    Purpose: To assess the clinical outcome and prostate-specific antigen (PSA) response and to determine prognostic factors for biochemical disease-free survival in patients treated with external beam radiotherapy following radical prostatectomy without hormonal therapy. Methods and Materials: Forty-eight patients were treated after prostatectomy with radiotherapy between March, 1988 and December, 1993. Seven patients had undetectable PSA ( 2.7. Five-year actuarial biochemical disease-free survival values were 71, 48, and 0%, respectively, for the three groups. Biochemical disease-free survival was not affected by preoperative PSA level, clinical stage, Gleason's score, pathologic stage, surgical margins, presence of undetectable PSA after surgery, surgery to radiation interval, total dose, or presence of clinically suspicious local disease. Based on digital rectal exam, there were no local failures. Conclusion: Biochemical disease-free survival after postprostatectomy radiation is predicted by the PSA at the time of irradiation. Clinical local control is excellent, but distant failure remains a significant problem in this population. The addition of concomitant systemic therapy should be investigated in patients with PSA >2.7

  18. Clinical and pathologic factors predictive of biochemical control following post-prostatectomy irradiation

    International Nuclear Information System (INIS)

    Stromberg, Jannifer S.; Ziaja, Ellen L.; Horwitz, Eric M.; Vicini, Frank A.; Brabbins, Donald S.; Dmuchowski, Carl F.; Gonzalez, Jose; Martinez, Alvaro A.

    1996-01-01

    -RT PSA values, Gleason score ≥8, and biopsy proven recurrence were significantly predictive of biochemical failure. Patients treated adjuvantly were more likely to achieve biochemical control when compared to those with persistent or rising PSA values. Further study is needed to identify the subset of post-prostatectomy patients most likely to benefit from the addition of irradiation

  19. Primary testicular failure in Klinefelter's syndrome

    DEFF Research Database (Denmark)

    Aksglaede, Lise; Andersson, Anna-Maria; Jørgensen, Niels

    2007-01-01

    The diagnosis of androgen deficiency is based on clinical features and confirmatory low serum testosterone levels. In early primary testicular failure, a rise in serum LH levels suggests inadequate androgen action for the individual's physiological requirements despite a serum testosterone level...

  20. Cytokines and Organ Failure in Acute Pancreatitis

    DEFF Research Database (Denmark)

    Malmstrøm, Marie Louise; Hansen, Mark Berner; Andersen, Anders Møller

    2012-01-01

    Objectives: We aimed at synchronously examining the early time course of 4 proinflammatory cytokines as predictive factors for development of organ failure in patients with acute pancreatitis (AP). Methods: Interleukin (IL) 6, IL-8, IL-18, and tumor necrosis factor > were measured on admission...

  1. Assessment of Nonorganic Failure To Thrive.

    Science.gov (United States)

    Wooster, Donna M.

    1999-01-01

    This article describes basic assessment considerations for infants and toddlers exhibiting nonorganic failure to thrive. The evaluation process must examine feeding, maternal-child interactions, child temperament, and environmental risks and behaviors. Early identification and intervention are necessary to minimize the long-term developmental…

  2. Biochemical disease-free survival following I-125 prostate implantation

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, David C; Priestley, Joseph B

    1995-07-01

    Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p < 0.0001). Patients with a normal pretreatment PSA enjoyed 93% BDFS, while those presenting with PSA > 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with

  3. Biochemical disease-free survival following I-125 prostate implantation

    International Nuclear Information System (INIS)

    Beyer, David C.; Priestley, Joseph B.

    1995-01-01

    Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with early stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and

  4. Biochemical Markers for Osteoarthritis: Is There any Promising Candidate?

    Directory of Open Access Journals (Sweden)

    Elif Aydın

    2016-04-01

    Full Text Available Osteoarthritis (OA is the most common degenerative joint disease. OA affects millions of individuals each year and becoming the most important cause of pain in geriatric population. Progressive destruction of articular cartilage is one of the prominent features of the disease. The diagnosis of OA is generally based on clinical and radiographical findings, which are insufficient to determine early-stage OA and predict disease course. There is a need for biomarkers that help clinicians early diagnose, assess disease activity, predict prognosis and monitor response to therapy. There are a growing number of publications regarding candidate markers in this field. The aim of this paper was to review recent studies on biochemical markers that reflect cartilage, synovial and bone turnover and their clinical use in patients with OA.

  5. Detecting failure of climate predictions

    Science.gov (United States)

    Runge, Michael C.; Stroeve, Julienne C.; Barrett, Andrew P.; McDonald-Madden, Eve

    2016-01-01

    The practical consequences of climate change challenge society to formulate responses that are more suited to achieving long-term objectives, even if those responses have to be made in the face of uncertainty1, 2. Such a decision-analytic focus uses the products of climate science as probabilistic predictions about the effects of management policies3. Here we present methods to detect when climate predictions are failing to capture the system dynamics. For a single model, we measure goodness of fit based on the empirical distribution function, and define failure when the distribution of observed values significantly diverges from the modelled distribution. For a set of models, the same statistic can be used to provide relative weights for the individual models, and we define failure when there is no linear weighting of the ensemble models that produces a satisfactory match to the observations. Early detection of failure of a set of predictions is important for improving model predictions and the decisions based on them. We show that these methods would have detected a range shift in northern pintail 20 years before it was actually discovered, and are increasingly giving more weight to those climate models that forecast a September ice-free Arctic by 2055.

  6. Biochemical thermodynamics: applications of Mathematica.

    Science.gov (United States)

    Alberty, Robert A

    2006-01-01

    reactants. Thus loading this package makes available 774 mathematical functions for these properties. These functions can be added and subtracted to obtain changes in these properties in biochemical reactions and apparent equilibrium constants.

  7. Fifteen-Year Biochemical Relapse-Free Survival, Cause-Specific Survival, and Overall Survival Following I125 Prostate Brachytherapy in Clinically Localized Prostate Cancer: Seattle Experience

    International Nuclear Information System (INIS)

    Sylvester, John E.; Grimm, Peter D.; Wong, Jason; Galbreath, Robert W.; Merrick, Gregory; Blasko, John C.

    2011-01-01

    Purpose: To report 15-year biochemical relapse-free survival (BRFS), cause-specific survival (CSS), and overall survival (OS) outcomes of patients treated with I 125 brachytherapy monotherapy for clinically localized prostate cancer early in the Seattle experience. Methods and Materials: Two hundred fifteen patients with clinically localized prostate cancer were consecutively treated from 1988 to 1992 with I 125 monotherapy. They were prospectively followed as a tight cohort. They were evaluated for BRFS, CSS, and OS. Multivariate analysis was used to evaluate outcomes by pretreatment clinical prognostic factors. BRFS was analyzed by the Phoenix (nadir + 2 ng/mL) definition. CSS and OS were evaluated by chart review, death certificates, and referring physician follow-up notes. Gleason scoring was performed by general pathologists at a community hospital in Seattle. Time to biochemical failure (BF) was calculated and compared by Kaplan-Meier plots. Results: Fifteen-year BRFS for the entire cohort was 80.4%. BRFS by D'Amico risk group classification cohort analysis was 85.9%, 79.9%, and 62.2% for low, intermediate, and high-risk patients, respectively. Follow-up ranged from 3.6 to 18.4 years; median follow-up was 15.4 years for biochemically free of disease patients. Overall median follow-up was 11.7 years. The median time to BF in those who failed was 5.1 years. CSS was 84%. OS was 37.1%. Average age at time of treatment was 70 years. There was no significant difference in BRFS between low and intermediate risk groups. Conclusion: I 125 monotherapy results in excellent 15-year BRFS and CSS, especially when taking into account the era of treatment effect.

  8. Morphological, physiological and biochemical studies on Pyricularia ...

    African Journals Online (AJOL)

    SARAH

    2014-02-28

    Feb 28, 2014 ... compounds seem to reflect inherent biochemical and physiological differences among P. grisea isolates .... solutions for imaging and microscopy, soft image system .... characteristics among 12 P. grisea isolates from rice were.

  9. Biochemical changes in blood caused by radioisotopes

    International Nuclear Information System (INIS)

    Zapol'skaya, N.A.; Fedorova, A.V.

    1975-01-01

    The changes were studied occurring in some biochemical indicators in blood at chronic peroral administration of strontium-90, cesium-137 and iodine-131 in amounts resulting in accumulation of commensurable doses in critical organs corresponding to each isotope

  10. Biochemical and kinetic characterization of geranylgeraniol 18 ...

    African Journals Online (AJOL)

    Suchart

    2015-07-22

    Jul 22, 2015 ... biochemical characterization of GGOH 18-hydroxylase activity in the microsomal fraction from C. .... method as previously described (Chanama et al., 2009). Briefly, 30 g of frozen ..... Catalytic properties of the plant cytochrome.

  11. Short Report Biochemical derangements prior to emergency ...

    African Journals Online (AJOL)

    MMJ VOL 29 (1): March 2017. Biochemical derangements prior to emergency laparotomy at QECH 55. Malawi Medical Journal 29 (1): March 2017 ... Venepuncture was performed preoperatively for urgent cases, defined as those requiring.

  12. A Program on Biochemical and Biomedical Engineering.

    Science.gov (United States)

    San, Ka-Yiu; McIntire, Larry V.

    1989-01-01

    Presents an introduction to the Biochemical and Biomedical Engineering program at Rice University. Describes the development of the academic and enhancement programs, including organizational structure and research project titles. (YP)

  13. [Biochemical diagnostics of fatal opium intoxication].

    Science.gov (United States)

    Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

    2013-01-01

    Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

  14. Improving Marine Ecosystem Models with Biochemical Tracers

    Science.gov (United States)

    Pethybridge, Heidi R.; Choy, C. Anela; Polovina, Jeffrey J.; Fulton, Elizabeth A.

    2018-01-01

    Empirical data on food web dynamics and predator-prey interactions underpin ecosystem models, which are increasingly used to support strategic management of marine resources. These data have traditionally derived from stomach content analysis, but new and complementary forms of ecological data are increasingly available from biochemical tracer techniques. Extensive opportunities exist to improve the empirical robustness of ecosystem models through the incorporation of biochemical tracer data and derived indices, an area that is rapidly expanding because of advances in analytical developments and sophisticated statistical techniques. Here, we explore the trophic information required by ecosystem model frameworks (species, individual, and size based) and match them to the most commonly used biochemical tracers (bulk tissue and compound-specific stable isotopes, fatty acids, and trace elements). Key quantitative parameters derived from biochemical tracers include estimates of diet composition, niche width, and trophic position. Biochemical tracers also provide powerful insight into the spatial and temporal variability of food web structure and the characterization of dominant basal and microbial food web groups. A major challenge in incorporating biochemical tracer data into ecosystem models is scale and data type mismatches, which can be overcome with greater knowledge exchange and numerical approaches that transform, integrate, and visualize data.

  15. RMBNToolbox: random models for biochemical networks

    Directory of Open Access Journals (Sweden)

    Niemi Jari

    2007-05-01

    Full Text Available Abstract Background There is an increasing interest to model biochemical and cell biological networks, as well as to the computational analysis of these models. The development of analysis methodologies and related software is rapid in the field. However, the number of available models is still relatively small and the model sizes remain limited. The lack of kinetic information is usually the limiting factor for the construction of detailed simulation models. Results We present a computational toolbox for generating random biochemical network models which mimic real biochemical networks. The toolbox is called Random Models for Biochemical Networks. The toolbox works in the Matlab environment, and it makes it possible to generate various network structures, stoichiometries, kinetic laws for reactions, and parameters therein. The generation can be based on statistical rules and distributions, and more detailed information of real biochemical networks can be used in situations where it is known. The toolbox can be easily extended. The resulting network models can be exported in the format of Systems Biology Markup Language. Conclusion While more information is accumulating on biochemical networks, random networks can be used as an intermediate step towards their better understanding. Random networks make it possible to study the effects of various network characteristics to the overall behavior of the network. Moreover, the construction of artificial network models provides the ground truth data needed in the validation of various computational methods in the fields of parameter estimation and data analysis.

  16. Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose Evaluation of biochemical response on early prostate cancer: comparison between treatment with external beam radiation alone and in combination with high-dose rate conformal brachytherapy boost

    Directory of Open Access Journals (Sweden)

    Douglas Guedes de Castro

    2004-08-01

    biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT. These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3 and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi, Gleason score (GS and clinical stage (CS, were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032 for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76 for PSAi 10 ng/mL, respectively. For patients with GS 6, BC3 was 78% versus 55% (p = 0.58 for RT versus BT, respectively. For patients with CS T2a, BC3 was 73% versus 69% (p = 0.692 for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0-5.1 for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0-5.7. CONCLUSION: The treatment modality was an independent prognostic factor for biochemical relapse, with a significant improvement in the biochemical control with BT. These early results suggest that this treatment was most beneficial in patients with PSAi > 10 ng/mL, CS < T2a and GS < 6.

  17. Immune mediated liver failure.

    Science.gov (United States)

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capacity. Direct damage and immune-mediated liver injury are two major factors involved in this process. Increasing evidence has suggested the essential role of immune-mediated liver injury in the pathogenesis of liver failure. Here, we review the evolved concepts concerning the mechanisms of immune-mediated liver injury in liver failure from human and animal studies. Both innate and adaptive immunity, especially the interaction of various immune cells and molecules as well as death receptor signaling system are discussed. In addition, we highlight the concept of "immune coagulation", which has been shown to be related to the disease progression and liver injury exacerbation in HBV related acute-on-chronic liver failure.

  18. The Reconstruction of Failure

    Science.gov (United States)

    Turner, Ralph H.

    1972-01-01

    Seeks to explain the use of ideologies concerning the failure or non-failure in American education in terms of the struggle of sponsoring and professional groups to establish or maintain position on the social scene and, correspondingly, to gain control over those clienteles which are relevant to drives for social or professional mobility. (RJ)

  19. Success by Failure

    Science.gov (United States)

    Andrews, Benjamin D.

    2017-01-01

    By taking the step to talk openly about his failure, the author stumbled upon one of several important lessons that he learned from this experience. The author recognized that he did not have to pretend anymore. In this article, the author shares his story of developing a "growth mindset" to overcome his own failure and support his…

  20. Central oxygen pipeline failure

    African Journals Online (AJOL)

    surgical intensive care unit (ICU), with two patients on full ventilation and ... uncertainty around the cause of the failure and the restoration, .... soon as its level also falls below three tons. Should ... (properly checked and closed prior to each anaesthetic). ... in use at the time of the central oxygen pipeline failure at Tygerberg.

  1. Salvage conformal radiotherapy for biochemical recurrent prostate cancer after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Carlos R. Monti

    2006-08-01

    Full Text Available OBJECTIVE: Assess the results of salvage conformal radiotherapy in patients with biochemical failure after radical prostatectomy and identify prognostic factors for biochemical recurrence and toxicity of the treatment. MATERIALS AND METHODS: From June 1998 to November 2001, 35 patients were submitted to conformal radiotherapy for PSA > 0.2 ng/mL in progression after radical prostatectomy and were retrospectively analyzed. The mean dose of radiation in prostatic bed was of 77.4 Gy (68-81. Variables related to the treatment and to tumor were assessed to identify prognostic factors for biochemical recurrence after salvage radiotherapy. RESULTS: The median follow-up was of 55 months (17-83. The actuarial survival rates free of biochemical recurrence and free of metastasis at a distance of 5 years were 79.7% e 84.7%, respectively. The actuarial global survival rate in 5 years was 96.1%.The actuarial survival rate free of biochemical recurrence in 5 years was 83.3% with PSA pre-radiotherapy 1 and 2 (p = 0.023. Dose > 70 Gy in 30% of the bladder volume implied in more acute urinary toxicity (p = 0.035. The mean time for the development of late urinary toxicity was 21 months (12-51. Dose > 55 Gy in 50% bladder volume implied in more late urinary toxicity (p = 0.018. A patient presented late rectal toxicity of 2nd grade. CONCLUSIONS: Conformal radiotherapy showed to be effective for the control of biochemical recurrence after radical prostatectomy. Patients with pre-therapy PSA < 2 ng/mL have more biochemical control.

  2. Salvage conformal radiotherapy for biochemical recurrent prostate cancer after radical prostatectomy

    International Nuclear Information System (INIS)

    Monti, Carlos R.; Nakamura, Ricardo A.; Ferrigno, Robson; Rossi Junior, Aristides; Kawakami, Neusa S.; Trevisan, Felipe A.

    2006-01-01

    Objective: Assess the results of salvage conformal radiotherapy in patients with biochemical failure after radical prostatectomy and identify prognostic factors for biochemical recurrence and toxicity of the treatment. Materials and methods: From June 1998 to November 2001, 35 patients were submitted to conformal radiotherapy for PSA ≥ 0.2 ng/mL in progression after radical prostatectomy and were retrospectively analyzed. The mean dose of radiation in prostatic bed was of 77.4 Gy (68-81). Variables related to the treatment and to tumor were assessed to identify prognostic factors for biochemical recurrence after salvage radiotherapy. Results: The median follow-up was of 55 months (17-83). The actuarial survival rates free of biochemical recurrence and free of metastasis at a distance of 5 years were 79.7% e 84.7%, respectively. The actuarial global survival rate in 5 years was 96.1%.The actuarial survival rate free of biochemical recurrence in 5 years was 83.3% with PSA pre-radiotherapy ≤ 1, 100% when > 1 and ≤ 2, and 57.1% when > 2 (p = 0.023). Dose > 70 Gy in 30% of the bladder volume implied in more acute urinary toxicity (p = 0.035). The mean time for the development of late urinary toxicity was 21 months (12-51). Dose > 55 Gy in 50% bladder volume implied in more late urinary toxicity (p = 0.018). A patient presented late rectal toxicity of second grade. Conclusions: Conformal radiotherapy showed to be effective for the control of biochemical recurrence after radical prostatectomy. Patients with pre-therapy PSA < 2 ng/mL have more biochemical control. (author)

  3. Radiology of renal failure

    International Nuclear Information System (INIS)

    Griffiths, H.J.

    1990-01-01

    This book covers most aspects of imaging studies in patients with renal failure. The initial chapter provides basic information on contrast agents, intravenous urography, and imaging findings in the urinary tract disorders responsible for renal failure and in patients who have undergone transplantation. It illustrates common gastro-intestinal abnormalities seen on barium studies in patients with renal failure. It illustrates the cardiopulmonary complications of renal failure and offers advice for radiologic differentiation. It details different aspects of skeletal changes in renal failure, including a basic description of the pathophysiology of the changes; many excellent illustrations of classic bone changes, arthritis, avascular necrosis, and soft-tissue calcifications; and details of bone mineral analysis

  4. SOR-ring failure

    International Nuclear Information System (INIS)

    Kitamura, Hideo

    1981-01-01

    It was in the autumn of 1976 that the SOR-ring (synchrotron radiation storage ring) has commenced the regular operation. Since then, the period when the operation was interrupted due to the failures of SOR-ring itself is in total about 8 weeks. Failures and accidents have occurred most in the vacuum system. Those failure experiences are described on the vacuum, electromagnet, radio-frequency acceleration and beam transport systems with their interrupted periods. The eleven failures in the vacuum system have been reported, such as bellows breakage in a heating-evacuating period, leakage from the bellows of straight-through valves (made in U.S.A. and Japan), and leakage from the joint flange of the vacuum system. The longest interruption was 5 weeks due to the failure of a domestically manufactured straight-through valve. The failures of the electromagnet system involve the breakage in a cooling water system, short circuit of a winding in the Q magnet power transformer, blow of a fuse protecting the deflection magnet power source by the current less than the rating, and others. The failures of the RF acceleration system include the breakage of an output electronic tube the breakage of a cavity ceramic, RF voltage fluctuation due to the contact deterioration at a cavity electrode, and the failure of grid bias power source. It is necessary to select the highly reliable components for the vacuum system because the vacuum system failures require longer time for recovery, and very likely to induce secondary and tertiary failures. (Wakatsuki, Y.)

  5. Acute Renal Failure due to Non-Traumatic Rhabdomyolysis

    Directory of Open Access Journals (Sweden)

    Nagehan Aslan

    2016-04-01

    Full Text Available Rhabdomyolysis is a musculoskeletal clinical and biochemical syndrome which is seen associated with traumatic and non-traumatic causes and is known as muscular dystrophy. Rhabdomyolysis which develops following crush-type trauma (Crush syndrome is rarely seen but is a well-known clinical event in the etiology of acute renal failure. Non-traumatic rhabdomyolysis is rare. The case is here presented of a patient who was diagnosed with rhabdomyolysis on presentation with acute renal failure and to whom repeated dialysis was applied.

  6. U.S. Department Of Energy's nuclear engineering education research: highlights of recent and current research-III. 4. Early Detection of Plant Equipment Failures: A Case Study in Just-In-Time Maintenance

    International Nuclear Information System (INIS)

    Parlos, Alexander G.; Kim, Kyusung; Bharadwaj, Raj M.

    2001-01-01

    Approximately 60% of all incipient electric motor failures is attributed to mechanical and electromechanical causes, whereas 33% of all motor failures is attributed to faults related to motor winding insulation. There has been much research reported on the detection and diagnosis of incipient motor failures. The most widely accepted approach for detection of mechanical failures is vibration monitoring, whereas motor current monitoring is used for electromechanical faults such as broken rotor bars and end-rings. In this paper, the development and testing of a model-based fault detection system for electric motors is briefly presented. In particular, the presented fault detection system has been developed using only motor nameplate information. Furthermore, the fault detection results presented utilize only motor voltage and current sensor information, minimizing the need for expensive or intrusive sensors. In this study, dynamic recurrent neural networks are used to predict the input-output response of a three-phase induction motor while using an estimate of the motor speed signal. Accurate state filtering of the motor speed using only electrical measurements is feasible, and it has been demonstrated in other recent publications. The developed input-output motor model requires no knowledge of the motor specifics; rather, only motor nameplate information is used. The resulting model appears very effective in accurately predicting the dynamic behavior of the nonlinear motor system to varying supply unbalance and load levels. The motor model is then used to generate the residuals needed in the fault diagnosis system. Following the residual generation step, fault detection must be pursued by appropriately processing the residuals. It is common to first extract features characteristic of the faults being investigated prior to attempting fault detection. In this study, multi-resolution (or wavelet) signal-processing techniques are used in combination with more traditional

  7. Impact of Gate 99mTc DTPA GFR, Serum Creatinine and Urea in Diagnosis of Patients with Chronic Kidney Failure

    Science.gov (United States)

    Miftari, Rame; Nura, Adem; Topçiu-Shufta, Valdete; Miftari, Valon; Murseli, Arbenita; Haxhibeqiri, Valdete

    2017-01-01

    Aim: The aim of this study was determination of validity of 99mTcDTPA estimation of GFR for early detection of chronic kidney failure Material and methods: There were 110 patients (54 males and 56 females) with kidney disease referred for evaluation of renal function at UCC of Kosovo. All patients were included in two groups. In the first group were included 30 patients confirmed with renal failure, whereas in the second group were included 80 patients with other renal disease. In study were included only patients with ready results of creatinine, urea and glucose in the blood serum. For estimation of GFR we have used the Gate GFR DTPA method. The statistical data processing was conducted using statistical methods such as arithmetic average, the student t-test, percentage or rate, sensitivity, specificity and accuracy of the test. Results: The average age of all patients was 36 years old. The average age of female was 37 whereas of male 35. Patients with renal failure was significantly older than patients with other renal disease (p<0.005). Renal failure was found in 30 patients (27.27%). The concentration of urea and creatinine in blood serum of patients with renal failure were significantly higher than in patients with other renal disease (P< 0.00001). GFR in patients with renal failure were significantly lower than in patients with other renal disease, 51.75 ml/min (p<0.00001). Sensitivity of uremia and creatininemia for detection of renal failure were 83.33%, whereas sensitivity of 99mTcDTPA GFR was 100%. Specificity of uraemia and creatininemia were 63% whereas specificity of 99mTcDTPA GFR was 47.5%. Diagnostic accuracy of blood urea and creatinine in detecting of renal failure were 69%, whereas diagnostic accuracy of 99mTcDTPA GFR was 61.8%. Conclusion: Gate 99mTc DTPA scintigraphy in collaboration with biochemical tests are very sensitive methods for early detection of patients with chronic renal failure. PMID:28883673

  8. Rationale and design of the Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research Trial (MANTICORE 101 - Breast): a randomized, placebo-controlled trial to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer using cardiac MRI

    International Nuclear Information System (INIS)

    Pituskin, Edith; Paterson, Ian; Haykowsky, Mark; Mackey, John R; Thompson, Richard B; Ezekowitz, Justin; Koshman, Sheri; Oudit, Gavin; Chow, Kelvin; Pagano, Joseph J

    2011-01-01

    MANTICORE 101 - Breast (Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research) is a randomized trial to determine if conventional heart failure pharmacotherapy (angiotensin converting enzyme inhibitor or beta-blocker) can prevent trastuzumab-mediated left ventricular remodeling, measured with cardiac MRI, among patients with HER2+ early breast cancer. One hundred and fifty-nine patients with histologically confirmed HER2+ breast cancer will be enrolled in a parallel 3-arm, randomized, placebo controlled, double-blind design. After baseline assessments, participants will be randomized in a 1:1:1 ratio to an angiotensin-converting enzyme inhibitor (perindopril), beta-blocker (bisoprolol), or placebo. Participants will receive drug or placebo for 1 year beginning 7 days before trastuzumab therapy. Dosages for all groups will be systematically up-titrated, as tolerated, at 1 week intervals for a total of 3 weeks. The primary objective of this randomized clinical trial is to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer, as measured by 12 month change in left ventricular end-diastolic volume using cardiac MRI. Secondary objectives include 1) determine the evolution of left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer, 2) understand the mechanism of trastuzumab mediated cardiac toxicity by assessing for the presence of myocardial injury and apoptosis on serum biomarkers and cardiac MRI, and 3) correlate cardiac biomarkers of myocyte injury and extra-cellular matrix remodeling with left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer. Cardiac toxicity as a result of cancer therapies is now recognized as a significant health problem of increasing prevalence. To our knowledge, MANTICORE will be the first randomized trial testing proven heart failure pharmacotherapy in

  9. Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure

    Energy Technology Data Exchange (ETDEWEB)

    Kukielka, A.M.; Hetnal, M.; Dabrowski, T.; Walasek, T.; Brandys, P.; Reinfuss, M. [Centre of Oncology, M. Sklodowska - Curie Institute, Krakow Branch, Department of Radiotherapy, Krakow (Poland); Nahajowski, D.; Kudzia, R.; Dybek, D. [Centre of Oncology, M. Sklodowska - Curie Institute, Krakow Branch, Department of Medical Physics, Department of Radiotherapy, Krakow (Poland)

    2014-02-15

    The aim of the present retrospective study is to evaluate toxicity and early clinical outcomes of interstitial hyperthermia (IHT) combined with high-dose rate (HDR) brachytherapy as a salvage treatment in patients with biopsy-confirmed local recurrence of prostate cancer after previous external beam radiotherapy. Between September 2008 and March 2013, 25 patients with local recurrence of previously irradiated prostate cancer were treated. The main eligibility criteria for salvage prostate HDR brachytherapy combined with interstitial hyperthermia were biopsy confirmed local recurrence and absence of nodal and distant metastases. All patients were treated with a dose of 30 Gy in 3 fractions at 21-day intervals. We performed 62 hyperthermia procedures out of 75 planned (83 %). The aim of the hyperthermia treatment was to heat the prostate to 41-43 C for 60 min. Toxicity for the organs of the genitourinary system and rectum was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE, v. 4.03). Determination of subsequent biochemical failure was based on the Phoenix definition (nadir + 2 ng/ml). The median age was 71 years (range 62-83 years), the median initial PSA level was 16.3 ng/ml (range 6.37-64 ng/ml), and the median salvage PSA level was 2.8 ng/ml (1.044-25.346 ng/ml). The median follow-up was 13 months (range 4-48 months). The combination of HDR brachytherapy and IHT was well tolerated. The most frequent complications were nocturia, weak urine stream, urinary frequency, hematuria, and urgency. Grade 2 rectal hemorrhage was observed in 1 patient. No grade 3 or higher complications were observed. The 2-year Kaplan-Meier estimate of biochemical control after salvage treatment was 74 %. The PSA in 20 patients decreased below the presalvage level, while 11 patients achieved a PSA nadir < 0.5 ng/ml. All patients are still alive. Of the 7 patients who experienced biochemical failure, bone metastases were found in 2 patients. IHT in combination

  10. Magnet failure workshop

    Energy Technology Data Exchange (ETDEWEB)

    Marston, P G [Massachusetts Institute of Technology, Cambridge (U.S.A.); Desportes, H [C.E.N.-Saclay, 91 - Gif-sur-Yvette (France); Morpurgo, M [C.E.R.N., Geneva (Switzerland); Komarek, P [Kernforschungszentrum, Karlsruhe (Germany, FR); Van Hulst, K [University of Nijmegen (The Netherlands); Hackley, D [General Dynamics Convair, San Diego, CA (U.S.A.); Young, J L [Westinghouse Electric Corporation, East Pittsburgh, PE (U.S.A.); Kibbe, K [Oak Ridge National Laboratory (U.S.A.)

    1984-01-01

    The dictionary defines failure as nonperformance or an unacceptable want of success. (The definition implies that the results should have been avoided). In an emerging technology such as ours, the boundaries of expectations and ''unacceptable success'' are often ill defined. Failures are often touted as hugh successes (occasionally rightfully so) and exceptional technological achievement can become dismal failure (if expectations are too high). We all, however, have experienced problems of one sort or another and the basic purpose of the workshop was simply to communicate these so that new or future workers don't make the same mistakes.

  11. Failure Diameter Resolution Study

    Energy Technology Data Exchange (ETDEWEB)

    Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-12-19

    Previously the SURFplus reactive burn model was calibrated for the TATB based explosive PBX 9502. The calibration was based on fitting Pop plot data, the failure diameter and the limiting detonation speed, and curvature effect data for small curvature. The model failure diameter is determined utilizing 2-D simulations of an unconfined rate stick to find the minimum diameter for which a detonation wave propagates. Here we examine the effect of mesh resolution on an unconfined rate stick with a diameter (10mm) slightly greater than the measured failure diameter (8 to 9 mm).

  12. Magnet failure workshop

    International Nuclear Information System (INIS)

    Marston, P.G.; Desportes, H.; Morpurgo, M.; Komarek, P.; Van Hulst, K.; Hackley, D.; Young, J.L.; Kibbe, K.

    1984-01-01

    The dictionary defines failure as nonperformance or an unacceptable want of success. (The definition implies that the results should have been avoided). In an emerging technology such as ours, the boundaries of expectations and ''unacceptable success'' are often ill defined. Failures are often touted as hugh successes (occasionally rightfully so) and exceptional technological achievement can become dismal failure (if expectations are too high). We all, however, have experienced problems of one sort or another and the basic purpose of the workshop was simply to communicate these so that new or future workers don't make the same mistakes

  13. Nutrition in Heart Failure

    OpenAIRE

    Reci Meseri

    2013-01-01

    Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilem...

  14. Neurological Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Mohan Rudrappa

    2018-01-01

    Full Text Available West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.

  15. Leigh-Like Syndrome Due to Homoplasmic m.8993T>G Variant with Hypocitrullinemia and Unusual Biochemical Features Suggestive of Multiple Carboxylase Deficiency (MCD).

    Science.gov (United States)

    Balasubramaniam, Shanti; Lewis, B; Mock, D M; Said, H M; Tarailo-Graovac, M; Mattman, A; van Karnebeek, C D; Thorburn, D R; Rodenburg, R J; Christodoulou, J

    2017-01-01

    Leigh syndrome (LS), or subacute necrotizing encephalomyelopathy, is a genetically heterogeneous, relentlessly progressive, devastating neurodegenerative disorder that usually presents in infancy or early childhood. A diagnosis of Leigh-like syndrome may be considered in individuals who do not fulfil the stringent diagnostic criteria but have features resembling Leigh syndrome.We describe a unique presentation of Leigh-like syndrome in a 3-year-old boy with elevated 3-hydroxyisovalerylcarnitine (C5-OH) on newborn screening (NBS). Subsequent persistent plasma elevations of C5-OH and propionylcarnitine (C3) as well as fluctuating urinary markers were suggestive of multiple carboxylase deficiency (MCD). Normal enzymology and mutational analysis of genes encoding holocarboxylase synthetase (HLCS) and biotinidase (BTD) excluded MCD. Biotin uptake studies were normal excluding biotin transporter deficiency. His clinical features at 13 months of age comprised psychomotor delay, central hypotonia, myopathy, failure to thrive, hypocitrullinemia, recurrent episodes of decompensation with metabolic keto-lactic acidosis and an episode of hyperammonemia. Biotin treatment from 13 months of age was associated with increased patient activity, alertness, and attainment of new developmental milestones, despite lack of biochemical improvements. Whole exome sequencing (WES) analysis failed to identify any other variants which could likely contribute to the observed phenotype, apart from the homoplasmic (100%) m.8993T>G variant initially detected by mitochondrial DNA (mtDNA) sequencing.Hypocitrullinemia has been reported in patients with the m.8993T>G variant and other mitochondrial disorders. However, persistent plasma elevations of C3 and C5-OH have previously only been reported in one other patient with this homoplasmic mutation. We suggest considering the m.8993T>G variant early in the diagnostic evaluation of MCD-like biochemical disturbances, particularly when associated with

  16. Definition and Classification of Heart Failure

    Directory of Open Access Journals (Sweden)

    Mitja Lainscak

    2017-01-01

    Full Text Available A review of the definition and classification of heart failure, updated since the recent 2016 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure. Heart failure is defined by the European Society of Cardiology (ESC as a clinical syndrome characterised by symptoms such as shortness of breath, persistent coughing or wheezing, ankle swelling and fatigue, that may be accompanied by the following signs: jugular venous pressure, pulmonary crackles, increased heart rate and peripheral oedema. However, these signs may not be present in the early stages and in patients treated with diuretics. When apparent, they are due to a structural and/or functional cardiac abnormality, leading to systolic and/or diastolic ventricular dysfunction, resulting in a reduced cardiac output and/or elevated intra- cardiac pressures at rest or during stress. According to the most recent ESC guidelines the initial evaluation of patients with suspected heart failure should include a clinical history and physical examination, laboratory assessment, chest radiography, and electrocardiography. Echocardiography can confirm the diagnosis. Beyond detecting myocardial abnormality, other impairments such as abnormalities of the valves, pericardium, endocardium, heart rhythm, and conduction may be found. The identification of the underlying aetiology is pivotal for the diagnosis of heart failure and its treatment. The authors review the definitions and classifications of heart failure.

  17. Biochemical Removal of HAP Precursors From Coal

    International Nuclear Information System (INIS)

    Olson, G.; Tucker, L.; Richards, J.

    1997-07-01

    This project addresses DOE's interest in advanced concepts for controlling emissions of air toxics from coal-fired utility boilers. We are determining the feasibility of developing a biochemical process for the precombustion removal of substantial percentages of 13 inorganic hazardous air pollutant (HAP) precursors from coal. These HAP precursors are Sb, As, Be, Cd, Cr, Cl, Co, F, Pb, Hg, Mn, Ni, and Se. Although rapid physical coal cleaning is done routinely in preparation plants, biochemical processes for removal of HAP precursors from coal potentially offer advantages of deeper cleaning, more specificity, and less coal loss. Compared to chemical processes for coal cleaning, biochemical processes potentially offer lower costs and milder process conditions. Pyrite oxidizing bacteria, most notably Thiobacillusferrooxidans, are being evaluated in this project for their ability to remove HAP precursors from U.S. coals

  18. Biochemical Removal of HAP Precursors From Coal

    Energy Technology Data Exchange (ETDEWEB)

    Olson, G.; Tucker, L.; Richards, J.

    1997-07-01

    This project addresses DOE`s interest in advanced concepts for controlling emissions of air toxics from coal-fired utility boilers. We are determining the feasibility of developing a biochemical process for the precombustion removal of substantial percentages of 13 inorganic hazardous air pollutant (HAP) precursors from coal. These HAP precursors are Sb, As, Be, Cd, Cr, Cl, Co, F, Pb, Hg, Mn, Ni, and Se. Although rapid physical coal cleaning is done routinely in preparation plants, biochemical processes for removal of HAP precursors from coal potentially offer advantages of deeper cleaning, more specificity, and less coal loss. Compared to chemical processes for coal cleaning, biochemical processes potentially offer lower costs and milder process conditions. Pyrite oxidizing bacteria, most notably Thiobacillusferrooxidans, are being evaluated in this project for their ability to remove HAP precursors from U.S. coals.

  19. eQuilibrator--the biochemical thermodynamics calculator.

    Science.gov (United States)

    Flamholz, Avi; Noor, Elad; Bar-Even, Arren; Milo, Ron

    2012-01-01

    The laws of thermodynamics constrain the action of biochemical systems. However, thermodynamic data on biochemical compounds can be difficult to find and is cumbersome to perform calculations with manually. Even simple thermodynamic questions like 'how much Gibbs energy is released by ATP hydrolysis at pH 5?' are complicated excessively by the search for accurate data. To address this problem, eQuilibrator couples a comprehensive and accurate database of thermodynamic properties of biochemical compounds and reactions with a simple and powerful online search and calculation interface. The web interface to eQuilibrator (http://equilibrator.weizmann.ac.il) enables easy calculation of Gibbs energies of compounds and reactions given arbitrary pH, ionic strength and metabolite concentrations. The eQuilibrator code is open-source and all thermodynamic source data are freely downloadable in standard formats. Here we describe the database characteristics and implementation and demonstrate its use.

  20. eQuilibrator—the biochemical thermodynamics calculator

    Science.gov (United States)

    Flamholz, Avi; Noor, Elad; Bar-Even, Arren; Milo, Ron

    2012-01-01

    The laws of thermodynamics constrain the action of biochemical systems. However, thermodynamic data on biochemical compounds can be difficult to find and is cumbersome to perform calculations with manually. Even simple thermodynamic questions like ‘how much Gibbs energy is released by ATP hydrolysis at pH 5?’ are complicated excessively by the search for accurate data. To address this problem, eQuilibrator couples a comprehensive and accurate database of thermodynamic properties of biochemical compounds and reactions with a simple and powerful online search and calculation interface. The web interface to eQuilibrator (http://equilibrator.weizmann.ac.il) enables easy calculation of Gibbs energies of compounds and reactions given arbitrary pH, ionic strength and metabolite concentrations. The eQuilibrator code is open-source and all thermodynamic source data are freely downloadable in standard formats. Here we describe the database characteristics and implementation and demonstrate its use. PMID:22064852

  1. PSA bounces after neoadjuvant androgen deprivation and external beam radiation: Impact on definitions of failure

    International Nuclear Information System (INIS)

    Zietman, Anthony L.; Christodouleas, John P.; Shipley, William U.

    2005-01-01

    Purpose: To determine the characteristics of prostate specific antigen (PSA) bounces after external beam radiation therapy (EBRT) with neoadjuvant androgen deprivation and their impact on definitions of biochemical failure. Methods and Materials: Characteristics of bounce were calculated for all patients treated by EBRT with neoadjuvant androgen deprivation at our institution between 1992 and 1998 (preexclusion analysis). Calculations were repeated for the subgroup that satisfied additional inclusion/exclusion criteria (postexclusion analysis). The percentage of bounces scoring as false positives according to the ASTRO definition of biochemical failure was compared with those for three alternative definitions (Vancouver, Nadir-plus-two, and Nadir-plus-three) using McNemar's tests. Results: Thirty-nine percent (preexclusion cohort) and 56% (postexclusion cohort) of patients demonstrated a PSA bounce. Twenty percent (preexclusion analysis) and 25% (postexclusion analysis) of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition scored the smallest percentage of bounces as failure, but the difference between this definition and the ASTRO definition reached statistical significance in neither preexclusion nor postexclusion analyses (p ≥ 0.070). Conclusions: A substantial proportion of patients treated by EBRT with neoadjuvant deprivation experienced a PSA bounce. A large percentage of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition is less vulnerable to this bias

  2. Acute heart failure syndrome

    African Journals Online (AJOL)

    and the classical syndrome of chronic persistent heart failure develops. The vast ... Flash pulmonary oedema: This is a severely elevated blood pressure with an .... (CPAP or bilevelNPPV) for cardiogenic pulmonary edema (review). Cochrane.

  3. Acute Liver Failure

    Science.gov (United States)

    ... can cause acute liver failure. It is an industrial chemical found in refrigerants and solvents for waxes, varnishes ... measures when spraying insecticides, fungicides, paint and other toxic chemicals. Follow product instructions carefully. Watch what gets on ...

  4. Failure to Fail

    Directory of Open Access Journals (Sweden)

    Samuel Vriezen

    2013-07-01

    Full Text Available Between pessimism and optimism, Samuel Vriezen attempts to intuit a third way through an assessment of failure and negativity in the consonances and tensions between the prosody of Irish playwright Samuel Becekett and American poet Gertrude Stein.

  5. Inverter ratio failure detector

    Science.gov (United States)

    Wagner, A. P.; Ebersole, T. J.; Andrews, R. E. (Inventor)

    1974-01-01

    A failure detector which detects the failure of a dc to ac inverter is disclosed. The inverter under failureless conditions is characterized by a known linear relationship of its input and output voltages and by a known linear relationship of its input and output currents. The detector includes circuitry which is responsive to the detector's input and output voltages and which provides a failure-indicating signal only when the monitored output voltage is less by a selected factor, than the expected output voltage for the monitored input voltage, based on the known voltages' relationship. Similarly, the detector includes circuitry which is responsive to the input and output currents and provides a failure-indicating signal only when the input current exceeds by a selected factor the expected input current for the monitored output current based on the known currents' relationship.

  6. Acute kidney failure

    Science.gov (United States)

    ... Renal failure - acute; ARF; Kidney injury - acute Images Kidney anatomy References Devarajan P. Biomarkers for assessment of renal function during acute kidney injury. In: Alpern RJ, Moe OW, Caplan M, ...

  7. Changes in cardiac glycoside receptor sites /sup 86/ rubidium uptake and intracellular sodium concentrations in the erythrocytes of patients receiving digoxin during the early phases of treatment of cardiac failure in regular rhythm and of atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Ford, A R; Aronson, J K; Grahame-Smith, D G; Carver, J G [Medical Research Council, Oxford (UK)

    1979-08-01

    Measurements of the binding of 12-..cap alpha..-(/sup 3/H)-digoxin to the membranes of intact erythrocytes, erythrocytic /sup 86/Rb uptake and intraerythrocytic sodium concentrations have been made in the red cells of patients receiving digoxin in the short-term for atrial fibrillation or cardiac failure in regular rhythm. During the first few days of treatment (/sup 3/H)-digoxin binding and /sup 86/Rb uptake fall and intraerythrocytic sodium concentrations rise. Subsequently parallel fluctuations occur in (/sup 3/H)-digoxin binding and /sup 86/Rb uptake but not in intraerythrocytic sodium concentrations and the significance of the fluctuations is discussed. The values of all three measurements correlate significantly with the response of the heart in sinus rhythm as measured by QS/sub 2/I. Plasma digoxin concentrations do not correlate with QS/sub 2/I.

  8. Acute heart failure

    OpenAIRE

    Sénior Sánchez, Juan Manuel; Gándara Ricardo, Jairo Alfonso

    2015-01-01

    We describe the clinical case of a 26 year-old woman who came to Hospital Universitario San Vicente Fundación (Medellín, Colombia) with symptoms and signs of acute heart failure. She had been previously diagnosed with chronic heart failure with reduced ejection fraction without clear origin, pulmonary thromboembolism and ischemic stroke, without optimal neurohormonal modulation. She was admitted with clinical findings of fluid overload and low tissue perfusion, with inotropic support requirem...

  9. Biochemical activity of fullerenes and related derivatives

    International Nuclear Information System (INIS)

    Huczko, A.; Lange, H.; Calko, E.

    1999-01-01

    An astonishing scientific interest, embodied in over 15000 research articles so far, has been encountered since 1985 when fullerenes were discovered. From new superconductors to a rich electrochemistry and reaction chemistry, fullerene nanostructures continue to excite the scientific world, and new findings continue at record pace. This review presents many examples of the biochemical activities of fullerenes and derivatives, e. g. cytotoxic activity, selective DNA cleavage and antiviral activity against HIV. We also present some results of our testing which show that, despite its chemical and biochemical activity, fullerene matter does not present any health hazard directly related to skin irritation and allergic risks. (author)

  10. Reliability analysis based on the losses from failures.

    Science.gov (United States)

    Todinov, M T

    2006-04-01

    The conventional reliability analysis is based on the premise that increasing the reliability of a system will decrease the losses from failures. On the basis of counterexamples, it is demonstrated that this is valid only if all failures are associated with the same losses. In case of failures associated with different losses, a system with larger reliability is not necessarily characterized by smaller losses from failures. Consequently, a theoretical framework and models are proposed for a reliability analysis, linking reliability and the losses from failures. Equations related to the distributions of the potential losses from failure have been derived. It is argued that the classical risk equation only estimates the average value of the potential losses from failure and does not provide insight into the variability associated with the potential losses. Equations have also been derived for determining the potential and the expected losses from failures for nonrepairable and repairable systems with components arranged in series, with arbitrary life distributions. The equations are also valid for systems/components with multiple mutually exclusive failure modes. The expected losses given failure is a linear combination of the expected losses from failure associated with the separate failure modes scaled by the conditional probabilities with which the failure modes initiate failure. On this basis, an efficient method for simplifying complex reliability block diagrams has been developed. Branches of components arranged in series whose failures are mutually exclusive can be reduced to single components with equivalent hazard rate, downtime, and expected costs associated with intervention and repair. A model for estimating the expected losses from early-life failures has also been developed. For a specified time interval, the expected losses from early-life failures are a sum of the products of the expected number of failures in the specified time intervals covering the

  11. A Failure Locus for Hydrogen Assisted Failure

    DEFF Research Database (Denmark)

    Fuentes-Alonso, Sandra; Harris, Zach D.; Burns, James T.

    2017-01-01

    of a hydrogen-dependent traction separation law. A special control algorithm is employed to overcome numerical instabilities intrinsically associated with cohesive zone formulations. The fracture energy is degraded by means of an experimentally-motivated hydrogen degradation relation. Numerical results provide...... important insight into the failure process, enabling to identify critical values of hydrogen concentration and remote stresses that trigger cracking. The work builds upon previous works by the authors and brings important insight into the technologically important problem of hydrogen assisted cracking....

  12. The human sunburn reaction: histologic and biochemical studies

    International Nuclear Information System (INIS)

    Gilchrest, B.A.; Soter, N.A.; Stoff, J.S.; Mihm, M.C. Jr.

    1981-01-01

    The ultraviolet-induced erythema reaction was investigated histologically and biochemically in four subjects, utilizing suction blister aspirates, analyzed for histamine and prostaglandin E2 (PGE2), and Epon-embedded 1-mu skin biopsy sections from control skin and from irradiated skin at intervals for 72 hours after exposure to a Hanovia lamp. Major histologic alterations in the epidermis included dyskeratotic and vacuolated keratinocytes (sunburn cells), and disappearance of Langerhans cells. In the dermis the major changes were vascular, involving both the superficial and deep venular plexuses. Endothelial cell enlargement was first apparent within 30 minutes of irradiation, peaked at 24 hours, and persisted throughout the 72-hour study period. Mast cell degranulation and associated perivenular edema were first apparent at 1 hour and striking at the onset of erythema, 3 to 4 hours postirradiation; edema was absent and mast cells were again normal in number and granule content at 24 hours. Histamine levels rose approximately fourfold above control values immediately after the onset of erythema and returned to baseline within 24 hours. PGE2 levels were statistically elevated even before the onset of erythema and reached approximately 150% of the control value at 24 hours. These data provide the first evidence that histamine may mediate the early phase of the human sunburn reaction and increase our understanding of its complex histologic and biochemical sequelae

  13. Clinical and Biochemical Characteristics of Children with Juvenile Idiopathic Arthritis

    International Nuclear Information System (INIS)

    Ahmed, S.; Ali, S. R.; Ishaque, S.

    2014-01-01

    Objective: To determine the clinical and biochemical characteristics of children with Juvenile Idiopathic Arthritis (JIA) at a tertiary care centre in Karachi, Pakistan. Study Design: A descriptive study. Place and Duration of Study: Paediatric Rheumatology Clinic of The Aga Khan University Hospital (AKUH), Karachi, from January 2008 to December 2011. Methodology: Clinical and laboratory profile and outcome of children less than 15 years of age attending the Paediatric Rheumatology Clinic of the Aga Khan University, Karachi with the diagnosis of Juvenile Idiopathic Arthritis according to International League against Rheumatism were studied. These children were classified into different types of JIA; their clinical and laboratory characteristics, response to therapy and outcome was evaluated. Results: Sixty eight patients satisfying the criteria of International League against Rheumatism (ILAR) for Juvenile Idiopathic Arthritis were enrolled during the study period of four consecutive years, their age ranged from 9 months to 15 years. Mean age at onset was 6.45 +- 4.03 years while mean age at diagnosis was 7.60 +- 3.93 years. Polyarticular was the most predominant subtype with 37 (54%) patients, out of these, 9 (24%) were rheumatoid factor positive. An almost equal gender predisposition was observed. Fever and arthritis were the most common presenting symptoms, with only 2 patients presenting with uveitis. Conclusion: The clinico-biochemical characteristics of JIA at the study centre showed a pattern distinct with early onset of disease, high frequency of polyarticular type and a higher rheumatoid factor (QRA) and ANA positivity in girls. (author)

  14. Physiological and biochemical aspects of the effect of ionizing radiations on the lung parenchyma

    International Nuclear Information System (INIS)

    Pasquier, Christian.

    1975-03-01

    Concerning the biochemical reactions of the lung parenchyma to irradiation the following points have been developed. Role of biochemically active substances (histamine, serotonin, kinins, catecholamines, prostaglandins) in the early reaction of the lung to irradiation, their common feature being their vascular impact point. Lung irradiation and lipids (fatty acids and lipid metabolism in general); irradiation, by raising the proportion of unsaturated at the expense of saturated fatty acids, may give rise to serious physiological respiratory disorders. Lung irradiation and blood fluidity (fibrinolytic activity, heparin, platelet factors). Pulmonary interstitium and irradiation (of the three interstitium components collagen plays a preferential part). Irradiation and immunological lung reaction (reasons behind the immunological theory, immunological assistance, immunological mechanism of pulmonary reactions towards pollutants). Enzymatic lung radiolesion indicators. Three kinds of physiological changes have been considered. Vascular physiology disturbances caused by the initial biochemical reactions; anomalies of physiological or functional trials, images of the lesion formed; disorders of the cell physiology of carcinogenesis [fr

  15. Structure and biochemical characterization of proliferating cellular nuclear antigen from a parasitic protozoon

    Energy Technology Data Exchange (ETDEWEB)

    Cardona-Felix, Cesar S.; Lara-Gonzalez, Samuel; Brieba, Luis G. (LNLS)

    2012-02-08

    Proliferating cellular nuclear antigen (PCNA) is a toroidal-shaped protein that is involved in cell-cycle control, DNA replication and DNA repair. Parasitic protozoa are early-diverged eukaryotes that are responsible for neglected diseases. In this work, a PCNA from a parasitic protozoon was identified, cloned and biochemically characterized and its crystal structure was determined. Structural and biochemical studies demonstrate that PCNA from Entamoeba histolytica assembles as a homotrimer that is able to interact with and stimulate the activity of a PCNA-interacting peptide-motif protein from E. histolytica, EhDNAligI. The data indicate a conservation of the biochemical mechanisms of PCNA-mediated interactions between metazoa, yeast and parasitic protozoa.

  16. BANK FAILURE PREDICTION WITH LOGISTIC REGRESSION

    Directory of Open Access Journals (Sweden)

    Taha Zaghdoudi

    2013-04-01

    Full Text Available In recent years the economic and financial world is shaken by a wave of financial crisis and resulted in violent bank fairly huge losses. Several authors have focused on the study of the crises in order to develop an early warning model. It is in the same path that our work takes its inspiration. Indeed, we have tried to develop a predictive model of Tunisian bank failures with the contribution of the binary logistic regression method. The specificity of our prediction model is that it takes into account microeconomic indicators of bank failures. The results obtained using our provisional model show that a bank's ability to repay its debt, the coefficient of banking operations, bank profitability per employee and leverage financial ratio has a negative impact on the probability of failure.

  17. Failure to thrive in babies and toddlers.

    Science.gov (United States)

    Goh, Lay Hoon; How, Choon How; Ng, Kar Hui

    2016-06-01

    Failure to thrive in a child is defined as 'lack of expected normal physical growth' or 'failure to gain weight'. Diagnosis requires repeated growth measurements over time using local, age-appropriate growth centile charts. Premature babies with appropriate growth velocity and children with 'catch-down' growth, constitutional growth delay or familial short stature show normal growth variants, and usually do not require further evaluation. In Singapore, the most common cause of failure to thrive in children is malnutrition secondary to psychosocial and caregiver factors. 'Picky eating' is common in the local setting and best managed with an authoritative feeding style from caregivers. Other causes are malabsorption and existing congenital or chronic medical conditions. Child neglect or abuse should always be ruled out. Iron deficiency is the most common complication. The family doctor plays a pivotal role in early detection, timely treatment, appropriate referrals and close monitoring of 'catch-up' growth in these children. Copyright: © Singapore Medical Association.

  18. Lower head failure analysis

    International Nuclear Information System (INIS)

    Rempe, J.L.; Thinnes, G.L.; Allison, C.M.; Cronenberg, A.W.

    1991-01-01

    The US Nuclear Regulatory Commission is sponsoring a lower vessel head research program to investigate plausible modes of reactor vessel failure in order to determine (a) which modes have the greatest likelihood of occurrence during a severe accident and (b) the range of core debris and accident conditions that lead to these failures. This paper presents the methodology and preliminary results of an investigation of reactor designs and thermodynamic conditions using analytic closed-form approximations to assess the important governing parameters in non-dimensional form. Preliminary results illustrate the importance of vessel and tube geometrical parameters, material properties, and external boundary conditions on predicting vessel failure. Thermal analyses indicate that steady-state temperature distributions will occur in the vessel within several hours, although the exact time is dependent upon vessel thickness. In-vessel tube failure is governed by the tube-to-debris mass ratio within the lower head, where most penetrations are predicted to fail if surrounded by molten debris. Melt penetration distance is dependent upon the effective flow diameter of the tube. Molten debris is predicted to penetrate through tubes with a larger effective flow diameter, such as a boiling water reactor (BWR) drain nozzle. Ex-vessel tube failure for depressurized reactor vessels is predicted to be more likely for a BWR drain nozzle penetration because of its larger effective diameter. At high pressures (between ∼0.1 MPa and ∼12 MPa) ex-vessel tube rupture becomes a dominant failure mechanism, although tube ejection dominates control rod guide tube failure at lower temperatures. However, tube ejection and tube rupture predictions are sensitive to the vessel and tube radial gap size and material coefficients of thermal expansion

  19. Construction of Academic Success and Failure in School Memories

    Science.gov (United States)

    Kaya, Gamze Inan

    2018-01-01

    The idea of "Apprenticeship of Observation", proposing that pre-service teachers' early academic experiences might have effects on their professional development, has been a concern in teacher education in the last forty years. Early success or failure experiences of pre-service teachers in school may have a role in their professional…

  20. Graves' disease presenting as right heart failure with severe pulmonary hypertension

    OpenAIRE

    Furqan Mohd Akram Khan; Anannya Mukherji; Shekhar T. Nabar; Ashwini G

    2016-01-01

    We report a patient who presented to our institution with clinical features of right sided heart failure and hyperthyroidism. Diagnosis of grave's disease induced reversible severe pulmonary hypertension leading to severe tricuspid regurgitation and right sided heart failure was made after all the common causes were ruled out using the biochemical and radiological investigations and review of literature. Graves disease is a common cause hyperthyroidism, is an immune system disorder that resul...

  1. Dependent failures of diesel generators

    International Nuclear Information System (INIS)

    Mankamo, T.; Pulkkinen, U.

    1982-01-01

    This survey of dependent failures (common-cause failures) is based on the data of diesel generator failures in U. S. nuclear power plants as reported in Licensee Event Reports. Failures were classified into random and potentially dependent failures. All failures due to design errors, manufacturing or installation errors, maintenance errors, or deviations in the operational environment were classified as potentially dependent failures.The statistical dependence between failures was estimated from the relative portion of multiple failures. Results confirm the earlier view of the significance of statistical dependence, a strong dependence on the age of the diesel generator was found in each failure class excluding random failures and maintenance errors, which had a nearly constant frequency independent of diesel generator age

  2. Biochemical characterization of Tunisian grapevine varieties

    Directory of Open Access Journals (Sweden)

    Ferjani Ben Abdallah

    1998-03-01

    The study of GPI, PGM, AAT and peroxydase isozyme banding patterns in combination with berry colour has led to establish a classification of the 61 autochton varieties into 37 groups including 26 varieties definitely differentiated through the results of this biochemical study.

  3. Survey of Biochemical Education in Japanese Universities.

    Science.gov (United States)

    Kagawa, Yasuo

    1995-01-01

    Reports findings of questionnaires sent to faculty in charge of biochemical education in medical schools and other programs from dentistry to agriculture. Total class hours have declined since 1984. New trends include bioethics and computer-assisted learning. Tables show trends in lecture hours, lecture content, laboratory hours, core subject…

  4. Haematological and biochemical responses of starter broiler ...

    African Journals Online (AJOL)

    A study was conducted to investigate the haematological and biochemical responses of starter broiler chickens fed copper and probiotics supplemented diets. A total of 180-day old Marshal broiler chicks were randomly allotted to six treatment groups of 30 birds each. The treatments were divided into three replicates of ten ...

  5. Probabilistic sensitivity analysis of biochemical reaction systems.

    Science.gov (United States)

    Zhang, Hong-Xuan; Dempsey, William P; Goutsias, John

    2009-09-07

    Sensitivity analysis is an indispensable tool for studying the robustness and fragility properties of biochemical reaction systems as well as for designing optimal approaches for selective perturbation and intervention. Deterministic sensitivity analysis techniques, using derivatives of the system response, have been extensively used in the literature. However, these techniques suffer from several drawbacks, which must be carefully considered before using them in problems of systems biology. We develop here a probabilistic approach to sensitivity analysis of biochemical reaction systems. The proposed technique employs a biophysically derived model for parameter fluctuations and, by using a recently suggested variance-based approach to sensitivity analysis [Saltelli et al., Chem. Rev. (Washington, D.C.) 105, 2811 (2005)], it leads to a powerful sensitivity analysis methodology for biochemical reaction systems. The approach presented in this paper addresses many problems associated with derivative-based sensitivity analysis techniques. Most importantly, it produces thermodynamically consistent sensitivity analysis results, can easily accommodate appreciable parameter variations, and allows for systematic investigation of high-order interaction effects. By employing a computational model of the mitogen-activated protein kinase signaling cascade, we demonstrate that our approach is well suited for sensitivity analysis of biochemical reaction systems and can produce a wealth of information about the sensitivity properties of such systems. The price to be paid, however, is a substantial increase in computational complexity over derivative-based techniques, which must be effectively addressed in order to make the proposed approach to sensitivity analysis more practical.

  6. Biochemical applications of FT-IR spectroscopy

    NARCIS (Netherlands)

    Pistorius, A.M.A.

    1996-01-01

    This thesis describes the use of (FT-)IR spectroscopy in general biochemical research. In chapter 3, IR spectroscopy is used in the quantitation of residual detergent after reconstitution of an integral membrane protein in a pre-defined lipid matrix. This chapter discusses the choice of the

  7. Some hematological and biochemical parameters in smokeless ...

    African Journals Online (AJOL)

    AJB SERVER

    2007-01-04

    Jan 4, 2007 ... The effect of Jharda powder (smokeless tobacco) on some hematological and biochemical parameters in consumers was investigated. Hematological parameters including hemoglobin content and white blood cell and leukocyte counts were higher in jharda powder consumers, while monocytes and.

  8. 2009 Biochemical Conversion Platform Review Report

    Energy Technology Data Exchange (ETDEWEB)

    Ferrell, John [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States)

    2009-12-01

    This document summarizes the recommendations and evaluations provided by an independent external panel of experts at the U.S. Department of Energy Biomass Program’s Biochemical Conversion platform review meeting, held on April 14-16, 2009, at the Sheraton Denver Downtown, Denver, Colorado.

  9. Some hematological and biochemical parameters in smokeless ...

    African Journals Online (AJOL)

    The effect of Jharda powder (smokeless tobacco) on some hematological and biochemical parameters in consumers was investigated. Hematological parameters including hemoglobin content and white blood cell and leukocyte counts were higher in jharda powder consumers, while monocytes and basophiles counts were ...

  10. Haematological And Biochemical Effects Of Sulphadimidine In ...

    African Journals Online (AJOL)

    Haematological and biochemical efects of sulphadmidine were studied in Nigerian mongrel dogs. Five Nigerian mongrel dogs of either sex weighing between 7 and 12 kg were used for the study. The pretreatment blood and serum samples were collected and the weight of animals taken before the administraton of 100 ...

  11. Biochemical and secondary metabolites changes under moisture ...

    African Journals Online (AJOL)

    The study showed the importance of carbohydrate and nitrogen cycle related metabolites in mediating tolerance in cassava by affecting their phenotypic expression in the plant. Keywords: Hydrothermal stress, bio-chemicals, pigments, secondary metabolites, cassava. African Journal of Biotechnology, Vol 13(31) 3173-3186 ...

  12. Biochemical and serological characterization of Escherichia coli ...

    African Journals Online (AJOL)

    This study was designed to determine the isolation rate, serotypes and biochemical profiles of E. coli from colibacillosis and dead-in-shell embryos in Zaria, Northern-Nigeria. The isolation rate of E. coli from hatcheries studied were 4.67% and 7.50% from farms of Simtu Agricultural Company and National Animal Production ...

  13. Biochemical and Kinetic Characterization of Geranylgeraniol 18 ...

    African Journals Online (AJOL)

    This enzyme and its gene are an attractive target for development of plaunotol production and its detailed biochemical properties need to be understood. Recently, even though the gene (CYP97C27) coding for GGOH 18-hydroxylase has been identified, cloned, and expressed in Escherichia coli system, the enzyme activity ...

  14. Characterizing multistationarity regimes in biochemical reaction networks.

    Directory of Open Access Journals (Sweden)

    Irene Otero-Muras

    Full Text Available Switch like responses appear as common strategies in the regulation of cellular systems. Here we present a method to characterize bistable regimes in biochemical reaction networks that can be of use to both direct and reverse engineering of biological switches. In the design of a synthetic biological switch, it is important to study the capability for bistability of the underlying biochemical network structure. Chemical Reaction Network Theory (CRNT may help at this level to decide whether a given network has the capacity for multiple positive equilibria, based on their structural properties. However, in order to build a working switch, we also need to ensure that the bistability property is robust, by studying the conditions leading to the existence of two different steady states. In the reverse engineering of biological switches, knowledge collected about the bistable regimes of the underlying potential model structures can contribute at the model identification stage to a drastic reduction of the feasible region in the parameter space of search. In this work, we make use and extend previous results of the CRNT, aiming not only to discriminate whether a biochemical reaction network can exhibit multiple steady states, but also to determine the regions within the whole space of parameters capable of producing multistationarity. To that purpose we present and justify a condition on the parameters of biochemical networks for the appearance of multistationarity, and propose an efficient and reliable computational method to check its satisfaction through the parameter space.

  15. Evaluation of Haematological and Biochemical Parameters of ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Evaluation of Haematological and Biochemical Parameters of Juvenile Oreochromis niloticus after Exposure to Water Soluble Fractions of ... niloticus were evaluated. After a preliminary determination of the 96 h-LC50 of ... evaporation, dissolution, emulsion, photolysis and biodegradation which generate a water soluble.

  16. Metabonomics and medicine: the Biochemical Oracle.

    Science.gov (United States)

    Mitchell, Steve; Holmes, Elaine; Carmichael, Paul

    2002-10-01

    Occasionally, a new idea emerges that has the potential to revolutionize an entire field of scientific endeavour. It is now within our grasp to be able to detect subtle perturbations within the phenomenally complex biochemical matrix of living organisms. The discipline of metabonomics promises an all-encompassing approach to understanding total, yet fundamental, changes occurring in disease processes, drug toxicity and cell function.

  17. Discordant results between biochemical and molecular transthyretin

    Indian Academy of Sciences (India)

    Discordant results between biochemical and molecular transthyretin assays: lessons learned from a unique testing algorithm at the Mayo Clinic. Honey V. Reddi Brittany C. Thomas Kurt S. Willkomm Matthew J. Ferber Kandelaria M. Rumilla Kimiyo M. Raymond John F. O'Brien W. Edward Highsmith. Research Note Volume ...

  18. Biochemical and microstructural characteristics of meat samples ...

    African Journals Online (AJOL)

    This study was conducted to compare the efficiency of different plant proteases for changing biochemical and microstructural characteristics in muscle foods. The meat samples from chicken, giant catfish, pork and beef were treated with four types of proteolytic enzymes: Calotropis procera latex proteases, papaya latex ...

  19. Biochemical paths in humans and cells: Frontiers of AMS bioanalysis

    International Nuclear Information System (INIS)

    Vogel, J.S.; Palmblad, N.M.; Ognibene, T.; Kabir, M.M.; Buchholz, B.A.; Bench, G.

    2007-01-01

    The publication rate of 3 H and 14 C use in biomedical research decreased by a factor of three since 1990 when the first applications of AMS in biomedicine were published. Against this decrease, the high sensitivity of AMS for these isotopes in small isolated samples has made significant contributions. New smaller spectrometers and increased commercial availability of AMS have solved some of the issues surrounding availability and cost, but improved quantitation in non-isotopic methods now compete with some early uses of AMS. We review the strength of AMS for quantifying rare biochemical events and chemical passages through individual people or cells and consider these as the frontiers of quantitation leading to profitable science unavailable to other techniques

  20. Biochemical markers for prediction of preclampsia: review of the literature.

    Science.gov (United States)

    Monte, Santo

    2011-07-01

    Preeclampsia (PE) is one of the most common diseases worldwide, complicating ~5% of all pregnancies.Although no major progress has been achieved in the treatment of PE, our ability to identify women at highrisk has increased considerably during the past decade.The early identification of patients with an increased risk for preeclampsia is therefore one of the most important goals in obstetrics. Today, several markers may offer the potential to be used, most likely in a combinatory analysis, as predictors or diagnostic tools. We present here the current knowledge on the biology of preeclampsia and review several biochemical markers which may be used to monitor preeclampsia in a future, that, we hope, is not to distant from today.

  1. Acute-on-chronic Liver Failure.

    Science.gov (United States)

    Sarin, Shiv Kumar; Choudhury, Ashok

    2016-12-01

    Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame. ACLF is characterized by a state of deregulated inflammation. Initial cytokine burst presenting as SIRS, progression to CARS and associated immunoparalysis leads to sepsis and multi-organ failure. Early identification of the acute insult and mitigation of the same, use of nucleoside analogue in HBV-ACLF, steroid in severe alcoholic hepatitis, steroid in severe autoimmune hepatitis and/or bridging therapy lead to recovery, with a 90-day transplant-free survival rate of up to 50 %. First-week presentation is crucial concerning SIRS/sepsis, development, multiorgan failure and consideration of transplant. A protocol-based multi-disciplinary approach including critical care hepatology, early liver transplant before multi-organ involvement, or priority for organ allocation may improve the outcome. Presentation with extrahepatic organ involvement or inclusion of sepsis as an acute insult in definition restricts the therapy, i.e., liver transplant or bridging therapy, and needs serious consideration. Augmentation of regeneration, cell-based therapy, immunotherapy, and gut microbiota modulation are the emerging areas and need further research.

  2. Nutrition in Heart Failure

    Directory of Open Access Journals (Sweden)

    Reci Meseri

    2013-10-01

    Full Text Available Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilemma. Since one of the main reasons of heart failure is cardiovascular diseases, in first phase, the patient may be obese. In the later phases, cachexia may show up. It was shown that cachexia is associated with mortality. Within this period, patients should not be over-fed and the patient should pass from catabolic state to anabolic state slowly. If the gastrointestinal track is functional oral/enteral feeding must be preferred. Multi vitamin and mineral supportsmay be beneficial, which may replace the increased loss, increase anti-inflammatory response and be anti-oxidants. Large, controlled and well-designed studies must be conducted in order to evaluate the benefits of nutritional practices such as nutritional assessment, enteral feeding and nutrient supports in heart failure patients.

  3. Syndromic (phenotypic diarrhea in early infancy

    Directory of Open Access Journals (Sweden)

    Bodemer Christine

    2008-02-01

    Full Text Available Abstract Syndromic diarrhea (SD, also known as phenotypic diarrhea (PD or tricho-hepato-enteric syndrome (THE, is a congenital enteropathy presenting with early-onset of severe diarrhea requiring parenteral nutrition (PN. To date, no epidemiological data are available. The estimated prevalence is approximately 1/300,000–400,000 live births in Western Europe. Ethnic origin does not appear to be associated with SD. Infants are born small for gestational age and present with facial dysmorphism including prominent forehead and cheeks, broad nasal root and hypertelorism. Hairs are woolly, easily removed and poorly pigmented. Severe and persistent diarrhea starts within the first 6 months of life (≤ 1 month in most cases and is accompanied by severe malabsorption leading to early and relentless protein energy malnutrition with failure to thrive. Liver disease affects about half of patients with extensive fibrosis or cirrhosis. There is currently no specific biochemical profile, though a functional T-cell immune deficiency with defective antibody production was reported. Microscopic analysis of the hair show twisted hair (pili torti, aniso- and poilkilotrichosis, and trichorrhexis nodosa. Histopathological analysis of small intestine biopsy shows non-specific villous atrophy with low or no mononuclear cell infiltration of the lamina propria, and no specific histological abnormalities involving the epithelium. The etiology remains unknown. The frequent association of the disorder with parental consanguinity and/or affected siblings suggests a genetic origin with an autosomal recessive mode of transmission. Early management consists of total PN. Some infants have a rather milder phenotype with partial PN dependency or require only enteral feeding. Prognosis of this syndrome is poor, but most patients now survive, and about half of the patients may be weaned from PN at adolescence, but experience failure to thrive and final short stature. Disease name

  4. Failure mechanism dependence and reliability evaluation of non-repairable system

    International Nuclear Information System (INIS)

    Chen, Ying; Yang, Liu; Ye, Cui; Kang, Rui

    2015-01-01

    Reliability study of electronic system with the physics-of-failure method has been promoted due to the increase knowledge of electronic failure mechanisms. System failure initiates from independent failure mechanisms, have effect on or affect by other failure mechanisms and finally result in system failure. Failure mechanisms in a non-repairable system have many kinds of correlation. One failure mechanism developing to a certain degree will trigger, accelerate or inhibit another or many other failure mechanisms, some kind of failure mechanisms may have the same effect on the failure site, component or system. The destructive effect will be accumulated and result in early failure. This paper presents a reliability evaluation method considering correlativity among failure mechanisms, which includes trigger, acceleration, inhibition, accumulation, and competition. Based on fundamental rule of physics of failure, decoupling methods of these correlations are discussed. With a case, reliability of electronic system is evaluated considering failure mechanism dependence. - Highlights: • Five types of failure mechanism correlations are described. • Decoupling methods of these correlations are discussed. • A reliability evaluation method considering mechanism dependence is proposed. • Results are quite different to results under failure independence assumption

  5. Serum testosterone level as a predictor of biochemical failure after radical prostatectomy for localized prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Christensen, Ib Jarle; Berg, Kasper Drimer

    2012-01-01

    Study Type - Aetiology (individual cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The precise relationship between serum testosterone (T) and prostate cancer (PCa) incidence and progression is controversial. Low pre-treatment serum T correlates with higher...

  6. Biochemical study on some adipocyto-kines in chronic renal failure ...

    African Journals Online (AJOL)

    Visfatin, apelin, TAT, ICAM, VCAM, CD40L, PAI-1, E-selectin, hsCRP, IL-1â and triglycerides were elevated while serum albumin and t-PA were decreased in CRF patients when compared with the control group.Significant positive correlations were found between Visfatin on one hand and each of apelin, t-PA, PAI-1, ...

  7. Ductile failure modeling

    DEFF Research Database (Denmark)

    Benzerga, Ahmed Amine; Leblond, Jean Baptiste; Needleman, Alan

    2016-01-01

    Ductile fracture of structural metals occurs mainly by the nucleation, growth and coalescence of voids. Here an overview of continuum models for this type of failure is given. The most widely used current framework is described and its limitations discussed. Much work has focused on extending void...... growth models to account for non-spherical initial void shapes and for shape changes during growth. This includes cases of very low stress triaxiality, where the voids can close up to micro-cracks during the failure process. The void growth models have also been extended to consider the effect of plastic...... anisotropy, or the influence of nonlocal effects that bring a material size scale into the models. Often the voids are not present in the material from the beginning, and realistic nucleation models are important. The final failure process by coalescence of neighboring voids is an issue that has been given...

  8. Acute renal failure in Yemeni patients

    Directory of Open Access Journals (Sweden)

    Muhamed Al Rohani

    2011-01-01

    Full Text Available Acute renal failure (ARF is defined as a rapid decrease in the glomerular filtration rate, occurring over a period of hours to days. The Science and Technology University Hospital, Sana′a, is a referral hospital that caters to patients from all parts of Yemen. The aim of this study is to have a deeper overview about the epidemiological status of ARF in Yemeni patients and to identify the major causes of ARF in this country. We studied 203 patients with ARF over a period of 24 months. We found that tropical infectious diseases constituted the major causes of ARF, seen in 45.3% of the patients. Malaria was the most important and dominant infectious disease causing ARF. Hypotension secondary to infection or cardiac failure was seen in 28.6% of the patients. Obstructive nephropathy due to urolithiasis or prostate enlargement was the cause of ARF in a small number of patients. ARF was a part of multi-organ failure in 19.7% of the patients, and was accompanied by a high mortality rate. Majority of the patients were managed conservatively, and only 39.9% required dialysis. Our study suggests that early detection of renal failure helps improve the outcome and return of renal function to normal. Mortality was high in patients with malaria and in those with associated hepatocellular failure.

  9. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...... the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used...... to evaluate multiple epidemic scenarios in various network types....

  10. Echo and heart failure

    DEFF Research Database (Denmark)

    Modin, Daniel; Andersen, Ditte Madsen; Biering-Sørensen, Tor

    2018-01-01

    Heart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid in establis......Heart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid...

  11. Generalized Block Failure

    DEFF Research Database (Denmark)

    Jönsson, Jeppe

    2015-01-01

    Block tearing is considered in several codes as a pure block tension or a pure block shear failure mechanism. However in many situations the load acts eccentrically and involves the transfer of a substantial moment in combination with the shear force and perhaps a normal force. A literature study...... shows that no readily available tests with a well-defined substantial eccentricity have been performed. This paper presents theoretical and experimental work leading towards generalized block failure capacity methods. Simple combination of normal force, shear force and moment stress distributions along...... yield lines around the block leads to simple interaction formulas similar to other interaction formulas in the codes....

  12. Accuracy of a Rationally Derived Method for Identifying Treatment Failure in Children and Adolescents

    Science.gov (United States)

    Bishop, Matthew J.; Bybee, Taige S.; Lambert, Michael J.; Burlingame, Gary M.; Wells, M. Gawain; Poppleton, Landon E.

    2005-01-01

    Psychotherapy outcome can be enhanced by early identification of potential treatment failures before they leave treatment. In adults, compelling data are emerging that provide evidence that an early warning system that identifies potential treatment failures can be developed and applied to enhance outcome. The present study reports an analysis of…

  13. Modification in CSF specific gravity in acutely decompensated cirrhosis and acute on chronic liver failure independent of encephalopathy, evidences for an early blood-CSF barrier dysfunction in cirrhosis.

    Science.gov (United States)

    Weiss, Nicolas; Rosselli, Matteo; Mouri, Sarah; Galanaud, Damien; Puybasset, Louis; Agarwal, Banwari; Thabut, Dominique; Jalan, Rajiv

    2017-04-01

    Although hepatic encephalopathy (HE) on the background of acute on chronic liver failure (ACLF) is associated with high mortality rates, it is unknown whether this is due to increased blood-brain barrier permeability. Specific gravity of cerebrospinal fluid measured by CT is able to estimate blood-cerebrospinal fluid-barrier permeability. This study aimed to assess cerebrospinal fluid specific gravity in acutely decompensated cirrhosis and to compare it in patients with or without ACLF and with or without hepatic encephalopathy. We identified all the patients admitted for acute decompensation of cirrhosis who underwent a brain CT-scan. Those patients could present acute decompensation with or without ACLF. The presence of hepatic encephalopathy was noted. They were compared to a group of stable cirrhotic patients and healthy controls. Quantitative brain CT analysis used the Brainview software that gives the weight, the volume and the specific gravity of each determined brain regions. Results are given as median and interquartile ranges and as relative variation compared to the control/baseline group. 36 patients presented an acute decompensation of cirrhosis. Among them, 25 presented with ACLF and 11 without ACLF; 20 presented with hepatic encephalopathy grade ≥ 2. They were compared to 31 stable cirrhosis patients and 61 healthy controls. Cirrhotic patients had increased cerebrospinal fluid specific gravity (CSF-SG) compared to healthy controls (+0.4 %, p encephalopathy did not modify CSF-SG (-0.09 %, p = 0.1757). Specific gravity did not differ between different brain regions according to the presence or absence of either ACLF or HE. In patients with acute decompensation of cirrhosis, and those with ACLF, CSF specific gravity is modified compared to both stable cirrhotic patients and healthy controls. This pattern is observed even in the absence of hepatic encephalopathy suggesting that blood-CSF barrier impairment is manifest even in absence of overt

  14. European spruce bark beetle (Ips typographus, L.) green attack affects foliar reflectance and biochemical properties

    Science.gov (United States)

    Abdullah, Haidi; Darvishzadeh, Roshanak; Skidmore, Andrew K.; Groen, Thomas A.; Heurich, Marco

    2018-02-01

    The European spruce bark beetle Ips typographus, L. (hereafter bark beetle), causes major economic loss to the forest industry in Europe, especially in Norway Spruce (Picea abies). To minimise economic loss and preclude a mass outbreak, early detection of bark beetle infestation (so-called ;green attack; stage - a period at which trees are yet to show visual signs of infestation stress) is, therefore, a crucial step in the management of Norway spruce stands. It is expected that a bark beetle infestation at the green attack stage affects a tree's physiological and chemical status. However, the concurrent effect on key foliar biochemical such as foliar nitrogen and chlorophyll as well as spectral responses are not well documented in the literature. Therefore, in this study, the early detection of bark beetle green attacks is investigated by examining foliar biochemical and spectral properties (400-2000 nm). We also assessed whether bark beetle infestation affects the estimation accuracy of foliar biochemicals. An extensive field survey was conducted in the Bavarian Forest National Park (BFNP), Germany, in the early summer of 2015 to collect leaf samples from 120 healthy and green attacked trees. The spectra of the leaf samples were measured using an ASD FieldSpec3 equipped with an integrating sphere. Significant differences (p < 0.05) between healthy and infested needle samples were found in the mean reflectance spectra, with the most pronounced differences being observed in the NIR and SWIR regions between 730 and 1370 nm. Furthermore, significant differences (p < 0.05) were found in the biochemical compositions (chlorophyll and nitrogen concentration) of healthy versus green attacked samples. Our results further demonstrate that the estimation accuracy of foliar chlorophyll and nitrogen concentrations, utilising partial least square regression model, was lower for the infested compared to the healthy trees. We show that early stage of infestation reduces not only

  15. Kombucha tea fermentation: Microbial and biochemical dynamics.

    Science.gov (United States)

    Chakravorty, Somnath; Bhattacharya, Semantee; Chatzinotas, Antonis; Chakraborty, Writachit; Bhattacharya, Debanjana; Gachhui, Ratan

    2016-03-02

    Kombucha tea, a non-alcoholic beverage, is acquiring significant interest due to its claimed beneficial properties. The microbial community of Kombucha tea consists of bacteria and yeast which thrive in two mutually non-exclusive compartments: the soup or the beverage and the biofilm floating on it. The microbial community and the biochemical properties of the beverage have so far mostly been described in separate studies. This, however, may prevent understanding the causal links between the microbial communities and the beneficial properties of Kombucha tea. Moreover, an extensive study into the microbial and biochemical dynamics has also been missing. In this study, we thus explored the structure and dynamics of the microbial community along with the biochemical properties of Kombucha tea at different time points up to 21 days of fermentation. We hypothesized that several biochemical properties will change during the course of fermentation along with the shifts in the yeast and bacterial communities. The yeast community of the biofilm did not show much variation over time and was dominated by Candida sp. (73.5-83%). The soup however, showed a significant shift in dominance from Candida sp. to Lachancea sp. on the 7th day of fermentation. This is the first report showing Candida as the most dominating yeast genus during Kombucha fermentation. Komagateibacter was identified as the single largest bacterial genus present in both the biofilm and the soup (~50%). The bacterial diversity was higher in the soup than in the biofilm with a peak on the seventh day of fermentation. The biochemical properties changed with the progression of the fermentation, i.e., beneficial properties of the beverage such as the radical scavenging ability increased significantly with a maximum increase at day 7. We further observed a significantly higher D-saccharic acid-1,4-lactone content and caffeine degradation property compared to previously described Kombucha tea fermentations. Our

  16. Characterization of Ions in Urine of Animal Model with Acute Renal Failure using NAA

    Science.gov (United States)

    Oliveira, Laura C.; Zamboni, Cibele B.; Pessoal, Edson A.; Borges, Fernanda T.

    2011-08-01

    Neutron Activation Analysis (NAA) technique has been used to determine elements concentrations in urine of rats Wistar (control group) and rats Wistar with Acute Renal Failure (ARF). These data contribute for applications in health area related to biochemical analyses using urine to monitor the dialyze treatment.

  17. Characterization of Ions in Urine of Animal Model with Acute Renal Failure using NAA

    International Nuclear Information System (INIS)

    Oliveira, Laura C.; Zamboni, Cibele B.; Pessoal, Edson A.; Borges, Fernanda T.

    2011-01-01

    Neutron Activation Analysis (NAA) technique has been used to determine elements concentrations in urine of rats Wistar (control group) and rats Wistar with Acute Renal Failure (ARF). These data contribute for applications in health area related to biochemical analyses using urine to monitor the dialyze treatment.

  18. Isogeometric failure analysis

    NARCIS (Netherlands)

    Verhoosel, C.V.; Scott, M.A.; Borden, M.J.; Borst, de R.; Hughes, T.J.R.; Mueller-Hoeppe, D.; Loehnert, S.; Reese, S.

    2011-01-01

    Isogeometric analysis is a versatile tool for failure analysis. On the one hand, the excellent control over the inter-element continuity conditions enables a natural incorporation of continuum constitutive relations that incorporate higher-order strain gradients, as in gradient plasticity or damage.

  19. Beyond Success and Failure

    NARCIS (Netherlands)

    Etalle, Sandro; Jaffar, Joxan; van Raamsdonk, Femke

    We study a new programming framework based on logic programming where success and failure are replaced by predicates for adequacy and inadequacy. Adequacy allows to extract a result from a partial computation, and inadequacy allows to flexibly constrain the search space. In this parameterized

  20. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this

  1. Poverty and aspirations failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    We develop a theoretical framework to study the psychology of poverty and ‘aspirations failure’, defined as the failure to aspire to one’s own potential. In our framework, rich and the poor persons share the same preferences and same behavioral bias in setting aspirations. We show that poverty can

  2. Copeptin in Heart Failure

    DEFF Research Database (Denmark)

    Balling, Louise; Gustafsson, Finn

    2016-01-01

    Heart failure (HF) is one of the most common causes of hospitalization and mortality in the modern Western world and an increasing proportion of the population will be affected by HF in the future. Although HF management has improved quality of life and prognosis, mortality remains very high...

  3. Acute liver failure

    DEFF Research Database (Denmark)

    Bernal, William; Lee, William M; Wendon, Julia

    2015-01-01

    Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver...

  4. Premature ovarian failure

    OpenAIRE

    Pacheco, José

    2011-01-01

    Premature ovarian failure is characterized by secondary amenorrhea affecting a woman before the age of 40, leading to hypoestrogenism, infertility, and consequences of premature menopause, such as osteoporosis, cardiovascular disease, neurovegetative alterations, and others. Follicular exhaustion is due to either follicles shortage or oocytes accelerated destruction. Main causes are genetic, autoimmune and iatrogenic. Among genetic causes Xq and Xp deletions, translocations, numeric aberratio...

  5. CMR in Heart Failure.

    OpenAIRE

    Sado, D. M.; Hasleton, J. M.; Herrey, A. S.; Moon, J. C.

    2011-01-01

    Heart Failure (HF) is a common syndrome with multiple causes. Cardiovascular magnetic resonance (CMR) is a medical imaging technique with significant advantages, allowing the understanding of aetiology and pathophysiology of HF in the individual patient, permitting specific therapy to be administered and predicting prognosis. This paper discusses the diverse role of CMR in HF.

  6. Diuretics for heart failure.

    Science.gov (United States)

    Faris, Rajaa F; Flather, Marcus; Purcell, Henry; Poole-Wilson, Philip A; Coats, Andrew J S

    2012-02-15

    Chronic heart failure is a major cause of morbidity and mortality worldwide. Diuretics are regarded as the first-line treatment for patients with congestive heart failure since they provide symptomatic relief. The effects of diuretics on disease progression and survival remain unclear. To assess the harms and benefits of diuretics for chronic heart failure Updated searches were run in the Cochrane Central Register of Controlled Trials in The Cochrane Library (CENTRAL Issue 1 of 4, 2011), MEDLINE (1966 to 22 February 2011), EMBASE (1980 to 2011 Week 07) and HERDIN database (1990 to February 2011). We hand searched pertinent journals and reference lists of papers were inspected. We also contacted manufacturers and researchers in the field. No language restrictions were applied. Double-blinded randomised controlled trials of diuretic therapy comparing one diuretic with placebo, or one diuretic with another active agent (e.g. ACE inhibitors, digoxin) in patients with chronic heart failure. Two authors independently abstracted the data and assessed the eligibility and methodological quality of each trial. Extracted data were analysed by determining the odds ratio for dichotomous data, and difference in means for continuous data, of the treated group compared with controls. The likelihood of heterogeneity of the study population was assessed by the Chi-square test. If there was no evidence of statistical heterogeneity and pooling of results was clinically appropriate, a combined estimate was obtained using the fixed-effects model. This update has not identified any new studies for inclusion. The review includes 14 trials (525 participants), 7 were placebo-controlled, and 7 compared diuretics against other agents such as ACE inhibitors or digoxin. We analysed the data for mortality and for worsening heart failure. Mortality data were available in 3 of the placebo-controlled trials (202 participants). Mortality was lower for participants treated with diuretics than for

  7. Biochemical and toxicological studies of aqueous extract of ...

    African Journals Online (AJOL)

    Biochemical and toxicological studies of aqueous extract of Syzigium ... tract diseases and also used as food spices), on some biochemical indices, such as ... liver functions and blood parameters were studied in adult albino rats of both sexes.

  8. Biochemical changes during aging of soybean seed

    Directory of Open Access Journals (Sweden)

    Balešević-Tubić Svetlana

    2009-01-01

    Full Text Available Biochemical changes that occur in the seed as a result of ageing are very significant for seed quality and longevity. Because of its characteristic composition, processes occurring in the seed of oil crops during storage will be typical as well. Six soybean varieties developed in Institute of field and vegetable crops Novi Sad, submitted to accelerated and natural aging, under controlled and conventional storage conditions were used in these trials. The content of malondialdehyde, superoxide dismutase and peroxidase activities were studied. The biochemical processes i.e. lipid peroxidation, as well as the decrease in supeoxide dismutase and peroxidase activities (especially pronounced by applied accelerated aging were caused by both type of aging. The degree of seed damage and the ability of seed to resist the negative consequences of aging were influenced, beside duration of aging period, by type of storage and characteristics of soybean varieties. .

  9. Reconstructing biochemical pathways from time course data.

    Science.gov (United States)

    Srividhya, Jeyaraman; Crampin, Edmund J; McSharry, Patrick E; Schnell, Santiago

    2007-03-01

    Time series data on biochemical reactions reveal transient behavior, away from chemical equilibrium, and contain information on the dynamic interactions among reacting components. However, this information can be difficult to extract using conventional analysis techniques. We present a new method to infer biochemical pathway mechanisms from time course data using a global nonlinear modeling technique to identify the elementary reaction steps which constitute the pathway. The method involves the generation of a complete dictionary of polynomial basis functions based on the law of mass action. Using these basis functions, there are two approaches to model construction, namely the general to specific and the specific to general approach. We demonstrate that our new methodology reconstructs the chemical reaction steps and connectivity of the glycolytic pathway of Lactococcus lactis from time course experimental data.

  10. Optical Slot-Waveguide Based Biochemical Sensors

    Directory of Open Access Journals (Sweden)

    Carlos Angulo Barrios

    2009-06-01

    Full Text Available Slot-waveguides allow light to be guided and strongly confined inside a nanometer-scale region of low refractive index. Thus stronger light-analyte interaction can be obtained as compared to that achievable by a conventional waveguide, in which the propagating beam is confined to the high-refractive-index core of the waveguide. In addition, slot-waveguides can be fabricated by employing CMOS compatible materials and technology, enabling miniaturization, integration with electronic, photonic and fluidic components in a chip, and mass production. These advantages have made the use of slot-waveguides for highly sensitive biochemical optical integrated sensors an emerging field. In this paper, recent achievements in slot-waveguide based biochemical sensing will be reviewed. These include slot-waveguide ring resonator based refractometric label-free biosensors, label-based optical sensing, and nano-opto-mechanical sensors.

  11. Optimal Information Processing in Biochemical Networks

    Science.gov (United States)

    Wiggins, Chris

    2012-02-01

    A variety of experimental results over the past decades provide examples of near-optimal information processing in biological networks, including in biochemical and transcriptional regulatory networks. Computing information-theoretic quantities requires first choosing or computing the joint probability distribution describing multiple nodes in such a network --- for example, representing the probability distribution of finding an integer copy number of each of two interacting reactants or gene products while respecting the `intrinsic' small copy number noise constraining information transmission at the scale of the cell. I'll given an overview of some recent analytic and numerical work facilitating calculation of such joint distributions and the associated information, which in turn makes possible numerical optimization of information flow in models of noisy regulatory and biochemical networks. Illustrating cases include quantification of form-function relations, ideal design of regulatory cascades, and response to oscillatory driving.

  12. Comparison of Sprint Fidelis and Riata defibrillator lead failure rates.

    Science.gov (United States)

    Fazal, Iftikhar A; Shepherd, Ewen J; Tynan, Margaret; Plummer, Christopher J; McComb, Janet M

    2013-09-30

    Sprint Fidelis and Riata defibrillator leads are prone to early failure. Few data exist on the comparative failure rates and mortality related to lead failure. The aims of this study were to determine the failure rate of Sprint Fidelis and Riata leads, and to compare failure rates and mortality rates in both groups. Patients implanted with Sprint Fidelis leads and Riata leads at a single centre were identified and in July 2012, records were reviewed to ascertain lead failures, deaths, and relationship to device/lead problems. 113 patients had Sprint Fidelis leads implanted between June 2005 and September 2007; Riata leads were implanted in 106 patients between January 2003 and February 2008. During 53.0 ± 22.3 months of follow-up there were 13 Sprint Fidelis lead failures (11.5%, 2.60% per year) and 25 deaths. Mean time to failure was 45.1 ± 15.5 months. In the Riata lead cohort there were 32 deaths, and 13 lead failures (11.3%, 2.71% per year) over 54.8 ± 26.3 months follow-up with a mean time to failure of 53.5 ± 24.5 months. There were no significant differences in the lead failure-free Kaplan-Meier survival curve (p=0.77), deaths overall (p=0.17), or deaths categorised as sudden/cause unknown (p=0.54). Sprint Fidelis and Riata leads have a significant but comparable failure rate at 2.60% per year and 2.71% per year of follow-up respectively. The number of deaths in both groups is similar and no deaths have been identified as being related to lead failure in either cohort. Copyright © 2012. Published by Elsevier Ireland Ltd.

  13. Some biochemical studies on thyroid immunity

    International Nuclear Information System (INIS)

    Shoush, M.A.M.

    1980-01-01

    The present study was carried out to investigate the effect of induced immunological environment on: a - Carbohydrate metabolism as reflected by immunoreactive insulin and blood sugar levels. b - Biochemical parameters, namely total protein, albumin, globulin, alkaline phosphatase and transaminases, reflecting liver function. c - Radioimmunological tests reflecting thyroid function. The study comprised 36 male rabbits, boscate strain of six months age assigned randomly to : control, albumin immunized and thyroglobulin immunized groups

  14. Biochemical composition and methane production correlations

    OpenAIRE

    Charnier, Cyrille; Latrille, Eric; Moscoviz, Roman; Miroux, Jérémie; Steyer, Jean-Philippe

    2016-01-01

    Substrates for anaerobic digestion are composed of heterogeneous and complex organic matter. General parameters of the organic matter can be used to describe its composition such as sugar, protein and lipid contents, Chemical Oxygen Demand (COD), Biochemical Methane Potential (BMP) and kinetic of methane production. These parameters are required for the monitoring of digesters but their characterization are time consuming and expensive; thus, these parameters are rarely assessed all together....

  15. Biochemical characterization of cholesterol-reducing Eubacterium.

    OpenAIRE

    Mott, G E; Brinkley, A W; Mersinger, C L

    1980-01-01

    We characterized two isolates of cholesterol-reducing Eubacterium by conducting conventional biochemical tests and by testing various sterols and glycerolipids as potential growth factors. In media containing cholesterol and plasmenylethanolamine, the tests for nitrate reduction, indole production, and gelatin and starch hydrolyses were negative, and no acid was produced from any of 22 carbohydrates. Both isolates hydrolyzed esculin to esculetin, indicating beta-glycosidase activity. In addit...

  16. Biochemical changes in ginger after gamma irradiation

    International Nuclear Information System (INIS)

    Kausar, T.; Salahuddin; Pervaiz, K.; Niazi, A.H.K.

    2001-01-01

    Ginger (Zingiber officinate) was irradiated with gamma rays (0.1Kgy, 1.0Kgy). Biochemical changes during storage at room temperature (23-28 degree centigrade), in sand (23-28 degree centigrade) and at cold (8 degree centigrade) temperature were observed. Changes in starch, soluble protein, fixed oil and volatile oil contents showed that treatment of ginger at 0.1Kgy radiation level was most appropriate for storage upto 45 days

  17. Chemical, biochemical and microbiological indicators to assess soil quality in temperate agro-ecosystems

    OpenAIRE

    Giacometti, Caterina

    2013-01-01

    Soil is a critically important component of the earth’s biosphere. Developing agricultural production systems able to conserve soil quality is essential to guarantee the current and future capacity of soil to provide goods and services. This study investigates the potential of microbial and biochemical parameters to be used as early and sensitive soil quality indicators. Their ability to differentiate plots under contrasting fertilization regimes is evaluated based also on their sensitivi...

  18. Biochemical Factors Modulating Cellular Neurotoxicity of Methylmercury

    Directory of Open Access Journals (Sweden)

    Parvinder Kaur

    2011-01-01

    Full Text Available Methylmercury (MeHg, an environmental toxicant primarily found in fish and seafood, poses a dilemma to both consumers and regulatory authorities, given the nutritional benefits of fish consumption versus the possible adverse neurological damage. Several studies have shown that MeHg toxicity is influenced by a number of biochemical factors, such as glutathione (GSH, fatty acids, vitamins, and essential elements, but the cellular mechanisms underlying these complex interactions have not yet been fully elucidated. The objective of this paper is to outline the cellular response to dietary nutrients, as well as to describe the neurotoxic exposures to MeHg. In order to determine the cellular mechanism(s of toxicity, the effect of pretreatment with biochemical factors (e.g., N-acetyl cysteine, (NAC; diethyl maleate, (DEM; docosahexaenoic acid, (DHA; selenomethionine, SeM; Trolox and MeHg treatment on intercellular antioxidant status, MeHg content, and other endpoints was evaluated. This paper emphasizes that the protection against oxidative stress offered by these biochemical factors is among one of the major mechanisms responsible for conferring neuroprotection. It is therefore critical to ascertain the cellular mechanisms associated with various dietary nutrients as well as to determine the potential effects of neurotoxic exposures for accurately assessing the risks and benefits associated with fish consumption.

  19. Multidimensional biochemical information processing of dynamical patterns.

    Science.gov (United States)

    Hasegawa, Yoshihiko

    2018-02-01

    Cells receive signaling molecules by receptors and relay information via sensory networks so that they can respond properly depending on the type of signal. Recent studies have shown that cells can extract multidimensional information from dynamical concentration patterns of signaling molecules. We herein study how biochemical systems can process multidimensional information embedded in dynamical patterns. We model the decoding networks by linear response functions, and optimize the functions with the calculus of variations to maximize the mutual information between patterns and output. We find that, when the noise intensity is lower, decoders with different linear response functions, i.e., distinct decoders, can extract much information. However, when the noise intensity is higher, distinct decoders do not provide the maximum amount of information. This indicates that, when transmitting information by dynamical patterns, embedding information in multiple patterns is not optimal when the noise intensity is very large. Furthermore, we explore the biochemical implementations of these decoders using control theory and demonstrate that these decoders can be implemented biochemically through the modification of cascade-type networks, which are prevalent in actual signaling pathways.

  20. Explorations into Chemical Reactions and Biochemical Pathways.

    Science.gov (United States)

    Gasteiger, Johann

    2016-12-01

    A brief overview of the work in the research group of the present author on extracting knowledge from chemical reaction data is presented. Methods have been developed to calculate physicochemical effects at the reaction site. It is shown that these physicochemical effects can quite favourably be used to derive equations for the calculation of data on gas phase reactions and on reactions in solution such as aqueous acidity of alcohols or carboxylic acids or the hydrolysis of amides. Furthermore, it is shown that these physicochemical effects are quite effective for assigning reactions into reaction classes that correspond to chemical knowledge. Biochemical reactions constitute a particularly interesting and challenging task for increasing our understanding of living species. The BioPath.Database is a rich source of information on biochemical reactions and has been used for a variety of applications of chemical, biological, or medicinal interests. Thus, it was shown that biochemical reactions can be assigned by the physicochemical effects into classes that correspond to the classification of enzymes by the EC numbers. Furthermore, 3D models of reaction intermediates can be used for searching for novel enzyme inhibitors. It was shown in a combined application of chemoinformatics and bioinformatics that essential pathways of diseases can be uncovered. Furthermore, a study showed that bacterial flavor-forming pathways can be discovered. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Cardiorespiratory Failure in Thyroid Storm: Case Report and Literature Review.

    Science.gov (United States)

    Nai, Qiang; Ansari, Mohammad; Pak, Stella; Tian, Yufei; Amzad-Hossain, Mohammed; Zhang, Yanhong; Lou, Yali; Sen, Shuvendu; Islam, Mohammed

    2018-04-01

    Thyroid storm is a potentially fatal manifestation of thyrotoxicosis. Cardiopulmonary failure is the most common cause of death in thyroid storm. Clinicians should keep in mind that thyroid storm complicated with cardiopulmonary failure can be the first presentation of thyrotoxicosis. As early intervention is associated with improved patient outcome, prompt diagnosis based on clinical grounds is of paramount importance in the management of thyrotoxicosis. A high index of suspicion and the ability of early recognition of impending thyroid storm depends on a thorough knowledge of both the typical and atypical clinical features of this illness. Herein, we report a case of thyroid storm presenting as cardiopulmonary failure in a 51-year-old woman with undiagnosed Grave's disease. Additionally, we review the pathophysiology of cardiopulmonary failure associated with thyrotoxicosis and various treatment modalities for thyroid storm.

  2. Cardiorespiratory Failure in Thyroid Storm: Case Report and Literature Review

    Science.gov (United States)

    Nai, Qiang; Ansari, Mohammad; Pak, Stella; Tian, Yufei; Amzad-Hossain, Mohammed; Zhang, Yanhong; Lou, Yali; Sen, Shuvendu; Islam, Mohammed

    2018-01-01

    Thyroid storm is a potentially fatal manifestation of thyrotoxicosis. Cardiopulmonary failure is the most common cause of death in thyroid storm. Clinicians should keep in mind that thyroid storm complicated with cardiopulmonary failure can be the first presentation of thyrotoxicosis. As early intervention is associated with improved patient outcome, prompt diagnosis based on clinical grounds is of paramount importance in the management of thyrotoxicosis. A high index of suspicion and the ability of early recognition of impending thyroid storm depends on a thorough knowledge of both the typical and atypical clinical features of this illness. Herein, we report a case of thyroid storm presenting as cardiopulmonary failure in a 51-year-old woman with undiagnosed Grave’s disease. Additionally, we review the pathophysiology of cardiopulmonary failure associated with thyrotoxicosis and various treatment modalities for thyroid storm. PMID:29511425

  3. Co-ordinated research project on isotopic techniques to examine the significance of infection and other insults in early childhood to diarrhoea morbidity, mal-assimilation and failure to thrive. Report on the first research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This Co-ordinated Research Project (CRP) addresses an important public health issue in many developing areas, which is the existence of high rates of infection and diarrhoea disease and its deleterious effects on the health and nutritional status of infants and children around the world. Persistent diarrhoea with associated malnutrition remains a major cause of morbidity and mortality in the developing countries. There are established relations between diarrhoea disease and Helicobacter pylori infection and the latter may also additionally specifically impair nutrient absorption. Helicobacter pylori infection is likely to be the most common world wide bacterial infection, and it is estimated that approximately 50% of the general population is affected. The World Health Organisation has classified H. pylori as a Group 1 carcinogen. Young children in developing countries are the main targets of infection, with a substantial risk of developing gastric carcinoma during adulthood. High infection rates of H. pylori among new-borns and young children in developing nations appear to be a major cause for chronic under-nutrition and diarrhoea syndrome with failure to thrive. This bacterium can survive in the acidic interior of the human stomach due to its capacity to secrete an enzyme called urease, which decomposes the urea contained in the stomach's interior into ammonia and carbon dioxide increasing the pH move underneath the protective mucous membrane in the stomach where it is protected from the caustic stomach acid. This transitory drop in stomach acidity, explained by a diminished gastric secretion and an increase in ammonia production during infection, promotes the transit of lower bowel pathogens leading to repeated gastrointestinal infections, causing diarrhoea and adverse consequences on nutrition and growth. This CRP seeks to identify and assist research groups in developing countries, which plan to conduct studies on the area of H. pylori infection and its

  4. Co-ordinated research project on isotopic techniques to examine the significance of infection and other insults in early childhood to diarrhoea morbidity, mal-assimilation and failure to thrive. Report on the first research co-ordination meeting

    International Nuclear Information System (INIS)

    2000-01-01

    This Co-ordinated Research Project (CRP) addresses an important public health issue in many developing areas, which is the existence of high rates of infection and diarrhoea disease and its deleterious effects on the health and nutritional status of infants and children around the world. Persistent diarrhoea with associated malnutrition remains a major cause of morbidity and mortality in the developing countries. There are established relations between diarrhoea disease and Helicobacter pylori infection and the latter may also additionally specifically impair nutrient absorption. Helicobacter pylori infection is likely to be the most common world wide bacterial infection, and it is estimated that approximately 50% of the general population is affected. The World Health Organisation has classified H. pylori as a Group 1 carcinogen. Young children in developing countries are the main targets of infection, with a substantial risk of developing gastric carcinoma during adulthood. High infection rates of H. pylori among new-borns and young children in developing nations appear to be a major cause for chronic under-nutrition and diarrhoea syndrome with failure to thrive. This bacterium can survive in the acidic interior of the human stomach due to its capacity to secrete an enzyme called urease, which decomposes the urea contained in the stomach's interior into ammonia and carbon dioxide increasing the pH move underneath the protective mucous membrane in the stomach where it is protected from the caustic stomach acid. This transitory drop in stomach acidity, explained by a diminished gastric secretion and an increase in ammonia production during infection, promotes the transit of lower bowel pathogens leading to repeated gastrointestinal infections, causing diarrhoea and adverse consequences on nutrition and growth. This CRP seeks to identify and assist research groups in developing countries, which plan to conduct studies on the area of H. pylori infection and its

  5. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  6. Uso do misoprostol em substituição à curetagem uterina em gestações interrompidas precocemente Misoprostol in substitution at uterine curettage in early pregnancy failure

    Directory of Open Access Journals (Sweden)

    Francisco Carlos Nogueira Arcanjo

    2011-06-01

    Full Text Available OBJETIVOS: Avaliar a eficácia do misoprostol administrado via vaginal para esvaziamento uterino em gestações interrompidas precocemente, bem como o tempo entre a administração e o esvaziamento, correlacionando-os com a idade gestacional. MÉTODOS: Ensaio clínico com 41 pacientes com gestações interrompidas entre a 7ª e a 12ª semanas gestacionais, com média de idade de 27,3 (±6,1 anos. A paridade média foi de 2,2 (±1,2 partos; o número médio de abortamentos prévios foi 0,2 (±0,5. Foram administrados 800 µg de misoprostol via vaginal, em dose única; após 24 horas, foi realizado ultrassom transvaginal. Considerou-se abortamento completo quando o diâmetro anteroposterior da cavidade endometrial media 8 semanas de idade gestacional em relação aos desfechos: frequência de abortamento completo e intervalo entre administração de misoprostol e o abortamento (em minutos. O nível de significância utilizado foi de 5%. RESULTADOS: A idade gestacional, no momento do diagnóstico, foi de 8,5 semanas em média (DP=1,5. Os intervalos entre a administração de misoprostol e as contrações uterinas, e entre a administração e o abortamento, foram de 322,5±97,0 min e 772,5±201,0 min, respectivamente. Houve abortamento completo em 80,3%. No primeiro grupo, a taxa de sucesso foi de 96,2% e no segundo, de 53,3% (pPURPOSE: To evaluate the effectiveness of misoprostol administered vaginally for uterine evacuation in interrupted early pregnancies and the time between the administration and emptying correlated with gestational age. METHODS: Clinical trial with 41 patients with pregnancies interrupted between the 7th and the 12th gestational weeks. The mean age was 27.3 (±6.1 years. Mean parity was 2.2 (±1.2 deliveries. The average number of previous abortions was 0.2 (± 0.5. Misoprostol was administered vaginally in a single 800 µg dose and transvaginal ultrasound was performed after 24 hours. Abortion was considered complete when the

  7. Opening up of plasmalemma type-1 VDAC to form apoptotic "find me signal" pathways is essential in early apoptosis - evidence from the pathogenesis of cystic fibrosis resulting from failure of apoptotic cell clearance followed by sterile inflammation.

    Science.gov (United States)

    Thinnes, Friedrich P

    2014-04-01

    Cell membrane-standing type-1 VDAC is involved in cell volume regulation and thus apoptosis. The channel has been shown to figure as a pathway for osmolytes of varying classes, ATP included. An early event in apoptotic cell death is the release of "find me signals" by cells that enter the apoptotic process. ATP is one of those signals. Apoptotic cells this way attract phagocytes for an immunologically silent cell clearance. Thus, whenever apoptosis fails by a blockade of plasmalemma type-1 VDAC processes of sterile inflammation must be assumed for cell elimination. This is evident from a close look on the pathogenetic process of cystic fibrosis (CF). However, in normal airway epithelia two different anion channels cooperate to guarantee an appropriate volume of airway surface liquid (ASL) necessary for surface clearing: the cystic fibrosis conductance regulator (CFTR) and the outwardly rectifying chloride channel (ORCC) complex also called "alternate chloride channel" and under the control of the CFTR. There are arguments, that type-1 VDAC forms the channel part of the ORCC complex, and it has been shown that CFTR and type-1 VDAC co-localize in the apical membranes of human surface respiratory epithelium. In cystic fibrosis, the central cAMP-dependent regulation of ion and water transport via functional CFTR is lost. Here, CFTR molecules do not reach the apical membranes of airway epithelia anymore or work in an insufficient way, respectively. In addition, type-1 VDAC is no longer available to work as a "find me signal" pathway. In consequence, clearing away of apoptotic cells is blocked. There are experimental data on the channel characteristics of type-1 VDAC under the anion channel blocker DIDS (4,4-diisothiocyanato-stilbenedisulphonic acid) that argue in favor of this hypothesis. Together, type-1 VDAC should be kept as a "find me signal" pathway, which may give way to several classes of such signals. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Novel biochemical markers of psychosocial stress in women.

    Directory of Open Access Journals (Sweden)

    Marie Asberg

    Full Text Available BACKGROUND: Prolonged psychosocial stress is a condition assessed through self-reports. Here we aimed to identify biochemical markers for screening and early intervention in women. METHODS: Plasma concentrations of interleukin (IL 1-alpha, IL1-beta, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (INF-gamma, tumor necrosis factor-alpha (TNF-alpha, monocyte chemotactic protein-1 (MCP-1, epidermal growth factor (EGF, vascular endothelial growth factor (VEGF, thyroid stimulating hormone (TSH, total tri-iodothyronine (TT3, total thyroxine (TT4, prolactin, and testosterone were measured in: 195 women on long-term sick-leave for a stress-related affective disorder, 45 women at risk for professional burnout, and 84 healthy women. RESULTS: We found significantly increased levels of MCP-1, VEGF and EGF in women exposed to prolonged psychosocial stress. Statistical analysis indicates that they independently associate with a significant risk for being classified as ill. CONCLUSIONS: MCP-1, EGF, and VEGF are potential markers for screening and early intervention in women under prolonged psychosocial stress.

  9. A case of functional growth hormone deficiency and early growth retardation in a child with IFT172 mutations.

    Science.gov (United States)

    Lucas-Herald, Angela K; Kinning, Esther; Iida, Aritoshi; Wang, Zheng; Miyake, Noriko; Ikegawa, Shiro; McNeilly, Jane; Ahmed, S Faisal

    2015-04-01

    Ciliopathies are a group of rare conditions that present through a wide range of manifestations. Given the relative common occurrence of defects of the GH/IGF-I axis in children with short stature and growth retardation, the association between ciliopathies and these defects needs further attention. Our patient is a boy who was born at term and noted to have early growth retardation and weight gain within the first 18 months of life. Biochemical tests demonstrated low IGF-I but a normal peak GH on stimulation and an adequat